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Gauld C, Tebeka S, Geoffroy PA, Fourneret P, Mazer N, Peyre H, Dubertret C. Modeling longitudinal relationships between sleep disturbances and depressed mood in postpartum: A cross-lagged panel design. J Affect Disord 2024; 362:169-173. [PMID: 38936702 DOI: 10.1016/j.jad.2024.06.089] [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: 03/06/2024] [Revised: 06/01/2024] [Accepted: 06/22/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND This short communication explores the interrelationships between depressed mood and sleep disturbances in one-year postpartum period. METHODS Utilizing data from the Interaction of Gene and Environment of Depression during PostPartum Cohort (IGEDEPP) involving 3310 French postpartum women, we employed a cross-lagged panel model (CLPM) to analyze the relationships between these two symptoms, across three time points (immediate postpartum [<1 week after delivery], early postpartum [<2 months after delivery], and late postpartum [2 months to 1 years after delivery]). RESULTS Depressed mood significantly influences sleep disturbances in late postpartum (β = 0.096, z-value = 7.4; p < 0.001) but not in early postpartum (p-value = 0.9). We found no cross-lagged influence of sleep disturbances on depressed mood in early (p = 0.066) or in late postpartum (p = 0.060). Moreover, depressed mood and sleep disturbances in immediate postpartum are predictive of similar symptoms in the two other postpartum periods (between each of the three periods, p = 0.006 and p < 0.001 for depressed mood, and p = 0.039 and p < 0.001 for sleep disturbances), thus demonstrating the stability of these symptoms over time. LIMITATIONS Although conducted with a prospectively assessed cohort, this study faces limitations due to potential methodological biases. CONCLUSIONS This study is a pioneering analysis of mutual causal interactions between depressed mood and sleep disturbances in the postpartum period, highlighting the need for vigilant monitoring, early detection, prevention of worsen outcomes and intervention on these symptoms.
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Affiliation(s)
- Christophe Gauld
- Department of Psychopathology of Child and Adolescent Development, Hospices Civils de Lyon, Lyon 1, France; Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, F-69000 Lyon, France
| | - Sarah Tebeka
- Université Paris Cité, INSERM UMR1266, Institute of Psychiatry and Neurosciences, Team 1, Paris, France; Department of Psychiatry, AP-HP, Louis Mourier Hospital, F-92700 Colombes, France.
| | - Pierre-Alexis Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, F-75018 Paris, France; Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France; Université Paris Cité, Inserm, NeuroDiderot, F-75019 Paris, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, F-67000 Strasbourg, France
| | - Pierre Fourneret
- Department of Psychopathology of Child and Adolescent Development, Hospices Civils de Lyon, Lyon 1, France; Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, F-69000 Lyon, France
| | - Nicolas Mazer
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, F-92700 Colombes, France
| | - Hugo Peyre
- Autism Reference Centre of Languedoc-Roussillon CRA-LR, gExcellence Centre for Autism and Neurodevelopmental disorders CeAND, Montpellier University Hospital, MUSE University, France; CESP, INSERM U1178, Centre de recherche en Epidémiologie et Santé des Populations, Villejuif, France
| | - Caroline Dubertret
- Université Paris Cité, INSERM UMR1266, Institute of Psychiatry and Neurosciences, Team 1, Paris, France; Department of Psychiatry, AP-HP, Louis Mourier Hospital, F-92700 Colombes, France
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Jayakody O, Blumen HM, Breslin M, Wang C, Verghese J. Risk factors associated with the Motoric Cognitive Risk syndrome: A meta-analysis of data from a cross-national study. J Am Geriatr Soc 2024; 72:2656-2666. [PMID: 38872608 PMCID: PMC11368625 DOI: 10.1111/jgs.19032] [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: 11/07/2023] [Revised: 04/01/2024] [Accepted: 05/13/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Identifying risk factors associated with the Motoric Cognitive Risk (MCR) syndrome (a pre-dementia syndrome) can assist in developing risk reduction strategies and interventions to delay progression to dementia. Tailored interventions require comparisons of high- and middle-income countries to determine if the same or different risk factors should be targeted. We examined risk factors associated with MCR in seven Health and Retirement Studies with harmonized measures. METHODS Data from adults aged ≥65 years (n = 20,036, mean age 71.2(SD 6.2)-80.1(SD 4.1)) from the U.S. Health and Retirement Study, English Longitudinal Study of Aging, Survey of Health, Aging and Retirement in Europe, China Health and Retirement Longitudinal Study, Harmonized Diagnostic Assessment of Dementia for Longitudinal Aging Study in India, Mexican Health and Aging Study, and Brazilian Longitudinal Study of Aging was included. MCR was defined as the presence of cognitive complaints and slow gait (no mobility disability and dementia). Associations of demographic [education], medical [hypertension, diabetes, heart disease, obesity, stroke, Parkinson's, falls], psychological [depressive symptoms, psychiatric problems], sensorimotor [grip strength, hearing], and behavioral factors [smoking, sedentariness, sleep], with prevalent MCR were examined using age- and sex-adjusted logistic regression models. A meta-analysis was performed to compare risk factors for MCR in high- versus middle-income countries. RESULTS Except for depressive symptoms and weak grip strength, different risk factor clusters were associated with individual studies. Poor sleep, hearing, weak grip, and multiple falls emerged as novel associations with MCR. When grouped by income, some risk factors (i.e., education) were associated with MCR in high- and middle-income countries. Others (i.e., obesity) were specific to high-income countries. CONCLUSIONS This cross-sectional, cross-national study identified new, shared, and specific risk factors associated with MCR in high- and middle-income countries, providing insights to develop public health approaches and interventions to forestall the onset of dementia in those with MCR.
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Affiliation(s)
- O Jayakody
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - H M Blumen
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Medicine and Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - M Breslin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - C Wang
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - J Verghese
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Medicine and Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
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Yang H, Huang L, Tang S, Xu J, Lin F, Wang Y, Chen X, Wang Y, Gao J, Xiao Q. Age-friendliness of community and sleep quality: The role of mental health. J Affect Disord 2024; 366:36-43. [PMID: 39187202 DOI: 10.1016/j.jad.2024.08.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 06/25/2024] [Accepted: 08/23/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND The relationship between age-friendliness of community (AFC), mental health and sleep quality is still unclear. METHOD Using a sample of Chinese older adults aged ≥60 years (N = 3099), this cross-sectional study aimed to investigate the serial mediating roles of resilience and depressive symptoms between AFC and sleep quality through structural equation modeling. Additionally, this study examined the association between each AFC dimension and sleep quality stratified by mental health, using the multivariable linear regression models. Mental health was categorized based on levels of resilience and depressive symptoms. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The AFC dimensions included housing, transportation, built environment, social participation, as well as social inclusion and health services. RESULTS Resilience and depressive symptoms completely mediated the relationship between AFC and sleep quality through three paths: (1) the independent mediating role of resilience or (2) depressive symptoms, and (3) the serial mediating roles of resilience and depressive symptoms. Furthermore, higher AFC and higher age-friendliness in transportation dimension as well as social inclusion and health services dimension were associated with better sleep quality among older adults with high levels of mental health. CONCLUSIONS Resilience and depressive symptoms played serial mediating roles in the relationship between AFC and sleep quality. For older adults with low or medium levels of mental health, a community-based approach may not be recommended. LIMITATIONS This cross-sectional study used self-reported sleep measures and could not make cause inferences.
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Affiliation(s)
- Huiting Yang
- Department of Preventive Medicine and Health Education, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China; Health Communication Institute, Fudan University, Shanghai 200032, China
| | - Limei Huang
- Songjiang Center of Disease Prevention and Control, Shanghai 201620, China
| | - Shuning Tang
- Department of Preventive Medicine and Health Education, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China; Health Communication Institute, Fudan University, Shanghai 200032, China
| | - Jixiang Xu
- Department of Preventive Medicine and Health Education, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China; Health Communication Institute, Fudan University, Shanghai 200032, China
| | - Fangting Lin
- Department of Preventive Medicine and Health Education, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China; Health Communication Institute, Fudan University, Shanghai 200032, China
| | - Yujie Wang
- Department of Preventive Medicine and Health Education, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China; Health Communication Institute, Fudan University, Shanghai 200032, China
| | - Xiuqin Chen
- Songjiang Center of Disease Prevention and Control, Shanghai 201620, China
| | - Yunhui Wang
- Songjiang District Xinqiao Town Community Health Service Center, Shanghai 201600, China
| | - Junling Gao
- Department of Preventive Medicine and Health Education, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China; Health Communication Institute, Fudan University, Shanghai 200032, China.
| | - Qianyi Xiao
- Department of Preventive Medicine and Health Education, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China; Health Communication Institute, Fudan University, Shanghai 200032, China.
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Faucher C, Borne L, Behler A, Paton B, Giorgio J, Fripp J, Thienel R, Lupton MK, Breakspear M. A central role of sulcal width in the associations of sleep duration and depression with cognition in mid to late life. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae058. [PMID: 39221446 PMCID: PMC11362672 DOI: 10.1093/sleepadvances/zpae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 07/02/2024] [Indexed: 09/04/2024]
Abstract
Study Objectives Evidence suggests that poor sleep impacts cognition, brain health, and dementia risk but the nature of the association is poorly understood. This study examined how self-reported sleep duration, napping, and subjective depression symptoms are associated with the brain-cognition relationship in older adults, using sulcal width as a measure of relative brain health. Methods A canonical partial least squares analysis was used to obtain two composite variables that relate cognition and sulcal width in a cross-sectional study of 137 adults aged 46-72. We used a combination of ANCOVA and path analyses to test the associations of self-reported sleep duration, napping, and subjective depression symptoms with the brain-cognition relationship. Results We observed a significant main effect of sleep duration on sulcal width, with participants reporting 7 hours showing narrower sulci than other durations. This effect remained significant after including subjective depression as a covariate, which also had a significant main effect on sulcal width in the model. There was no significant effect of napping on sulcal width. In path analyses where the effects of age, self-reported sleep duration and depression symptoms were investigated together, sulcal width mediated the relationship between age and cognition. We also observed a significant indirect effect of sulci width in the subjective depression-cognition relationship. Conclusions Findings suggest that self-reported sleep duration and subjective depression may each be independently associated with brain morphology, which is related to cognitive functions. Results could help inform clinical trials and related intervention studies that aim at delaying cognitive decline in adults at risk of developing dementia.
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Affiliation(s)
- Caroline Faucher
- School of Psychological Science, College of Science, Engineering and the Environment, University of Newcastle, Australia
- Australian eHealth Research Centre, CSIRO, Brisbane, Australia
| | - Léonie Borne
- School of Psychological Science, College of Science, Engineering and the Environment, University of Newcastle, Australia
| | - Anna Behler
- School of Psychological Science, College of Science, Engineering and the Environment, University of Newcastle, Australia
| | - Bryan Paton
- School of Psychological Science, College of Science, Engineering and the Environment, University of Newcastle, Australia
| | - Joseph Giorgio
- School of Psychological Science, College of Science, Engineering and the Environment, University of Newcastle, Australia
- Helen Wills Neuroscience Institute, University of California, Berkeley, USA
| | - Jurgen Fripp
- Australian eHealth Research Centre, CSIRO, Brisbane, Australia
| | - Renate Thienel
- School of Public Health and Medicine, College of Health Medicine and Wellbeing, University of Newcastle, Australia
| | - Michelle K Lupton
- Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - Michael Breakspear
- School of Psychological Science, College of Science, Engineering and the Environment, University of Newcastle, Australia
- School of Public Health and Medicine, College of Health Medicine and Wellbeing, University of Newcastle, Australia
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Menculini G, Cirimbilli F, Raspa V, Scopetta F, Cinesi G, Chieppa AG, Cuzzucoli L, Moretti P, Balducci PM, Attademo L, Bernardini F, Erfurth A, Sachs G, Tortorella A. Insights into the Effect of Light Pollution on Mental Health: Focus on Affective Disorders-A Narrative Review. Brain Sci 2024; 14:802. [PMID: 39199494 PMCID: PMC11352354 DOI: 10.3390/brainsci14080802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 08/04/2024] [Accepted: 08/08/2024] [Indexed: 09/01/2024] Open
Abstract
The presence of artificial light at night has emerged as an anthropogenic stressor in recent years. Various sources of light pollution have been shown to affect circadian physiology with serious consequences for metabolic pathways, possibly disrupting pineal melatonin production with multiple adverse health effects. The suppression of melatonin at night may also affect human mental health and contribute to the development or exacerbation of psychiatric disorders in vulnerable individuals. Due to the high burden of circadian disruption in affective disorders, it has been hypothesized that light pollution impacts mental health, mainly affecting mood regulation. Hence, the aim of this review was to critically summarize the evidence on the effects of light pollution on mood symptoms, with a particular focus on the role of circadian rhythms in mediating this relationship. We conducted a narrative review of the literature in the PubMed, Scopus, and Web of Science datasets. After the screening process, eighteen papers were eligible for inclusion. The results clearly indicate a link between light pollution and the development of affective symptoms, with a central role of sleep disturbances in the emergence of mood alterations. Risk perception also represents a crucial topic, possibly modulating the development of affective symptoms in response to light pollution. The results of this review should encourage a multidisciplinary approach to the design of healthier environments, including lighting conditions among the key determinants of human mental health.
