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Ding J, Zeng Q, Tu R, He H, Wang S, Li Y, Huang Y, Gu J, Wang Z, Lu G. Gender Differences in the Association Between Childhood Neighborhood Quality and Depressive Symptoms Trajectory in Middle-Aged and Elderly Chinese: A Seven-Year Longitudinal Study. Int J Aging Hum Dev 2024:914150241278199. [PMID: 39279262 DOI: 10.1177/00914150241278199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2024]
Abstract
This study aimed to examine the role of childhood neighborhood quality on trajectories of depressive symptoms throughout later life based on a nationally representative sample, and to explore the role of gender in the association. Linear mixed-effects model analysis was performed to investigate a longitudinal association of childhood neighborhood quality with depressive symptoms. A total of 7,016 participants aged 45 and above were included in this study. Depressive symptoms progression was significantly faster (β [95% confidence interval, CI]: 0.13 [0.01, 0.25]; P = .027) in the low childhood neighborhood quality when compared with the high childhood neighborhood quality. The quality of childhood neighborhood was significantly associated with a change in depressive symptoms over time in females (β [95% CI]: 0.19 [0.02, 0.36]; P = .029) but not in males (β [95% CI]: 0.09 [-0.06, 0.25]; P = .224). Targeted interventions should be developed to prevent depressive symptoms for those vulnerable groups.
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Affiliation(s)
- Jiali Ding
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
- Nursing Department, Haimen People's Hospital, Nantong, China
| | - Qingping Zeng
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Raoping Tu
- Health Research Institute, Fujian Medical University, Fuzhou, China
| | - Huihui He
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Suhang Wang
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Yuping Li
- Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
- Neuro-Intensive Care Unit, Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Yujia Huang
- Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
- Neuro-Intensive Care Unit, Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Jiyue Gu
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Zhiyao Wang
- Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
- Neuro-Intensive Care Unit, Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Guangyu Lu
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
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Cavdar VC, Ballica B, Aric M, Karaca ZB, Altunoglu EG, Akbas F. Exploring depression, comorbidities and quality of life in geriatric patients: a study utilizing the geriatric depression scale and WHOQOL-OLD questionnaire. BMC Geriatr 2024; 24:687. [PMID: 39143531 PMCID: PMC11325729 DOI: 10.1186/s12877-024-05264-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 07/30/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND The increasing prevalence of depression among older adults is a growing concern. Chronic health conditions, cognitive impairments, and hospitalizations amplify emotional distress and depression levels in this population. Assessing the quality of life is crucial for the well-being of older adults. AIMS Our study aimed to examine how comorbidities affect depression and quality of life in geriatric patients in both outpatient and hospital settings. METHODS 100 patients (50 from internal medicine outpatient clinic and 50 from internal medicine ward) were included in the study according to inclusion and exclusion criteria. Patients were classified into different age groups (65-74 years, 75-84 years and ≥ 85 years). Data on patients' location of application, age, sex, living alone or with family status, number of comorbid diseases, types of accompanying diseases were recorded and WHOQOL-OLD and Geriatric Depression Scale (GDS) questionnaires were administered. Results were evaluated using SPSS. RESULTS The WHOQOL-OLD questionnaire score was higher in the 65-74 age group compared to other groups, but there was no significant difference between outpatient group and hospitalized group. Patients with comorbid diseases had lower WHOQOL-OLD questionnaire scores compared to those without comorbid diseases. In the 75-84 and ≥ 85 age groups, the GDS scores were higher compared to the 65-74 age group. In hospitalized group, GDS scores were higher than outpatient clinic group. In patients with comorbid diseases, GDS scores were higher than the ones without comorbid diseases. DISCUSSION Our findings indicate that quality of life is higher among those aged 65-74, with lower incidence of depression compared to other age groups. Hospitalization correlates with higher depression rates but not quality of life. As number of comorbid diseases increases in older adults, the frequency of depression rises and the quality of life declines. CONCLUSIONS Early detection and intervention for depression are crucial for enhancing older adults' well-being.
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Affiliation(s)
- Vahit Can Cavdar
- University of Health Sciences, Department of Internal Medicine, Istanbul Training and Research Hospital, Abdurrahman Nafiz Gürman Cad. Etyemez, Samatya, Istanbul, 34098, Turkey
| | - Basak Ballica
- Faculty of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Mert Aric
- University of Health Sciences, Department of Internal Medicine, Istanbul Training and Research Hospital, Abdurrahman Nafiz Gürman Cad. Etyemez, Samatya, Istanbul, 34098, Turkey
| | - Zekiye Busra Karaca
- Department of Internal Medicine, Beylikduzu State Hospital, Istanbul, Turkey
| | | | - Feray Akbas
- University of Health Sciences, Department of Internal Medicine, Istanbul Training and Research Hospital, Abdurrahman Nafiz Gürman Cad. Etyemez, Samatya, Istanbul, 34098, Turkey.
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Dang M, Chen Y, Ji JS, Zhang Y, Chen C, Zhang Z. The association between household and family composition and mental health of the elderly: mediating role of lifestyle. BMC Public Health 2024; 24:2055. [PMID: 39080574 PMCID: PMC11290097 DOI: 10.1186/s12889-024-19516-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/17/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Mental health in the elderly has multiple determinants, and studies indicate household and family composition, economic status, and family support are key factors. However, these are difficult to modify, and better lifestyle for the elderly can be a possible intervention. The current study examined the mediating role of lifestyle in the association between these three types of the household and family composition (living alone, living with a spouse, and living with children) and mental health in older adults. METHODS We studied 5,407 participants (58.7% female, age 45 + years) from the Beijing Aging Brain Rejuvenation Initiative Project. All participants underwent a battery of examinations to measure degree loneliness, depression, and global cognitive function. We also surveyed personal lifestyles. We used a mediation analysis to determine the relative contribution of each lifestyle factor on mental health outcomes. RESULTS Older adults living alone rarely participated in mental and social activities and often had irregular diets; those adults living with children spent most of their time caring for grandchildren and had irregular eating and sleeping schedules; those living with a spouse often engaged in a variety of leisure activities and had the best life habits. Mediation analyses showed that dietary and sleeping irregularity partially mediated the negative effects of living alone on mental health, and were moderated by age and gender. CONCLUSIONS Living with a spouse was associated with benefits for the mental health of middle-aged and older adults (especially older and female individuals), through modifying better lifestyles than those of individuals with the other two types of the household and family composition.
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Affiliation(s)
- Mingxi Dang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, P. R. China
- BABRI Centre, Beijing Normal University, Beijing, 100875, P. R. China
| | - Yaojing Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, P. R. China.
- BABRI Centre, Beijing Normal University, Beijing, 100875, P. R. China.
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, 100083, P. R. China
| | - Yutong Zhang
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Chuansheng Chen
- Department of Psychological Science, University of California, Irvine, CA, 92697, USA
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, P. R. China.
- BABRI Centre, Beijing Normal University, Beijing, 100875, P. R. China.
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Bae S, Ju Y, Nam S, Jin Y, Kang S, Ryu JK, Hong I. The association between self-rated health, number of family members, and cognitive function in community-dwelling older adults: Mediating role of depression. PLoS One 2024; 19:e0306907. [PMID: 38980869 PMCID: PMC11232972 DOI: 10.1371/journal.pone.0306907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 06/24/2024] [Indexed: 07/11/2024] Open
Abstract
With the increasing number of older adults, research on cognitive function has expanded. However, studies examining the mediating effect of depression on the association between complex factors and cognitive function in older adults are still insufficient. Additionally, there is a lack of studies that have investigated these relationships by integrating multiple factors related to the cognitive function of older adults. Therefore, our study investigated the association between the number of family members, self-rated health, depression, and cognitive function in community-dwelling older adults and highlighted the mediating role of depression in these relationships. We used data from 218 older adults aged over 65 collected in a previous study. The independent variables were the number of family members and self-rated health, and the dependent variable was cognitive function measured by the cognitive impairment screening test (CIST). The mediation variable was depression measured by the Patient Health Questionnaire-9 (PHQ-9). Structural equation modeling was used to examine the association between the independent, dependent, and mediation variable. The mean ages of the participants were 81.71 (standard deviation [SD] = 6.00) years, with 198 females (90.83%) and 20 males (9.17%). The structural equation model demonstrated a good model fit (chi-square value = 33.375; degrees of freedom = 24; p-value = 0.0964; RMSEA = 0.042; CFI = 0.970; TLI = 0.956; SRMR = 0.042). Self-rated health and the number of family members were not directly associated with cognitive function; however, depression had significant indirect effects (self-rated health to cognitive function: coefficient = -0.023, p-value = 0.017; number of family members and cognitive function: coefficient = 0.012, p-value = 0.030). Our findings indicated that depression plays a crucial mediating role between self-rated health, number of family members, and cognitive function. The results highlight the need for comprehensive strategies for mental health care to support cognitive health in older adults.
