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Sun Y, Li X, Liu H, Li Y, Gui J, Zhang X, Li X, Sun L, Wang C, Li J, Liu M, Zhang D, Gao J, Kang X, Lei Y, Zhang L, Yuan T. Predictive role of depressive symptoms on frailty and its components in Chinese middle-aged and older adults: a longitudinal analysis. BMC Public Health 2024; 24:2201. [PMID: 39138460 PMCID: PMC11321163 DOI: 10.1186/s12889-024-19627-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 07/29/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND To investigate the cross-sectional and longitudinal associations between depressive symptoms and the prevalence of frailty and its components in a nationally representative sample of middle-aged and older Chinese adults. METHOD The China Health and Retirement Longitudinal Study (CHARLS) provided data on 2581 (after inclusion and exclusion criteria) adults aged ≥ 45 years. Every two years, face-to-face, computer-aided personal interviews (CAPI), and structured questionnaires were used to follow up with the respondents. The Chinese version of the Center for Epidemiologic Studies-Depression Scale (CES-D) was used to evaluate depressive symptoms, and the Fried criteria were used to measure frailty. The odds ratio (OR) and 95% confidence interval (CI) for the association of exposure (depressive symptoms at baseline) with the onset of the outcome (frailty and its components) in the individuals at baseline were analyzed by binary logistic regression. RESULTS At baseline, 11.62% of participants had frailty, and 57.92% had depressive symptoms. In the cross-sectional analysis, depressive symptoms (OR = 5.222, 95%CI 3.665-7.442) were associated with frailty. In the longitudinal analysis, after adjusting for the full set of covariates among participants free of baseline frailty, depressive symptoms were significantly associated with incident frailty during the short term (OR = 2.193, 95%CI 1.324-3.631) and the long term (OR = 1.926, 95%CI 1.021-3.632). Meanwhile, depressive symptoms were associated with an increased risk of weakness (OR = 1.990, 95%CI 1.250-3.166), slowness (OR = 1.395, 95%CI 1.044-1.865), and exhaustion (OR = 2.827, 95%CI 2.150-3.719) onset during the short-term. Depressive symptoms were associated with an increased risk of exhaustion (OR = 2.869, 95%CI 2.004-4.109) onset during the long-term. CONCLUSION Among middle-aged and older adults, depressive symptoms could predict frailty during 2 years of follow-up and 4 years of follow-up. When considering potential confounding factors, depressive symptoms were considered a predictor of weakness, slowness, and exhaustion. Interventions aimed at preventing depressive symptoms may be beneficial in reducing frailty and its components.
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Affiliation(s)
- Yuanhao Sun
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, P.R. China
| | - Xiangdong Li
- Department of Gerontology, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Zheshan West Road, Yijishan District, Wuhu City, Anhui Province, P.R. China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Yuqing Li
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, P.R. China
| | - Jiaofeng Gui
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, P.R. China
| | - Xiaoyun Zhang
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, P.R. China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Jing Li
- Department of Surgery Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Mingming Liu
- Department of Surgery Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Jingyi Gao
- Department of Nursing School, Wannan Medical College, Wuhu, An Hui, P.R. China
| | - Xuefeng Kang
- Department of Nursing School, Wannan Medical College, Wuhu, An Hui, P.R. China
| | - Yunxiao Lei
- Department of Gynecology and Obstetrics Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Ting Yuan
- Department of Gynecology and Obstetrics Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China.
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Zhu X, Yue Y, Li L, Zhu L, Cai Y, Shu Y. The relationship between depression and relative fat mass (RFM): A population-based study. J Affect Disord 2024; 356:323-328. [PMID: 38614443 DOI: 10.1016/j.jad.2024.04.031] [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: 12/23/2023] [Revised: 03/27/2024] [Accepted: 04/08/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Relative fat mass (RFM) is a novel indicator for measuring body fat. The relationship between RFM and depression was explored using National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018. METHODS A general statistical description of the population included in the study was performed, and logistic analyses were used to explore the association between body mass index (BMI), waist circumference (WC), RFM and depression. Sensitivity analyses and restricted cubic spline (RCS) were also conducted to investigate the association between RFM and depression. RESULTS A total of 28,836 participants were included in the study. In multivariate models, all obesity indices were associated with depression (P < 0.001). An increase of 1 SD in BMI, WC, and RFM was associated with a respective increased risk of depression of 2.3 %, 1.0 %, and 3.3 %. Excluding those taking antidepressants, the risk of depression was OR 1.88 (95 % CI: 1.26-2.79) for those with RFM in the highest quartile compared with those in the lowest quartile. After Inverse probability of weighting (IPW), the risk of depression in individuals with RFM in the highest quartile compared with individuals in the lowest quartile was 2.62 (95 % CI: 2.21-3.09). The RCS showed a possible nonlinear relationship between RFM and depression. CONCLUSIONS RFM is associated with depression, suggesting that attention to RFM may be helpful for depression research.
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Affiliation(s)
- Xianlin Zhu
- Department of Clinical Psychology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Ya Yue
- Department of Psychiatry of Women and Children, The Second People's Hospital of Guizhou Province, Guiyang, China
| | - Lin Li
- Department of Clinical Psychology, Deyang City mental Health Center, Deyang, China
| | - Liying Zhu
- Medical Section, The Second People's Hospital of Huizhou, Huizhou, China
| | - Yuexi Cai
- Department of Psychiatry, Changzhou Dean Hospital, Changzhou, China
| | - Yanping Shu
- Department of Psychiatry of Women and Children, The Second People's Hospital of Guizhou Province, Guiyang, China.
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Li X, Li X, Sun L, Yang L, Wang C, Yuan T, Lei Y, Li J, Liu M, Zhang D, Hua Y, Liu H, Zhang L. The bidirectional relationship between activities of daily living and frailty during short-and long-term follow-up period among the middle-aged and older population: findings from the Chinese nationwide cohort study. Front Public Health 2024; 12:1382384. [PMID: 38746004 PMCID: PMC11091387 DOI: 10.3389/fpubh.2024.1382384] [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: 02/05/2024] [Accepted: 04/12/2024] [Indexed: 05/16/2024] Open
Abstract
Objective Frailty and activities of daily living (ADL) disability are common conditions among older population. Studies on the bidirectional relationship between frailty and ADL are limited. The current study examined the cross-sectional and longitudinal associations between frailty and ADL in middle-aged and older Chinese individuals. Methods The data was collected through the China Health and Retirement Longitudinal Study (CHARLS), conducted in 2011, 2013, and 2015, encompassing 17,284 individuals aged ≥45 years. We excluded individuals without follow-up data. 2,631 participants finished the baseline survey. The definition of ADL disability encompasses difficulty in engaging in either basic activities of daily living (BADL) or instrumental activities of daily living (IADL). Frailty was assessed according to the Fried criteria. Logistic regression was utilized to examine odds ratios (ORs) and 95% confidence intervals (CIs) for assessing the cross-sectional relationships between ADL with frailty at baseline. The prediction effects were explored using Cox proportional hazards analysis, testing hazard ratios (HRs) and 95%CIs. Results In cross-sectional analysis, BADL [OR = 6.660 (4.519-9.815)], IADL [OR = 5.950 (4.490-7.866)], and ADL [OR = 5.658 (4.278-7.483)] exhibited significant associations with frailty; frailty demonstrated significant associations with BADL [OR = 6.741 (4.574-9.933)], IADL [OR = 6.042 (4.555-8.016)] and ADL [OR = 5.735 (4.333-7.591)]. In longitudinal analysis, IADL and ADL were significantly associated with frailty in participants without baseline frailty in the short-term period [IADL: HR = 1.971 (1.150-3.379), ADL: HR = 1.920 (1.146-3.215)], IADL exhibited a significant association with frailty in the long-term period [HR = 2.056 (1.085-3.895)]. There was no significant link observed between frailty and an elevated risk of disability onset in BADL, IADL and ADL during the short-term period. When considering the long-term perspective, frailty exhibited a significant association with an elevated risk of disability onset in BADL [HR= 1.820 (1.126-2.939)] and IADL [HR = 1.724 (1.103-2.694)]. Conclusion In middle-aged and older adults, ADL and IADL disability predicted frailty after 2-year follow-up, IADL disability predicted frailty after 4-year follow-up. Moreover, frailty did not predict BADL, IADL and ADL disability after 2-year follow-up. However, frailty predicted BADL and IADL disability after 4-year follow-up.
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Affiliation(s)
- Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Xiaoguang Li
- National Center For Occupational Safety and Health, National Health Commission of the People’s Republic of China, Beijing, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wanna Medical College, Wuhu, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, China
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Sun Y, Li X, Liu H, Li Y, Gui J, Zhang X, Li X, Sun L, Wang C, Li J, Liu M, Zhang D, Gao J, Kang X, Lei Y, Zhang L, Yuan T. Predictive Role of Depressive Symptoms on Frailty and its Components in Chinese Middle-Aged and Older Adults: a Longitudinal Analysis. RESEARCH SQUARE 2024:rs.3.rs-3821620. [PMID: 38260409 PMCID: PMC10802750 DOI: 10.21203/rs.3.rs-3821620/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Background To investigate the cross-sectional and longitudinal associations between depressive symptoms and the prevalence of frailty and its components in a nationally representative sample of middle-aged and older Chinese adults. Method The China Health and Retirement Longitudinal Study (CHARLS) provided data on 17,104 adults aged ≥ 45 years. Every two years, face-to-face, computer-aided personal interviews (CAPI), and structured questionnaires were used to follow up with the respondents. The Chinese version of the Center for Epidemiologic Studies-Depression Scale (CES-D) was used to evaluate depressive symptoms, and the Fried criteria were used to measure frailty. The odds ratio (OR) and 95% confidence interval (CI) for the cross-sectional connections among depressive symptoms and frailty and its components in the individuals at baseline were analyzed using logistic regression. A Cox proportional hazards analysis was performed using the hazard ratio (HR) and 95% confidence interval for the prospective connection between baseline depressive symptoms and frailty and its component in the participants without frailty at baseline. Results At baseline, 11.62% of participants had frailty, and 57.92% had depressive symptoms. In the cross-sectional analysis, depressive symptoms (OR = 5.222, 95%CI 3.665-7.442) were associated with frailty. In the longitudinal analysis, after adjusting for the full set of covariates among participants free of baseline frailty, depressive symptoms were significantly associated with incident frailty during the short term [HR = 2.193 (1.324-3.631)] and the long term [HR = 1.926 (1.021-3.632)]. Meanwhile, depressive symptoms were associated with an increased risk of weakness [HR = 1.990 (1.250-3.166)], slowness [HR = 1.395 (1.044-1.865)], and exhaustion [HR = 2.827 (2.150-3.719)] onset during the short-term. Depressive symptoms were associated with an increased risk of exhaustion [HR = 2.869 (2.004-4.109)] onset during the long-term. Conclusion Among middle-aged and older adults, depressive symptoms could predict frailty during 2 years of follow-up and 4 years of follow-up. When considering potential confounding factors, depressive symptoms were considered a predictor of weakness, slowness, and exhaustion. Interventions aimed at preventing depressive symptoms may be beneficial in reducing frailty and its components.