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Affiliation(s)
- Giulia Menculini
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Federica Cirimbilli
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Veronica Raspa
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Francesca Scopetta
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Gianmarco Cinesi
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Anastasia Grazia Chieppa
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Lorenzo Cuzzucoli
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Patrizia Moretti
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
| | - Pierfrancesco Maria Balducci
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
- CSM Terni, Department of Mental Health, Local Health Unit USL Umbria 2, 05100 Terni, Italy
| | - Luigi Attademo
- Department of Mental Health, North West Tuscany Local Health Authority, 57023 Cecina, Italy;
| | - Francesco Bernardini
- SPDC Pordenone, Department of Mental Health, AsFO Friuli Occidentale, 33170 Pordenone, Italy;
| | - Andreas Erfurth
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria; (A.E.); (G.S.)
- Klinik Hietzing, 1st Department of Psychiatry and Psychotherapeutic Medicine, 1130 Vienna, Austria
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria; (A.E.); (G.S.)
| | - Alfonso Tortorella
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (F.C.); (V.R.); (F.S.); (G.C.); (A.G.C.); (L.C.); (P.M.); (P.M.B.); (A.T.)
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Anderson AR, Ostermiller L, Lastrapes M, Hales L. Does sunlight exposure predict next-night sleep? A daily diary study among U.S. adults. J Health Psychol 2024:13591053241262643. [PMID: 39077837 DOI: 10.1177/13591053241262643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024] Open
Abstract
Poor sleep is becoming increasingly prevalent and is associated with adverse health outcomes. Sunlight exposure may improve sleep by regulating circadian rhythms, increasing vitamin D, and influencing melatonin production. However, research on the sunlight-sleep association is limited, especially outside of cross-sectional designs. This study examined associations between daily self-reported sunlight exposure and next-night sleep quality in 103 adults for up to 70 days. The timing of sunlight exposure predicted next-night sleep quality. Specifically, morning sunlight exposure, relative to no sunlight, predicted better sleep quality based on responses to the brief Pittsburg Sleep Quality Index. Duration of sunlight exposure was generally not associated with sleep quality. Morning sunlight may regulate circadian rhythms, subsequently improving sleep. Findings have potential implications for sleep interventions and daylight savings time policies. Future research should test whether morning sunlight exposure can enhance the effectiveness of sleep interventions.
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Ghani SB, Granados K, Wills CCA, Alfonso-Miller P, Buxton OM, Ruiz JM, Parthasarathy S, Patel SR, Molina P, Seixas A, Jean-Louis G, Grandner MA. Association of Birthplace for Sleep Duration, Sleep Quality, and Sleep Disorder Symptoms, at the US-Mexico Border. Behav Sleep Med 2024; 22:393-409. [PMID: 37968911 PMCID: PMC11093882 DOI: 10.1080/15402002.2023.2279308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
OBJECTIVES The present study investigated the roles birthplace and acculturation play in sleep estimates among Hispanic/Latino population at the US-Mexico border. MEASURES Data were collected in 2016, from N = 100 adults of Mexican descent from the city of Nogales, AZ, at the US-Mexico border. Sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index categorized as none, mild, moderate, and severe, and Multivariable Apnea Prediction Index (MAP) categorized as never, infrequently, and frequently. Acculturation was measured with the Acculturation Rating Scale for Mexican-Americans II (ARSMA-II). RESULTS The sample consisted of majority Mexican-born (66%, vs. born in the USA 38.2%). Being born in the USA was associated with 55 fewer minutes of nighttime sleep (p = .011), and 1.65 greater PSQI score (p = .031). Compared to no symptoms, being born in the USA was associated with greater likelihood of severe difficulty falling asleep (OR = 8.3, p = .030) and severe difficulty staying asleep (OR = 11.2, p = .050), as well as decreased likelihood of breathing pauses during sleep (OR = 0.18, P = .020). These relationships remained significant after Mexican acculturation was entered in these models. However, greater Anglo acculturation appears to mediate one fewer hour of sleep per night, poorer sleep quality, and reporting of severe difficulty falling asleep and staying asleep. CONCLUSIONS Among individuals of Mexican descent, being born in the USA (vs Mexico) is associated with about 1 hour less sleep per night, worse sleep quality, more insomnia symptoms, and less mild sleep apnea symptoms. These relationships are influenced by acculturation, primarily the degree of Anglo rather than the degree of Mexican acculturation.
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Affiliation(s)
- Sadia B Ghani
- Department of Psychiatry, University of Arizona, Tucson, USA
| | - Karla Granados
- Department of Psychiatry, University of Arizona, Tucson, USA
| | - Chloe C A Wills
- Department of Psychiatry, University of Arizona, Tucson, USA
| | | | - Orfeu M Buxton
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - John M Ruiz
- Department of Psychology, University of Arizona, Tucson, USA
| | - Sairam Parthasarathy
- University of Arizona Health Sciences Center for Sleep and Circadian Sciences, University of Arizona, Tucson, USA
| | - Sanjay R Patel
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | | | - Azizi Seixas
- Department of Population Health, and Department of Psychiatry, NYU Langone Health, New York
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences and Department of Neurology, The University of Miami Miller School of Medicine Miami, USA
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Williamson TJ, Garon EB, Irwin MR, Choi AK, Goldman JW, Stanton AL. Sleep Disturbance as a Mediator of Lung Cancer Stigma on Psychological Distress and Physical Symptom Burden. Psychosom Med 2024; 86:334-341. [PMID: 38436657 PMCID: PMC11081853 DOI: 10.1097/psy.0000000000001299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
OBJECTIVE This study tested sleep disturbance as a mediator through which stigma and discrimination predict psychological distress and physical symptom burden in adults with lung cancer. METHODS Lung cancer patients on active oncological treatment ( N = 108; 74.1% stage IV) completed questionnaires on lung cancer stigma, sleep, distress, and physical symptoms at study entry and at 6- and 12-week follow-up. Mediation analyses were conducted to investigate whether stigma and discrimination predicted distress and physical symptoms at study entry and across 12 weeks through disrupted sleep. RESULTS Higher discrimination ( b = 5.52, 95% confidence interval [CI] = 2.10-8.94) and constrained disclosure ( b = 0.45, 95% CI = 0.05-0.85) were associated significantly with higher sleep disruption at study entry. Sleep disruption, in turn, was associated with higher distress ( b = 0.19, 95% CI = 0.09-0.29) and physical symptoms ( b = 0.28, 95% CI = 0.17-0.40) at study entry. Sleep disruption significantly mediated relationships between higher discrimination and the outcomes of distress (indirect effect = 1.04, 95% CI = 0.13-1.96) and physical symptoms (indirect effect = 1.58, 95% CI = 0.37-2.79) at study entry. Sleep disruption also mediated relationships between constrained disclosure and the outcomes of distress (indirect effect = 0.85, 95% CI = < 0.01-0.17) and physical symptoms (indirect effect = 0.13, 95% CI = 0.01-0.25). CONCLUSIONS Lung cancer patients evidenced pronounced sleep disruption, which mediated relationships between indicators of lung cancer stigma and distress and physical symptoms at study entry. Research is needed to test additional mechanisms through which lung cancer stigma predicts these outcomes longitudinally.
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Affiliation(s)
- Timothy J. Williamson
- Department of Psychological Science, Loyola Marymount University
- Department of Psychology, University of California, Los Angeles
| | - Edward B. Garon
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles
| | - Michael R. Irwin
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Alyssa K. Choi
- Department of Psychology, University of California, Los Angeles
- Department of Psychology, San Diego State University
| | - Jonathan W. Goldman
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles
| | - Annette L. Stanton
- Department of Psychology, University of California, Los Angeles
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
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Huang Y, Fleury J. Socially-supported sleep in older adults aged 50 and older: a concept analysis. Front Public Health 2024; 12:1364639. [PMID: 38645458 PMCID: PMC11027164 DOI: 10.3389/fpubh.2024.1364639] [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: 01/02/2024] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction The population of older adults is growing disproportionately, constituting 13% of the global population in 2022, and is expected to double by 2050. One of public health's priorities is healthy aging, the maintenance of functional ability aligned with well-being. As many as 50% of older adults report poor sleep quality, leading to an increased risk of morbidity and mortality. The quality and quantity of social relationships may broadly benefit sleep in older adults. However, the concept of socially-supported sleep is underdeveloped as a basis for intervention. Methods Existing literature was searched without time restriction in PubMed, CINAHL, PsycINFO, and Scopus ending in August 2022. Thematic analysis was used to determine the defining attributes, antecedents, and consequences of socially-supported sleep guided by Rodgers' evolutionary concept analysis. Results Twenty-nine articles written in English, peer-reviewed, and examined social support and sleep in participants aged ≥50 were included. The defining attributes reflect dimensions of sleep quality. The antecedents are safe and secure, belonging and connection, and warmth and comfort. The consequences of socially-supported sleep include improved regulatory capabilities, physical and emotional well-being, and quality of life. Conclusion Socially-supported sleep has the potential to inform interventions that promote sleep in older adults. Ongoing research is needed to address the antecedents and mechanisms through which socially-supported sleep may promote sleep quality for healthy aging.
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Affiliation(s)
- Yingyan Huang
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
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10
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Garcia CM, Schrier EF, Carey C, Valle KA, Evans JL, Kushel M. Sleep Quality among Homeless-Experienced Older Adults: Exploratory Results from the HOPE HOME Study. J Gen Intern Med 2024; 39:460-469. [PMID: 37783981 PMCID: PMC10897106 DOI: 10.1007/s11606-023-08429-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/13/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Sleep is essential to health and affected by environmental and clinical factors. There is limited longitudinal research examining sleep quality in homeless older adults. OBJECTIVE To examine the factors associated with poor sleep quality in a cohort of older adults in Oakland, California recruited while homeless using venue-based sampling and followed regardless of housing status. DESIGN Longitudinal cohort study. PARTICIPANTS 244 homeless-experienced adults aged ≥ 50 from the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) cohort. MAIN MEASURES We assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). We captured variables via biannual questionnaires and clinical assessments. KEY RESULTS Our sample was predominantly men (71.3%), Black (82.8%), and had a median age of 58.0 years old (IQR 54.0, 61.0). Two-thirds of participants (67.2%) reported poor sleep during one or more study visits; sleep duration was the worst rated subdomain. In a multivariable model, having moderate-to-severe depressive symptoms (AOR 2.03, 95% CI 1.40-2.95), trouble remembering (AOR 1.56, 95% CI 1.11-2.19), fair or poor physical health (AOR 1.49, 95% CI 1.07-2.08), two or more chronic health conditions (AOR 1.76, 95% CI 1.18-2.62), any ADL impairment (AOR 1.85, 95% CI 1.36-2.52), and being lonely (AOR 1.55, 95% CI 1.13-2.12) were associated with increased odds of poor sleep quality. Having at least one confidant was associated with decreased odds of poor sleep (AOR 0.56, 95% CI 0.37-0.85). Current housing status was not significantly associated with poor sleep quality. CONCLUSIONS Homeless-experienced older adults have a high prevalence of poor sleep. We found that participants' physical and mental health was related to poor sleep quality. Poor sleep continued when participants re-entered housing. Access to physical and mental healthcare, caregiving support, and programs that promote community may improve homeless-experienced older adults sleep quality, and therefore, their overall health.
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Affiliation(s)
- Cheyenne M Garcia
- Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA
- UCSF Benioff Homelessness and Housing Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Elizabeth F Schrier
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Caitlin Carey
- Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA
- UCSF Benioff Homelessness and Housing Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Karen A Valle
- Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA
- UCSF Benioff Homelessness and Housing Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Jennifer L Evans
- Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA
- UCSF Benioff Homelessness and Housing Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Margot Kushel
- Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA.
- UCSF Benioff Homelessness and Housing Initiative, University of California, San Francisco, San Francisco, CA, USA.
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11
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Zekibakhsh Mohammadi N, Kianimoghadam AS, Mikaeili N, Asgharian SS, Jafari M, Masjedi-Arani A. Sleep Disorders and Fatigue among Patients with MS: The Role of Depression, Stress, and Anxiety. Neurol Res Int 2024; 2024:6776758. [PMID: 38322749 PMCID: PMC10843872 DOI: 10.1155/2024/6776758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 01/07/2024] [Accepted: 01/18/2024] [Indexed: 02/08/2024] Open
Abstract
Sleep disorders and fatigue represent prominent symptoms frequently experienced by individuals with multiple sclerosis (MS). Some psychological factors such as depression, stress, and anxiety seem to have a relationship with such problems. This study aimed to examine the role of depression, stress, and anxiety in predicting sleep disorders and fatigue among patients with MS. Employing a cross-sectional descriptive-correlational design, the study involved a sample size of 252 participants selected through purposive sampling based on inclusion and exclusion criteria. We utilized a demographic information questionnaire along with the Mini-Sleep Questionnaire (MSQ), Fatigue Severity Scale (FSS), and Depression, Anxiety, and Stress Scale (DASS-21) to collect data and analyzed them applying SPSS22, incorporating statistical measures including Pearson correlation and regression. The results of the Pearson correlation coefficient showed that sleep disorders had a positive and significant relationship with depression (r = 0.56; P < 0.001), stress (r = 0.40; P < 0.001), and anxiety (r = 0.52; P < 0.001). There was no significant relationship between age and the development of sleep disorders in total score (r = -0.001; P < 0.985), but age had a relationship with insomnia (r = -0.146; P < 0.021) and oversleeping (r = 0.153; P < 0.015). Age and fatigue did not have a significant relationship as well (r = -0.044; P < 0.941). In addition, fatigue had a positive and significant relationship with depression (r = 0.52; P < 0.001), stress (r = 0.48; P < 0.001), and anxiety (r = 0.54; P < 0.001). The results of the regression analysis also showed that depression, stress, and anxiety predict 0.37% of the total variance of sleep disorders (F = 48.34; P < 0.001) and 0.35% of the total variance of fatigue (F = 44.64; P < 0.001). Our findings suggest that depression, stress, and anxiety play a significant role in predicting sleep disorders and fatigue among patients with MS. This study has been reported in accordance with the TREND checklist for nonrandomized trials.