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Affiliation(s)
- Suyeong Bae
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju-si, Gangwon-do, Republic of Korea
| | - Yumi Ju
- Human Development and Rehabilitation, Graduate School of Education Service Science, Dongguk University, Seoul, Republic of Korea
| | - Sanghun Nam
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju-si, Gangwon-do, Republic of Korea
| | - Yeonju Jin
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju-si, Gangwon-do, Republic of Korea
| | - Sura Kang
- Convergence Research Center for Artificial Intelligence, Dongguk University, Seoul, Republic of Korea
| | - Jeh-Kwang Ryu
- Human Development and Rehabilitation, Graduate School of Education Service Science, Dongguk University, Seoul, Republic of Korea
- Convergence Research Center for Artificial Intelligence, Dongguk University, Seoul, Republic of Korea
- Department of Physical Education, College of Education, Dongguk University, Seoul, Republic of Korea
| | - Ickpyo Hong
- Department of Occupational Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju-si, Gangwon-do, Republic of Korea
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Carrasco PM, Crespo DP, García AIR, Ibáñez ML, Rubio BM, Montenegro-Peña M. Predictive factors and risk and protection groups for loneliness in older adults: a population-based study. BMC Psychol 2024; 12:238. [PMID: 38671496 PMCID: PMC11055238 DOI: 10.1186/s40359-024-01708-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Loneliness is considered a public health problem, particularly among older adults. Although risk factors for loneliness have been studied extensively, fewer studies have focused on the protected and risk groups that these factors configure. Our objective is to analyze the variables and latent factors that predict loneliness in older adults and that enable risk and protected groups to be configured. METHODS We employed an epidemiological, cross-sectional survey that was carried out on a random sample of 2060 people over 65 years extracted from the census. A structured telephone interview was used to assess mental and physical health, habits, quality of life, and loneliness, applying the COOP-Wonca, Goldberg General Health (GHQ-12), and Barber Questionnaires. RESULTS Predictors of loneliness were: mental health, living alone, quality of life, depressive symptoms, low educational level, and some deficiency situations such as having no one to turn to for help. The factors extracted (Factorial Analysis) were: a subjective experience of poor health, objective isolation, and psychological isolation. We established at risk and protected groups ("Decision Tree" procedure), and loneliness was referred to by 73.2% of the people living alone and with poor mental health and quality of life (risk group). By contrast, only 0.8% of people living with others, with good mental health and good quality of life felt loneliness (protected group). CONCLUSION In a well-developed city, subjective and objective factors are associated with loneliness. These factors, especially those associated with at risk or protected groups, must be considered to develop strategies that address loneliness.
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Affiliation(s)
| | - David Prada Crespo
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain
- Department of Basic Psychology I, Faculty of Psychology, National University of Distance Education of Madrid, Madrid, Spain
| | | | | | | | - Mercedes Montenegro-Peña
- Centre for the Prevention of Cognitive Impairment, Madrid Salud, Madrid, Spain.
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain.
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Gafaranga JP, Bitunguhari L, Mudenge C, Manirakiza F, Kelly B, Gatabazi P. Screening of Depression Among Medical Outpatients Visiting the University Teaching Hospital of Kigali, Rwanda. Neuropsychiatr Dis Treat 2024; 20:845-854. [PMID: 38618154 PMCID: PMC11011719 DOI: 10.2147/ndt.s443811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 04/03/2024] [Indexed: 04/16/2024] Open
Abstract
Background Depression is a significant global public health concern, affecting individuals across different age groups and cultural backgrounds. However, screening for depression remains an essential but often neglected aspect of healthcare, particularly in outpatient settings. This study aimed to assess the prevalence of depression among outpatients visiting the internal medicine department of the University Teaching Hospital of Kigali in Rwanda and evaluate the feasibility of implementing a depression screening program in this setting. Methods An institution-based cross-sectional study design was employed, involving 300 adult medical outpatients through convenience sampling, aged 18 years and above, who visited the internal medicine department between October 7 to November 6, 2019. The Patient Health Questionnaire-9 (PHQ-9) was used as the screening tool to assess depressive symptoms. Additionally, socio-demographic and clinical data were collected to explore potential risk factors associated with depression using a binary logistic regression model. Results A high prevalence of depression was identified among internal medicine outpatients, with 45.7% of participants screened positive for depression, with moderate, moderately severe, and severe depression accounting for 21%, 17%, and 8%, respectively. The following factors were significantly associated with positive screening for depression: lack of formal education (OR=4.463, p=0.011, 95% CI= [1.410; 14.127]), secondary education (OR=3.402, p=0.003, 95% CI= [1.517; 7.630]), low-income (OR=2.392, p=0.049, 95% CI= [1.003; 5.706]) and headache as a chief complaint (OR=3.611, p=0.001, CI= [1.718; 7.591]). Conclusion This study highlights the high prevalence of depression among medical outpatients. Due to the stigma associated with mental health, patients frequently seek help for physical symptoms such as headaches and other bodily complaints rather than mental health concerns. Introducing routine depression screening in medical departments could potentially facilitate early identification, and intervention, and lead to improved patient care. Future research should focus on evaluating such screening programs' effectiveness and long-term outcomes in resource-limited settings like Rwanda.
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Affiliation(s)
- Jean Pierre Gafaranga
- Department of Psychiatry and Behavioral Sciences, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
- Department of Mental Health, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Leopold Bitunguhari
- Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali, Rwanda
- Department of Internal Medicine, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
| | - Charles Mudenge
- Department of Psychiatry and Behavioral Sciences, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
- Department of Psychiatry, Ndera Neuropsychiatric Teaching Hospital, Kigali, Rwanda
| | - Felix Manirakiza
- Department of Clinical Biology, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Brian Kelly
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Paul Gatabazi
- School of Economics and Business, College of Business and Economics, University of Johannesburg, Johannesburg, South Africa
- Department of Mathematics and Applied Mathematics, University of Johannesburg, Johannesburg, South Africa
- Department of Statistics, University of South Africa, Pretoria, South Africa
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Ha SC, Nam E, Lee SY. Perceived Risk of Solitary Death and Depressive Symptoms Among Older Adults Living Alone in Seoul: Can Structural and Functional Social Support Buffer the Impact? J Appl Gerontol 2024; 43:251-260. [PMID: 37990529 DOI: 10.1177/07334648231211452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Abstract
Although older adults living alone are at a greater risk of solitary death, there is a dearth of literature in this area. Using the 2018 Seoul Elderly Survey, we investigated the extent to which older adults living alone in Seoul perceive the risk of solitary death and examined the association between the perceived risk of solitary death and depressive symptoms. Additionally, we explored the role of structural and functional support in that association as a buffering factor. Results showed that more than half of the older adults living alone in Seoul perceived that they could be victims of solitary death. The perceived risk of solitary death among older adults living alone was independently associated with depressive symptoms. Additionally, the structural aspect of social support moderated the impact of the perceived risk of solitary death on depressive symptoms. Interventions that enhance the structural aspect of social support should be primarily considered.
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Affiliation(s)
- Seok Cheol Ha
- Policy Research Department, Seoul Welfare Foundation, Mapo-Gu, Seoul, Korea
| | - Eunji Nam
- Department of Social Welfare, Incheon National University, Yeonsu-Gu, Inchoen, Korea
| | - Sun Young Lee
- Department of Social Welfare, Gangneung-Wonju National University, Wonju-Si, Kangwon, Korea
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Tang F, Li K, Wang Y, Zhu Y, Jiang Y. Social Disconnectedness, Perceived Loneliness, and Cognitive Functioning: The Role of Neighborhood Environment. Innov Aging 2024; 8:igae009. [PMID: 38500713 PMCID: PMC10946307 DOI: 10.1093/geroni/igae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Indexed: 03/20/2024] Open
Abstract
Background and Objectives Social disconnectedness and loneliness pose significant challenges for older Chinese immigrants. Yet, it remains unclear whether they are associated with an increased risk of cognitive decline in this population. This study aimed to investigate the association of social disconnectedness and loneliness with cognitive functioning and examine the moderation role of neighborhood contexts. Research Design and Methods This longitudinal analysis examined a sample of individuals aged 60 years and older from the Population Study of Chinese Elderly in Chicago (N = 2,044). Global cognition was assessed using the averaged z-scores of cognitive performance tests. Social disconnectedness was constructed using 5 indicators about structural aspects of social relationships. Loneliness was assessed with the R-UCLA loneliness scale. Neighborhood socioeconomic status (NSES) and neighborhood segregation index were constructed using 2010-2014 American Community Survey data at the census tract level. Individual perceptions about neighborhood environments were used to construct neighborhood cohesion index and neighborhood disorder index (NDI). Latent growth curve models with adjusted cluster robust standard errors were estimated. Results More loneliness was associated with a higher level of initial cognitive functioning (B = 0.030, p < .01), but also with a faster decline rate over time (B = -0.007, p < .01) after adjusting for covariates. High NSES and less neighborhood segregation buffered the negative effects of loneliness on cognitive decline, respectively. High NDI amplified the positive relationship between loneliness and initial functioning, but accelerated the rate of cognitive decline associated with loneliness. Discussion and Implications The study revealed that perceived loneliness, but not social disconnectedness, is a risk factor for cognitive decline among older Chinese immigrants. Living in a neighborhood with low socioeconomic status, more segregation, and high disorder elevated the detrimental effect of loneliness on long-term cognitive decline. Further research needs to investigate the complex interplay between social relationships, neighborhood environment, and cognition.