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Affiliation(s)
| | - Xiangdong Li
- the First Affiliated Hospital of Wannan Medical College
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Lu G, Xiao S, He J, Xie W, Ge W, Meng F, Yang Y, Yu S, Liu R. Prevalence of depression and its correlation with anxiety, headache and sleep disorders among medical staff in the Hainan Province of China. Front Public Health 2023; 11:1122626. [PMID: 37441641 PMCID: PMC10333496 DOI: 10.3389/fpubh.2023.1122626] [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: 12/13/2022] [Accepted: 06/05/2023] [Indexed: 07/15/2023] Open
Abstract
Objective This cross-sectional survey aimed to investigate the prevalence of depression among medical staff and its risk factors as well as the association between depression, anxiety, headache, and sleep disorders. Methods Stratified random cluster sampling was used to select medical staff from various departments of four hospitals in Sanya City. The Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Pittsburgh Sleep Quality Index (PSQI) were used to quantitatively assess depression, anxiety, and sleep disorders. Correlation and regression analyses were performed to determine factors affecting the depression occurrence and scores. Results Among 645 medical staff members, 548 (85%) responded. The 1-year prevalence of depression was 42.7% and the prevalence of depression combined with anxiety, headache, and sleep disorders was 23, 27, and 34.5%, respectively. The prevalence of depression in women, nurses, the unmarried or single group, and the rotating-shift population was significantly higher than that in men (48.3% vs. 27.1%, odds ratio OR = 2.512), doctors (55.2% vs. 26.7%, OR = 3.388), the married group (50.5% vs. 35.8%, OR = 1.900), and the day-shift population (35.2% vs. 7.5%, OR = 1.719). The occurrence of depression was correlated with anxiety, sleep disorders, headache, and migraines, with anxiety having the highest correlation (Spearman's Rho = 0.531). The SDS was significantly correlated with the SAS and PSQI (Spearman's Rho = 0.801, 0.503) and was also related to the presence of headache and migraine (Spearman Rho = 0.228, 0.159). Multiple logistic regression indicated that nurse occupation and anxiety were risk factors for depression, while grades of anxiety, sleep disorders and nurse occupation were risk factors for the degree of depression in multiple linear regression. Conclusion The prevalence of depression among medical staff was higher than that in the general population, especially among women, nurses, unmarried people, and rotating-shift workers. Depression is associated with anxiety, sleep disorders, headache, and migraines. Anxiety and nursing occupation are risk factors for depression. This study provides a reference for the promotion of occupational health among medical professionals.
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Affiliation(s)
- Guangshuang Lu
- Department of Pediatrics, The Lu’an Hospital Affiliated to Anhui Medical University, The Lu’an People’s Hospital, Lu’an, China
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shaobo Xiao
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jiaji He
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wei Xie
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wei Ge
- Medical School of Chinese PLA, Beijing, China
| | - Fanchao Meng
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ying Yang
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shengyuan Yu
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ruozhuo Liu
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
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Wang Y, Zhang X, Li Y, Gui J, Mei Y, Yang X, Liu H, Guo LL, Li J, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Li J, Liu M, Hua Y, Zhang L. Predicting depressive symptom by cardiometabolic indicators in mid-aged and older adults in China: a population-based cross-sectional study. Front Psychiatry 2023; 14:1153316. [PMID: 37351000 PMCID: PMC10282944 DOI: 10.3389/fpsyt.2023.1153316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/19/2023] [Indexed: 06/24/2023] Open
Abstract
Objective Depressive symptom is a serious mental illness often accompanied by physical and emotional problems. The prevalence of depressive symptom in older adults has become an increasingly important public health priority. Our study used cardiometabolic indicators to predict depressive symptom in middle-aged and older adults in China. Methods The data came from the China Health and Retirement Longitudinal Study 2011 (CHARLS2011), which was a cross-sectional study. The analytic sample included 8,942 participants aged 45 years or above. The study evaluated the relationship between cardiometabolic indicators and depression by measuring 13 indicators, including body mass index (BMI), waist circumference, waist-height ratio (WHtR), conicity index, visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), a body shape index (ABSI), body roundness index (BRI), triglyceride glucose index (TyG-index) and its correlation index (TyG-BMI, TyG-waist circumference, TyG-WHtR). Binary logistic regression analysis was used to examine the association between thirteen cardiometabolic indicators and depressive symptom. In addition, the receiver operating characteristic (ROC) curve analysis and area under curve (AUC) were used to evaluate the predictive anthropometric index and to determine the optimum cut-off value. Results The study included 8,942 participants, of whom 4,146 (46.37%) and 4,796 (53.63%) were male and female. The prevalence of depressive symptom in mid-aged and older adults in China was 41.12% in males and 55.05% in females. The results revealed that BMI [AUC = 0.440, 95%CI: 0.422-0.457], waist circumference [AUC = 0.443, 95%CI: 0.425-0.460], WHtR [AUC = 0.459, 95%CI: 0.441-0.476], LAP [AUC = 0.455, 95%CI: 0.437-0.472], BRI [AUC = 0.459, 95%CI: 0.441-0.476], CVAI [AUC = 0.449, 95%CI: 0.432-0.467], TyG-BMI [AUC = 0.447, 95%CI: 0.429-0.465], and TyG-waist circumference [AUC =0.452, 95%CI: 0.434-0.470] were weak predictors of depressive symptom (p < 0.05) in males. In females, BMI [AUC = 0.470, 95%CI: 0.453-0.486], LAP [AUC = 0.484, 95%CI: 0.467-0.500], TyG-BMI [AUC = 0.470, 95%CI: 0.454-0.487], and TyG-waist circumference [AUC =0.481, 95%CI: 0.465-0.498] were weak predictors of depressive symptom (p < 0.05). On the other side, VAI, ABSI, conicity index and TyG index could not predict depressive symptom in middle-aged and older adults. Conclusion Most cardiometabolic indicators have important value in predicting depressive symptom. Our results can provide measures for the early identification of depressive symptom in middle-aged and older adults in China to reduce the prevalence of depressive symptom and improve health.
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Affiliation(s)
- Ying Wang
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Xiaoyun Zhang
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Yuqing Li
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Jiaofeng Gui
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Yujin Mei
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Xue Yang
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, An Hui, China
| | - Lei-lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Jinlong Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wanna Medical College, Wuhu, An Hui, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
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Association between adiposity and emergent depressive symptoms in a 10-years prospective cohort of older adults: The EpiFloripa Aging study. J Affect Disord 2023; 330:198-205. [PMID: 36907463 DOI: 10.1016/j.jad.2023.03.009] [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: 07/20/2022] [Revised: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND The association between obesity and depressive symptoms has been described in the literature, but there is a scarcity of longitudinal data. This study aimed to verify the association between body mass index (BMI) and waist circumference and the incidence of depressive symptoms over a 10-year follow-up in a cohort of older adults. METHODS Data from the first (2009-2010), second (2013-2014), and third (2017-2019) waves of the EpiFloripa Aging Cohort Study were used. Depressive symptoms were assessed by the 15-item Geriatric Depression Scale (GDS-15) and classified in significant depressive symptoms for those with ≥6 points. The Generalized Estimating Equations model was used to estimate the longitudinal association between BMI and waist circumference and depressive symptoms across a 10-year follow-up. RESULTS The incidence of depressive symptoms (N = 580) was 9.9 %. The relationship between BMI and the incidence of depressive symptoms in older adults followed a U-shaped curve. Older adults with obesity had an incidence relative ratio of 76 % (IRR = 1.24, p = 0.035) for increasing the score of depressive symptoms after 10 years, compared to those with overweight. The higher category of waist circumference (Male: ≥102; Female: ≥88 cm) was associated with depressive symptoms (IRR = 1.09, p = 0.033), only in a non-adjusted analysis. LIMITATIONS Relatively high follow-up dropout rate; Few individuals in the underweight BMI category; BMI must be considered with caution because it does not measure only fat mass. CONCLUSIONS Obesity was associated with the incidence of depressive symptoms when compared with overweight in older adults.
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Gui J, Li Y, Liu H, Guo LL, Li J, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Wei H, Li J, Liu M, Hua Y, Zhang L. Obesity- and lipid-related indices as a predictor of obesity metabolic syndrome in a national cohort study. Front Public Health 2023; 11:1073824. [PMID: 36875382 PMCID: PMC9980350 DOI: 10.3389/fpubh.2023.1073824] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/16/2023] [Indexed: 02/18/2023] Open
Abstract
Objective Metabolic syndrome is a common condition among middle-aged and elderly people. Recent studies have reported the association between obesity- and lipid-related indices and metabolic syndrome, but whether those conditions could predict metabolic syndrome is still inconsistent in a few longitudinal studies. In our study, we aimed to predict metabolic syndrome by obesity- and lipid-related indices in middle-aged and elderly Chinese adults. Method A national cohort study that consisted of 3,640 adults (≥45 years) was conducted. A total of 13 obesity- and lipid-related indices, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), conicity index (CI), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), a body shape index (ABSI), body roundness index (BRI), and triglyceride glucose index (TyG-index) and its correlation index (TyG-BMI, TyG-WC, and TyG-WHtR), were recorded. Metabolic syndrome (MetS) was defined based on the criteria of the National Cholesterol Education Program Adult Treatment Panel III (2005). Participants were categorized into two groups according to the different sex. Binary logistic regression analyses were used to evaluate the associations between the 13 obesity- and lipid-related indices and MetS. Receiver operating characteristic (ROC) curve studies were used to identify the best predictor of MetS. Results A total of 13 obesity- and lipid-related indices were independently associated with MetS risk, even after adjustment for age, sex, educational status, marital status, current residence, history of drinking, history of smoking, taking activities, having regular exercises, and chronic diseases. The ROC analysis revealed that the 12 obesity- and lipid-related indices included in the study were able to discriminate MetS [area under the ROC curves (AUC > 0.6, P < 0.05)] and ABSI was not able to discriminate MetS [area under the ROC curves (AUC < 0.6, P > 0.05)]. The AUC of TyG-BMI was the highest in men, and that of CVAI was the highest in women. The cutoff values for men and women were 187.919 and 86.785, respectively. The AUCs of TyG-BMI, CVAI, TyG-WC, LAP, TyG-WHtR, BMI, WC, WHtR, BRI, VAI, TyG index, CI, and ABSI were 0.755, 0.752, 0.749, 0.745, 0.735, 0.732, 0.730, 0.710, 0.710, 0.674, 0.646, 0.622, and 0.537 for men, respectively. The AUCs of CVAI, LAP, TyG-WC, TyG-WHtR, TyG-BMI, WC, WHtR, BRI, BMI, VAI, TyG-index, CI, and ABSI were 0.687, 0.674, 0.674, 0.663, 0.656, 0.654, 0.645, 0.645, 0.638, 0.632, 0.607, 0.596, and 0.543 for women, respectively. The AUC value for WHtR was equal to that for BRI in predicting MetS. The AUC value for LAP was equal to that for TyG-WC in predicting MetS for women. Conclusion Among middle-aged and older adults, all obesity- and lipid-related indices, except ABSI, were able to predict MetS. In addition, in men, TyG-BMI is the best indicator to indicate MetS, and in women, CVAI is considered the best hand to indicate MetS. At the same time, TyG-BMI, TyG-WC, and TyG-WHtR performed better than BMI, WC, and WHtR in predicting MetS in both men and women. Therefore, the lipid-related index outperforms the obesity-related index in predicting MetS. In addition to CVAI, LAP showed a good predictive correlation, even more closely than lipid-related factors in predicting MetS in women. It is worth noting that ABSI performed poorly, was not statistically significant in either men or women, and was not predictive of MetS.