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Affiliation(s)
- Nassim Zekibakhsh Mohammadi
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Amir Sam Kianimoghadam
- Department of Clinical Psychology, Religion and Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloofar Mikaeili
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | | | - Mahdieh Jafari
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Abbas Masjedi-Arani
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Minaeva O, Schat E, Ceulemans E, Kunkels YK, Smit AC, Wichers M, Booij SH, Riese H. Individual-specific change points in circadian rest-activity rhythm and sleep in individuals tapering their antidepressant medication: an actigraphy study. Sci Rep 2024; 14:855. [PMID: 38195786 PMCID: PMC10776866 DOI: 10.1038/s41598-023-50960-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/26/2023] [Indexed: 01/11/2024] Open
Abstract
Group-level studies showed associations between depressive symptoms and circadian rhythm elements, though whether these associations replicate at the within-person level remains unclear. We investigated whether changes in circadian rhythm elements (namely, rest-activity rhythm, physical activity, and sleep) occur close to depressive symptom transitions and whether there are differences in the amount and direction of circadian rhythm changes in individuals with and without transitions. We used 4 months of actigraphy data from 34 remitted individuals tapering antidepressants (20 with and 14 without depressive symptom transitions) to assess circadian rhythm variables. Within-person kernel change point analyses were used to detect change points (CPs) and their timing in circadian rhythm variables. In 69% of individuals experiencing transitions, CPs were detected near the time of the transition. No-transition participants had an average of 0.64 CPs per individual, which could not be attributed to other known events, compared to those with transitions, who averaged 1 CP per individual. The direction of change varied between individuals, although some variables showed clear patterns in one direction. Results supported the hypothesis that CPs in circadian rhythm occurred more frequently close to transitions in depression. However, a larger sample is needed to understand which circadian rhythm variables change for whom, and more single-subject research to untangle the meaning of the large individual differences.
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Affiliation(s)
- Olga Minaeva
- Department of Psychiatry (CC72), Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
| | - Evelien Schat
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Eva Ceulemans
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Yoram K Kunkels
- Department of Psychiatry (CC72), Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Arnout C Smit
- Department of Psychiatry (CC72), Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
- Clinical Psychology, Faculty of Behavioral and Movement Sciences, VU Amsterdam, Amsterdam, The Netherlands
| | - Marieke Wichers
- Department of Psychiatry (CC72), Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Sanne H Booij
- Department of Psychiatry (CC72), Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
- Lentis, Center for Integrative Psychiatry, Groningen, The Netherlands
| | - Harriëtte Riese
- Department of Psychiatry (CC72), Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
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13
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Choi NG, Choi BY, Marti CN. Mediation of the Association Between Physical Exercise and Depressive/Anxiety Symptoms by Pain and Sleep Problems Among Older Adults. Gerontol Geriatr Med 2024; 10:23337214241241397. [PMID: 38525486 PMCID: PMC10960979 DOI: 10.1177/23337214241241397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/23/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Abstract
In this study, based on the 2022 National Health and Aging Trend Study (N = 5,593, age 65+), we examined direct associations between moderate and vigorous physical exercise (PE) and depressive/anxiety symptoms as well as bothersome pain and sleep problems. We then examined if the association between PE and depressive/anxiety symptoms would be partially mediated by the effects of PE on bothersome pain and sleep problems. Results from a path model showed that controlling for sociodemographic and health statuses, PE was negatively associated with depressive/anxiety symptoms and bothersome pain, but it was not significantly associated with sleep problems. The mediation analysis showed that 10% of the total effects of PE on depressive/anxiety symptoms was indirect effects of PE on bothersome pain. This study is important as it examined the associations among PE, pain, sleep, and depression/anxiety in community-dwelling older adults in their natural environments. Healthcare and social service providers for older adults need to emphasize the importance and benefits of PE for older adults' physical and mental health. Easy access to venues for PE is also important.
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Affiliation(s)
| | - Bryan Y. Choi
- Philadelphia College of Osteopathic Medicine and BayHealth, Dover, DE, USA
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14
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Zhang W, Zhou B, Jiang C, Jin Y, Zhu T, Zhu F, Cheng KK, Lam TH, Xu L. Associations of daytime napping and nighttime sleep quality with depressive symptoms in older Chinese: the Guangzhou biobank cohort study. BMC Geriatr 2023; 23:875. [PMID: 38114908 PMCID: PMC10731710 DOI: 10.1186/s12877-023-04579-6] [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: 09/02/2022] [Accepted: 12/07/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Poor sleep quality has been linked to depression in older adults, but results of the association between daytime napping and depression remains limited and conflicting. Moreover, whether the association of daytime napping with depression varies by nighttime sleep quality is unclear. Hence, we examined the associations of daytime napping and nighttime sleep quality with depressive symptoms in older Chinese. METHODS A total of 16,786 participants aged ≥50 from the Guangzhou Biobank Cohort Study second-round examination (2008-2012) were included in this cross-sectional study. Geriatric Depression Scale (GDS-15), Pittsburgh Sleep Quality Index (PSQI), napping and demographic data were collected by face-to-face interview using a computerized questionnaire. Logistic regression was used to calculate odds ratio (OR) of depressive symptoms for napping and sleep quality. RESULTS The prevalence of depressive symptoms (GDS score > 5) and poor global sleep quality (PSQI score ≥ 6) was 5.3 and 31.9%, respectively. Compared to non-nappers, nappers showed significantly higher odds of depressive symptoms, with OR (95% confidence interval (CI)) being 1.28 (1.11-1.49). The odds of depressive symptoms for daytime napping varied by nighttime sleep quality (P for interaction = 0.04). In good-quality sleepers, compared to non-nappers, nappers had significantly higher odds of depressive symptoms, with OR (95% CI) being 1.57 (1.23-2.01), whereas no association was found in poor-quality sleepers (OR = 1.13, 0.94-1.36). CONCLUSION Napping was associated with higher odds of depressive symptoms in older people, and the association was stronger in good-quality sleepers.
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Affiliation(s)
- Weisen Zhang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, Guangdong, China
| | - Baijing Zhou
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, Guangdong, China
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chaoqiang Jiang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, Guangdong, China
| | - Yali Jin
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, Guangdong, China
| | - Tong Zhu
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, Guangdong, China
| | - Feng Zhu
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, Guangdong, China
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China.
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15
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Yue WL, Ng KK, Koh AJ, Perini F, Doshi K, Zhou JH, Lim J. Mindfulness-based therapy improves brain functional network reconfiguration efficiency. Transl Psychiatry 2023; 13:345. [PMID: 37951943 PMCID: PMC10640625 DOI: 10.1038/s41398-023-02642-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 08/29/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023] Open
Abstract
Mindfulness-based interventions are showing increasing promise as a treatment for psychological disorders, with improvements in cognition and emotion regulation after intervention. Understanding the changes in functional brain activity and neural plasticity that underlie these benefits from mindfulness interventions is thus of interest in current neuroimaging research. Previous studies have found functional brain changes during resting and task states to be associated with mindfulness both cross-sectionally and longitudinally, particularly in the executive control, default mode and salience networks. However, limited research has combined information from rest and task to study mindfulness-related functional changes in the brain, particularly in the context of intervention studies with active controls. Recent work has found that the reconfiguration efficiency of brain activity patterns between rest and task states is behaviorally relevant in healthy young adults. Thus, we applied this measure to investigate how mindfulness intervention changed functional reconfiguration between rest and a breath-counting task in elderly participants with self-reported sleep difficulties. Improving on previous longitudinal designs, we compared the intervention effects of a mindfulness-based therapy to an active control (sleep hygiene) intervention. We found that mindfulness intervention improved self-reported mindfulness measures and brain functional reconfiguration efficiency in the executive control, default mode and salience networks, though the brain and behavioral changes were not associated with each other. Our findings suggest that neuroplasticity may be induced through regular mindfulness practice, thus bringing the intrinsic functional configuration in participants' brains closer to a state required for mindful awareness.
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Affiliation(s)
- Wan Lin Yue
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore, Singapore
| | - Kwun Kei Ng
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Amelia Jialing Koh
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Francesca Perini
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kinjal Doshi
- Department of Psychology, Singapore General Hospital, Singapore, Singapore
| | - Juan Helen Zhou
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore, Singapore.
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore.
| | - Julian Lim
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Department of Psychology, National University of, Singapore, Singapore.
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Yin L, Rong T, Zhang Y, Gao J. The relationship between sleep quality and anxiety and depression among older caregivers of centenarians in China: A cross-sectional study. Geriatr Nurs 2023; 54:302-309. [PMID: 37918038 DOI: 10.1016/j.gerinurse.2023.10.005] [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: 08/07/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 11/04/2023]
Abstract
To explore the relationship between sleep quality and anxiety and depression in older caregivers. From April 2020 to November 2022, GAD-7, GDS-15, and PSQI were used to measure anxiety, depression, and sleep quality. The correlation of each variable was explored by regression analysis. Among 442 caregivers ≥ 65 years old, the prevalence of sleep disorders, anxiety, and depression was 40.5 %, 20.2 %, and 26.4 %. After adjustment for multiple potential confounders, anxiety (OR1.1; 95 % CI 1-1.2) and depression (OR 1.29; 95 % CI 1.21-1.38) were associated with sleep disorders. Daytime dysfunction components of PSQI measurements were associated with anxiety(P < 0.05). Meanwhile, sleep efficiency, sleep medication use, and daytime dysfunction components of PSQI measurements were associated with depression(P < 0.05). Therefore, the sleep quality of older caregivers is strongly related to anxiety and depression. It is necessary to provide sleep guidance or professional intervention for older caregivers to reduce anxiety and depression.
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Affiliation(s)
- Lanxin Yin
- Medical School of Nantong University, Nantong 226001, China; Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong University, Nantong 226001, China; Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - Ting Rong
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong University, Nantong 226001, China; Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong 226001, China; School of Public Health, Nantong University, Nantong 226001, China
| | - Yi Zhang
- Medical School of Nantong University, Nantong 226001, China; Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong University, Nantong 226001, China; Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - Jianlin Gao
- Medical School of Nantong University, Nantong 226001, China; Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong University, Nantong 226001, China; Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong 226001, China.
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Antonsdottir IM, Low DV, Chen D, Rabinowitz JA, Yue Y, Urbanek J, Wu MN, Zeitzer JM, Rosenberg PB, Friedman LF, Sheikh JI, Yesavage JA, Zipunnikov V, Spira AP. 24 h Rest/Activity Rhythms in Older Adults with Memory Impairment: Associations with Cognitive Performance and Depressive Symptomatology. Adv Biol (Weinh) 2023; 7:e2300138. [PMID: 37423973 DOI: 10.1002/adbi.202300138] [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: 04/07/2023] [Revised: 06/16/2023] [Indexed: 07/11/2023]
Abstract
Little is known about links of circadian rhythm alterations with neuropsychiatric symptoms and cognition in memory impaired older adults. Associations of actigraphic rest/activity rhythms (RAR) with depressive symptoms and cognition are examined using function-on-scalar regression (FOSR). Forty-four older adults with memory impairment (mean: 76.84 ± 8.15 years; 40.9% female) completed 6.37 ± 0.93 days of actigraphy, the Beck depression inventory-II (BDI-II), mini-mental state examination (MMSE) and consortium to establish a registry for Alzheimer's disease (CERAD) delayed word recall. FOSR models with BDI-II, MMSE, or CERAD as individual predictors adjusted for demographics (Models A1-A3) and all three predictors and demographics (Model B). In Model B, higher BDI-II scores are associated with greater activity from 12:00-11:50 a.m., 2:10-5:50 p.m., 8:40-9:40 p.m., 11:20-12:00 a.m., higher CERAD scores with greater activity from 9:20-10:00 p.m., and higher MMSE scores with greater activity from 5:50-10:50 a.m. and 12:40-5:00 p.m. Greater depressive symptomatology is associated with greater activity in midafternoon, evening, and overnight into midday; better delayed recall with greater late evening activity; and higher global cognitive performance with greater morning and afternoon activity (Model B). Time-of-day specific RAR alterations may affect mood and cognitive performance in this population.