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Affiliation(s)
- Fengyan Tang
- School of Social Work, Univeristy of Pittsburgh. Pittsburgh, Pennsylvania, USA
| | - Ke Li
- School of Social Work, Univeristy of Pittsburgh. Pittsburgh, Pennsylvania, USA
| | - Yi Wang
- School of Social Work, University of Iowa, Iowa City, Iowa, USA
| | - Yuyang Zhu
- School of Public Health, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Yanping Jiang
- Department of Family Medicine and Community Health, Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
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Lin YC, Yan HT. Impact of Residential Area Characteristics and Political Group Participation on Depression Among Middle-Aged and Older Adults: Results of an 11-Year Longitudinal Study. Innov Aging 2024; 8:igae004. [PMID: 38426023 PMCID: PMC10902823 DOI: 10.1093/geroni/igae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Indexed: 03/02/2024] Open
Abstract
Background and Objectives The claim that political group attendance is associated with poor mental health among older adults may be conditioned on geographic conditions. This study examined the geographical context in which political group participation may be associated with depression. Research Design and Methods The 11-year follow-up data from the Taiwan Longitudinal Study on Aging, covering 5,334 persons aged ≥50 years, were analyzed using random-effects panel logit models. Depression was assessed using 10 items on the Centre for Epidemiologic Studies Depression scale. Participants were asked to indicate whether they belonged to different social groups. We modeled depression as a function of political group participation (the independent variable) and geographical region (moderators), adjusting for individual-level characteristics. Results Respondents in political groups were more likely to report depression than those in nonpolitical groups (adjusted odds ratio [AOR] = 1.90, 95% confidence interval [CI] = 1.34-2.68). Between urban and rural settlements, there were no statistically significant differences in mental health outcomes among older adults engaged in political groups (AOR = 1.72, 95% CI = 0.81-3.67). For those who remained politically engaged, living in areas with lower levels of electoral competition was associated with a lower likelihood of depression (AOR = 0.92, 95% CI = 0.86-0.98); this conditional effect was not prevalent among those who were solely engaged in nonpolitical groups (AOR = 1.02, 95% CI = 0.99-1.03). Discussion and Implications Political group participation is associated with poor mental health among older adults living in politically competitive regions.
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Affiliation(s)
- Yu-Chun Lin
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Huang-Ting Yan
- Institute of Political Science, Academia Sinica, Taipei, Taiwan
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Thwin KM, Kaneko N, Okubo H, Yamaga T, Suwama K, Yoshihara A, Iwasaki M, Ito Y, Tanaka J, Narita I, Ogawa H. Association between dry eye and periodontal disease in community-dwelling Japanese adults: data from the Uonoma cohort study. BMC Oral Health 2024; 24:47. [PMID: 38191354 PMCID: PMC10775486 DOI: 10.1186/s12903-023-03773-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/13/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND While research has explored the risk of periodontal disease in various eye conditions, the link between dry eye and periodontal disease remains underexplored, especially in Japanese adults. This study aims to investigate the association between dry eye and periodontal disease in community-dwelling Japanese adults. METHODS This study is a subset of the Uonuma cohort study, which includes Japanese adults aged 40 years and older residing in the Uonuma area of Niigata Prefecture, Japan. Participants completed a self-administered, paper-based questionnaire. Statistical analyses, including the chi-square test, independent t test, ANOVA test, and logistic regressions, were employed to assess the association of periodontal disease with independent variables. RESULTS Among 36,488 participants (average age 63.3 years, 47.4% men), 39.3% had a history of periodontal disease, and gender differences were statistically significant (p < 0.001). Significant associations were found between periodontal disease and dry eye diagnosis or symptoms. Univariable logistic regression revealed links between periodontal disease and age, gender, living status, alcohol consumption, remaining teeth, bite molar availability, and history of dry eye disease or symptoms. Multiple-adjusted regression found that doctor-diagnosed dry eye was associated with a higher likelihood of periodontal disease (odds ratio, 1.12; 95% confidence interval, 1.03-1.22). Participants who never experienced dryness or foreign body sensation had lower ORs of periodontal disease than those who always experienced such symptoms across all models. CONCLUSION A significant correlation was found between dry eye and periodontal disease in Japanese adults. Regular check-ups, early detection, and effective management of both conditions are strongly recommended.
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Affiliation(s)
- Kaung Myat Thwin
- Division of Preventive Dentistry, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Noboru Kaneko
- Division of Preventive Dentistry, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Hikaru Okubo
- Division of Preventive Dentistry, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Takayuki Yamaga
- Department of Oral Health, School of Dentistry, Matsumoto Dental University, Shiojiri, Japan
| | - Kana Suwama
- Division of Oral Science for Health Promotion, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Akihiro Yoshihara
- Division of Oral Science for Health Promotion, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Masanori Iwasaki
- Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Yumi Ito
- Department of Health Promotion Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Junta Tanaka
- Department of Health Promotion Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Ichiei Narita
- Department of Health Promotion Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hiroshi Ogawa
- Division of Preventive Dentistry, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan.
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Scharf A, Kleinke F, Michalowsky B, Rädke A, Pfitzner S, Mühlichen F, Buchholz M, van den Berg N, Hoffmann W. Sociodemographic and Clinical Characteristics of People Living with Dementia and Their Associations with Unmet Healthcare Needs: Insights from the Baseline Assessment of the InDePendent Study. J Alzheimers Dis 2024; 99:559-575. [PMID: 38669533 PMCID: PMC11191535 DOI: 10.3233/jad-231173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2024] [Indexed: 04/28/2024]
Abstract
Background The healthcare needs of People living with Dementia (PlwD) (such as Alzheimer's disease) are often unmet. Information about the needs of community-dwelling PlwD and their association with sociodemographic and clinical characteristics is needed to fill the knowledge gap regarding factors influencing unmet needs among PlwD and to conduct a comprehensive needs assessment to develop tailored interventions. Objective To describe sociodemographic and clinical characteristics of the InDePendent study population with particular reference to determinants of unmet needs. Methods We analyzed baseline data of the multi-centre cluster-randomized controlled trial (InDePendent) using descriptive statistics to describe patients' sociodemographic and clinical characteristics and Poisson regression models to predict unmet needs, separated by sex. Data were collected personally via face-to-face interviews. Results Most of the n = 417 participating PlwD were mild to moderately cognitively impaired, were not depressed, had an average of 10.8 diagnoses, took 6.7 medications, and had, on average, 2.4 unmet needs (62% of PlwD had at least one unmet need) measured by the Camberwell Assessment of Need for the Elderly (CANE). Low social support, a high body-mass-index, a lower education, functional impairment, and worse health status were associated with more unmet needs, regardless of sex. In women, higher unmet needs were associated with more depressive symptoms, a poor financial situation, living alone and not being recently treated by a general practitioner. In males, unmet needs increased with the number of medications taken. Conclusions PlwD had a broad array of unmet healthcare needs, indicating primary healthcare provision improvement potentials. The results underscore the significance of early assessment of patient's clinical characteristics and unmet needs as a basis for individualized gender-sensible intervention strategies.∥ClinicalTrials.gov Identifier: NCT04741932, Registered on February 5, 2021.
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Affiliation(s)
- Annelie Scharf
- Deutsches Zentum für Neurodegenerative Erkrankungen (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Fabian Kleinke
- Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Bernhard Michalowsky
- Deutsches Zentum für Neurodegenerative Erkrankungen (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Anika Rädke
- Deutsches Zentum für Neurodegenerative Erkrankungen (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Stefanie Pfitzner
- Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Franka Mühlichen
- Deutsches Zentum für Neurodegenerative Erkrankungen (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Maresa Buchholz
- Deutsches Zentum für Neurodegenerative Erkrankungen (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Neeltje van den Berg
- Deutsches Zentum für Neurodegenerative Erkrankungen (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- Deutsches Zentum für Neurodegenerative Erkrankungen (DZNE), Rostock/Greifswald, Greifswald, Germany
- Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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Hu F, Jing Y, Qin W, Han W, Xu L, Li Y. The mechanisms underlying the negative effect of socioeconomic status on depressive symptoms among older adults: The roles of social support and living arrangement. Int J Geriatr Psychiatry 2023; 38:e5991. [PMID: 37655502 DOI: 10.1002/gps.5991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 08/12/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVES Previous studies have found an association between socioeconomic status (SES) and depressive symptoms among older adults, however the mechanisms underlying this association remained unclear. This study aimed to examine the mediating role of social support and the moderating role of living arrangement in the association between SES and depressive symptoms. METHODS Data was collected from the 2020 Household Health Interview Survey in Taian city, Shandong Province, China. A total of 3896 older adults aged 60 and above were included in this study. Depressive symptoms was measured by the Patient health Questionnaire-9 (PHQ-9), Social support by the Multidimensional Scale of Perceived Social Support (MSPSS), and other variables by related demographic scales. The moderated mediation model was examined using HAYES PROCESS 3.5. RESULTS SES negatively predicted depressive symptoms among older adults, and social support could mediate this association. Living arrangement played a moderating role in the relationship between social support and depressive symptoms (the second half of the mediating effect), and the effect was stronger among older adults who lived alone. CONCLUSIONS Social support partially mediated the relationship between SES and depressive symptoms among older adults, and living alone strengthened the effect of social support on depressive symptoms. Interventions that address older adults' social support and living arrangement may ameliorate depressive symptoms among older adults.
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Affiliation(s)
- Fangfang Hu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Yurong Jing
- School of Public Health, Fudan University, Shanghai, China
| | - Wenzhe Qin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Wantong Han
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Lingzhong Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Yinlong Li
- School of Public Health, Jining Medical University, Jining, Shandong, China
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Huang M, Liu K, Liang C, Wang Y, Guo Z. The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety. BMC Geriatr 2023; 23:506. [PMID: 37608361 PMCID: PMC10463962 DOI: 10.1186/s12877-023-04161-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 07/10/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND With modernization and ageing in China, the population of older adults living alone is increasing. Living alone may be a potential risk factor for depressive symptoms. However, no parallel mediation model analysis has investigated the mediating factors for living alone or not (living arrangements) and depressive symptoms. METHODS This cross-sectional study included a total number of 10,980 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), 1699 of whom lived alone and 9281 of whom did not live alone. Binary logistic regression and parallel mediation effect model were used to explore the relationship between living alone or not and depressive symptoms and possible mediation effects. Bootstrap analysis was used to examine the mediation effect of living alone or not on depressive symptoms. RESULTS Compared to the participants who were not living alone, the living alone group had a higher rate of depressive symptoms. The binary logistic regression showed that after adjusting for other covariates, the risk of depressive symptoms was approximately 0.21 times higher for living alone compared to not living alone (OR = 1.21, 95% CI: 1.06, 1.37). Further, the results of the bootstrap analysis supported the partial mediating role of sleep quality and anxiety. Mediation analysis revealed that sleep quality and anxiety partially mediate the relationship between living alone and depressive symptoms (β = 0.008, 95% CI [0.003, 0.014]; β = 0.015, 95% CI [0.008, 0.024], respectively). CONCLUSIONS Sleep quality and anxiety were identified as partially parallel mediators between living alone or not and depressive symptoms. Older adults living alone with poorer sleep quality and more pronounced anxiety were positively associated with higher levels of depressive symptoms. Older adults living alone should be encouraged to engage in social activities that may improve sleep quality, relieve anxiety, and improve feelings of loneliness caused by living alone. Meanwhile, older adults living alone should receive attention and support to alleviate their depressive symptoms.