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Affiliation(s)
- Jiaofeng Gui
- Department of Graduate School, Wannan Medical College, Wuhu, Anhui, China
| | - Yuqing Li
- Department of Graduate School, Wannan Medical College, Wuhu, Anhui, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, Anhui, China
| | - Lei-lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Jinlong Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Huanhuan Wei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wanna Medical College, Wuhu, Anhui, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
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Roy A, Barman P. Does BMI Really Matter to Our Overall Health? Findings from a Cross-sectional Analysis of Middle-aged and Older Adults in India. JOURNAL OF POPULATION AGEING 2023. [DOI: 10.1007/s12062-023-09413-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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10
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Xu J, Zhang H, Zhang T, Sun J, Shi Q, Liu J, Tian G, Zhang B, Wang H, Wu Q, Kang Z. The "jolly fat" for the middle-aged and older adults in China, was education level considered? J Affect Disord 2022; 317:347-353. [PMID: 36057286 DOI: 10.1016/j.jad.2022.08.093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/10/2022] [Accepted: 08/26/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Several studies have found a negative association between obesity and depression in Chinese middle-aged and elderly, suggesting the existence of "jolly fat". This study aims to investigate whether "jolly fat" is applicable among middle-aged and elderly with different education levels, and to provide a new perspective for depression screening and obesity interventions in middle-aged and older adults. METHODS 10,018 individuals aged 45 years and over in China Family Panel Study (2018) were selected for analysis. A short version of Center for Epidemiological Research Depression Scale was used to assess depression. Body mass index was applied to define obesity status. Subgroup analysis of multiple logistic regression was performed to explore whether the relationship between obesity and depression was influenced by education levels. RESULTS The prevalence of obesity and depression was 9.02 % and 22.96 % among participants. Obesity reduced the probability of depression in middle-aged and elderly with primary school education or below (OR = 0.71, 95 % CI = 0.56-0.91) while not affecting those with junior high school education or above (OR = 0.80, 95 % CI = 0.57-1.13). LIMITATIONS The results cannot be interpreted as causality due to the cross-sectional design. Besides, we cannot directly measure the body composition of the participants. CONCLUSIONS "Jolly fat" existed among middle-aged and elderly with low education, but not in those with junior high school education or above. Health care providers need to monitor the psychological status of low-educated middle-aged and older adults who are seen as needing to lose weight, while the underweight group should be the key target of depression screening.
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Affiliation(s)
- Jinpeng Xu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Hongyu Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Ting Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Jiale Sun
- Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Qi Shi
- School of Health Management, Harbin Medical University, Harbin, China
| | - Jian Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Guomei Tian
- Department of Nuclear Medicine, The Fourth Hospital of Harbin Medical University, Harbin, China
| | - Bokai Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Haixin Wang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Zheng Kang
- School of Health Management, Harbin Medical University, Harbin, China.
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11
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Chang HC, Gau SY. Environmental and cultural factors as concerns of depressive symptoms. Brain Behav Immun 2022; 106:179. [PMID: 36049706 DOI: 10.1016/j.bbi.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 08/25/2022] [Indexed: 10/31/2022] Open
Affiliation(s)
- Hui-Chin Chang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Library, Chung Shan Medical University Hospital, Taichung, Taiwan; Evidence-based Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shuo-Yan Gau
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
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12
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Yu M, Shi Y, Gu L, Wang W. "Jolly fat" or "sad fat": a systematic review and meta-analysis of the association between obesity and depression among community-dwelling older adults. Aging Ment Health 2022; 26:13-25. [PMID: 33300393 DOI: 10.1080/13607863.2020.1857687] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To review the evidence and explore the association between obesity and depression in community-dwelling older adults. METHODS We searched 6 electronic databases from inception to November 28, 2019. Observational studies investigating the association between obesity and depression among community-dwelling older adults aged 60 years or older were included. Two reviewers independently screened the studies, extracted the data and assessed the quality of the studies. The eligible studies were meta-analysed using the Comprehensive Meta-analysis Version 3.0. RESULTS Among the 16,059 studies identified from these databases, 19 studies meeting the inclusion criteria were included, of which 14 were meta-analysed. Meta-analyses showed that older adults who were overweight (pooled odds ratio: 0.847, 95% CI:0.789-0.908, p < 0.001) or obesity (pooled odds ratio: 0.795, 95% CI:0.658-0.960, p = 0.017) - assessed using the body mass index - were significantly less likely to be depressed than their counterparts with a normal weight. No significant association between obesity (as measured via waist circumference) and depression was detected (pooled odds ratio: 0.722, 95% CI:0.465-1.119, p = 0.145) in this group population. The subgroup analyses demonstrated that both female and male older adults with overweight/obesity were significantly less likely to have depression. CONCLUSIONS The "jolly fat" hypothesis is deemed to be applicable among community-dwelling older adults. Older adults might, therefore, be encouraged to increase their body weight above the normal level to be mentally healthy. Monitoring intentional weight loss among older adults should be reinforced for public health strategies.
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Affiliation(s)
- Mingming Yu
- School of Nursing, Peking University, Beijing, P.R. China
| | - Yuexian Shi
- School of Nursing, Peking University, Beijing, P.R. China
| | - Libin Gu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, P.R. China
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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13
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Liu H, Yang X, Guo LL, Li JL, Xu G, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Wei H, Li J, Liu M, Hua Y, Li Y, Che H, Zhang L. Frailty and Incident Depressive Symptoms During Short- and Long-Term Follow-Up Period in the Middle-Aged and Elderly: Findings From the Chinese Nationwide Cohort Study. Front Psychiatry 2022; 13:848849. [PMID: 35463534 PMCID: PMC9021567 DOI: 10.3389/fpsyt.2022.848849] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/21/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Prefrailty and frailty are two common conditions among older individuals. Recent studies have reported the association between frailty and depressive symptoms, but whether those conditions could predict depressive symptoms is still inconsistent in a few longitudinal studies. In our study, we aimed to estimate the cross-sectional and longitudinal associations between frailty and incident depressive symptoms in a nationally representative sample of community-dwelling middle-aged and older Chinese adults. METHOD Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), which included 17,284 adults aged ≥ 45 years. Participants were followed every two years using a face-to-face, computer-aided personal interview (CAPI) and structured questionnaire. We excluded participants with no follow-up data. The numbers of individuals who completed the baseline surveys were 2,579 and follow-up surveys were 839 for the short-term (2 years from 2011 to 2013) and 788 for the long-term (4 years from 2011 to 2015). In addition, Frailty was measured by the Fried criteria and depressive symptoms were estimated by the Chinese version of the Center for Epidemiologic Studies-Depression scale (CES-D). Logistic regression was used to analyze the odds ratio (OR), and 95% confidence interval (CI) for the cross-sectional associations of frailty and its components with depressive symptoms in the participants at baseline. Cox proportional hazards analysis was conducted using the hazard ratio (HR), and 95% confidence interval (CI) for the prospective associations of baseline frailty and pre-frailty and its component in the participants without depressive symptoms at baseline. RESULTS At baseline, 57.93% of participants had depressive symptoms and 55.84% had pre-frail and 11.63% had frailty. In the cross-sectional analysis, both pre-frailty (OR = 5.293, 95%CI 4.363-6.422) and frailty (OR = 16.025, 95%CI 10.948-23.457) were associated with depressive symptoms. In the longitudinal analysis, frailty [HR = 1.395 (0.966-2.013)] and pre-frailty [HR = 2.458 (0.933, 6.479)] were not significantly associated with incident depressive symptoms in a full-adjusted model among participants free of baseline depressive symptoms during the short-term. However, frailty [HR = 1.397 (1.017, 1.920)] and pre-frailty [HR = 2.992 (1.210, 7.397)] were significantly associated with incident depressive symptoms during the short term. In the components of frailty, slowness [HR = 1.597 (1.078, 2.366)] was associated with an increased risk of depressive symptoms onset during the short-term. Weakness [HR = 2.08 (1.055, 4.104)] and exhaustion [HR = 1.928 (1.297, 2.867)] were associated with increased risk of depressive symptoms onset during the short-term. CONCLUSION Among the middle-aged and older adults, frailty, pre-frailty did not predict depressive symptoms during 2 years of follow-up, when accounting for the potential confounders, slowness considered alone predicted depressive symptoms. Additionally, frailty, pre-frailty predicted depressive symptoms during 4 years of follow-up, when accounting for the potential confounders, weakness and exhaustion considered alone predicted depressive symptoms.