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Affiliation(s)
- Inga M Antonsdottir
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease, Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview, Johns Hopkins Medicine, Baltimore, MD, 21224, USA
| | - Dominique V Low
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Diefei Chen
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
- Johns Hopkins University Center on Aging and Health, Baltimore, MD, 21205, USA
| | - Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House, Baltimore, MD, 21205, USA
| | - Yiwei Yue
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House, Baltimore, MD, 21205, USA
| | - Jacek Urbanek
- Regeneron Pharmaceuticals Inc., Johns Hopkins University, 777 Old Saw Mill River Rd, Tarrytown, NY, 10591, USA
| | - Mark N Wu
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Jamie M Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, 94305, USA
| | - Paul B Rosenberg
- Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease, Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview, Johns Hopkins Medicine, Baltimore, MD, 21224, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 5300 Alpha Commons Drive, Baltimore, MD, 21224, USA
| | - Leah F Friedman
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, 94305, USA
| | - Javaid I Sheikh
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, 24144, Qatar
| | - Jerome A Yesavage
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, 94305, USA
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Adam P Spira
- Johns Hopkins University Center on Aging and Health, Baltimore, MD, 21205, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House, Baltimore, MD, 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 5300 Alpha Commons Drive, Baltimore, MD, 21224, USA
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18
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Li W, Sun L, Yue L, Xiao S. The left temporal transverse cortex is affected by poor sleep quality, which in turn contributes to depressive symptoms in older adults. Heliyon 2023; 9:e20751. [PMID: 37860546 PMCID: PMC10582376 DOI: 10.1016/j.heliyon.2023.e20751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023] Open
Abstract
Sleep quality is critical for improving mental health among older adults. Despite this, there is a dearth of studies examining the correlation between sleep quality and emotional symptoms in the elderly population of China. This study included 496 community elders aged 55 years and older. The participants were divided into two groups based on their scores on the Pittsburgh Sleep Quality Index (PSQI), with 249 being classified as poor sleepers and 247 as good sleepers. All participants were asked to fill out a uniform survey which included details about their demographics, daily habits, and any illnesses they were dealing with. The Self-rating anxiety scale (SAS) and Geriatric Depression Scale (GDS) were employed to measure their levels of anxiety and depression, respectively. In addition, 50 healthy individuals also agreed to brain MR imaging. The finding of our study indicated that those with inadequate sleep had higher levels of depression and anxiety, and the overall anxiety and depression score was linked to the total PSQI score in a positive manner; The MRI subgroup analysis revealed that those with inadequate sleep quality had a greater thickness of the left transverse temporal gyrus (p < 0.05). In addition, a Linear regression analysis of the mediation model showed that poor sleep quality would result in higher scores on the GDS, and cortical thickness in the left transverse temporal gyrus played a fully mediated role in this process. Our research indicates that elderly people in community who have difficulty sleeping may be more likely to suffer from anxiety and depression, and this lack of sleep can result in depressive symptoms due to its impact on the thickness of the left transverse temporal cortex.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Lin Sun
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
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Huang M, Liu K, Liang C, Wang Y, Guo Z. The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety. BMC Geriatr 2023; 23:506. [PMID: 37608361 PMCID: PMC10463962 DOI: 10.1186/s12877-023-04161-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 07/10/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND With modernization and ageing in China, the population of older adults living alone is increasing. Living alone may be a potential risk factor for depressive symptoms. However, no parallel mediation model analysis has investigated the mediating factors for living alone or not (living arrangements) and depressive symptoms. METHODS This cross-sectional study included a total number of 10,980 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), 1699 of whom lived alone and 9281 of whom did not live alone. Binary logistic regression and parallel mediation effect model were used to explore the relationship between living alone or not and depressive symptoms and possible mediation effects. Bootstrap analysis was used to examine the mediation effect of living alone or not on depressive symptoms. RESULTS Compared to the participants who were not living alone, the living alone group had a higher rate of depressive symptoms. The binary logistic regression showed that after adjusting for other covariates, the risk of depressive symptoms was approximately 0.21 times higher for living alone compared to not living alone (OR = 1.21, 95% CI: 1.06, 1.37). Further, the results of the bootstrap analysis supported the partial mediating role of sleep quality and anxiety. Mediation analysis revealed that sleep quality and anxiety partially mediate the relationship between living alone and depressive symptoms (β = 0.008, 95% CI [0.003, 0.014]; β = 0.015, 95% CI [0.008, 0.024], respectively). CONCLUSIONS Sleep quality and anxiety were identified as partially parallel mediators between living alone or not and depressive symptoms. Older adults living alone with poorer sleep quality and more pronounced anxiety were positively associated with higher levels of depressive symptoms. Older adults living alone should be encouraged to engage in social activities that may improve sleep quality, relieve anxiety, and improve feelings of loneliness caused by living alone. Meanwhile, older adults living alone should receive attention and support to alleviate their depressive symptoms.
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Affiliation(s)
- Mina Huang
- Department of Nursing, The Jinzhou Medical University, Jinzhou, China
| | - Kun Liu
- Department of Medical College, The Jinzhou Medical University, Jinzhou, China
| | - Chunguang Liang
- Department of Nursing, The Jinzhou Medical University, Jinzhou, China
| | - Yongzhu Wang
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, No.2, Section 5, Renmin Street, Jinzhou, Liaoning, 121001, China
| | - Zhanpeng Guo
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, No.2, Section 5, Renmin Street, Jinzhou, Liaoning, 121001, China.
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Mou H, Xu D, Zhu S, Zhao M, Wang Y, Wang K. The sleep patterns and their associations with mental health among nursing home residents: a latent profile approach. BMC Geriatr 2023; 23:468. [PMID: 37537539 PMCID: PMC10401828 DOI: 10.1186/s12877-023-04124-5] [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: 10/15/2022] [Accepted: 06/21/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Nursing home residents commonly experience poor sleep conditions. However, few studies have explored the potential sleep patterns among nursing home residents. This study aimed to identify the sleep patterns in nursing home residents, compare residents' characteristics across sleep patterns, and examine the relationships between sleep patterns and residents' mental health (i.e., depressive and anxiety symptoms). METHODS This cross-sectional study was conducted in 27 nursing homes in Jinan, China, from March to June 2018. In total, 353 participants were recruited via convenience sampling, and of which, 326 completed the survey. A latent profile analysis was performed to identify sleep patterns based on the seven dimensions of the Pittsburgh Sleep Quality Index. Bivariate analyses were conducted to compare residents' characteristics among the sleep patterns. Mixed-effects logistic regression analyses were adopted to investigate the relationships between sleep patterns and residents' mental health. RESULTS Three sleep patterns were identified, including 'good sleepers', 'poor sleepers without hypnotic use', and 'poor sleepers with hypnotic use'. Residents' gender, education, pain, instrumental activities of daily living, and number of chronic conditions were significantly differentiated across the sleep patterns. Compared with 'good sleepers', 'poor sleepers without hypnotic use' were significantly associated with more depressive symptoms (OR = 3.73, 95% CI = 2.09, 6.65, p < 0.001), but not with anxiety symptoms (OR = 2.04, 95% CI = 0.97, 4.29, p = 0.062); whereas 'poor sleepers with hypnotic use' had significantly more depressive (OR = 5.24, 95% CI = 2.54, 10.79, p < 0.001) and anxiety symptoms (OR = 5.02, 95% CI = 2.13, 11.83, p < 0.001). CONCLUSIONS This study reveals three distinct sleep patterns in nursing home residents and their significant associations with residents' mental health. These findings can inform future research to develop appropriate and tailored intervention strategies for improving sleep and promoting mental health for nursing home residents.
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Affiliation(s)
- Huanyu Mou
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, 250012, China
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Dongjuan Xu
- School of Nursing, Purdue University, West Lafayette, IN, 47907, USA
| | - Shanshan Zhu
- Geriatrics Department, Henan Provincial People's Hospital, Zhengzhou, Henan Province, 450000, China
| | - Meng Zhao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, 250012, China
| | - Yaqi Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, 250012, China
| | - Kefang Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, 250012, China.
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Castelnuovo G, Perez-Diaz-Del-Campo N, Rosso C, Guariglia M, Armandi A, Nicolosi A, Caviglia GP, Bugianesi E. Impact of Chronotype and Mediterranean Diet on the Risk of Liver Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease. Nutrients 2023; 15:3257. [PMID: 37513675 PMCID: PMC10385040 DOI: 10.3390/nu15143257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
Late chronotype, the individual's aptitude to perform daily activities late in the day, has been associated with low adherence to the Mediterranean diet (MedDiet) and metabolic syndrome. The aim of this work was to investigate the potential association of chronotype and adherence to the MedDiet with the liver fibrosis risk in patients with non-alcoholic fatty liver disease (NAFLD). Liver stiffness was assessed in 126 patients by FibroScan®530. Significant (F ≥ 2) and advanced (F ≥ 3) hepatic fibrosis were defined according to liver stiffness values ≥7.1 kPa and ≥8.8 kPa, respectively. Chronotype (MSFsc) was defined by the Munich Chronotype Questionnaire, and adherence to the MedDiet was defined by the Mediterranean diet score (MDS). Overall, the median age was 55 (46-63) years, and 57.9% of participants were male. The principal comorbidities were type-2 diabetes mellitus (T2DM) (26.1%), arterial hypertension (53.1%), dyslipidaemia (63.4%), obstructive sleep apnoea (5.5%) and depression (5.5%). Most subjects (65.0%) had intermediate + late chronotype and showed higher mid-sleep on workdays (p < 0.001) and on work-free days (p < 0.001) compared to those with early chronotype. In the logistic regression model, intermediate + late chronotype (p = 0.024), MDS (p = 0.019) and T2DM (p = 0.004) were found to be significantly and independently associated with the risk of both F ≥ 2 And F ≥ 3. We observed that the intermediate + late chronotype and low adherence to the MedDiet were associated with both significant and advanced liver fibrosis in patients with NAFLD.
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Affiliation(s)
| | | | - Chiara Rosso
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Marta Guariglia
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Angelo Armandi
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
- Metabolic Liver Disease Research Program, I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany
| | - Aurora Nicolosi
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | | | - Elisabetta Bugianesi
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
- Gastroenterology Unit, Città della Salute e della Scienza-Molinette Hospital, 10126 Turin, Italy
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Sun X, Tan J, Chen Y, Liu Y, Dong GH, Yang BY, Li N, Wang L, Li S, Chen G, Guo Y. The association between long-term exposure to outdoor artificial light at night and poor sleep quality among Chinese veterans: A multi-city study. Int J Hyg Environ Health 2023; 252:114218. [PMID: 37429120 DOI: 10.1016/j.ijheh.2023.114218] [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: 01/03/2023] [Revised: 06/26/2023] [Accepted: 07/01/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND A handful of previous studies have reported the association between exposure to outdoor artificial light at night (ALAN) and sleep problems. However, evidence for such association is limited in low- and middle-income countries. This study aimed to examine the association between outdoor ALAN exposure and sleep quality in veterans across different regions of China. METHODS Within the network of the Chinese Veteran Clinical Research Platform, we selected 7258 participants from 277 veteran communities in 18 cities across China during December 2009 and December 2011, using a multi-stage stratified cluster sampling strategy. Face-to-face interviews with the participants were conducted by trained investigators. We used the Pittsburgh Sleep Quality Index (PSQI) to assess participants' sleep quality. We defined poor sleep quality as a PSQI global score >7. The 3-year average exposure to outdoor ALAN prior to the baseline interview was calculated using satellite imagery data, according to participants' geolocation information. The association of ALAN exposure with sleep quality was examined using the mixed-effects logistic regression models with natural cubic splines. RESULTS The exposure-response curve for sleep quality associated with ALAN exposure was nonlinear, with a threshold value of 49.20 nW/cm2/sr for the 3-year average exposure to outdoor ALAN prior to the baseline interview. Higher ALAN exposure above the threshold was associated with increased risk of poor sleep quality. After adjusting for potential confounders, the odds ratios (and 95%CI, 95% confidence intervals) were 1.15 (0.97, 1.36) and 1.45 (1.17, 1.78) at the 75th and 95th percentiles of ALAN against the threshold. The association of ALAN exposure with poor sleep quality was more pronounced in veterans with depression than those without. Higher OR of poor sleep quality at the 75th percentile of ALAN against the threshold was observed in veterans with depression than those without [2.09 (1.16, 3.76) vs. 1.09 (0.92, 1.30)]. CONCLUSIONS Long-term exposure to outdoor ALAN was associated with higher risk of poor sleep quality in Chinese veterans. Effective outdoor ALAN management may help to reduce the burden of sleep disorders in Chinese veterans.
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Affiliation(s)
- Xinyi Sun
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Jiping Tan
- Geriatric Neurology Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100039, China
| | - Yan Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Guang-Hui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Bo-Yi Yang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, 100191, China
| | - Luning Wang
- Geriatric Neurology Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100039, China
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
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Christodoulou E, Pavlidou E, Mantzorou M, Koutelidakis A, Vadikolias K, Psara E, Vorvolakos T, Antasouras G, Serdari A, Vasios G, Giaginis C. Depression is associated with worse health-related quality of life, lower physical activity levels, and inadequate sleep quality in a Greek elderly population. PSYCHOL HEALTH MED 2023; 28:2486-2500. [PMID: 37280787 DOI: 10.1080/13548506.2023.2221446] [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: 10/23/2022] [Accepted: 05/30/2023] [Indexed: 06/08/2023]
Abstract
The present study is a cross-sectional study that aimed to investigate the potential associations between depression status, health-related quality of life, physical activity levels and sleep quality in a representative Greek elderly population. Three thousand four hundred five (3405) men and women over 65 years old from 14 different Greek regions were enrolled. Geriatric Depression Scale (GDS) was used to assess depression status, Health-Related Quality of Life (HRQOL) was evaluated using Short Form Health Survey, physical activity levels were assessed via the International Physical Activity Questionnaire (IPAQ) and sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). A high prevalence of depression and an increased incidence of poor quality of life, low physical activity levels and inadequate sleep quality among the elderly population were recorded. Depression status was independently associated with worse quality of life, poor physical activity, inadequate sleep quality, female gender, BMI and living alone after adjustment for potential confounding factors. Elderly age, low muscle mass, educational and financial status were also identified as indicators of depression; however, their impact on depression status was considerably attenuated after adjusting for confounding factors. In conclusion, depression was associated with worse health-related quality of life, poor physical activity and inadequate sleep quality in a Greek elderly population. Future randomized control trials should be performed to confirm the findings of this cross-sectional study.