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Affiliation(s)
- Mina Huang
- Department of Nursing, The Jinzhou Medical University, Jinzhou, China
| | - Kun Liu
- Department of Medical College, The Jinzhou Medical University, Jinzhou, China
| | - Chunguang Liang
- Department of Nursing, The Jinzhou Medical University, Jinzhou, China
| | - Yongzhu Wang
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, No.2, Section 5, Renmin Street, Jinzhou, Liaoning, 121001, China
| | - Zhanpeng Guo
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, No.2, Section 5, Renmin Street, Jinzhou, Liaoning, 121001, China.
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Quashie NT, García C, Meltzer G, Andrade FCD, Matos-Moreno A. Neighborhood socioeconomic position, living arrangements, and cardiometabolic disease among older Puerto Ricans: An examination using PREHCO 2002-2007. PLoS One 2023; 18:e0289170. [PMID: 37527246 PMCID: PMC10393176 DOI: 10.1371/journal.pone.0289170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023] Open
Abstract
Cardiometabolic diseases are among the leading causes of mortality worldwide and are increasingly prevalent in rapidly aging populations. Neighborhood socioeconomic position (SEP) and living arrangements are increasingly recognized as important determinants of cardiometabolic health but have not been examined within Puerto Rico. This study examined the association between neighborhood SEP, living arrangements, and incidence of cardiometabolic conditions among island-dwelling older Puerto Ricans, using longitudinal data from the Puerto Rican Elderly Health Conditions Project (Waves I 2002/03 and II 2006/07) linked with 2000 Census data for neighborhood-level conditions. Our sample consists of non-institutionalized adults aged 60 and older who remained in the same residence over both waves of data collection (N = 2,769). We used multilevel multinomial logistic regression models to examine the relationship between neighborhood SEP and the prevalence and incidence of cardiometabolic disease. Findings show that residence in a socioeconomically advantaged neighborhood was positively associated with reporting having one cardiometabolic condition at baseline, but not associated with the incidence of cardiometabolic conditions at follow-up. Living without a partner was negatively associated with reporting having cardiometabolic conditions compared to living with a partner. Similar results were found for the incidence of cardiometabolic conditions. Living arrangements significantly modified the relationship between neighborhood SEP and cardiometabolic conditions. Compared to living with a partner, living alone in a socioeconomically advantaged neighborhood was associated with a reduced risk of reporting having one condition. Living with children in a socioeconomically advantaged neighborhood was associated with a reduced risk of developing one cardiometabolic condition than living with a partner. Living arrangements are more salient to cardiometabolic health than neighborhood SEP. Social programs and services focused on household composition and familial support are needed to identify older Puerto Ricans potentially at risk of underdiagnosed chronic conditions, especially as ongoing economic, demographic, environmental, and healthcare crises potentially exacerbate social inequalities.
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Affiliation(s)
- Nekehia T Quashie
- Department of Health Studies, University of Rhode Island, Kingston, RI, United States of America
| | - Catherine García
- Department of Human Development and Family Science, Aging Studies Institute, Center for Aging and Policy Studies, Lerner Center for Public Health Promotion and Population Health, Syracuse University, Syracuse, NY, United States of America
| | - Gabriella Meltzer
- Departments of Epidemiology and Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, United States of America
| | - Flavia C D Andrade
- School of Social Work, University of Illinois, Urbana-Champaign, Urbana, IL, United States of America
| | - Amílcar Matos-Moreno
- Population Research Institute, The Pennsylvania State University, State College, PA, United States of America
- Clinical Psychology Department, Carlos Albizu University, San Juan, Puerto Rico
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Gong R, Xia D, Hu Z, Hu Y. The impact of neighborhood mental health on the mental health of older adults. BMC Public Health 2023; 23:1352. [PMID: 37452289 PMCID: PMC10347814 DOI: 10.1186/s12889-023-16263-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND In this article, we use cross-sectional data obtained from the 2018 China Health and Aging Tracking Survey (CHARLS) to examine the impact of neighborhood mental health at the community level on the mental health of older adults aged 60 years and older. METHODS NMH is the average mental health of older adults in the same community, excluding the older adults themselves. The explained variable mental health in this paper was measured using the simple CES-D depression scale. The mediating variables were social connectedness, social participation and social inclusion, and the instrumental variables were physical exercise and amusement. regression analysis was conducted using OLS regression models, two-stage least squares (IV-2SLS) instrumental variables to address the two-way causality of NMH and MH, and KHB decomposition was used to investigate the effect mechanism. RESULTS Baseline regressions showed that the neighborhood mental health effect positively influenced the mental health of older adults (Coef. = 0.356, 95% CI 0.315,0.397). The neighborhood mental health effect estimated by IV-2SLS (Coef. = 0.251, 95% CI 0.096,0.405) was higher than the OLS regression, indicating endogeneity. The mediated effects of KHB showed total (Coef. = 0.356, 95% CI 0.314,0.398), direct (Coef. = 0.281, 95% CI 0.232,0.330), and indirect effects (Coef. = 0.075, 95% CI 0.049,0.101). While the total effect was 1.266 times higher than the direct effect, 21.03% of the total effect came from mediating variables. CONCLUSIONS First, the neighborhood mental health effect has a positive impact on the mental health of older adults, but there are heterogeneous differences based on gender, age, and place of residence. Second, the results of the IV-2SLS estimation showed that the effect of the neighborhood mental health effect was underestimated if endogenous problems were not controlled for. Third, the effect of neighborhood mental health on older adults' mental health was tested to be stable. Moreover, social connectedness, social participation, and social interaction are important mediating mechanisms for the effect of neighborhood mental health on older adults' mental health. This study provides new perspectives and ideas for an in-depth understanding of the mental health of older adults in the context of social transformation in China.
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Affiliation(s)
- Rengui Gong
- School of Public Management and Law, Anhui University of Technology, Ma'anshan, China
| | - Dongping Xia
- College of Public Administration and law, Hunan Agricultural University, Changsha, China
| | - Zan Hu
- The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China.
| | - Yangming Hu
- College of Public Administration and law, Hunan Agricultural University, Changsha, China.
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16
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Wu HY, Chiou AF. The effects of social media intergenerational program on depressive symptoms, intergenerational relationships, social support, and well-being in older adults: A quasi-experimental research. Geriatr Nurs 2023; 52:31-39. [PMID: 37243990 DOI: 10.1016/j.gerinurse.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 05/29/2023]
Abstract
Depressive symptoms are common among older adults. This quasi-experimental study aims to examine the effects of a social media intergenerational program on depressive symptoms, intergenerational relationships, social support, and well-being in older adults. This study enrolled 100 older adults who were divided into the intervention group (n=50) and control group (n=50). The intervention group received 5 weeks of the social media intergenerational program. The control group maintained their daily routines. Data were collected using structured questionnaires at baseline and 5 and 9 weeks after enrollment. We found that approximately 35% of older adults had mild to severe depressive symptoms. Compared to the control group, the intervention group exhibited significantly greater improvements in depressive symptoms, intergenerational relationships, social support, and well-being in the fifth week and the ninth week after intervention. Intergenerational social media activities were recommended for older adults to improve their depressive symptoms, and promote intergenerational relationships and well-being.
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Affiliation(s)
- Hsiao-Ying Wu
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan city33303, Taiwan, R.O.C.
| | - Ai-Fu Chiou
- College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan, R.O.C.
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17
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Lee H, Lim JH. Living Alone, Environmental Hazards, and Falls Among U.S. Older Adults. Innov Aging 2023; 7:igad055. [PMID: 37583969 PMCID: PMC10424630 DOI: 10.1093/geroni/igad055] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Indexed: 08/17/2023] Open
Abstract
Background and Objectives Physical conditions of living environments can affect the incidence of falls; however, prior work has focused typically on 1 domain at a time-either neighborhood or home, capturing limited environmental boundaries of older adults. We examined how neighborhood together with the home environment affect the incidence of falls over time and whether living arrangement modifies the influence of the environmental risks on falls. Research Design and Methods Using the 2012-2020 waves of the Health and Retirement Study (HRS; N = 1,893), we fitted logistic regression to estimate the incidence of falls over an 8-year study period. We used the neighborhood and housing data that are collected systematically by trained observers in the HRS to assess environmental hazards. Sidewalk quality, neighborhood disorder, and the presence of green space were measured to capture outdoor environmental hazards. Indoor environmental hazards included the presence of housing decay and poorly maintained stairways. All models were stratified by living arrangement. Results Neighborhood and housing environment were independently associated with the odds of falls net of demographic characteristics and preexisting health conditions, and effects were significant for people living alone only. The presence of green space and poorly maintained stairways were associated with greater odds of falling, net of covariates during 8 years of follow-up (odds ratios = 2.10 and 2.65, p < .05, respectively). None of the environmental risk factors were significant for those living with others. Discussion and Implications Falls in old age may be determined in part by a combination of outdoor and indoor risk factors. More research is needed to understand pathways that lead to greater vulnerability among older adults living alone to environmental hazards.