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Affiliation(s)
- Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, China
| | - Xu Yang
- Department of Radiotherapy, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Lei-Lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Jin-Long Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Guang Xu
- Department of Radiotherapy, Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Huanhuan Wei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Yuanzhen Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Hengying Che
- Department of Nursing, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, China
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Adeomi A, Obiajunwa C, Oduntan O, Ogbukwo E. Is nutritional status associated with depression? evidence from a cross-sectional study among workers in tertiary educational institutions in Southwestern Nigeria. Pan Afr Med J 2021; 39:94. [PMID: 34466196 PMCID: PMC8379402 DOI: 10.11604/pamj.2021.39.94.23567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 05/10/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction different studies have shown a relationship between depression and nutrition, but there seems to be no consistent consensus on this. This study therefore investigated the relationship of nutrition status and depression among workers in tertiary educational institutions in Southwestern Nigeria. Methods this was a cross-sectional study conducted among 399 members of staff of three tertiary educational institutions in Osun State, Southwestern Nigeria. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), while nutritional status was assessed using the body mass index (BMI), waist circumference and waist hip ratio (WHR). The respondents were selected using multi-stage sampling technique, and data were collected using pre-tested structured questionnaires. Analysis was done using IBM SPSS. Results the mean age of the respondents was 45.8 ± 10.4 years. The prevalence of depression was 23.8%. Concerning the nutritional status of respondents, 2.3% were underweight and 69.7% were overweight/obese. There were statistically significant associations between depression and the nutritional status of the respondents using BMI (p = 0.001), WHR (p = 0.015) and waist circumference (p = 0.036). After controlling for other factors, only the BMI was still significantly associated with depression, such that those underweight were more likely to be depressed (Odds ratio: 7.9; p-value: 0.009). Conclusion the prevalence of depression among the respondents was relatively high, and this was significantly associated with the BMI, even after controlling for co-founders.
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Affiliation(s)
- Adeleye Adeomi
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State, Nigeria
| | - Chukwubueze Obiajunwa
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State, Nigeria
| | - Olajuwon Oduntan
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State, Nigeria
| | - Ebuka Ogbukwo
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State, Nigeria
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Liao W, Luo Z, Hou Y, Cui N, Liu X, Huo W, Wang F, Wang C. Age and gender specific association between obesity and depressive symptoms: a large-scale cross-sectional study. BMC Public Health 2020; 20:1565. [PMID: 33069213 PMCID: PMC7568408 DOI: 10.1186/s12889-020-09664-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/08/2020] [Indexed: 01/09/2023] Open
Abstract
Background This is a cross-sectional study to explore the age and gender specific association between obesity and depression in Chinese rural adults. Methods A total of 29,900 eligible participants from the Henan Rural Cohort Study were included. Standard anthropometric measurements were undertaken to obtain data on body mass index (BMI) and waist circumference (WC). The Patient Health Questionnaire-2 (PHQ-2) was utilized to discover depressive symptoms. Logistic regression was performed to explore the association between obesity (independent variable) and depressive symptoms (dependent variable). Results There were 1777 subjects with depressive symptoms, accounting for 5.94%. After multivariable adjustment, compared with normal weight group, the odds ratios (ORs) [95% confidence interval (CI)] for depressive symptoms in underweight, overweight and general obese groups were 1.41 (1.08–1.84), 0.87 (0.78–0.97) and 0.86 (0.74–0.99), respectively. Similarly, the OR (95% CI) of abdominal obesity group was 0.84 (0.76–0.93). Besides, there was linear decreasing trend of WC with depressive symptoms, but not BMI. Moreover, the inverse association between obesity and depressive symptoms was stronger in men and the elderly than that in women and the young. Conclusion Underweight was associated with a higher prevalence of depressive symptoms, which indicated that health care should pay attention to underweight as well as obesity, especially for women and the young. Clinical trial registration The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06.
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Affiliation(s)
- Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 100 Kexue Avenue, Zhengzhou, 450001, Henan, PR China
| | - Zhicheng Luo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 100 Kexue Avenue, Zhengzhou, 450001, Henan, PR China
| | - Yitan Hou
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
| | - Ningning Cui
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 100 Kexue Avenue, Zhengzhou, 450001, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 100 Kexue Avenue, Zhengzhou, 450001, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 100 Kexue Avenue, Zhengzhou, 450001, Henan, PR China
| | - Fang Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, PR China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 100 Kexue Avenue, Zhengzhou, 450001, Henan, PR China.
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16
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Hwang AC, Lee WJ, Peng LN, Liu LK, Lin MH, Loh CH, Chen LK. Unfavorable body composition and quality of life among community-dwelling middle-aged and older adults: What really matters? Maturitas 2020; 140:34-40. [DOI: 10.1016/j.maturitas.2020.05.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/19/2020] [Accepted: 05/29/2020] [Indexed: 12/25/2022]
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17
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Hoang MT, Do KN, Pham HQ, Nguyen CT, Ha GH, Vu GT, Tran BX, Latkin C, Ho RCM, Ho CS. Psychological distress among mountainous farmers in Vietnam: a cross-sectional study of prevalence and associated factors. BMJ Open 2020; 10:e038490. [PMID: 32764088 PMCID: PMC7412583 DOI: 10.1136/bmjopen-2020-038490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Psychological distress has been known as a major health problem among farmers across the world. In Vietnam, approximately 50% of farmers have lived in rural and mountainous areas. Yet, little has been known about how psychological distress impacts mountainous farmers' health. OBJECTIVES This study aimed to examine the prevalence and risk factors related to psychological distress among mountainous farmers in Vietnam. DESIGN AND SETTING A cross-sectional study was performed from August to September 2018 in Moc Chau district, Vietnam. A structured questionnaire and face-to-face interviews were used for data collection. PARTICIPANTS A random sample of 197 farmers aged at least 18 years, spoke Vietnamese, was not suffering from severe diseases and residing in Moc Chau at the time of the survey were recruited. PRIMARY AND SECONDARY OUTCOME MEASURES The Kessler Psychological Distress Scale (K6) was employed to measure psychological distress. The tobit and logistic regressions were applied to indicate associated factors. RESULTS The prevalence of psychological distress was 38.2% (95% CI 31.3% to 45.5%). Having a greater comorbidities (OR=6.17; 95% CI 1.44 to 26.43), drinking alcohol (OR=3.86; 95% CI 1.02 to 14.59) and obtaining health information from health workers (OR=3.77; 95% CI 1.22 to 11.66) were positively associated with the prevalence of psychological distress. By contrast, being overweight (OR=0.29; 95% CI 0.09 to 0.93), adopting books as the primary source of health information (OR=0.11; 95% CI 0.01 to 0.8), and receiving a higher number of home visits by community health workers (CHWs) (OR=0.38; 95% CI 0.14 to 0.99) were negatively associated with the prevalence of psychological distress. CONCLUSION This study highlighted a high prevalence of psychological distress among mountainous farmers. Providing routine psychological and physical health screening, developing CHWs to provide clinical support and raising health awareness are critical implications for reducing psychological distress in this population.
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Affiliation(s)
- Men Thi Hoang
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Pharmacy, Duy Tan University, Da Nang, Viet Nam
| | - Khanh Nam Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Medicine, Duy Tan University, Da Nang, Viet Nam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Medicine, Duy Tan University, Da Nang, Viet Nam
| | - Giang Hai Ha
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Pharmacy, Duy Tan University, Da Nang, Viet Nam
| | - Giang Thu Vu
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Viet Nam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Carl Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - Cyrus Sh Ho
- Department of Psychological Medicine, National University Hospital, Singapore
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Song X, Zhang W, Hallensleben C, Versluis A, van der Kleij R, Jiang Z, Chavannes NH, Gobbens RJJ. Associations Between Obesity and Multidimensional Frailty in Older Chinese People with Hypertension. Clin Interv Aging 2020; 15:811-820. [PMID: 32606623 PMCID: PMC7294100 DOI: 10.2147/cia.s234815] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 04/11/2020] [Indexed: 12/28/2022] Open
Abstract
Purpose To investigate the prevalence of multidimensional frailty in older people with hypertension and to examine a possible relationship of general obesity and abdominal obesity to frailty in older people with hypertension. Patients and Methods A sample of 995 community-dwelling older people with hypertension, aged 65 years and older and living in Zhengzhou (China), completed the Tilburg Frailty Indicator (TFI), a validated self-report questionnaire for assessing multidimensional frailty. In addition, socio-demographic and lifestyle characteristics were assessed by self-report, and obesity was determined by measuring waist circumference and calculating the body mass index. Results The prevalence of multidimensional frailty in this older population with hypertension was 46.5%. Using multiple linear regression analysis, body mass index was significantly associated with physical frailty (p = 0.001), and waist circumference was significantly positively associated with multidimensional frailty and all three frailty domains. Older age was positively associated with multidimensional frailty, physical frailty, and psychological frailty, while gender (woman) was positively associated with multidimensional, psychological, and social frailty. Furthermore, comorbid diseases and being without a partner were positively associated with multidimensional, physical, psychological, and social frailty. Of the lifestyle characteristics, drinking alcohol was positively associated with frailty domains. Conclusion Multidimensional frailty was highly prevalent among Chinese community-dwelling older people with hypertension. Abdominal obesity could be a concern in physical frailty, psychological frailty, and social frailty, while general obesity was concerning in relation to physical frailty.
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Affiliation(s)
- Xiaoyue Song
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden 2333 ZD, The Netherlands.,School of Nursing, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Weihong Zhang
- School of Nursing, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Cynthia Hallensleben
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden 2333 ZD, The Netherlands
| | - Anke Versluis
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden 2333 ZD, The Netherlands
| | - Rianne van der Kleij
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden 2333 ZD, The Netherlands
| | - Zongliang Jiang
- School of Nursing, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden 2333 ZD, The Netherlands
| | - Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands.,Zonnehuisgroep Amstelland, Amstelveen, The Netherlands.,Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Zhang L, Li JL, Zhang LL, Guo LL, Li H, Li D. Body mass index and serum uric acid level: Individual and combined effects on blood pressure in middle-aged and older individuals in China. Medicine (Baltimore) 2020; 99:e19418. [PMID: 32118796 PMCID: PMC7478523 DOI: 10.1097/md.0000000000019418] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Few studies on the individual and combined analysis between serum uric acid (SUA) and body mass index (BMI) and blood pressure (BP) were conducted in individuals aged ≥45 years. We aimed to assess the extent to which BMI and SUA and their interaction affect BP in Chinese middle-aged and older adults.Data were selected from the China Health and Retirement Longitudinal Study (CHARLS). A total of 5888 individuals aged 45 to 96 was included. Differences between BMI, or between categories of blood pressure were evaluated by t test or chi-square test. The trend of related variables according to four BMI categories was also tested using contrast analysis. The adjusted associations between various characteristics and BP status were first compared using linear regression models, as appropriate. Then, general linear models adjusting for related potential confounders were used to examine the synergistic effect of SUA and BMI level on BP for middle-aged and elderly individuals in China.Age-adjusted partial Pearson correlation coefficient showed that BMI was significantly and positively correlated with BP both in male and female, SUA positively correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in males with BMI <24.0 kg/m and females with BMI <24.0 kg/m. However, SUA level significantly and positively correlated with DBP, but not with SBP, in females with BMI ≥24.0 kg/m. Multiple linear regression analysis showed that BMI was independently associated with BP both in male and female, SUA significantly and positively associated with SBP in both males and females with BMI <24.0 kg/m, However, SUA level positively correlated with DBP in females with BMI <24.0 kg/m, but not with males with BMI <24.0 kg/m, independent of other confounding factors. A general linear model analysis adjusted for confounding factors did not reveal interaction between BMI, SUA levels and SBP (β=-1.404, P = .686 in males; β=-2.583, P = .575 in females) and DBP (β=-2.544, P = .263 in males; β=-2.619, P = .622 in females).No interaction between BMI, SUA levels, and BP was observed in either males or females; However, BMI was independently associated with BP both in male and female, SUA independently associated with SBP both in males and females with BMI <24.0 kg/m, and SUA independently associated with DBP in females with BMI ≥24.0 kg/m.