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Affiliation(s)
- Efstratios Christodoulou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, Greece
| | - Eleni Pavlidou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, Greece
| | - Maria Mantzorou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, Greece
| | - Antonios Koutelidakis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, Greece
| | | | - Evmorfia Psara
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, Greece
| | - Theofanis Vorvolakos
- Department of Geriatric Psychiatry, School of Medicine, Democritus University of Thrace, Alexandroupoli, Greece
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, Greece
| | - Aspasia Serdari
- Department of Psychiatry and Child Psychiatry, School of Medicine, Democritus University of Thrace, Alexandroupoli, Greece
| | - Georgios Vasios
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, Greece
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24
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Zhu X, Zheng T, Ding L, Zhang X. Exploring associations between eHealth literacy, cyberchondria, online health information seeking and sleep quality among university students: A cross-section study. Heliyon 2023; 9:e17521. [PMID: 37408886 PMCID: PMC10319213 DOI: 10.1016/j.heliyon.2023.e17521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 06/09/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023] Open
Abstract
Background University students are increasingly inclined to use the Internet for health-related purposes, and their sleep problems are becoming increasingly prominent. Currently, the relationship between sleep quality and online health-related searches is poorly understood. The aim of this study was to exam the associations of sleep quality, Internet use, eHealth literacy, online health information seeking and cyberchondria in the sample of Chinese university students. Methods A total of 2744 students completed self-reported questionnaires online containing the Pittsburgh Sleep Quality Index (PSQI), eHealth Literacy Scale, Online Health Information Seeking, Cyberchondria Severity Scale (CSS) and questions regarding sleep duration, Internet use, health status, and demographic information. Results The prevalence of poor sleep quality (PSQI >7) among the university students was 19.9% and 15.6% students slept less than 7 h per day. As time spent on online daily and playing phone before bed increased, the prevalence of sleep disturbance gained. Sleep disturbance was significantly associated with cyberchondria (OR = 1.545, p = 0.001), health status [good (OR = 0.625, p = 0.039), poor (OR = 3.128, p = 0.010), and fair (OR = 1.932, p = 0.001)]. Sleep quality, online health information seeking and eHealth literacy positively influenced with cyberchondria. Compared to 7-8 h sleep duration, online health information seeking (OR = 0.750, p = 0.012) was significantly associated with ≥8 h sleep duration. Conclusion Our findings highlighted poor health status, too much time spent on online daily and high cyberchondria level might decrease sleep quality in the sample of Chinese university students, further suggesting the need for developing interventions based on online health-related searches for improving sleep quality among university students.
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25
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Jemcov A, Olthuis JV, Watt MC, Stewart SH. Do anxiety sensitivity cognitive concerns and/or depression symptoms independently explain sleep disturbances in a high anxiety sensitive treatment-seeking sample? J Anxiety Disord 2023; 97:102731. [PMID: 37236069 DOI: 10.1016/j.janxdis.2023.102731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 05/08/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023]
Abstract
Cognitive models of insomnia posit a role for anxiety sensitivity (AS) in sleep difficulties. While sleep disturbances have been linked to AS, particularly AS cognitive concerns, prior studies have rarely accounted for the correlated construct of depression. We used pre-treatment intervention trial data from 128 high AS, treatment-seeking adults with a DSM-5 diagnosis of an anxiety, depressive, or posttraumatic stress disorder to determine whether AS cognitive concerns and/or depression are independently associated with sleep impairment domains (e.g., sleep quality, latency, daytime dysfunction). Participants provided data on AS, depressive symptoms, and sleep impairments. AS cognitive concerns (but not other AS dimensions) were correlated with four of five sleep impairment domains; depression was correlated with all five. Multiple regressions revealed four of five sleep impairment domains were predicted by depression with no independent contribution of AS cognitive concerns. In contrast, AS cognitive concerns and depression were independently associated with daytime dysfunction. Results suggest previous findings linking AS cognitive concerns to sleep impairments may have been largely secondary to the overlap of cognitive concerns with depression. Findings demonstrate the importance of incorporating depression into the cognitive model of insomnia. Both AS cognitive concerns and depression may be useful targets for reducing daytime dysfunction.
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Affiliation(s)
- Anastasija Jemcov
- Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, 1355 Oxford St., Halifax, Nova Scotia B3H 4R2, Canada
| | - Janine V Olthuis
- Department of Psychology, Faculty of Arts, University of New Brunswick, 38 Dineen Drive, Fredericton, New Brunswick E3B 5A3, Canada
| | - Margo C Watt
- Department of Psychology, Faculty of Science, St. Francis Xavier University, 2323 Notre Dame Ave., Antigonish, Nova Scotia B2G 2W5, Canada
| | - Sherry H Stewart
- Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, 1355 Oxford St., Halifax, Nova Scotia B3H 4R2, Canada; Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veteran's Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada.
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Urmanche AA, Solomonov N, Sankin LS, Subramanyam A, Pedreza-Cumba M, Scaduto L, Garcia J, Jockers K, Wolf R, Sirey JA. Research-Practice Partnership to Develop and Implement Routine Mental Health Symptom Tracking Tool Among Older Adults During COVID-19. Am J Geriatr Psychiatry 2023; 31:326-337. [PMID: 36641298 PMCID: PMC9788852 DOI: 10.1016/j.jagp.2022.12.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Older adults are disproportionally impacted by the COVID-19 pandemic, causing a mental health crisis in late life, due to physical restrictions (e.g., quarantine), limited access to services, and lower literacy and access to technology. Despite established benefits, systematic screening of mental health needs of older adults in community and routine care settings is limited and presents multiple challenges. Cross-disciplinary collaborations are essential for identification and evaluation of mental health needs and service delivery. METHODS Using a research-practice partnership model, we developed and implemented a routine mental health needs identification and tracking tool at a community-based social services organization. Repeated screenings were conducted remotely over 5 months and included depression, anxiety, perceived loneliness, social support, and related domains such as sleep quality, resilience, and trauma symptoms linked to COVID-19. We examined symptomatic distress levels and associations between different domains of functioning. RESULTS Our project describes the process of establishing a research-practice partnership during the COVID-19 pandemic. We collected 292 screenings from 124 individuals; clients were mildly to moderately depressed and anxious, reporting large amounts of time alone and moderate levels of loneliness. Those reporting higher depressive symptoms reported higher anxiety symptoms, poorer sleep quality, lower quality of life, lower capacity to adapt to challenging situations, and greater trauma symptoms due to COVID-19. CONCLUSION Our routine screening tool can serve as a blueprint for case management agencies and senior centers nationwide, beyond the pressing mental health crisis due to COVID-19, to continue identifying needs as they emerge in the community.
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Affiliation(s)
- Adelya A Urmanche
- Weill Cornell Institute of Geriatric Psychiatry (AAU, NS, LSS, JAS), Weill Cornell Medical College, New York, NY; Mount Sinai Beth Israel (AAU), New York, NY
| | - Nili Solomonov
- Weill Cornell Institute of Geriatric Psychiatry (AAU, NS, LSS, JAS), Weill Cornell Medical College, New York, NY
| | - Lindsey S Sankin
- Weill Cornell Institute of Geriatric Psychiatry (AAU, NS, LSS, JAS), Weill Cornell Medical College, New York, NY
| | | | | | | | | | - Ken Jockers
- Hudson Guild (AS, MPC, LS, JG, KJ, RW), New York, NY
| | - Robert Wolf
- Hudson Guild (AS, MPC, LS, JG, KJ, RW), New York, NY
| | - Jo Anne Sirey
- Weill Cornell Institute of Geriatric Psychiatry (AAU, NS, LSS, JAS), Weill Cornell Medical College, New York, NY.
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27
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Zhang N, Wang C, Li Y, Chen F, Yan P. Hypothetical interventions on risk factors for depression among middle-aged and older community-dwellers in China: An application of the parametric g-formula in a longitudinal study. J Affect Disord 2023; 327:355-361. [PMID: 36754095 DOI: 10.1016/j.jad.2023.01.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND Sleep disturbances, frailty, and body pain are widespread in middle-aged and older adults with depression, and have been identified as depression risk factors. However, there is a scarcity of research on the benefits of sleep improvement, frailty amelioration, and pain management on incident depression. METHODS A total of 8895 respondents aged above 45 years were derived from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2018. The parametric g-formula was used to estimate the 7-year risks of depression under independent hypothetical interventions on nighttime sleep duration (NSD), daytime napping duration (DND), perceived sleep quality (PSQ), frailty, and pain, as well as their various combinations. RESULTS The observed depression risk was 41.77 %. The independent intervention on frailty was the most effective in lowering incident depression, with a risk ratio (RR) of 0.61 (95 % CI: 0.57-0.64), followed by PSQ (RR: 0.75, 95 % CI: 0.73-0.78), pain (RR: 0.90, 95 % CI: 0.87-0.91), and NSD (RR: 0.96, 95 % CI: 0.93-0.98). In subgroup analysis, intervention on NSD was more effective in men, PSQ was more effective in middle-aged individuals, and frailty and pain were more effective in older persons. The combined intervention of NSD, PSQ, frailty, and pain lowered the risk the greatest (RR: 0.35, 95 % CI: 0.32-0.37). LIMITATIONS Generalizing our results to other populations should be possible if they have the same distribution of effect modifiers and interference patterns because of the calculation principle of the parametric g-formula. CONCLUSIONS Interventions for sleep disturbances, frailty, and body pain can minimize the risk of depression.
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Affiliation(s)
- Nan Zhang
- School of Nursing, Xinjiang Medical University, Urumqi, China
| | - Cui Wang
- School of Nursing, Peking University, Beijing, China
| | - Yuli Li
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Fenghui Chen
- School of Nursing, Xinjiang Medical University, Urumqi, China
| | - Ping Yan
- School of Nursing, Xinjiang Medical University, Urumqi, China.
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28
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Collinge AN, Bath PA. Socioeconomic Background and Self-Reported Sleep Quality in Older Adults during the COVID-19 Pandemic: An Analysis of the English Longitudinal Study of Ageing (ELSA). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4534. [PMID: 36901540 PMCID: PMC10001974 DOI: 10.3390/ijerph20054534] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic negatively impacted sleep quality. However, research regarding older adults' sleep quality during the pandemic has been limited. This study examined the association between socioeconomic background (SEB) and older adults' sleep quality during the COVID-19 pandemic. Data on 7040 adults aged ≥50 were acquired from a COVID-19 sub-study of the English Longitudinal Study of Ageing (ELSA). SEB was operationalized using educational attainment, previous financial situation, and concern about the future financial situation. Sociodemographic, mental health, physical health, and health behavior variables were included as covariates. Chi-squared tests and binary logistic regression were used to examine associations between SEB and sleep quality. Lower educational attainment and greater financial hardship and concerns were associated with poor sleep quality. The relationship between educational attainment and sleep quality was explained by the financial variables, while the relationship between previous financial difficulties and sleep quality was explained by physical health and health behavior variables. Greater financial concerns about the future, poor mental health, and poor physical health were independent risk factors for poor sleep quality in older adults during the pandemic. Healthcare professionals and service providers should consider these issues when supporting older patients with sleep problems and in promoting health and wellness.
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Affiliation(s)
- Adam N. Collinge
- Information School, University of Sheffield, Sheffield S1 4DP, UK
| | - Peter A. Bath
- Information School, University of Sheffield, Sheffield S1 4DP, UK
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK
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Mobile Phone Addiction and Sleep Quality among Older People: The Mediating Roles of Depression and Loneliness. Behav Sci (Basel) 2023; 13:bs13020153. [PMID: 36829382 PMCID: PMC9952244 DOI: 10.3390/bs13020153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
Rapid social development has made the elderly increasingly dependent on mobile phones, and mobile phone addiction has a negative effect on sleep quality. The underlying mechanism between the two is unclear. This study examined the mediating role of depression and loneliness in the relationship between phone addiction and sleep quality in older adults. Mobile Phone Addiction Scale Short Version, Pittsburgh Sleep Quality Index scale, UCLA (University of California, Los Angeles)-8 Loneliness Scale, and Short Geriatric Depression Scale (GDS-15) were used to investigate 459 older adults in China. The results showed that there was a positive correlation between mobile phone addiction and sleep quality in the elderly. In addition, depression and loneliness partially mediated the relationship between mobile phone addiction and sleep quality in older adults. The current study provides new insights into the impact of mobile phone addiction on sleep quality and the importance of depression and loneliness in older adults. The limitations and significance of this study are discussed.
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Li XL, Wei J, Zhang X, Meng Z, Zhu W. Relationship between night-sleep duration and risk for depression among middle-aged and older people: A dose-response meta-analysis. Front Physiol 2023; 14:1085091. [PMID: 36935736 PMCID: PMC10017495 DOI: 10.3389/fphys.2023.1085091] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Objective: The study aimed to examine the dose-response associations between night-sleep duration and depression risk in middle-aged and older adults. Methods: We searched PubMed, Embase, Web of Science, CNKI, VIP, and the Wanfang data knowledge service platforms from inception to 31 July 2022. Cohort and case-control studies assessing the relationship between night-sleep duration and depression were selected. We used the Newcastle-Ottawa scale to assess the quality of the published research. Two researchers carried out data extraction and quality assessment. The restricted cubic spline function and generalized least squares method were used to establish dose-response relationships between sleep duration and depression. We aimed to analyze the estimated effect size presented as the risk ratio (RR) and its 95% confidence interval (CI) using Stata 12.0. Result: Six cohort studies with 33,595 participants were included in this meta-analysis. A U-shaped association between sleep duration and depression risk was revealed. On one hand, compared with 7-h of night sleep, both shorter and longer sleep duration were associated with an increased risk of depression (5 h: risk ratio = 1.09, 95% confidence interval = 1.07-1.12; 6 h: RR = 1.03, 95% CI = 1.02-1.04; 8 h: RR = 1.10, 95% CI = 1.05-1.15; 9 h: RR = 1.31, 95% CI = 1.17-1.47; 10 h: RR = 1.59, 95% CI = 1.31-1.92; non-linear test p < 0.05). On the other hand, an increased risk of depression with shorter sleep duration was observed in middle-aged and older people among the non-Asian population (5 h: RR = 1.09; 95% CI = 1.02-1.17), while both shorter and longer sleep duration can increase the risk of depression among an Asian population (5 h: RR = 1.10, 95% CI = 1.07-1.13; 6 h: RR = 1.04, 95% CI = 1.02-1.05; 8 h: RR = 1.09, 95% CI = 1.05-1.14; 9 h: RR = 1.35, 95% CI = 1.18-1.53; 10 h: RR = 1.70, 95% CI = 1.36-2.12). Conclusion: The lowest-risk onset of depression occurred among middle-aged and older people with 7 h of night sleep, which suggested that shorter and longer night-sleep duration might lead to an increased incidence of depression. Clinical Trial Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=344052, identifier 344052.