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Affiliation(s)
- Haena Lee
- Department of Sociology, Sungkyunkwan University, Seoul, South Korea
| | - Justin H Lim
- Graduate School of Environmental Studies, Seoul National University, Seoul, South Korea
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Liu X, Zhang J, Zhang S, Peng S, Pei M, Dai C, Wang T, Zhang P. Quality of life and associated factors among community-dwelling adults with multimorbidity in Shanghai, China: A cross-sectional study. Nurs Open 2023. [PMID: 37243492 DOI: 10.1002/nop2.1770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/23/2023] [Accepted: 04/16/2023] [Indexed: 05/28/2023] Open
Abstract
AIM To compare the quality of life of patients with and without multimorbidity and investigate potential factors related to the quality of life in patients with multimorbidity. DESIGN A descriptive cross-sectional study. METHODS This study included 1778 residents with chronic diseases, including single disease (1255 people, average age: 60.78 ± 9.42) and multimorbidity (523 people, average age: 64.03 ± 8.91) groups, who were recruited from urban residents of Shanghai through a multistage, stratified, probability proportional to size sampling method. The quality of life was measured using the World Health Organization Quality of Life Questionnaire. The socio-demographic data and psychological states were measured using a self-made structured questionnaire, Self-rating Anxiety Scale, and Self-rating Depression Scale. Differences in demographic characteristics were estimated using Pearson's chi-squared test, and independent t-test or one-way ANOVA followed by S-N-K test was used to compare the mean quality of life. Multiple linear regression analysis was conducted to identify risk factors for multimorbidity. RESULTS There were differences in age, education, income, and BMI between single-disease and multimorbidity groups, but no differences in gender, marriage, and occupation. Multimorbidity had lower quality of life, reflected in all four domains. Multiple linear regression analyses showed that low level of education, low income, number of diseases, depression, and anxiety were negatively related to quality of life in all domains.
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Affiliation(s)
- Xingyue Liu
- Graduate School, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Juhua Zhang
- Department of integrated traditional Chinese and Western Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Shixiang Zhang
- School of Nursing & Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Shuzhi Peng
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mengyun Pei
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chunying Dai
- Department of medicine, Kashgar Vocational and Technical College, Kashgar, China
| | - Tingting Wang
- School of Nursing & Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Peng Zhang
- School of Management, Hainan Medical University, Haikou, China
- School of Clinical Medicine, Shanghai University of Medicine & Health Sciences, Shanghai, China
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Xia L, Qiu S, Kong FB, Lai J, Huang H, Hu H, Liu X, Ye Z, Cao J. Epidemiology and Nomogram for Predicting the Cancer-specific Survival of Ovarian Granulosa Cell Tumor: A Seer database study. J Gynecol Obstet Hum Reprod 2023; 52:102601. [PMID: 37156420 DOI: 10.1016/j.jogoh.2023.102601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/26/2023] [Accepted: 05/04/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE ovarian granulosa cell tumor (OGCT) is a kind of infrequent ovarian malignant tumor with limited epidemiological data available. we established a predictive nomograph to verify the clinical prognosis. METHODS 1005 diagnosed with ovarian granulosa cell tumor (OGCT) were extracted from Surveillance, Epidemiology, and End Results (SEER) public database from 2000-2018. Kaplan-Meier analysis was applied to distinguish risk factors, univariate and multivariate Cox analyses were used to determine the independent prognostic factors for cancer-specific survival (CSS) of OGCT patients. The obtained prognostic variables were combined to construct a nomogram model for predicting CSS in OGCT patients. RESULTS Model performance was detected and evaluated with ROC curves and calibration plots. Data collected from 1005 patients were divided into two groups: training cohort(n=703,70%) and validation cohort(n=302,30%). The multivariate Cox model identified five covariates including age, marital status, AJCC stages, surgery and chemotherapy as independent interfering factors of CSS. The nomogram has shown a promising and excellent accuracy in evaluating 3 -, 5 -, 8-year CSS in OGCT patients. In terms of the CSS of the training cohort, the AUC values of the 3 -, 5 -, 8-year ROC curves were 0.819,0.8,0.819, while in terms of the CSS of the validation cohort, the AUC values of the validation cohort were 0.822,0.84,0.823, respectively. All the calibration curves showed pleasant consistency between predicted and actual survival rates. The nomogram model established in the study can improve the veracity of prognosis prediction, thereby improving the accuracy of individualized survival risk assessment, and providing targeted and constructive recommendations for specific treatment options. CONCLUSION Age, advanced clinical stage, widower and without surgery therapy are independent risk factors for poor prognosis and the nomogram we constructed can help clinicians efficiently recognize high-risk OGCT patients to guide targeted therapies and improve their outcomes.
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Affiliation(s)
- Longjie Xia
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, China.; Department of General Surgery, Guangzhou First People's Hospital, Guangzhou, No. 1 Panfu Road, Yuexiu District, Guangzhou 510180, China
| | - Shenghui Qiu
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, China.; Department of General Surgery, Guangzhou First People's Hospital, Guangzhou, No. 1 Panfu Road, Yuexiu District, Guangzhou 510180, China
| | - Fan-Biao Kong
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, China.; Department of Colorectal and Anal Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning, Guangxi Zhuang autonomous region 530021, People's Republic of China.; Institute of Minimally Invasive Technology and Applications Guangxi Academy of Medical Science,6 Taoyuan Road, Nanning, Guangxi Zhuang autonomous region 530021, People's Republic of China
| | - Jianqin Lai
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, China.; Department of General Surgery, Guangzhou First People's Hospital, Guangzhou, No. 1 Panfu Road, Yuexiu District, Guangzhou 510180, China
| | - Huixian Huang
- Department of Plastic Surgery, The First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Road 2, Guangzhou 510080, China
| | - Huiqiong Hu
- Department of General Surgery, Guangzhou First People's Hospital, Guangzhou, No. 1 Panfu Road, Yuexiu District, Guangzhou 510180, China
| | - Xiangxia Liu
- Department of Plastic Surgery, University of Tennessee Health Science Center, Memphis, TN, USA 38138..
| | - Zi Ye
- Department of Emergency, The First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Road 2, Guangzhou 510080, China.
| | - Jie Cao
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, China.; Department of General Surgery, Guangzhou First People's Hospital, Guangzhou, No. 1 Panfu Road, Yuexiu District, Guangzhou 510180, China.
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Hou B, Zhang H. Latent profile analysis of depression among older adults living alone in China. J Affect Disord 2023; 325:378-385. [PMID: 36640808 DOI: 10.1016/j.jad.2022.12.154] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 12/28/2022] [Accepted: 12/31/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND The number of older adults living alone has increased significantly. Depression is one of the significant mental health problems they face; classifying depressive conditions into homogeneous subgroups can help discover hidden information. METHODS The data comes from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Latent profile analysis (LPA) was used to identify depression subgroups among elderly living alone, Chi-square tests and Kruskal-Wallis tests were used to univariate analysis, multinomial logistic regression was used to analyze the related factors. RESULTS 1831 older adults living alone were identified and classified as low-level (30.4 %), moderate-level (55.3 %) and high-level (14.4 %). All variables, except age, were significant in the univariate analysis. Multinomial logistic regression showed that not participating in exercise, sometimes interacting with friends, anxiety symptoms, and impaired IADL were associated with the moderate- and high-level of depression in older adults living alone; good or fair self-rated health and life satisfaction were associated with the low-level of depression in older adults living alone. Anxiety symptoms were associated with high-level of depression in older adults living alone compared to moderate-level; good or fair self-rated health and life satisfaction were associated with moderate-level of depression in older adults living alone. LIMITATIONS The CES-D-10 cannot fully determine the presence of depression in elderly people living alone at high-level. CONCLUSIONS In future primary health care, it would be more meaningful to provide targeted interventions for different subgroups of depression in older adults living alone.
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Affiliation(s)
- Bailing Hou
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Huijun Zhang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China.
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Gan T, Yang J, Jiang L, Gao Y. Living alone and cardiovascular outcomes: a meta-analysis of 11 cohort studies. PSYCHOL HEALTH MED 2023; 28:719-731. [PMID: 34477038 DOI: 10.1080/13548506.2021.1975784] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To explore whether living alone could increase the risk of cardiovascular outcomes. We searched PubMed, EMBASE, and Web of Science from their inception to 5 October 2020. Cohort studies evaluating the relationship between living alone and cardiovascular outcomes were included. Subgroup analyses were conducted to explore which characteristics would affect the relationship. A total of 13 effect sizes obtained from 11 studies were included and spanned from 1993 to 2019, with 424,286 participants. This study found that living alone increased the risk of cardiovascular outcomes (HR = 1.22, 95% CI: 1.10-1.36, I2 = 80.3%, P = 0.000). In subgroup analyses, living alone increased the risk of cardiovascular outcomes in patients from Europe (HR = 1.37, 95% CI: 1.17-1.61, I2 = 76.2%, P = 0.000), but not increased in Asia (HR = 1.17, 95% CI: 0.83-1.66, I2 = 76.2%, P = 0.000) and multiple regions (HR = 1.02, 95% CI: 0.96-1.08, I2 = 0.0%, P = 0.738). For different cardiovascular outcomes, living alone has statistical significance in increasing the risk of cardiovascular mortality (HR = 1.23, 95% CI: 1.05-1.46, I2 = 84.0%, P = 0.000) and myocardial infarction (HR = 1.11, 95% CI: 1.02-1.21, I2 = 29.6%, P = 0.213). The risk of cardiovascular mortality in men was higher than women (HR = 1.52, 95% CI: 1.24-1.86 vs HR = 1.01, 95% CI: 0.85-1.20; P < 0.05 for interaction). Sensitivity analysis suggested that the results of the meta-analysis were robust. In conclusion, living alone could increase the risk of cardiovascular outcomes and men were more prone to cardiovascular mortality and myocardial infarction.