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Affiliation(s)
- Lin Zhang
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, Liaoning Province
| | - Jin-Long Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province
| | - Li-Li Zhang
- Department of Surgery, Third Affiliated Hospital of Jinzhou Medical University, Chongqing Road, Linghe District, Jinzhou City, Liaoning Province
| | - Lei-Lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, Liaoning Province
| | - Hong Li
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, Liaoning Province
| | - Dan Li
- Experimental Center for Nursing, School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, Liaoning Province, P.R.China
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20
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Estrella-Castillo DF, Gómez-de-Regil L. Comparison of body mass index range criteria and their association with cognition, functioning and depression: a cross-sectional study in Mexican older adults. BMC Geriatr 2019; 19:339. [PMID: 31795994 PMCID: PMC6889317 DOI: 10.1186/s12877-019-1363-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 11/21/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND World population is living longer, demanding adjustments in public health policies. Body mass index (BMI) is widely known and used as a parameter and predictor of health status although an adapted criterion for older adults is usually overlooked. BMI has been extensively analysed in relation to mortality but fewer studies address its association with cognition, functioning and depression in older adults. The present study aimed at 1) comparing BMI distribution according to the ranges proposed by the World Health Organization (WHO) and the United States National Research Council Committee on Diet and Health (CDH), 2) analysing their association with cognitive functioning, physical functioning and depression and 3) analysing a possible, interaction of BMI criteria with sex on the outcome measures. METHODS This cross-sectional study included 395 participants recruited by convenience sampling; 283 (71.6%) women and 112 (24.58%) men. Mean age was 74.68 (SD = 8.50, range: 60-98). Outcome measures included the Short Portable Mental State Questionnaire for cognitive status, the Barthel's Index of Activities of Daily Living for physical functioning, and the Geriatric Depression Scale. RESULTS WHO criterion classified most cases (65.3%) as overweight, followed by normal weight (32.2%) and underweight (2.5%) whereas CDH criterion considered most (48.1%) as normal weight, and followed by overweight (31.4%) and underweight (20.5%). Analysing cognitive status, independent physical functioning and depression mean scores, significant differences (p ≤ .001) were found when comparing the three weight groups (underweight, normal weight and overweight) using either the WHO- or the CDH criterion. Post-hoc tests revealed that in all comparisons the underweight group scored the lowest in all three outcome measures. According to the CDH criterion, overweight was favourable for females but unfavourable for males regarding cognitive status (interaction F(2,389) = 4.52, p ≤ .01) and independent functioning (interaction F(2,389) = 3.86, p ≤ .05). CONCLUSIONS BMI and its associations to relevant outcome measures in the older adults must rely on criteria that take into account the particular features of this population, such as the CDH criterion. Underweight was associated with decremented cognition, less independent physical functioning and more depression. Overweight seemed favourable for women but unfavourable for men.
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Affiliation(s)
- Damaris Francis Estrella-Castillo
- Universidad Autónoma de Yucatán. Facultad de Medicina. Licenciatura en Rehabilitación, Avenida Itzáes No. 498 x 59 y 59A. Colonia Centro. Mérida, 97000 Merida, Yucatán Mexico
| | - Lizzette Gómez-de-Regil
- Hospital Regional de Alta Especialidad de la Península de Yucatán, Calle 7, No. 433 por 20 y 22, Fraccionamiento Altabrisa. Mérida, 97130 Merida, Yucatán Mexico
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Amini S, Shirali S, Jafarirad S, Ehsani H, Mohseni H, Bargard MS. Are Lipid Profile, Body Mass Index, Waist Circumference, and Blood Pressure of Depressed Elderly Patients Different from Healthy Subjects? Int J Prev Med 2019; 10:185. [PMID: 32133103 PMCID: PMC6826675 DOI: 10.4103/ijpvm.ijpvm_372_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 02/26/2018] [Indexed: 12/11/2022] Open
Abstract
Background Depression and obesity are among the increasingly publicized health problems, both being related to critical complications, and increasing the risk of substantial morbidity and mortality. An increasing number of documents indicate that obesity affects mental status, low serum cholesterol levels, and is related to depressive symptoms. The purpose of the present study was to evaluate the possible significant difference in lipid profile levels, body mass index (BMI), waist circumference (WC), and blood pressure (BP), between depressive and nondepressive older adults. Methods This was a case-control study where 107 patients, over 65-year-old, were enrolled in this study. Serum total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol (LDL-C), triglycerides (TG), BP, and fasting blood sugar were measured. Data were analyzed using the statistical SPSS software version 22. Independent t-test was used to compare the results between the two groups and the Chi-square test was used to compare categorical variables. In addition, nonparametric Mann-Whitney test was used to evaluate the data. Results The depressive group showed significant lower BMI, WC, LDL-C, and TG (P < 0.001, P < 0.001, P < 0.016, and P < 0.014). Furthermore, the findings showed significantly higher systolic and diastolic BP in participants who had shown depressive symptoms (P < 0.035 and P < 0.024). Conclusions The findings suggest that a low BMI, serum LDL-C, and TG are related to depressive symptoms the Iranian elderly.
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Affiliation(s)
- Shirin Amini
- Department of Nutrition, Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeed Shirali
- Department of Laboratory Sciences, Hyperlipidemia Research Center, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sima Jafarirad
- Department of Nutrition, Nutrition and Metabolic Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hajar Ehsani
- Baghmalek Health Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Houra Mohseni
- Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Sayah Bargard
- Educational Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Association of Body Fat With Health-Related Quality of Life and Depression in Nonagenarians: The Mugello Study. J Am Med Dir Assoc 2019; 20:564-568. [PMID: 30852165 DOI: 10.1016/j.jamda.2019.01.128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/07/2019] [Accepted: 01/13/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The association of body fat with health status and depression in the oldest old is still debated. The aim of this cross-sectional study is to investigate the association of body fat with health-related quality of life and depression in a sample of nonagenarians. DESIGN Data are from the Mugello study, a community-based project conducted in Italian older adults aged 90 years. SETTING AND PARTICIPANTS Total body fat was assessed by body impedance assessment. Participants were divided into 3 groups according to gender-specific tertiles of body fat percentage (BF%). Self-perceived mental and physical health status were assessed by the Mental Component Summary (MCS) and the Physical Component Summary (PCS) subscales derived from the 12-item Short Form Health Survey. Lower scores of MCS and PCS indicated poorer mental health and physical health status, respectively. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale, and a score ≥5 was used to identify participants with depression. RESULTS The mean age of 251 study participants was 92.5 years, and 173 (68.9%) were women. Participants were included in the low (n = 83), medium (n = 83), and high (n = 85) BF% groups. In the whole sample, mean scores at PCS progressively declined with the increasing BF% group (P = .004). This association was stronger in women, although no significant interaction was observed between the gender and BF% group (P = .63). No significant association between BF% and MCS was documented. Medium and high BF% were associated with a significantly higher probability of depression as compared with low BF% [odds ratio (OR) 2.15, 95% confidence interval (CI) 1.04-4.44, and OR 2.15, 95% CI 1.06-4.34, respectively]. This association was stronger in women, although no significant interaction was observed between gender and BF% group (P = .70). CONCLUSIONS AND IMPLICATIONS High BF% is significantly positively associated with poor health-related quality of life and depression, underpinning the clinical relevance to test BF% in older adults. These associations appear to be stronger in women than in men, highlighting the need to investigate deep inside this gender discrepancy.