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Affiliation(s)
- Xin-lin Li
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jiayin Wei
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Xinying Zhang
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Zhuo Meng
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Wentao Zhu
- School of Management, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Wentao Zhu, ,
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Scharfenberg D, Schild AK, Warnke C, Maier F. A Network Perspective on Neuropsychiatric and Cognitive Symptoms of the Post-COVID Syndrome. EUROPES JOURNAL OF PSYCHOLOGY 2022; 18:350-356. [PMID: 36605094 PMCID: PMC9780734 DOI: 10.5964/ejop.10097] [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: 08/19/2022] [Accepted: 09/25/2022] [Indexed: 12/05/2022]
Abstract
Many patients that were infected with SARS-CoV-2 experience cognitive and affective symptoms weeks and months after their acute COVID-19 disease, even when acute symptoms were mild to moderate. For these patients, purely neurological explanations are struggling to explain the development and maintenance of the great variety of neuropsychiatric and cognitive symptoms occurring after COVID-19. We provide a psychological perspective based on the network theory of mental disorders as an added explanation that does not displace neurological mechanism but rather complements them. We suggest viewing the SARS-CoV-2 infection as a trigger that first activates nodes in a causally connected network of neuropsychiatric and cognitive symptoms. In the following, activation will spread throughout the network that will get in a self-sustaining stable and dysfunctional state manifesting in ongoing symptoms known as post-COVID-19 syndrome. The network perspective allows to generalize explanations for persistent neuropsychiatric and cognitive symptoms to patients that experienced mild or moderate acute courses of COVID-19, but also to similar phenomena following other viral infections. In addition, it could explain why some symptoms did not occur during acute COVID-19, but develop weeks or months after it. This network perspective shifts the focus from viewing persistent symptoms as a continuation of COVID-19 to acknowledging it as a complex syndrome that indeed originates from the disease but fully unfolds after it (post-COVID). To test the presented network perspective, we will need extensive cross-sectional as well as longitudinal data on cognitive and neuropsychiatric symptoms in post-COVID patients.
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Affiliation(s)
- Daniel Scharfenberg
- Medical Psychology | Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ann-Katrin Schild
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Clemens Warnke
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Franziska Maier
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Hausman HK, Dai Y, O’Shea A, Dominguez V, Fillingim M, Calfee K, Carballo D, Hernandez C, Perryman S, Kraft JN, Evangelista ND, Van Etten EJ, Smith SG, Bharadwaj PK, Song H, Porges E, DeKosky ST, Hishaw GA, Marsiske M, Cohen R, Alexander GE, Wu SS, Woods AJ. The longitudinal impact of the COVID-19 pandemic on health behaviors, psychosocial factors, and cognitive functioning in older adults. Front Aging Neurosci 2022; 14:999107. [PMID: 36506467 PMCID: PMC9732386 DOI: 10.3389/fnagi.2022.999107] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/31/2022] [Indexed: 11/27/2022] Open
Abstract
Background: Older adults are at a greater risk for contracting and experiencing severe illness from COVID-19 and may be further affected by pandemic-related precautions (e.g., social distancing and isolation in quarantine). However, the longitudinal impact of the COVID-19 pandemic on older adults is unclear. The current study examines changes in health behaviors, psychosocial factors, and cognitive functioning in a large sample of older adults using a pre-pandemic baseline and longitudinal follow-up throughout 9 months of the COVID-19 pandemic. Methods: One hundred and eighty-nine older adults (ages 65-89) were recruited from a multisite clinical trial to complete additional virtual assessments during the COVID-19 pandemic. Mixed effects models evaluated changes in health behaviors, psychosocial factors, and cognitive functioning during the pandemic compared to a pre-pandemic baseline and over the course of the pandemic (i.e., comparing the first and last COVID-19 timepoints). Results: Compared to their pre-pandemic baseline, during the pandemic, older adults reported worsened sleep quality, perceived physical health and functioning, mental health, slight increases in depression and apathy symptoms, reduced social engagement/perceived social support, but demonstrated better performance on objective cognitive tasks of attention and working memory. Throughout the course of the pandemic, these older adults reported continued worsening of perceived physical health and function, fewer depression symptoms, and they demonstrated improved cognitive performance. It is important to note that changes on self-report mood measures and cognitive performance were relatively small regarding clinical significance. Education largely served as a protective factor, such that greater years of education was generally associated with better outcomes across domains. Conclusions: The present study provides insights into the longitudinal impact of the COVID-19 pandemic on health behaviors, psychosocial factors, and cognitive functioning in a population disproportionately affected by the virus. Replicating this study design in a demographically representative older adult sample is warranted to further inform intervention strategies targeting older adults negatively impacted by the COVID-19 pandemic.
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Affiliation(s)
- Hanna K. Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Yunfeng Dai
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL,, United States
| | - Andrew O’Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Vanessa Dominguez
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Matthew Fillingim
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Kristin Calfee
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Daniela Carballo
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Cindy Hernandez
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Sean Perryman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Jessica N. Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Nicole D. Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Emily J. Van Etten
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Samantha G. Smith
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Pradyumna K. Bharadwaj
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Hyun Song
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Eric Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Steven T. DeKosky
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Georg A. Hishaw
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer’s Disease Consortium, Tucson, AZ, United States
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Gene E. Alexander
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States,Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer’s Disease Consortium, Tucson, AZ, United States
| | - Samuel S. Wu
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL,, United States
| | - Adam J. Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States,*Correspondence: Adam J. Woods
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Yue Z, Zhang Y, Cheng X, Zhang J. Sleep Quality among the Elderly in 21st Century Shandong Province, China: A Ten-Year Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14296. [PMID: 36361172 PMCID: PMC9656170 DOI: 10.3390/ijerph192114296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/24/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Despite the enormous changes observed in China since entering the 21st century, little is known about changes in sleep quality among older adults. AIMS The purpose of this study is to explore the changes, features, and influence factors of sleep quality among the elderly in a ten-year period, providing evidence for sleep-quality enhancement. METHODS The data were obtained from the data of epidemiological sampling surveys on mental disorders in Shandong province in 2004 and 2015. A total of 4451 subjects (aged ≥ 60 years) in 2004 and 10,894 subjects (aged ≥ 60 years) in 2015 were selected by the multistage stratified sampling method. The demographic information and Pittsburgh Sleep Quality Index (PSQI) were collected. RESULTS The adjusted 1-month prevalence of poor sleep in 2015 was 22.5% (95% CI:21.7-23.3), which is lower than that in 2004 (24.8%) (95% CI:23.5-26.0, p = 0.002). The total score of the PSQI in 2015 (4.74 ± 3.96) was lower than that in 2004 (4.97 ± 4.18, p = 0.002). In 2015, a binary multi-factor logistic and stepwise regression analysis showed that being female, living in a rural area, living alone, being older, spending less years in school, and being jobless/unemployed made the participants more likely to develop poor sleep (p < 0.05, p < 0.01). CONCLUSIONS In 2015, the overall sleep quality of the elderly (aged ≥ 60) in Shandong province was significantly improved compared to 2004. After more than 10 years, the characteristics of the elderly with sleep disturbances in Shandong province has changed. Therefore, more attention should be paid to gender, location of residence (rural or urban), living arrangement, age, education, occupation, and other factors to improve the sleep quality of the elderly.
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Affiliation(s)
- Zenghe Yue
- Shandong Mental Health Center, Shandong University, Jinan 250014, China
| | - Yi Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Xiaojing Cheng
- Shandong Mental Health Center, Shandong University, Jinan 250014, China
| | - Jingxuan Zhang
- Shandong Mental Health Center, Shandong University, Jinan 250014, China
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Oh S, Kim S, Sung E, Kim CH, Kang JH, Shin H, Cho IY. The association between cotinine-measured smoking
intensity and sleep quality. Tob Induc Dis 2022; 20:77. [PMID: 36118556 PMCID: PMC9443078 DOI: 10.18332/tid/152221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/29/2022] [Accepted: 07/19/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION METHODS RESULTS CONCLUSIONS
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Affiliation(s)
- Supa Oh
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sinae Kim
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eunju Sung
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Cheol-Hwan Kim
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae-Heon Kang
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hocheol Shin
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - In Young Cho
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Aguilar-Latorre A, Pérez Algorta G, Navarro-Guzmán C, Serrano-Ripoll MJ, Oliván-Blázquez B. Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care. Front Med (Lausanne) 2022; 9:954644. [PMID: 35957845 PMCID: PMC9361711 DOI: 10.3389/fmed.2022.954644] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022] Open
Abstract
Background Depression symptoms are prevalent in the general population, and their onset and continuation may be related to biological and psychosocial factors, many of which are related to lifestyle aspects. Health promotion and lifestyle modification programmes (LMPs) may be effective on reducing the symptoms. The objective of this study was to analyse the clinical effectiveness of a LMP and a LMP plus Information and Communication Technologies, when compared to Treatment as Usual (TAU) over 6 months. The interventions were offered as an adjuvant treatment delivered in Primary Healthcare Centers (PHCs) for people with depression symptoms. Methods We conducted an open-label, multicentre, pragmatic, randomized clinical trial. Participants were recruited from several PHCs. Those participants visiting general practitioner for any reason, who also met the inclusion criteria (scoring 10 to 30 points on the Beck II Self-Applied Depression Inventory) were invited to take part in the study. TAU+LMP consisted of six weekly 90-min group sessions focused on improving lifestyle. TAU+LMP + ICTs replicated the TAU+LMP format, plus the addition of a wearable smartwatch to measure daily minutes walked and sleep patterns. A total of 188 participants consented to participate in the study and were randomized. We used linear mixed models, with a random intercept and an unstructured covariance to evaluate the impact of the interventions compared to TAU. Results Both interventions showed a statistically significant reduction on depressive symptoms compared to TAU (TAU+LMP vs. TAU slope difference, b = −3.38, 95% CI= [−5.286, −1.474] p = 0.001 and TAU+LMP+ICTs vs. TAU slope difference, b = −4.05, 95% CI = [−5.919, −2.197], p < 0.001). These reductions imply a moderate effect size. In the TAU+LMP+ICTs there was a significant increase regarding minutes walking per week (b = 99.77) and adherence to Mediterranean diet (b = 0.702). In the TAU+LMP there was a significant decrease regarding bad sleep quality (b = −1.24). Conclusion TAU+LMPs administered in PHCs to people experiencing depression symptoms were effective on reducing these symptoms compared to TAU. They also have a positive impact on changing several lifestyle factors. These findings indicate that these interventions can be promising strategies for PHCs.
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Affiliation(s)
- Alejandra Aguilar-Latorre
- Primary Healthcare Center Arrabal, Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Guillermo Pérez Algorta
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | | | - María J. Serrano-Ripoll
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
- Research in Preventive Activities and Promotion and in Cancer Illes Balears (GRAPP-CAIB), Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- *Correspondence: María J. Serrano-Ripoll
| | - Bárbara Oliván-Blázquez
- Primary Healthcare Center Arrabal, Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
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Barrenetxea J, Pan A, Feng Q, Koh WP. Factors associated with depression across age groups of older adults: The Singapore Chinese health study. Int J Geriatr Psychiatry 2022; 37. [PMID: 34816486 DOI: 10.1002/gps.5666] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 11/21/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES We studied sociodemographic and health factors associated with depression across three age groups of community-dwelling older adults. METHODS/DESIGN We used data from 16,785 participants from the third follow-up of the Singapore Chinese Health Study (mean age: 73, range: 61-96 years). We defined depression as having a score of ≥5 using the 15-item Geriatric Depression Scale. We used regression splines to examine the pattern of depression risk with age and applied multivariable logistic regression to study factors associated with depression. RESULTS Increasing age was associated with depression in an inverted J-shape relationship with the highest odds ratio (OR) at age 75. Compared to the youngest-old (<70 years), the middle-old (70-80 years) had higher odds of depression [OR = 1.20, 95% confidence interval (CI) = 1.09-1.31], while the oldest-old (>80 years) had no increased risk (OR = 1.01, 95% CI = 0.89-1.15). We also found demographic (men, lower education, unemployment), social (living alone, poor social support, no social activity) and health factors (instrumental limitations, poor physical function, function-limiting pain, chronic diseases, cognitive impairment, poor sleep quality, poor self-rated health) associated with depression. In stratified analysis by age groups, the OR estimates for lower education level, instrumental limitations and cognitive impairment decreased with age, whereas the risk of depression for men increased with age (all p-values for interaction<0.03). CONCLUSIONS Compared to the youngest-old, the likelihood of depression was highest among middle-old adults and decreased to null in the oldest-old. The associations between some factors and depression were attenuated with age, suggesting a coping mechanism among oldest-old survivors.