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Affiliation(s)
- Ting Gan
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Jingli Yang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.,College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Lili Jiang
- Institute of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
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22
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Kim HHS, Jung JH. Relational burden, depression, and loneliness among American older adults: an inquiry into the 'dark side of social capital'. Aging Ment Health 2023; 27:630-639. [PMID: 35274587 DOI: 10.1080/13607863.2022.2045564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Social networks and resources embedded in them are shown to promote mental health. This study examines whether there may be deleterious consequences of interpersonal ties and social capital on loneliness and depression in later life. METHOD Using data from the latest wave of National Social Life, Health and Aging Project (NSHAP) 2015-2016, we examine how relational burden is associated with mental health outcomes among older American adults. We also assess whether relational burden measured at the contextual, or regional, level may moderate the link between collective efficacy (neighborhood cohesion) and depression/loneliness. RESULTS Individual-level relational burden stemming from both kin and non-kin members is associated with higher levels of depression and loneliness. Moreover, regional-level kin and non-kin types of relational burden significantly amplify the negative relationship between collective efficacy and depression. For loneliness, however, we do not find such cross-level interaction. CONCLUSION Unlike prior research using conventional measures of social capital (e.g. trust, frequency of social interaction, and organizational participation) to evaluate its potential downside, our study contributes to the literature by directly operationalizing the concept of 'relational burden', stress due to excessive demands from others, at individual and contextual levels of analysis.
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Affiliation(s)
| | - Jong Hyun Jung
- School of Social Science, Nanyang Technological University, Singapore
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23
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Decreasing patterns of depression in living alone across middle-aged and older men and women using a longitudinal mixed-effects model. Soc Sci Med 2023; 317:115513. [PMID: 36450172 DOI: 10.1016/j.socscimed.2022.115513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/23/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022]
Abstract
There is little evidence regarding the association between living arrangement and depression, and no studies have examined the age- and gender-specific differences in this association. The present study sought to examine the longitudinal changes in depression patterns between isolative living versus living in company among middle-aged and older men and women by obtaining data from waves 1-7 of the Korean Longitudinal Study of Aging (KloSA), which comprises a sample of persons at least 45 years of age in the Republic of Korea (2273 middle-aged and 1387 older men, 2805 middle aged and 1862 older women). Depression scores were based on the self-reported Center for Epidemiologic Studies Depression Scale (CES-D-10) short forms. Using mixed-effect linear regression models, we estimated depression patterns by living arrangement across age- and gender groups. Our findings from the mixed-effects model revealed that over a 14-year follow-up period, there were significant decreasing patterns of depression were among middle-aged men and women, and older men living alone compared to living with a spouse and living with others. However, living alone still had the highest depression compared to other living arrangement types. On the other hand, the depression of older women living alone changed to a level similar to those living with others during the follow-up period. In conclusion, these findings indicate that living alone significantly increases the risk of depression, but the risk decreases over time. Additionally, depression patterns by living arrangement proved to differ across age and gender groups.
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Jiang Y, Li M, Chung T. Living alone and all-cause mortality in community-dwelling older adults: The moderating role of perceived neighborhood cohesion. Soc Sci Med 2023; 317:115568. [PMID: 36442301 PMCID: PMC9839549 DOI: 10.1016/j.socscimed.2022.115568] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 10/23/2022] [Accepted: 11/19/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The adverse effect of living alone on health has been well-documented in community-dwelling older adults. A less understood topic in this research area is whether some neighborhood characteristics may mitigate the negative impact of living alone on health outcomes and mortality. This study aimed to extend the existing work on living arrangements and health by examining the potential interactive effect of living alone and perceived neighborhood cohesion on all-cause mortality among older Chinese Americans. METHODS Data were drawn from 3154 (58.0% female) participants from a prospective cohort study of community-dwelling US older Chinese adults aged 60 and older in the greater Chicago area. Living arrangements and perceived neighborhood cohesion were assessed at baseline from 2011 to 2013. Mortality status was tracked through December 2021. Covariates, including sociodemographic characteristics, health and behavioral covariates, loneliness, depression, and social engagement, were assessed at baseline. Cox proportional hazards regression model was used to test our hypotheses. RESULTS Living alone was significantly associated with an increased risk of all-cause mortality among participants reporting low levels of perceived neighborhood cohesion but not among those reporting high levels of perceived neighborhood cohesion. This protective effect of perceived neighborhood cohesion was robust to the inclusion of covariates. CONCLUSIONS Our results suggest that strong perceived neighborhood cohesion may protect against the increased risk of premature mortality associated with living alone in community-dwelling older Chinese Americans.
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Affiliation(s)
- Yanping Jiang
- Center for Population Behavioral Health, Institute for Health, Health Care Policy and Aging Research, The State University of New Jersey, New Brunswick, NJ, United States; Department of Family Medicine and Community Health, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States.
| | - Mengting Li
- Department of Social Security, School of Labor and Human Resources, Renmin University of China, Beijing, China
| | - Tammy Chung
- Center for Population Behavioral Health, Institute for Health, Health Care Policy and Aging Research, The State University of New Jersey, New Brunswick, NJ, United States; Department of Psychiatry, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
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25
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Susanty S, Sufriyana H, Su ECY, Chuang YH. Questionnaire-free machine-learning method to predict depressive symptoms among community-dwelling older adults. PLoS One 2023; 18:e0280330. [PMID: 36696383 PMCID: PMC9876369 DOI: 10.1371/journal.pone.0280330] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 12/27/2022] [Indexed: 01/26/2023] Open
Abstract
The 15-item Geriatric Depression Scale (GDS-15) is widely used to screen for depressive symptoms among older populations. This study aimed to develop and validate a questionnaire-free, machine-learning model as an alternative triage test for the GDS-15 among community-dwelling older adults. The best models were the random forest (RF) and deep-insight visible neural network by internal validation, but both performances were undifferentiated by external validation. The AUROC of the RF model was 0.619 (95% CI 0.610 to 0.627) for the external validation set with a non-local ethnic group. Our triage test can allow healthcare professionals to preliminarily screen for depressive symptoms in older adults without using a questionnaire. If the model shows positive results, then the GDS-15 can be used for follow-up measures. This preliminary screening will save a lot of time and energy for healthcare providers and older adults, especially those persons who are illiterate.
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Affiliation(s)
- Sri Susanty
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Nursing Study Program, Faculty of Medicine, Universitas Halu Oleo, Kendari, Southeast Sulawesi, Indonesia
| | - Herdiantri Sufriyana
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Department of Medical Physiology, Faculty of Medicine, Universitas Nahdlatul Ulama Surabaya, Surabaya, Indonesia
| | - Emily Chia-Yu Su
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
- * E-mail: (YHC); (ECYS)
| | - Yeu-Hui Chuang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- * E-mail: (YHC); (ECYS)
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26
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Jin Y, Zhou X, Deng L, Xiong X, Li Y, Wei Q, Dong B, Qiu S. Association between the domestic use of solid cooking fuel and increased prevalence of depression and cognitive impairment in a big developing country: A large-scale population-based study. Front Public Health 2022; 10:1038573. [PMID: 36504928 PMCID: PMC9731231 DOI: 10.3389/fpubh.2022.1038573] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background Previous studies have suggested that air pollution affects physiological and psychological health. Using solid fuel at home is a significant source of indoor air pollution. The associations between solid fuel use and depressive symptoms and cognitive health were unclear among older adults from low- and middle-income countries (LMICs). Methods To evaluate the association of solid fuel use with depressive symptoms and cognitive health among older adults, we obtained data from the Longitudinal Aging Study in India (LASI) and excluded subjects younger than 60 years and without critical data (solid fuel use, depressive symptoms, and cognitive health). The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) was used to assess depressive symptoms, with more than ten indicative of depression. Cognitive health was assessed using measures from the Health and Retirement Study (HRS), and subjects with the lowest 10th percentile were considered to have cognitive impairment. The participants' responses defined solid fuel use. Multivariable logistic regression, linear regression, subgroup analysis, and interaction tests were performed to appraise the relationship between solid fuel use and depression and cognitive impairment. Results A total of 29,789 participants over 60 years old were involved in this study. Almost half of the participants (47.5%) reported using solid fuel for home cooking. Compared with clean fuel use, solid fuel use was related to an increased prevalence of depression [odds ratio (OR) 1.09, 95% CI 1.03-1.16] and higher CES-D-10 scores (β 0.23, 95% CI 0.12-0.35) after fully adjusted covariables. Using solid fuel was also related to a higher risk of cognitive impairment (OR 1.21, 95% CI 1.11-1.32) and a lower cognitive score (β -0.63, 95% CI -0.79 to -0.47) compared with those who used clean fuel. In the subgroup analysis, the prevalence of depression increased in females and non-smokers. The association of solid fuel use with depression and cognitive impairment exists in subgroups of BMI, economic status, caste, living area, education, and drinking. Conclusions The use of solid fuel at home was associated with an increased prevalence of depression and cognitive impairment among older adults in India.