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Zhang L, Li JL, Zhang LL, Guo LL, Li H, Yan W, Li D. Relationship between adiposity parameters and cognition: the "fat and jolly" hypothesis in middle-aged and elderly people in China. Medicine (Baltimore) 2019; 98:e14747. [PMID: 30855469 PMCID: PMC6417533 DOI: 10.1097/md.0000000000014747] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The association between adiposity parameters and cognition is complex. The purpose of this study was to assess the relationship between adiposity parameters and cognition in middle-aged and elderly people in China.Data were obtained from a cross-sectional study. Cognitive function was evaluated in 5 domains, and adiposity parameters were measured. The association between adiposity parameters and cognition was analyzed using multiple linear and binary logistic regression analyses.After controlling for confounders, men with overweight and obesity had better scores in TICS-10 ([1] total, overweight vs normal: P = .006, β = 0.04; obesity vs normal: P = .005, β = 0.04. [2] stratification by age, with age ≥ 59 years, overweight vs normal: P = .006, β = 0.05; obesity vs normal: P = .014, β = 0.05. [3] stratification by educational levels, with less than elementary education, overweight vs normal: P = .011, β = 0.05; obesity vs normal: P = .005, β = 0.05), immediate word recall ([1] total, overweight vs normal: P = .015, β = 0.04. [2] stratification by age, with age 45-58 years, overweight vs normal: P = .036, β = 0.05. [3] stratification by educational levels, with less than elementary education, overweight vs normal: P = .044, β = 0.04; above high school, overweight vs normal: P = .041, β = 0.09), self-rated memory ([1] stratification by age, with age ≥ 59 years, overweight vs normal: P = .022, β = 0.05. [2] stratification by educational levels, with less than elementary education, overweight vs normal: P = .023, β = 0.04), and drawing a picture ([1] total, overweight vs normal: OR = 1.269, 95% CI = 1.05-1.53. [2] stratification by educational levels, with less than elementary education, overweight vs normal: OR = 1.312, 95% CI = 1.06-1.63); obesity vs normal: OR = 1.601, 95% CI = 1.11-2.31 than the normal weight; women with overweight and obesity had better measure scores in the TICS-10 ([1] total, overweight vs normal: P < .0001, β = 0.06; obesity vs normal: P < .0001, β = 0.05. [2] stratification by age, with age 45-58 years, obesity vs normal: P = .007, β = 0.05; with age ≥ 59 years: overweight vs normal: P < .0001, β = 0.07, obesity vs normal: P = .002, β = 0.06. [3] stratification by educational levels, with illiterate, overweight vs normal: P = .001, β = 0.08; obesity vs normal: P = .004, β = 0.06; with less than elementary education, overweight vs normal: P < .0001, β = 0.07; obesity vs normal: P = .010, β = 0.05), immediate word recall ([1] total, overweight vs normal: P = .011, β = 0.04; obesity vs normal: P = .002, β = 0.04. [2] stratification by age, with age 45-58 years, obesity vs normal: P = .021, β = 0.05; with age ≥ 59 years: overweight vs normal: P = .003, β = 0.06. [3] stratification by educational levels, with illiterate, obesity vs normal: P = .028, β = 0.05; with less than elementary education, obesity vs normal: P = .016, β = 0.05), delay word recall ([1] total, overweight vs normal: P = .015, β = 0.03; obesity vs normal: P = .031, β = 0.03. [2] stratification by age, with age ≥ 59 years: overweight vs normal: P = .004, β = 0.06. [3] stratification by educational levels, with less than elementary education, obesity vs normal: P = .043, β = 0.04), self-rated memory ([1] total, obesity vs normal: P = .026, β = 0.03. [2] stratification by age, with age ≥ 59 years, overweight vs normal: P = .044, β = 0.04; obesity vs normal: P = .018, β = 0.05), and drawing a picture ([1] total, overweight vs normal: OR = 1.226, 95% CI = 1.06-1.42. [2] stratification by age, with age 45-58 years: overweight vs normal: OR = 1.246, 95% CI = 1.02-1.53) than the normal weight. Regarding the association between WC and cognitive function, the obesity demonstrated better mental capacity ([1] total, men: P < .0001, β = 0.06; women: P < .0001, β = 0.05. [2] stratification by age, men with age 45-58 years: P < .0001, β = 0.08; men with ≥ 59 years: P = .006, β = 0.05. women with age 45-58 years: P = .001, β = 0.06; women with ≥ 59 years: P = .012, β = 0.04. [3] stratification by educational levels, men with illiterate: P = .045, β = 0.09; men with less than elementary education: P < .0001, β = 0.08; women with illiterate: P < .0001, β = 0.09), ability to recall immediately ([1] total, men: P = .030, β = 0.03; women: P = .001, β = 0.05. [2] stratification by age, women with age 45-58 years: P = .028, β = 0.04; women with ≥ 59 years: P = .007, β = 0.05. [3] stratification by educational levels, men with less than elementary education: P = .007, β = 0.05; women with illiterate: P = .027, β = 0.05; women with less than elementary education: P = .002, β = 0.06), delay word recall ([1] total, women: P = .044, β = 0.03. [2] stratification by educational levels, men with less than elementary education: P = .023, β = 0.04), self-rated memory (stratification by educational levels, women with less than elementary education: P = .030, β = 0.04), and draw a picture ([1] total, men: OR = 1.399, 95% CI = 1.17-1.67; women: OR = 1.273, 95% CI = 1.12-1.45. [2] stratification by age, men with age 45-58 years: OR = 1.527, 95% CI = 1.15-2.03; men with age ≥ 59 years: OR = 1.284, 95% CI = 1.02-1.61; women with age 45-58 years: OR = 1.320, 95% CI = 1.10-1.58; women with age ≥ 59 years: OR = 1.223, 95% CI = 1.01-1.49. [3] stratification by educational levels, men with less than elementary education: OR = 1.528, 95% CI = 1.25-1.87; women with illiterate: OR = 1.404, 95% CI = 1.14-1.73) than the participants with normal weight after the multivariate adjustment.Our study demonstrated a significant relationship between adiposity parameters and cognition that supports the "jolly fat" hypothesis.
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Affiliation(s)
- Lin Zhang
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District Jinzhou City, Liaoning Province
| | - Jin-Long Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province
| | - Li-Li Zhang
- Department of Surgery, Third Affiliated Hospital of Jinzhou Medical University, No.28, Section 2, Chongqing Road
| | - Lei-Lei Guo
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District Jinzhou City, Liaoning Province
| | - Hong Li
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District Jinzhou City, Liaoning Province
| | - Wenzhu Yan
- Department of anatomy, School of Basic Medical Sciences, Jinzhou Medical University, No.40, Section 3, Songpo Road
| | - Dan Li
- Experimental Center for Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District Jinzhou City, Liaoning Province, PR China
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Amiri S, Behnezhad S, Nadinlui KB. Body Mass Index (BMI) and risk of depression in adults: A systematic review and meta-analysis of longitudinal studies. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.obmed.2018.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Association and Interaction Analysis of Body Mass Index and Triglycerides Level with Blood Pressure in Elderly Individuals in China. BIOMED RESEARCH INTERNATIONAL 2018; 2018:8934534. [PMID: 30596101 PMCID: PMC6282155 DOI: 10.1155/2018/8934534] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 09/11/2018] [Accepted: 10/04/2018] [Indexed: 01/18/2023]
Abstract
Objectives To assess the extent of interaction between body mass index (BMI) and triglyceride (TG) level and its effects on blood pressure (BP) in elderly individuals in China. Design Cross-sectional study. Setting Data were taken from a cross-sectional study called the China Health and Retirement Longitudinal Study. Participants The analytic sample included 3629 subjects aged 45 to 96 years. Main Outcome Measurements Data were obtained from the China Health and Retirement Longitudinal Study, which is a cross-sectional study. Age-adjusted partial Pearson's correlation test was used to compare various characteristics and BP. Adjusted associations were first used as linear regression models, as appropriate. Then, general linear models adjusted for related potential confounders were used to examine the synergistic effects of BMI and TG level on BP. Finally, a binary logistic regression model adjusted for confounding factors was used to examine the association between BMI or TG level and hypertension. Results Age-adjusted partial Pearson's correlation coefficient showed that the TG level was positively correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in both men and women with BMI < 24.0 kg/m2; however, TG level was positively correlated with DBP in women with BMI ≥ 24.0 kg/m2 but not with DBP in men with BMI ≥ 24.0 kg/m2. Multiple linear regression analysis showed that BMI level was significantly and positively associated with both SBP and DBP in men and women with BMI < 24.0 kg/m2, and TG level was significantly and positively associated with SBP in women with BMI < 24.0 kg/m2, independent of other confounding factors. A general linear model analysis with adjustment for confounding factors (age, educational level, marital status, current residence, smoking, eating habits, taking activities, antidiabetic medication, antihypertensive therapy, fasting plasma glucose [FPG], low-density lipoprotein cholesterol [LDL-C], estimated glomerular filtration rate [eGFR], and serum uric acid [SUA]) showed no interaction between BMI and TG level and SBP (men, β = 0.572, P = 0.845; women, β = 0.122, P = 0.923) and DBP (men, β = -0.373, P = 0.810; women, β = 0.272, P = 0.828). A binary logistic regression model analysis with adjustment for confounding factors (age, educational level, marital status, current residence, smoking, drinking, eating habits, taking activities, major accidental injury, physical activity, history of cardiovascular disease, history of liver disease, antilipidemic medication, antidiabetic medication, antihypertensive therapy, FPG, LDL-C, high-density lipoprotein cholesterol [HDL-C], eGFR, and SUA) showed that overweight and obese men and women were more likely to have hypertension (men: odds ratio [OR] = 1.781, 95% confidence interval [CI] = 1.393–2.277; women: OR = 1.653, 95% CI = 1.330–2.055) and women with high TG were more likely to have hypertension (OR = 1.558, 95% CI = 1.219–1.992). Conclusion An interactive effect of BMI and TG level on BP was not observed in either men or women; however, independent effects of BMI on BP were observed in both men and women, and an association between TG level and hypertension was observed in women.
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Zhang L, Li JL, Zhang LL, Guo LL, Li H, Li D. No association between C-reactive protein and depressive symptoms among the middle-aged and elderly in China: Evidence from the China Health and Retirement Longitudinal Study. Medicine (Baltimore) 2018; 97:e12352. [PMID: 30235693 PMCID: PMC6160211 DOI: 10.1097/md.0000000000012352] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The depressive symptoms have been associated with increased disabilities, and the depressive symptoms-related elevation of high C-reactive protein (CRP) has been proposed as a possible mechanism. We examined the relations between CRP and depressive symptoms among the middle-aged and elderly in China.A longitudinal sample of the middle-aged and elderly (4404 men and 5055 women) who were interviewed in the 2011 China Health and Retirement Longitudinal Study was used. A multivariate logistic regression analysis was used to examine the effects of sociodemographic characteristics, lifestyle, activity status, physical exercise, systolic blood pressure, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, body mass index (BMI), and CRP levels on depressive symptoms.The mean age in the study was 60.26 years [standard deviation (SD) ± 9.25; 46.56% men]. The mean CPR level was 2.79 mg/L (range, 0.01-178.10; SD ± 7.80). Depression scores ranged from 0 to 30 with a mean 8.65 (SD ± 6.33). The prevalence of depressive symptoms was 38.49% in the total population, 31.04% in men and 44.99% in men. Compared with baseline CRP levels (≤1.00 mg/L), the depressive symptoms are only weakly correlated with CRP levels among women [CRP 1.01-3.00 mg/L: odds ratio (OR) = 0.85, 95% confidence interval (CI) = 0.73-0.98; CRP 3.01-10.00 mg/L: OR = 1.25, 95% CI = 1.03-1.51; CRP >10 mg/L: OR = 1.41, 95% CI = 1.06-1.88]. After adjusting for age, education, marital status, hukou, residence, cigarette smoking, alcohol drinking, eating meals, activity status, major accidental injury, diseases, health status, physical exercise, systolic blood pressure, LDL, HDL, triglycerides, and BMI, depressive symptoms were not associated with subsequent high CPR levels among the middle-aged and elderly (CRP 1.01-3.00 mg/L: OR = 0.93, 95% CI = 0.83-1.03; CRP 3.01-10.00 mg/L: OR = 0.95, 95% CI = 0.82-1.10; CRP >10 mg/l: OR = 1.11, 95% CI = 0.88-1.39).Our data do not support an association between CRP and depressive symptoms in both middle-aged and elderly men and women among china.