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Affiliation(s)
- Jon Barrenetxea
- Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore
| | - An Pan
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qiushi Feng
- Department of Sociology & Centre for Family and Population Research, National University of Singapore, Singapore
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore
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Hwang G, Cho YH, Kim EJ, Woang JW, Hong CH, Roh HW, Son SJ. Differential Effects of Sleep Disturbance and Malnutrition on Late-Life Depression Among Community-Dwelling Older Adults. Front Psychiatry 2022; 13:820427. [PMID: 35599763 PMCID: PMC9122027 DOI: 10.3389/fpsyt.2022.820427] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Late-life depression is a complex phenomenon that cannot be fully understood simply as depression occurring in older adults, prompting researchers to suggest that it represents a component of geriatric syndrome. Given the inherent complexity and multifactorial nature of geriatric syndrome, understanding the interactions between the comorbid conditions involved is important for establishing appropriate preventive strategies. While sleep disturbance and malnutrition are common manifestations of geriatric syndrome, they have also been regarded as indicators of late-life depression. However, the differential effects of sleep disturbance and malnutrition on late-life depression and their interrelationships remain unclear. OBJECTIVE The objective of this study was to examine the effects of sleep disturbance and malnutrition on depression and the interactions between them among community-dwelling older adults. METHODS Sleep disturbance and malnutrition in 1,029 community-dwelling older adults from Suwon Geriatric Mental Health Center were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Mini Nutritional Assessment (MNA), respectively. The Korean version of the Short Form of the Geriatric Depression Scale (SGDS-K) was used to evaluate depressive symptoms. Sociodemographic parameters were recorded. A multiple linear regression analysis was conducted to examine the effects of sleep and nutrition on depressive symptoms after adjusting for covariates. The effect size and conditional effects of sleep disturbance and malnutrition on late-life depression were assessed using Cohen's f2 values and the Johnson-Neyman technique, respectively. RESULTS After possible confounders were adjusted, the SGDS-K score was positively associated with the PSQI score (standardized beta = 0.166, P < 0.001) and negatively associated with the MNA score (standardized beta = -0.480, P < 0.001). The local effect size of the associations was small for PSQI and medium for MNA. A significant interaction was observed between the PSQI and MNA scores. The result of the Johnson-Neyman technique indicated that the influence of PSQI on SGDS-K became weaker and insignificant as nutritional status worsened. However, the association between the MNA and SGDS-K scores was significant regardless of PSQI. CONCLUSION Both sleep disturbance and malnutrition were significantly associated with late-life depression, although malnutrition may be more critically associated with depression than sleep disturbance in community-dwelling older adults.
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Affiliation(s)
- Gyubeom Hwang
- Department of Psychiatry, Ajou University School of Medicine, Suwon, South Korea
| | - Yong Hyuk Cho
- Department of Psychiatry, Ajou University School of Medicine, Suwon, South Korea
| | - Eun Jwoo Kim
- Suwon Geriatric Mental Health Center, Suwon, South Korea
| | - Ji Won Woang
- Suwon Geriatric Mental Health Center, Suwon, South Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, South Korea
| | - Hyun Woong Roh
- Department of Psychiatry, Ajou University School of Medicine, Suwon, South Korea.,Suwon Geriatric Mental Health Center, Suwon, South Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, South Korea.,Suwon Geriatric Mental Health Center, Suwon, South Korea
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Drew RJ, Morgan PJ, Collins CE, Callister R, Kay-Lambkin F, Kelly BJ, Young MD. Behavioral and Cognitive Outcomes of an Online Weight Loss Program for Men With Low Mood: A Randomized Controlled Trial. Ann Behav Med 2021; 56:1026-1041. [PMID: 34964449 DOI: 10.1093/abm/kaab109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Depression and obesity are major health concerns and commonly co-exist, but men rarely seek help for these conditions. SHED-IT: Recharge was a gender-tailored eHealth program for men that generated clinically meaningful improvements in weight and depressive symptoms. PURPOSE To evaluate behavioral and psychological outcomes from the SHED-IT: Recharge intervention designed for overweight/obese men with low mood. METHODS Overall, 125 men (18-70 years) with a BMI between 25 and 42 kg/m2 and depressive symptoms (PHQ-9 ≥ 5) were randomly allocated to SHED-IT: Recharge (n = 62) or wait-list control (n = 63) groups. The self-directed program targeted key health behaviors combined with online mental fitness modules based on cognitive behavioral therapy. Behavioral (e.g., physical activity) and psychological outcomes (e.g., cognitive flexibility) were assessed with validated measures at baseline, 3 months (post-test) and 6 months (follow-up). Intention-to-treat linear mixed models examined treatment effects, which were adjusted for covariates, and effect size estimated (Cohen's d). RESULTS At post-test, intervention men achieved small-to-medium improvements in several health behavior outcomes including moderate-to-vigorous physical activity, light physical activity, sedentary behavior, sleep, energy intake, portion size, and risky alcohol consumption (range, d = 0.3-0.5), when compared with the control group. Intervention effects were also observed for perceived physical self-worth, perceived physical strength, cognitive flexibility, and behavioral activation (range, d = 0.3-0.8). No effects were found for fruit and vegetable intake, or mindful attention. Most effects were maintained at follow-up. CONCLUSIONS This gender-tailored, eHealth program with integrated mental fitness support elicited meaningful improvements in health behaviors and psychological outcomes for men with low mood. Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN12619001209189).
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Affiliation(s)
- Ryan J Drew
- Priority Research Centre for Physical Activity and Nutrition, School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, New South Wales, Australia
| | - Philip J Morgan
- Priority Research Centre for Physical Activity and Nutrition, School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, New South Wales, Australia
| | - Clare E Collins
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Frances Kay-Lambkin
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Brian J Kelly
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Myles D Young
- Priority Research Centre for Physical Activity and Nutrition, School of Psychology, College of Engineering, Science and Environment, University of Newcastle, Callaghan, New South Wales, Australia
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Tetsuka S. Depression and Dementia in Older Adults: A Neuropsychological Review. Aging Dis 2021; 12:1920-1934. [PMID: 34881077 PMCID: PMC8612610 DOI: 10.14336/ad.2021.0526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/26/2021] [Indexed: 01/23/2023] Open
Abstract
Depression and dementia are the most common neuropsychiatric disorders in the older adult population. There are a certain number of depressed patients who visit outpatient clinics because they suspect dementia due to similarities in the clinical symptoms in both disorders. Depressive symptoms associated with dementia may be diagnosed with depression, and treatment with antidepressants is continued for a long time. Depression and dementia differ in their treatment approaches and subsequent courses, and it is necessary to carefully differentiate between the two in the clinical practice of dementia treatment. In this review, I describe the similarities between depression and dementia and how to differentiate depression in dementia treatment based on the differences and emphasize that there is a significant potential to cure depression, in contrast to dementia, for which there is currently no fundamental therapy. Therefore, it is important to recognize that depression and dementia may present with common symptoms and to appropriately differentiate depressed patients who are suspected of having dementia. Dementia is a disorder in which cognitive dysfunction is caused by a variety of causative diseases and conditions, resulting in impairment of activities of daily living. However, current medical science has had difficulty finding a cure for the causative disease. Based on clinical findings, it has also been shown that the degree of symptoms for preexisting psychiatric disorders is alleviated as the brain ages. In the presence of dementia, the speed of the alleviation will increase. The importance of focusing on the positive aspects of aging is also discussed.
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Affiliation(s)
- Syuichi Tetsuka
- Department of Neurology, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, 329-2763, Japan
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Validation of the geriatric sleep questionnaire. Sleep Med 2021; 88:162-168. [PMID: 34763253 DOI: 10.1016/j.sleep.2021.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/27/2021] [Accepted: 10/13/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Assessing sleep in later life is essential for diagnosing and treating sleep problems and their consequences. We aimed to test a short questionnaire specifically designed to assess the subjective sleep quality in older people, the Geriatric Sleep Questionnaire (GSQ). METHOD The GSQ was validated in a Portuguese sample of older people (N = 443; 65-100 years; M = 80.02; SD = 6.95). We analyzed reliability, factor validity, convergent validity with other theoretical similar constructs, discriminant validity with a theoretically divergent measure, and predictive power to detect sleep problems (ROC analysis). RESULTS A six-item version was obtained with good reliability (Cronbach's α = 0.79), and adequate convergent and divergent validity (p < 0.01). ROC analysis revealed a sensitivity of 80.0% and a specificity of 66.7% in detecting sleep problems with a cutoff point of 16 (AUC = 0.72). Older people in social care, low education, and living in rural areas reported worse sleep quality. CONCLUSION The GSQ-6 is a brief instrument with good psychometric characteristics to assess the subjective sleep quality in older people. The GSQ-6 seems to be a valuable tool for future investigations on the relationship of sleep quality with mental health and well-being in older people.
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Alnaser AR, Joudeh RM, Zitoun OA, Battah A, Al-Odat I, Jum’ah M, Battah AA. The impact of COVID-19 pandemic on medical students’ mental health and sleep quality in Jordan: a nationwide cross-sectional study. MIDDLE EAST CURRENT PSYCHIATRY 2021. [PMCID: PMC8546377 DOI: 10.1186/s43045-021-00150-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background COVID-19 pandemic is expected to affect the mental health, especially among medical students. Data from the literature in Jordan are scarce, especially during the second wave of the pandemic. We aimed to assess medical students’ level of fear, prevalence of depressive and anxiety symptoms—represented in psychological distress (PD)—and sleep quality (SQ) amid the current pandemic of COVID-19. A total of 2104 students were included through convenient sampling from the six schools of Medicine in Jordan. Online-based questionnaire using Patient Health Questionnaire-4 (PHQ-4) scale, Fear of COVID-19 scale (FCV-19S), and Sleep Quality Scale (SQS) was used to collect the data. Chi-square, t-tests, and ANOVA were used to establish the associations. Results 88.4% and 47.4% of the students were found to have PD and poor or just fair sleep quality on SQS, respectively, with PD ranging from mild (18.6%) to severe (42.1%). Calculated FCV-19S score was 14.62 (SD=5.38), indicating high level of fear. Students with excellent SQ had significantly lower rates of depression, anxiety, and PD as compared to those with good, fair, and poor SQ (P < 0.001 for all). Conclusion Jordanian medical students appear to be especially susceptible to COVID-19 pandemic impact on mental health and reported high rates of PD. While rates of COVID-19 fear are still considered high, they are remarkably lower than that reported in early studies. We strongly recommend providing resources and access to professional mental health care to students reporting poor SQ and/or symptoms of anxiety and depression. Limitations Using a cross-sectional design, online-based survey, convenient sampling, and scarcity of local literature are among the inevitable limitations caused by the pandemic that have prevented us from drawing cause-effect associations.
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Kakazu VA, Pinto RZ, Dokkedal-Silva V, Fernandes GL, Gobbi C, Andersen ML, Tufik S, Pires GN, Morelhão PK. Sleep Quality, Body Mass Index and Waist-to-Hip Ratio in Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2021.1994098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Viviane Akemi Kakazu
- Departamento de Fisioterapia, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Presidente Prudente, Brazil
| | - Rafael Zambelli Pinto
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Vinicius Dokkedal-Silva
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Cynthia Gobbi
- Departamento de Fisioterapia, Universidade Cesumar, Maringá, Brazil
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Priscila Kalil Morelhão
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Tsai LC, Chen SC, Chen YC, Lee LY. The impact of physical pain and depression on sleep quality in older adults with chronic disease. J Clin Nurs 2021; 31:1389-1396. [PMID: 34498323 DOI: 10.1111/jocn.16000] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/15/2021] [Accepted: 07/29/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES This study's purpose was to identify the correlates of sleep quality in older adults with chronic disease. BACKGROUND Sleep quality is a common problem in older adults that may be affected by physical and mental status. DESIGN A cross-sectional correlational design was employed. METHODS The study was conducted between July 2019 and April 2020 in a teaching hospital of southern Taiwan. The Geriatric Depression Scale, Pittsburgh Sleep Quality Index and Numerical Rating Scale were used to assess depression, sleep quality and physical pain respectively. RESULTS Of the 120 older adults (age >65 years) with chronic disease, the average Pittsburgh Sleep Quality Index score was 5.67. A total of 45.8% subjects had sleep disturbance. Older adults who were living with a partner and those who urinated at night were significantly more likely to report sleep disturbance. The presence of sleep disturbance was associated with greater levels of depression and higher levels of physical pain. CONCLUSION Living with a partner, nocturia, physical pain and depression were associated with the presence of sleep disturbance in older adults with chronic disease. RELEVANCE TO CLINICAL PRACTICE The results of this study can help healthcare providers understand the factors associated with sleep disturbance in older adults with chronic disease, thereby facilitating the early resolution of sleep disturbance issues in this population.