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Affiliation(s)
- Yuming Jin
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Xianghong Zhou
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Linghui Deng
- National Clinical Research Center of Geriatrics, The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xingyu Xiong
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yifan Li
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Wei
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Birong Dong
- National Clinical Research Center of Geriatrics, The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China,Birong Dong
| | - Shi Qiu
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China,Institute of Oncology Research (IOR) and Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland,*Correspondence: Shi Qiu
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27
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Chen TY, Geng JH, Chen SC, Lee JI. Living alone is associated with a higher prevalence of psychiatric morbidity in a population-based cross-sectional study. Front Public Health 2022; 10:1054615. [PMID: 36466461 PMCID: PMC9714444 DOI: 10.3389/fpubh.2022.1054615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022] Open
Abstract
Background Living alone has been linked to poor mental health, however large-scale epidemiological studies on the association between living alone and psychiatric morbidity including depression and anxiety are lacking. The aim of this study was to investigate this issue in a large Taiwanese cohort. Methods In this cross-sectional study, we enrolled 121,601 volunteers from 29 community recruitment stations in Taiwan and divided them into two groups based on whether or not they lived alone. Psychiatric morbidity was defined as a Generalized Anxiety Disorder 2-item score ≥ 3, Patient Health Questionnaire 2-item score ≥ 3, or self-reported depression. Logistic regression was used to explore the associations between living alone and psychiatric morbidity. Results The participants who lived alone had a higher prevalence of psychiatric morbidity [odds ratio (OR) = 1.608, 95% confidence interval (CI) = 1.473 to 1.755] after adjusting for potential confounders. In a subgroup analysis, married subjects who lived alone and divorce/separation (OR = 2.013, 95% CI = 1.763 to 2.299) or widowing (OR = 1.750, 95% CI = 1.373 to 2.229) were more likely to have psychiatric morbidity than those who were married and not living alone. Conclusions Our findings suggest that living alone is a risk factor for psychiatric morbidity, especially for married subjects who live alone in concordance with divorce, separation, or the death of a spouse.
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Affiliation(s)
- Te-Yu Chen
- School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jiun-Hung Geng
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan,Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jia-In Lee
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,*Correspondence: Jia-In Lee
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28
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Association of suicidal ideation and depression with the use of proton pump inhibitors in adults: a cross-sectional study. Sci Rep 2022; 12:19539. [PMID: 36376493 PMCID: PMC9663563 DOI: 10.1038/s41598-022-24244-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
Proton pump inhibitors (PPIs) were found to be associated with depression. This study aimed to find the cross-sectional association between recent PPI use and suicidal ideation. Item 9 of Patient Health Questionnaire-9 (PHQ-9) of the US National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018 was used to categorize whether or not the participants had suicidal ideation. The secondary outcome of this study was depression and the scores of the PHQ-9 were used as the depression diagnostic instrument. The study population included 16,881 participants who were over 20 years old. The bivariate Rao-Scott χ2 test showed a significant association between PPI use and suicidal ideation (P < 0.001) and a stronger association was observed between PPIs and depression (P < 0.001). Multiple logistic regression analysis of the education, gender, race and age-adjusted model revealed that the PPI users had a 2.34 (95% CI 1.66-3.31) greater risk of having suicidal ideation than the non-PPI users. Middle-aged participants (40-49 years) showed the greatest number of differences in suicidal ideation between PPI and non-PPI users (P < 0.001). Future research should continue to consider the psychiatric effects of taking PPIs.
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Marin IB, Fernández D, Ayuso-Mateos JL, Leonardi M, Tobiasz-Adamczyk B, Koskinen S, Sanchez-Niubo A, Cristóbal-Narváez P. Healthy aging and late-life depression in Europe: Does migration matter? Front Med (Lausanne) 2022; 9:866524. [PMID: 36425106 PMCID: PMC9680089 DOI: 10.3389/fmed.2022.866524] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/22/2022] [Indexed: 11/03/2023] Open
Abstract
Background There is limited research examining the impact of risk and protective factors on late-life depression using large population-based datasets, particularly those examining differences among older migrants and non-migrants in Europe countries. Thus, the first aim was to analyze differences between migrants and non-migrants regarding socioeconomic status, depression, multimorbidity, healthy aging, and lifestyle behaviors. The second aim was to examine the impact of healthy aging on late-life depression in older migrants compared to their counterparts without a history of international migration in extensive and harmonized data from different population-based cohort studies. Materials and methods We analyzed cross-sectional, predominantly nationally representative, community-based data from European participants in the Aging Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) cohort. The descriptive analyses included sociodemographic variables, somatic comorbidities, multimorbidity, healthy aging, and lifestyle behaviors according to migration status. The effects of these variables on late-life depression were examined in a multivariate logistic regression model, including migration status and years since migration as predictors. Results Data of 122,571 individuals aged ≥ 50 years were analyzed, of which 11,799 (9.60%) were migrants. The descriptive analyses indicated that compared to non-migrants, migrants showed a higher prevalence of diabetes (25.6%), hypertension (38.0%), coronary artery disease (49.4%), stroke (4.9%), and depression (31.1%). Healthy aging was also better in non-migrants (51.7; SD = 9.7) than in migrants (39.6; SD = 18.2). The results of the logistic regression showed that migration status [OR = 1.231 (CIs: 0.914-1.547)] and increased number of years since migration in the host country [OR = 0.003 (CIs: 0.001-0.005)] were associated with greater levels of depressive symptoms. Concerning health variables, multimorbidity was associated with higher levels of depressive symptoms [OR = 0.244 (CIs: 0.211-0.278)], whereas better healthy aging was associated with fewer depressive symptoms [OR = -0.100 (CIs: -0.102 to -0.098)]. The interaction between migration and healthy aging status was also significant [OR. = -0.019 (CIs: -0.025 to -0.014)]. Conclusion Migrants reported higher risks for worse health outcomes compared to non-migrants. Significantly, worse healthy aging was associated with a greater risk of depressive symptoms in migrants than in non-migrants. Shedding light on migration and aging processes is essential for promoting a cross-cultural understanding of late-life depression in Europe.
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Affiliation(s)
- Ivet Bayes Marin
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut–Campus Clínic, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Fernández
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Serra Húnter fellow, Department of Statistics and Operations Research (DEIO), Universitat Politècnica de Catalunya BarcelonaTech, Barcelona, Spain
- Institute of Mathematics of UPC–BarcelonaTech, Barcelona, Spain
| | - Jose Luis Ayuso-Mateos
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit–IRCCS Neurology Institute Besta, Milan, Italy
| | - Beata Tobiasz-Adamczyk
- Department of Medical Sociology, Jagiellonian University Medical College, Kraków, Poland
| | - Seppo Koskinen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Albert Sanchez-Niubo
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Paula Cristóbal-Narváez
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
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Zhang J, Lu N. How does neighbourhood environment influence loneliness in later life in Urban China? The role of financial status. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5314-e5325. [PMID: 35912778 DOI: 10.1111/hsc.13950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 06/04/2022] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to examine whether older adults' financial status moderated the association between neighbourhood environment (i.e. physical and social environment) and loneliness among older adults in urban China. A cross-sectional survey was collected from urban communities of Shanghai in mid-2020. The final analytic sample was 459 older adults (age range = 60-91 years; proportion of women: 55.8%). Multiple group analysis was applied to test the hypothesised model. A measurement model of community social capital (i.e. cognitive and structural dimensions of social capital), a crucial indicator of neighbourhood social environment, was first established in both high-income and low-income groups. Factor loading invariance was established in these two groups. The results show that structural social capital (i.e. organisation memberships, volunteering, social participation and citizenship activities) was negatively associated with loneliness among older respondents from the high-income group only, whereas better community security was significantly associated with lower levels of loneliness among low-income older respondents only. The findings imply that both structural social capital and household income should be considered as important indicators in needs assessment among lonely older adults. Future social policies and interventions should pay attention to enhancing the role of both social and physical neighbourhood environment among older adults.
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Affiliation(s)
- Jingyue Zhang
- Department of Sociology, School of Philosophy and Sociology, Jilin University, Changchun, China
| | - Nan Lu
- Department of Social Work and Social Policy, School of Sociology and Population Studies, Renmin University of China, Beijing, China
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Meyer OL, Koo HJ, Strominger J, Tran D, Bach A, Leggett AN. Neighborhood Characteristics and Caregiver Depressive Symptoms in the National Study of Caregiving. J Aging Health 2022; 34:1005-1015. [PMID: 35428405 PMCID: PMC9749613 DOI: 10.1177/08982643221085106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objectives: We examined the association between neighborhood characteristics and depressive symptoms in a population-based sample of dementia caregivers. Methods: Data came from the 2017 National Health and Aging Trends Study (NHATS) and National Study of Caregiving. The sample included 956 caregivers of those with dementia. Linear regression was used to examine associations between neighborhood physical disorder neighborhood social cohesion, and depressive symptoms, and to test the moderating effect of social support on these relations. Results: Results suggested that having friends and family (1) to talk to buffered the effect of high NPD and low cohesion on depressive symptoms, (2) to help with daily activities buffered the effect of low cohesion on depressive symptoms, and finally, and (3) to help with care had a protective effect on depressive symptoms if social cohesion was high. Discussion: Neighborhood contextual characteristics and social support interact to affect caregiver depressive symptoms in complex ways.