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Affiliation(s)
- Lin Zhang
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning Province
| | - Jin-long Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province
| | - Li-li Zhang
- Department of Surgery, Third Affiliated Hospital of Jinzhou Medical University
| | - Lei-lei Guo
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning Province
| | - Hong Li
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning Province
| | - Dan Li
- Experimental Center for Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning Province, P.R. China
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Association of visceral fat area with the presence of depressive symptoms in Chinese postmenopausal women with normal glucose tolerance. Menopause 2018. [PMID: 28640157 DOI: 10.1097/gme.0000000000000917] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Depression is one of the most common mental disorders, and women are more vulnerable to depression than men, particularly during stages of hormonal fluctuations. After menopause, fat accumulation shifts from the subcutaneous area to the visceral area, and the risk of metabolic disorder increases in parallel. The present study aimed to evaluate the association between abdominal fat distribution and the presence of depressive symptoms in postmenopausal women. METHODS Visceral fat area (VFA) was detected by magnetic resonance imaging. Depressive symptoms were evaluated with Zung's Self-Rating Depression Scale. RESULTS In all, 437 normoglycemic postmenopausal women with a mean age of 58.4 ± 5.0 years (mean age at final menstrual period: 50.1 ± 3.5 years) were enrolled in the present study, including 117 individuals with depressive symptoms and 320 individuals without depressive symptoms. The prevalence of abdominal obesity in women with depressive symptoms was much higher than that in those without depressive symptoms (37.6% vs 27.5%; P = 0.042). Participants with depressive symptoms showed elevated VFA values (74.6 ± 29.8 vs 65.9 ± 28.9 cm; P = 0.006). Multivariate stepwise regression analysis demonstrated that VFA was independently correlated with the presence of depressive symptoms (standardized β = 0.099, P = 0.012). CONCLUSIONS In Chinese postmenopausal women, visceral fat accumulation was an independent and positive factor significantly associated with the presence of depressive symptoms.
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Cui J, Sun X, Li X, Ke M, Sun J, Yasmeen N, Khan JM, Xin H, Xue S, Baloch Z. Association Between Different Indicators of Obesity and Depression in Adults in Qingdao, China: A Cross-Sectional Study. Front Endocrinol (Lausanne) 2018; 9:549. [PMID: 30364162 PMCID: PMC6191471 DOI: 10.3389/fendo.2018.00549] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 08/29/2018] [Indexed: 12/22/2022] Open
Abstract
Background: This study was designed to investigate the perceived relationship between body weight and depression risk in a Chinese population in Qingdao, China. Methods: A population-based cross-sectional survey was performed with 4,573 participants (between 35 and 74 years) from the year 2009 to 2012 in Qingdao, China. We applied the Zung self-rating depression scale to ascertain the level of depression in participants. The associations between different indicators of obesity [body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR)] and depression were assessed by logistic regression based on the Chinese criteria of obesity. Sensitivity analysis was done based on the Asian and WHO criteria of obesity. Results: The Zung scores for the 243 participants (5.2%) were over 45 and they were entitled as depression. Furthermore, multivariable logistic analyses revealed that being overweight [odds ratios (OR): 1.48, 95% confidence intervals [95% CI]: 1.08-2.03] and having abdominal obesity (WC category in Chinese criteria) (OR: 1.47, 95% CI: 1.08-2.00) were often associated with a higher risk for depression compared to normal weight subjects. Sensitivity analysis revealed that abdominal obesity (Asian criterion) (OR: 1.41, 95% CI: 1.03-1.91) was a significant risk factor for depression. Similarly, being overweight (WHO criterion) (OR: 1.39, 95% CI: 1.03-1.87) was an obvious risk factor for depression. Conclusion: Being overweight and having abdominal obesity (WC category) were found to be linked with a higher risk of depression. However, abdominal obesity (WHR category) was not associated with depression.
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Affiliation(s)
- Jing Cui
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
- Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Xiufen Sun
- Qingdao Shi'nan Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Xiaojing Li
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
- Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Ma Ke
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jianping Sun
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
- Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Nafeesa Yasmeen
- Institute of Microbiology, Agriculture University Faisalabad Pakistan, Bahawalpur, Pakistan
| | - Jamal Muhammad Khan
- Department of Patho-biology, The Islamia University of Bahawalpur, University College of Veterinary and Animal Sciences, Bahawalpur, Pakistan
| | - Hualei Xin
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
- Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Shouyong Xue
- Qingdao Shi'bei Municipal Center for Disease Control and Prevention, Qingdao, China
- *Correspondence: Shouyong Xue
| | - Zulqarnain Baloch
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
- Zulqarnain Baloch
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Hong SM, Hur YI. Relationship between obesity and depression in Korean adults: Korea National Health and Nutrition Examination Survey 2014. Medicine (Baltimore) 2017; 96:e9478. [PMID: 29384940 PMCID: PMC6392747 DOI: 10.1097/md.0000000000009478] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Previous studies on the relationship between obesity and depression have produced conflicting results. And only a limited number of studies have been conducted in Asians, and few large-scale nationwide studies have been conducted in Korean populations.We investigated the relationship between obesity and depression in Korean adults using data from a population-based sample from the 2014 Korea National Health and Nutritional Examination Survey (KNHANES) by cross-sectional study.In total, 4026 subjects (1692 men, 2334 women) aged 19 to 69 years participated in the 2014 KNHANES. Current depression was defined as a score ≥10 on the 9-item Patient Health Questionnaire. Height and weight were measured and the body mass index (BMI) was calculated. The participants were asked to complete questionnaires about socio-demographic factors and disease comorbidities, and health-related behaviors. The chi-squared test and multivariate logistic regression analyses were performed to examine the relationship between obesity and depression.Depression was diagnosed in 5.7% of the study participants (3.9% of men, 7.0% of women). According to body weight status, there was a significant difference in the prevalence of depression (underweight: 16.2%, normal weight: 5.5%, overweight: 4.3%, obese [BMI ≥30]: 6.9%). Compared with the normal weight group, the underweight group had a higher adjusted odds ratio (OR) for depression (OR = 3.27, 95% confidence interval [CI]: 1.22, 8.75 in men; OR = 2.00, 95% CI: 1.12, 3.57 in women). Overweight (OR = 0.60, 95% CI: 0.32, 1.13) and obese (OR = 0.62, 95% CI: 0.17, 2.27) men had lower ORs for depression, but this trend was not significant. Compared with normal weight women, obese women had higher adjusted ORs for depression (OR = 1.75, 95% CI: 0.79, 3.88), while overweight women had lower ORs for depression (OR = 0.90, 95% CI: 0.56, 1.45), but these trends were not significant.This study shows differences in the risk of depression depending upon body weight status. Being underweight was correlated with a high risk of developing depression in both men and women, but obesity cannot be ruled out as a risk factor for this condition.
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Affiliation(s)
| | - Yang-Im Hur
- Department of Family Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
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Severe obesity increases the prevalence but not the incidence of depressive symptoms in the elderly-population-based cohort in Southern Brazil. Int Psychogeriatr 2017; 29:1307-1316. [PMID: 28162115 DOI: 10.1017/s1041610216002246] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The relation between body weight status and depressive symptoms in the elderly differs according to age and country of origin. The goal of this study was to analyze the cross-sectional and longitudinal relationship between body mass index (BMI), waist circumference (WC) and depressive symptoms in the elderly. METHODS A population-based cohort study of 1,702 elderly individuals (70.6+8.0 years) in Southern Brazil evaluated in 2009/10 and 2013/14 was accessed. The body weight status was assessed using measured data of BMI and WC. The Geriatric Depression Scale (GDS-15) was used to determine depressive symptoms. Logistic regression analysis adjusted for sociodemographic and behavioral variables was performed. RESULTS The prevalence of depressive symptoms in 2009/10 was 23.3% (95% CI 20.3-26.6) and the cumulative incidence in the 4-years period was 10.9% (95% CI 8.7-13.6). Elderly people with obesity class II-III and WC in the highest quartile had higher prevalence odds ratio of being depressed than individuals with normal weight or WC in the lower quartile (OR 2.34; 95% CI 1.42-3.87 and OR 1.73; 95% CI 1.13-2.65, respectively). Meanwhile, intermediary values of BMI and WC were associated with a lower prevalence. When evaluating the incidence of depressive symptoms, overweight individuals and those in the second quartile of WC had a lower risk (58% and 57%, respectively), but severely obese individuals had the same risk compared to those with normal BMI/WC. CONCLUSIONS Severely obese individuals presented a similar incidence of depressive symptoms compared to those with normal BMI/WC, but higher prevalence. Intermediary values of body weight status decrease the risk of depressive symptoms.
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Zhang L, Liu K, Li H, Li D, Chen Z, Zhang LL, Guo LL. Relationship between body mass index and depressive symptoms: the "fat and jolly" hypothesis for the middle-aged and elderly in China. BMC Public Health 2016; 16:1201. [PMID: 27894296 PMCID: PMC5126817 DOI: 10.1186/s12889-016-3864-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 11/22/2016] [Indexed: 11/24/2022] Open
Abstract
Background Obesity has been identified as a worldwide epidemic. In China, the highest prevalence of obesity is observed in adults aged ≥45 years old. This study aimed to describe the association between BMI and depressive symptoms among a large representative sample of middle-aged and elderly in China. Method A longitudinal sample of the middle-aged and elderly (6,224 males and 6,883 females) who were interviewed in the 2011 China Health and Retirement Longitudinal Study was used. A multivariate logistic regression analysis was used to examine the effects of socio-demographic characteristics, lifestyle, activity status, health status, physical exercise and body weight on depressive symptoms. Results Approximately 6.94% of the males were underweight, 25.48% were overweight and 8.16% were obese. A higher prevalence of obesity was found among women, with 6.89% being underweight, 31.98% overweight and 14.28% obese. The underweight subjects were more likely to be depressed (odds ratio; OR = 1.30 and 1.19) compared with the normal weight people, respectively, whereas overweight and obese men and women were less likely to be depressed (overweight: OR = 0.76 and 0.80; obesity: OR = 0.64 and 0.65, respectively) than people of normal weight. Conclusion Our data are consistent with the “fat and jolly” hypothesis being valid in both middle-aged and elderly men and women.
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Affiliation(s)
- Lin Zhang
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China
| | - Kun Liu
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China
| | - Hong Li
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China
| | - Dan Li
- Department of Experimental Center, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China
| | - Zhuo Chen
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China
| | - Li-Li Zhang
- Department of Surgery, Third Affiliated Hospital of Jinzhou Medical University, No.28, Section 2, Chongqing Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China
| | - Lei-Lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China.