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Affiliation(s)
- Li-Chuan Tsai
- China Medical University Beigang Hospital, Beigang, Taiwan (ROC)
| | - Shu-Ching Chen
- School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan (ROC).,School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan (ROC).,Department of Radiation Oncology and Proton and Radiation Therapy Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan (ROC)
| | - Yen-Chin Chen
- China Medical University Beigang Hospital, Beigang, Taiwan (ROC)
| | - Li-Yun Lee
- Department of Nursing, DA-YEH University, Changhua, Taiwan (ROC)
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Liu C, Zhao Y, Qin S, Wang X, Jiang Y, Wu W. Randomized controlled trial of acupuncture for anxiety and depression in patients with chronic insomnia. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1426. [PMID: 34733978 PMCID: PMC8506741 DOI: 10.21037/atm-21-3845] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/10/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Acupuncture treatment of chronic insomnia (CI) was effective. Anxiety and depression symptoms of the CI patients were improved to varying degrees after acupuncture treatment. Corticosterone (CORT) and 5-hydroxytryptamine (5-HT) are involved in the occurrence and development of comorbidity of insomnia, anxiety, and depression. Whether acupuncture can treat insomnia and accompany anxiety and depression symptoms by regulating CORT and 5-HT is still unclear. METHODS This was a randomized, single-blind (participant), parallel, placebo-controlled trial. Sixty CI patients were randomly divided into acupuncture and sham acupuncture groups, with 30 patients in each group. In the acupuncture group, acupuncture was applied at Baihui (GV20), Yintang (GV29), Shenmen (HT7, bilateral), and Sanyinjiao (SP6, bilateral), while in the sham acupuncture group, superficial needles were used on non-disorder-related acupoints. Both groups were treated 3 times a week (once every other day) for 4 weeks and at the 3-month follow-up. The patients were assessed using the Pittsburgh Sleep Quality Index (PQSI), Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD). The serum concentrations of CORT and 5-HT were also measured before and after treatment. RESULTS After treatment, the decrease in serum CORT and the increase in serum 5-HT were significantly greater in the acupuncture group than in the sham acupuncture group. At follow-up, the PSQI, HAMA, and HAMD scores in the acupuncture group were significantly lower than those in the sham acupuncture group. CONCLUSIONS Elevated serum CORT and decreased serum 5-HT levels may be associated with mood regulation disorders in CI patients. Acupuncture can significantly improve the sleep quality, efficiency, and latency of CI patients, and it can alleviate anxiety and depression in such patients. Compared with the sham acupuncture group, the acupuncture group showed a stable long-term efficacy. TRIAL REGISTRATION Chinese Clinical Trials Register ChiCTR1800020298.
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Affiliation(s)
- Chenyong Liu
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yanan Zhao
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shan Qin
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiaoqiu Wang
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuanyuan Jiang
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Wenzhong Wu
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Abstract
Emotions can be defined as states elicited by rewards or punishments, and indeed the neurology of emotional disorders can be understood in terms of this foundation. The orbitofrontal cortex in humans and other primates is a critical area in emotion processing, determining the value of stimuli and whether they are rewarding or nonrewarding. The cortical processing that occurs before the orbitofrontal cortex primarily involves defining the identity of stimuli, i.e., "what" is present and not reward value. There is evidence that this holds true for taste, visual, somatosensory, and olfactory stimuli. The human medial orbitofrontal cortex is important in processing many different types of reward, and the lateral orbitofrontal cortex in processing nonreward and punishment. Humans with damage to the orbitofrontal cortex have an impaired ability to identify facial and voice expressions of emotions, and impaired subjective experience of emotion. They can have an altered personality and be impulsive because they are impaired at processing failures to receive expected rewards and at processing punishments. In humans, the role of the amygdala in the processing of emotions is reduced because of the great evolutionary development of the orbitofrontal cortex: amygdala damage has much less effect on emotion than does orbitofrontal cortex damage. The orbitofrontal cortex projects reward value information to the anterior cingulate cortex, which is involved in learning those actions required to obtain rewards and avoid punishments. The cingulate cortex thus provides an output route for emotional behavior. In depression, the medial orbitofrontal cortex has decreased connectivity and sensitivity to reward, and the lateral orbitofrontal cortex has increased connectivity and sensitivity to nonreward. The orbitofrontal cortex has major projections to the anterior cingulate cortex, including its subcommissural region, and the anterior cingulate cortex is also implicated in depression.
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Affiliation(s)
- Edmund T Rolls
- Oxford Centre for Computational Neuroscience, Oxford, United Kingdom; Department of Computer Science, University of Warwick, Coventry, United Kingdom.
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Liu I, Huang YJ, Wang LK, Tsai YH, Hsu SL, Chang CJ, Li YH, Hsiao YC, Chen CY, Wann SR. Dual trajectories of loneliness and depression and their baseline correlates over a 14-year follow-up period in older adults: Results from a nationally representative sample in Taiwan. Int J Older People Nurs 2021; 16:e12410. [PMID: 34379889 DOI: 10.1111/opn.12410] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/30/2021] [Accepted: 07/12/2021] [Indexed: 11/28/2022]
Abstract
AIMS To explore the codevelopment between loneliness and depression in older adults, and to identify its potential baseline individual, family and extrafamilial correlates. BACKGROUND The number of older adults around the world has steadily increased over the last decades. Later life is a particularly vulnerable life stage due to multiple unfavourable conditions, and mental health in this stage appears to become an inescapable issue. Previous research has found the cross-sectional association between loneliness and depression, but their codevelopment has been understudied. Therefore, exploring the codevelopment and its correlates has significant implications for prevention and healthcare professionals. DESIGN A longitudinal follow-up study. METHODS The study used nationally representative data over a 14-year follow-up period from the Taiwan Longitudinal Study on Ageing focused on Taiwanese aged 60 years and above (n = 4049). Group-based trajectory modelling, group-based dual-trajectory modelling and multinomial logistic regression were the primary analytical methods. RESULTS We identified three distinct dual trajectories of loneliness and depression: longitudinal low-frequency lonely depressed (29.3%), longitudinal moderate-frequency lonely depressed (59.4%) and longitudinal high-frequency lonely depressed (11.3%). After considering several demographic and background characteristics, difficulty in physical functioning, number of physical symptoms and diseases, sleep quality and number of child deaths were found to be significantly associated. CONCLUSION Across the three identified dual-trajectory groups, they all showed a stable loneliness frequency pattern over time; however, the moderate-frequency group and high-frequency group both had a trajectory of increasing depression. It seems that depression tends to change over time in a worsening direction, especially for those with a certain frequency of loneliness. Furthermore, differences in individual and family correlates were found across the groups. IMPLICATIONS FOR PRACTICE Interventions focusing on the specific factors may help hinder coexisting loneliness and depression, and have implications for developing health promotion strategies and chronic disease care plans.
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Affiliation(s)
- I Liu
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Pingtung Branch, Pingtung, Taiwan
| | - Yu-Jen Huang
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Liang-Kai Wang
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Yi-Hsuan Tsai
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Sheng-Lun Hsu
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Chun-Jui Chang
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Ying-Hsien Li
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Yi-Chen Hsiao
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taiwan.,Institute of Health and Welfare Policy, School of Medicine, National Yang-Ming University, Taiwan
| | - Chun-Yuan Chen
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taiwan.,Biostatistics Center, Wan Fang Hospital, Taipei Medical University, Taiwan.,Research Institute and Centre for Global Child Health, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Canada
| | - Shue-Ren Wann
- Kaohsiung Veterans General Hospital, Pingtung Branch, Pingtung, Taiwan.,Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
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The Beneficial Role of Auricular Point Pressure in Insomnia and Anxiety in Isolated COVID-19 Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6611942. [PMID: 34306148 PMCID: PMC8282373 DOI: 10.1155/2021/6611942] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 05/09/2021] [Accepted: 06/25/2021] [Indexed: 12/27/2022]
Abstract
Background Coronavirus disease 2019 (COVID-19) causes psychological distress and can have a negative impact on the general mental health and rehabilitation in affected patients under currently implemented isolation guidelines. Auricular point pressure (APP) as well-established technique in traditional Chinese medicine may help to relieve sleep disturbance and anxiety in COVID-19 patients. Methods During the early phase of the epidemic/pandemic, patients were enrolled in this study (02/2020 until 03/2020 n = 84). They were strictly isolated on specific wards at the Hubei Provincial Hospital of Integrated Chinese and Western Medicine in Hubei. The retrospective cohort study design included two groups. Group A patients were treated with an auricular point pressure (APP) in addition to standard intensive care medicine while Group B participants (No-APP) received routine nursing measures alone. Treatment outcome was measured using the St. Mary's Hospital Sleep Questionnaire (SMH) Score and the 7-Item Generalized Anxiety Disorder Scale (GAD-7). Both scores were measured in each patient at baseline and on the discharge day. Results The SMH score and sleep status changed in APP patients at the end of the treatment period when compared with No-APP patients (P < 0.01). APP-treated patients demonstrated lower GAD-7 scores than No-APP controls (P < 0.01). Further, no significant differences in safety or adverse events between the APP and No-APP groups were observed. Conclusion The results from our snapshot study during the early phase of the SARS-CoV-2 epidemic/pandemic suggest that auricular point pressure could be a simple and effective tool to relieve insomnia and situational anxiety in hospitalized patients suffering from COVID-19 and kept under disconcerting conditions of isolation.
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DeViva JC, McCarthy E, Southwick SM, Tsai J, Pietrzak RH. The impact of sleep quality on the incidence of PTSD: Results from a 7-Year, Nationally Representative, Prospective Cohort of U.S. Military Veterans. J Anxiety Disord 2021; 81:102413. [PMID: 33991819 PMCID: PMC10693322 DOI: 10.1016/j.janxdis.2021.102413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/19/2021] [Accepted: 04/27/2021] [Indexed: 11/21/2022]
Abstract
Sleep and posttraumatic stress disorder (PTSD) have a complex relationship, with some studies showing that disrupted sleep is associated with subsequent development of PTSD. The purpose of the current study was to examine the relationship between sleep quality and the development of probable PTSD in U.S. veterans surveyed as part of the National Health and Resilience in Veterans Study, a 7-year, nationally representative, prospective cohort study with four waves of data collection. Sociodemographic, military, trauma, and clinical variables were entered into a multivariate analysis to examine independent determinants of new-onset PTSD. A total of 142 (7.3 %) veterans developed PTSD over the 7-year study period. Poor/fair sleep quality at Wave 1 was associated with 60 % greater likelihood of developing PTSD, with more than twice as many veterans who developed PTSD reporting poor sleep quality at Wave 1 (47.8 % vs. 20.7 %). Younger age, using the VA as a primary source of healthcare, greater traumas since Wave, and lifetime depression were additionally associated with this outcome. Results of this study underscore the importance of self-reported sleep quality as a potential risk factor for the development of PTSD in the U.S. veteran population.
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Affiliation(s)
- Jason C DeViva
- Veterans Affairs Connecticut Health Care System, 950 Campbell Ave., West Haven, CT, 06516, United States; Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT, 06511, United States.
| | - Elissa McCarthy
- National Center for PTSD, 163 Veterans Drive, White River Junction, VT, 05009, United States
| | - Steven M Southwick
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT, 06511, United States
| | - Jack Tsai
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT, 06511, United States; U.S. Department of Veterans Affairs National Center on Homelessness among Veterans, 50 Irving ST. NW, Washington, DC, 20422, United States; School of Public Health, University of Texas Health Science Center at Houston, 1200 Pressler St., Houston, TX, 77030, United States
| | - Robert H Pietrzak
- Veterans Affairs Connecticut Health Care System, 950 Campbell Ave., West Haven, CT, 06516, United States; Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT, 06511, United States; U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT, 06516, United States; Department of Social and Behavioral Sciences, Yale School of Public Health, Laboratory of Epidemiology and Public Health, 60 College St., New Haven, CT, 06510, United States
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Eight-week high-intensity interval training is associated with improved sleep quality and cardiorespiratory fitness in patients with depressive disorders. Sleep Breath 2021; 26:397-406. [PMID: 34046817 DOI: 10.1007/s11325-021-02388-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This study aimed to examine the effect of high-intensity interval training (HIIT) on both sleep and cardiorespiratory fitness in patients with depression. METHODS Using a single pre- and post-test study design with no control group, 82 patients diagnosed with depressive disorders underwent HIIT comprising a total of 24 15-min sessions, three times per week for 8 weeks. Depressive symptoms, sleep quality, and cardiorespiratory fitness were evaluated using the Beck depression inventory-II, the Pittsburgh sleep quality index (PSQI), and cardiopulmonary exercise testing (CPET) in the form of maximum oxygen uptake (VO2 max), respectively. RESULTS All 82 patients completed the intervention. HIIT training was associated with significant improvements in BDI-II score (diff = - 1.57 [95% CI - 2.40 to - 0.73], P = 0.001), PSQI score (diff = - 1.20 [95% CI - 2.10 to - 0.32], P = 0.008), and CPET VO2 max (diff = 0.95 [95% CI 0.62-1.28], P = 0.001). Effect size calculations revealed that the greatest improvement occurred in CPET VO2 max (Cohen's d = 0.64) and that improvements in the BDI-II and PSQI scores were somewhat smaller in magnitude (Cohen's d = - 0.41 and - 0.30, respectively). Sleep quality improvements were observed in sleep latency, habitual sleep efficiency, and the use of sleep-promoting medications (Cohen's d = 0.18, 0.19, and 0.25, respectively). Change in cardiorespiratory fitness successfully predicted change in sleep quality but not in depressive symptoms. Adverse effects were limited to minor injuries which did not interfere with completion of training. CONCLUSIONS HIIT training delivered over 8 weeks was associated with improvements in depression symptoms, sleep quality, and cardiorespiratory fitness in patients with depressive disorders.
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Lee S, Deason K, Rancourt D, Gray HL. Disentangling the Relationship between Food Insecurity and Poor Sleep Health. Ecol Food Nutr 2021; 60:580-595. [PMID: 34032535 DOI: 10.1080/03670244.2021.1926245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The COVID-19 pandemic has created disruptions in global and national food supply chains. Along with an increase in the unemployment rate, this resulted in a rise in food insecurity at the community-level, threatening individual and family well-being. Food insecurity is associated with inadequate nutrient intakes, weight gain, and psychological distress, including anxiety and depressive symptoms, all of which are known to affect sleep. Yet, little is known about whether and how food insecurity is associated with sleep health, a critical but underrecognized health outcome. This paper reviews literature describing associations between food insecurity and sleep, summarizes key findings based on proposed mechanisms, and discusses directions for future research.
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Affiliation(s)
- Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Karley Deason
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Heewon L Gray
- College of Public Health, University of South Florida, Tampa, Florida, USA
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