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Isla Pera P, Ferrér MCO, Nuñez Juarez M, Nuñez Juarez E, Maciá Soler L, López Matheu C, Rigol Cuadra A, Pérez MH, Marre D. Obesity, knee osteoarthritis, and polypathology: factors favoring weight loss in older people. Patient Prefer Adherence 2016; 10:957-65. [PMID: 27313449 PMCID: PMC4890692 DOI: 10.2147/ppa.s92183] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
AIM We aimed to explore the meaning of obesity in elderly persons with knee osteoarthritis (KO) and to determine the factors that encourage or discourage weight loss. BACKGROUND Various studies have demonstrated that body mass index is related to KO and that weight loss improves symptoms and functional capacity. However, dietary habits are difficult to modify and most education programs are ineffective. DESIGN A phenomenological qualitative study was conducted. Intentional sampling was performed in ten older persons with KO who had lost weight and improved their health-related quality of life after participating in a health education program. A thematic content analysis was conducted following the stages proposed by Miles and Huberman. FINDINGS Participants understood obesity as a risk factor for health problems and stigma. They believed that the cause of obesity was multifactorial and criticized health professionals for labeling them as "obese" and for assigning a moral value to slimness and diet. The factors identified as contributing to the effectiveness of the program were a tolerant attitude among health professionals, group education that encouraged motivation, quantitative dietary recommendations, and a meaningful learning model based on social learning theories. CONCLUSION Dietary self-management without prohibitions helped participants to make changes in the quantity and timing of some food intake and to lose weight without sacrificing some foods that were deeply rooted in their culture and preferences. Dietary education programs should focus on health-related quality of life and include scientific knowledge but should also consider affective factors and the problems perceived as priorities by patients.
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Affiliation(s)
- Pilar Isla Pera
- School of Nursing, University of Barcelona, Barcelona, Spain
| | | | - Montserrat Nuñez Juarez
- Department of Rheumatology, Musculoskeletal Clínic Institute Hospital Clínic, Barcelona, Spain
| | | | | | | | | | | | - Diana Marre
- Universitat Autònoma de Barcelona, Barcelona, Spain
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Mansur RB, Brietzke E, McIntyre RS. Is there a "metabolic-mood syndrome"? A review of the relationship between obesity and mood disorders. Neurosci Biobehav Rev 2015; 52:89-104. [PMID: 25579847 DOI: 10.1016/j.neubiorev.2014.12.017] [Citation(s) in RCA: 202] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 12/19/2014] [Accepted: 12/31/2014] [Indexed: 12/12/2022]
Abstract
Obesity and mood disorders are highly prevalent and co-morbid. Epidemiological studies have highlighted the public health relevance of this association, insofar as both conditions and its co-occurrence are associated with a staggering illness-associated burden. Accumulating evidence indicates that obesity and mood disorders are intrinsically linked and share a series of clinical, neurobiological, genetic and environmental factors. The relationship of these conditions has been described as convergent and bidirectional; and some authors have attempted to describe a specific subtype of mood disorders characterized by a higher incidence of obesity and metabolic problems. However, the nature of this association remains poorly understood. There are significant inconsistencies in the studies evaluating metabolic and mood disorders; and, as a result, several questions persist about the validity and the generalizability of the findings. An important limitation in this area of research is the noteworthy phenotypic and pathophysiological heterogeneity of metabolic and mood disorders. Although clinically useful, categorical classifications in both conditions have limited heuristic value and its use hinders a more comprehensive understanding of the association between metabolic and mood disorders. A recent trend in psychiatry is to move toward a domain specific approach, wherein psychopathology constructs are agnostic to DSM-defined diagnostic categories and, instead, there is an effort to categorize domains based on pathogenic substrates, as proposed by the National Institute of Mental Health (NIMH) Research Domain Criteria Project (RDoC). Moreover, the substrates subserving psychopathology seems to be unspecific and extend into other medical illnesses that share in common brain consequences, which includes metabolic disorders. Overall, accumulating evidence indicates that there is a consistent association of multiple abnormalities in neuropsychological constructs, as well as correspondent brain abnormalities, with broad-based metabolic dysfunction, suggesting, therefore, that the existence of a "metabolic-mood syndrome" is possible. Nonetheless, empirical evidence is necessary to support and develop this concept. Future research should focus on dimensional constructs and employ integrative, multidisciplinary and multimodal approaches.
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Affiliation(s)
- Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.
| | - Elisa Brietzke
- Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada
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Kim J, Noh JW, Park J, Kwon YD. Body mass index and depressive symptoms in older adults: a cross-lagged panel analysis. PLoS One 2014; 9:e114891. [PMID: 25501372 PMCID: PMC4263712 DOI: 10.1371/journal.pone.0114891] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 11/11/2014] [Indexed: 01/17/2023] Open
Abstract
Background There are conflicting results about the association between body mass index (BMI) and depressive symptoms in older adults. The present study examined the relationship between weight and depressive symptoms over time in older adults in South Korea. Methods We used data from three waves of the Korean Longitudinal Study of Aging and ran a series of cross-lagged panel models to test the reciprocal relationship between depressive symptoms and obesity in older Korean adults. We assumed a temporally stable relationship between depressive symptoms and obesity and, thus imposed equality constraints over time. Results After controlling for the effect of depressive symptoms two years prior, underweight older adults had a higher depressive symptom score than those of normal weight. When controlling for obesity status from two years prior, older adults with higher levels of depressive symptoms were more likely to be underweight and less likely to be overweight than normal weight. The same patterns were observed in data from 2006 to 2008 and from 2008 to 2010. Conclusions These results show that there is a correlation between depressive symptoms and weight status. In middle-aged and elderly Asian populations, depression can lead to weight loss rather than obesity, and underweight may develop depressive symptoms.
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Affiliation(s)
- Jinseok Kim
- Department of Social Welfare, Seoul Women's University, Seoul, Korea
| | - Jin-Won Noh
- Department of Healthcare Management, Eulji University, Seongnam, Korea
| | - Jumin Park
- University of Maryland School of Nursing, Baltimore, Maryland, United States of America
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, the Catholic University of Korea, Seoul, Korea
- * E-mail:
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Dong Q, Liu JJ, Zheng RZ, Dong YH, Feng XM, Li J, Huang F. Obesity and depressive symptoms in the elderly: a survey in the rural area of Chizhou, Anhui province. Int J Geriatr Psychiatry 2013; 28:227-32. [PMID: 22492613 DOI: 10.1002/gps.3815] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 03/14/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The aim of the present study is to examine the relationship between obesity and depressive symptoms and to test the "Jolly Fat" hypothesis among older Chinese. METHODS A total of 736 rural Chinese aged 60 years and older participated in this cross-sectional study. Body mass index (BMI = kg/m(2) ) was calculated from the subjects' measured weight (kg) and height (meter). Depressive symptoms were assessed using the 30-item Geriatric Depression Scale (GDS-30), with a cut-off point of 11. RESULTS Among 736 total participants, the prevalence of depressive symptoms was 24.1% in men and 27.9% in women. A trend about depressive symptoms decreased with increasing BMI was found in men (χ(2) trend = 5.74, df = 1, p = 0.01). A weak inverse linear trend between obesity and depressive symptoms was observed among subjects. In men, obese group was less likely to suffer from depressive symptoms compared with normal weight group before or after adjustment for confounders, with odds ratios of 0.32 (95% confidence interval (CI): 0.12-0.85) and 0.28 (95% CI: 0.09-0.85), respectively. However, the association between BMI and depressive symptoms in women showed no significant differences. CONCLUSIONS Our results supported the "Jolly Fat" hypothesis only in rural older Chinese men, but not in women. Gender differences existed in the relationship between obesity and depressive symptoms.
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Affiliation(s)
- Qing Dong
- Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, China
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Brandheim S, Rantakeisu U, Starrin B. BMI and psychological distress in 68,000 Swedish adults: a weak association when controlling for an age-gender combination. BMC Public Health 2013; 13:68. [PMID: 23347701 PMCID: PMC3564918 DOI: 10.1186/1471-2458-13-68] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 01/11/2013] [Indexed: 11/23/2022] Open
Abstract
Background Study results concerning associations between body mass index (BMI) and psychological distress are conflicting. The purpose of this study was to describe the shape of the association between BMI and psychological distress in a large sample of Swedish adults. Methods Data was measured with the General Health Questionnaire-12 (GHQ-12), in 68,311 adults aged 18–74. Self-reported data was derived from a merger of the 2000, 2004 and 2008 Life and Health (Liv och Hälsa) questionnaires focusing general perceived distress as well as living conditions. Logistic regression analysis was used to describe the association between BMI and psychological distress when controlled for age and gender in combination. Results Women reported an overall higher psychological distress than men. A significant pattern of decreasing psychological distress with increasing age emerged among women in all BMI categories. Trends of this same pattern showed for men. Small or no differences were seen in psychological distress between those in normal weight, overweight, and obesity I categories (among women: 20.4%, 18.4%, 20.5%; among men: 12.8%, 11.2%, 12.9%). For both genders, any notable increase in psychological distress appeared first in the obesity II category (among women: 27.2%. Among men: 17.8%). Conclusions Psychological distress decreases with increasing age regardless of BMI; a pattern more obvious for women. Being categorized with obesity II leads to a markedly higher psychological distress than being categorized with normal weight, overweight or obesity I. From this, we suggest that future obesity research focusing on psychological distress could investigate the role of stigma and norm susceptibility in relationships where people are evaluated through the eyes of the other.
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Affiliation(s)
- Susanne Brandheim
- Department of Social and Psychological Studies, Karlstad University, Karlstad, SE 651 88, Sweden.
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Gan WY, Mohd Nasir MT, Zalilah MS, Hazizi AS. Psychological distress as a mediator in the relationships between biopsychosocial factors and disordered eating among Malaysian university students. Appetite 2012; 59:679-87. [PMID: 22885453 DOI: 10.1016/j.appet.2012.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 07/28/2012] [Accepted: 08/01/2012] [Indexed: 11/28/2022]
Abstract
The mechanism linking biopsychosocial factors to disordered eating among university students is not well understood especially among Malaysians. This study aimed to examine the mediating role of psychological distress in the relationships between biopsychosocial factors and disordered eating among Malaysian university students. A self-administered questionnaire measured self-esteem, body image, social pressures to be thin, weight-related teasing, psychological distress, and disordered eating in 584 university students (59.4% females and 40.6% males). Body weight and height were measured. Structural equation modeling analysis revealed that the partial mediation model provided good fit to the data. Specifically, the relationships between self-esteem and weight-related teasing with disordered eating were mediated by psychological distress. In contrast, only direct relationships between body weight status, body image, and social pressures to be thin with disordered eating were found and were not mediated by psychological distress. Furthermore, multigroup analyses indicated that the model was equivalent for both genders but not for ethnic groups. There was a negative relationship between body weight status and psychological distress for Chinese students, whereas this was not the case among Malay students. Intervention and prevention programs on psychological distress may be beneficial in reducing disordered eating among Malaysian university students.
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Affiliation(s)
- Wan Ying Gan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Darul Ehsan, Malaysia
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