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Affiliation(s)
- Oanh L. Meyer
- Department of Neurology, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA
| | - Hyun Jung Koo
- Department of Psychiatry, Geriatric Psychiatry Section, University of Michigan, Michigan Medicine, MI 48109, USA
| | - Julie Strominger
- Department of Psychiatry, Geriatric Psychiatry Section, University of Michigan, Michigan Medicine, MI 48109, USA
| | - Duyen Tran
- Department of Neurology, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA
| | - Anna Bach
- Department of Neurology, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA
| | - Amanda N. Leggett
- Department of Psychiatry, Geriatric Psychiatry Section, University of Michigan, Michigan Medicine, MI 48109, USA
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Qin Y, Liu J, Wang R, Qi X, Jiang S, Li J, Guo P, Wu Q. Can leisure and entertainment lifestyle promote health among older people living alone in China?-A simultaneous equation approach. Front Public Health 2022; 10:967170. [PMID: 36249231 PMCID: PMC9558104 DOI: 10.3389/fpubh.2022.967170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 09/01/2022] [Indexed: 01/24/2023] Open
Abstract
Objectives With the surging number of older people living alone, their lifestyles and health status have aroused increasing concern. This study aims to investigate whether a leisure and entertainment lifestyle (LEL) can improve the multidimensional health among older people living alone and try to identify the latent mechanisms among them. Method For this purpose, we extracted data from the Chinese General Social Survey (CGSS) and established a simultaneous equations model, comprising ordinary least square regression (OLS), two-stage least squares (2SLS), and the mediating effect model. Results Older people living alone in China reported relatively better mental health status (3.64 ± 1.07), followed by physical health (3.41 ± 1.26) and social health (2.75 ± 1.18). In the OLS model, LEL significantly improved the social health of older people living alone (β = 0.054, P < 0.01), followed by physical health (β = 0.042, P < 0.01) and mental health (β = 0.027, P < 0.01). After endogenous tests from 2SLS model and robustness tests, we found that more active LEL was associated with higher levels of physical health and mental health. However, LEL had no significant effect on the improvement of the social health of the older people living alone. Using the mediation analysis, exercise efficacy partially mediated the relationship of LEL with physical health and mental health, and the ratios were 19.75 and 24.85%, respectively. Similarly, positive life attitudes partially mediated the relationship between LEL and physical health, and LEL and mental health, with ratios of 10.65 and 26.83%, respectively. Conclusion Our findings suggested that LEL is significantly associated with better physical and mental health for older people living alone in China, and the association is mediated by exercise efficacy and positive attitudes toward life. Promoting more leisure and recreational activities, upgrading exercise efficacy, and encouraging positive life attitudes are necessary health promotion measures in active aging policies for the wellbeing of older people living alone.
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Affiliation(s)
- Yinghua Qin
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China,Department of Health Economy and Social Security, College of Humanities and Management, Guilin Medical University, Guilin, China
| | - Jingjing Liu
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Rizhen Wang
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Xinye Qi
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Shengchao Jiang
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Jiacheng Li
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Pengfei Guo
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China,*Correspondence: Qunhong Wu
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Yu Y, Zhang J, Song C, Petrovic M, Pei X, Zhang WH. Perceived availability of home- and community-based services and self-reported depression among Chinese older adults: A cross-sectional study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2827-e2837. [PMID: 35040216 DOI: 10.1111/hsc.13726] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 12/23/2021] [Accepted: 12/31/2021] [Indexed: 06/14/2023]
Abstract
Few studies have assessed the association between perceived availability of home- and community-based services (HCBSs) and self-reported depression among Chinese older adults, which the present study attempts to rectify. This cross-sectional study enrolled 11,941 participants aged 65 and older from the Chinese Longitudinal Healthy Longevity Survey 2018 wave. The 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) was used to evaluate depression, and perceived availability was measured for four categories of HCBSs: daily life assistance, medical care services, emotional support and social services, and other. These four categories and the number of services in each were used to represent the perceived availability of service provision. Binary logistic models were used to explore the relationship between perceived availability of HCBSs and depression in older adults. Perceived daily life assistance was found to be negatively associated with depression symptoms among Chinese older adults in both urban and rural areas [rural: OR (95%CI) = 0.66 (0.55-0.78), p < 0.001; urban: OR (95% CI) = 0.69(0.60-0.79), p < 0.001], while perceived levels of medical care services, emotional support and social services, and other were not associated with depression symptoms in rural or urban areas. Our primary finding was that providing daily life assistance at the community level may help to meet more older adults' daily needs, thus potentially decreasing the risk of depression.
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Affiliation(s)
- Yushan Yu
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jun Zhang
- The Research Center for Public Health, Tsinghua University, Beijing, China
| | - Chao Song
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Mirko Petrovic
- Section of Geriatrics, Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium
| | - Xiaomei Pei
- Department of Sociology, School of Social Sciences, Tsinghua University, Beijing, China
| | - Wei-Hong Zhang
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- School of Public Health, Université libre de Bruxelles (ULB), Bruxelles, Belgium
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Mao S, Lu N, Xiao C. Perceived neighborhood environment and depressive symptoms among older adults living in Urban China: The mediator role of social capital. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1977-e1990. [PMID: 34725894 DOI: 10.1111/hsc.13631] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/09/2021] [Accepted: 10/23/2021] [Indexed: 06/13/2023]
Abstract
An increasing number of studies have focused on the relationship between neighbourhood environment and depressive symptoms among older people. However, the underlying mechanisms are still unclear. This study examined the association between neighbourhood environment and depressive symptoms among older urban Chinese adults and the mediator role of social capital in this association. Using a quota sampling approach, 472 respondents aged 60 years or older were recruited from 23 urban communities of Shanghai, China, in 2020. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale. Social capital was measured by two latent constructs: cognitive social capital (e.g., trust, reciprocity, belongingness) and structural social capital (e.g., memberships, social participation). Perceived physical neighbourhood environment was assessed in terms of health care, security, and public transportation status. Structural equation modelling was conducted to test the study hypotheses. Health care services in the community had a direct effect on depressive symptoms (β = -0.097, p < .05). Cognitive social capital played a mediator role in the relationship between physical neighbourhood environment and depressive symptoms (community health care: β = -0.124, p < .01; community security: β = -0.284, p < .01). The mediator effect of structural social capital in the relationship between physical neighbourhood environment and depressive symptoms was not significant. The findings highlight the role of physical neighbourhood environment in fostering community-based social capital and promoting mental health among older adults in urban China. Policy strategies could focus on improving community health care and security to promote mental health.
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Affiliation(s)
- Shan Mao
- Department of Social Work and Social Policy, School of Sociology and Population Studies, Renmin University of China, Beijing, China
| | - Nan Lu
- Department of Social Work and Social Policy, School of Sociology and Population Studies, Renmin University of China, Beijing, China
| | - Chunhui Xiao
- Department of Spanish Language and Literature, School of Foreign Languages, Renmin University of China, Beijing, China
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Qin P, He J, Yang X, Chen S, Chen X, Jiang H, Fung AWT, Wang Z, Lau JTF. The Role of Depressive Symptoms and Physical Activity Levels in Mediating the Association Between HIV Status and Neurocognitive Functions Among Individuals Aged at Least 50 Years in China: Cross-sectional Study. JMIR Public Health Surveill 2022; 8:e32968. [PMID: 35984684 PMCID: PMC9440416 DOI: 10.2196/32968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 06/13/2022] [Accepted: 06/26/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Neurocognitive impairments are prevalent among older people in China. It is more problematic among older people living with HIV. OBJECTIVE This study aims to compare neurocognitive performance between older people living with HIV and HIV-negative controls, and to explore whether the association between HIV status and neurocognitive performance was mediated by depressive symptoms and level of physical activity. METHODS A cross-sectional study was conducted in Yongzhou, China. All people living with HIV aged ≥50 years listed in the registry were invited. Frequency matching was used to sample HIV-negative controls from the general population according to the distribution of age, sex, and years of formal education of older people living with HIV. A total of 315 older people living with HIV and 350 HIV-negative controls completed the face-to-face interview and comprehensive neuropsychological assessment of seven domains (learning, memory, working memory, verbal fluency, processing speed, executive function, and motor skills). RESULTS As compared to HIV-negative controls, older people living with HIV performed worse in global score and all seven domains (P<.05). HIV infection was associated with higher depressive symptoms (P<.001) and lower level of physical activity (P<.001). Depressive symptoms and physical activity were negatively correlated (P<.001). Depressive symptoms and level of physical activity mediated the association between HIV status and global z-score and four domain z-scores of neurocognitive performance (learning, memory, verbal fluency, and processing speed). CONCLUSIONS Change in mental health and physical activity after HIV infection may partially explain why older people living with HIV are more susceptible to neurocognitive impairment. Promoting mental health and physical activity are potential entry points to slow down the progress of neurocognitive impairment among older people living with HIV.
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Affiliation(s)
- Pei Qin
- Shenzhen Qianhai Shekou Free Zone Hospital, Shenzhen, China
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Jianmei He
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Xue Yang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Siyu Chen
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Xi Chen
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Hui Jiang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ada Wai Tung Fung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Zixin Wang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Joseph Tak Fai Lau
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Affilliated Kangning Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
- School of Mental Health, Wenzhou Medical University, Wen Zhou, China
- School of Public Health, Zhejiang University, Zhejiang, China
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Xu J, Zhang L. The effect of living alone on the mental health of the economically active floating population during the COVID-19 pandemic. Front Public Health 2022; 10:931425. [PMID: 36033794 PMCID: PMC9402925 DOI: 10.3389/fpubh.2022.931425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/25/2022] [Indexed: 01/24/2023] Open
Abstract
Background The Coronavirus disease 2019 (COVID-19) pandemic broke out at the end of 2019 in China. Through a strict Zero-Tolerant strategy, the pandemic was nearly controlled in the first half of 2020, and production resumed in most regions of China. A survey was performed to explore the effect of living alone on the mental health of the economically active floating population (EAFP) in developed regions of China during the COVID-19 pandemic. Methods The online cross-sectional survey was conducted in work resumed time in the first half of 2020 in several developed regions of China. The 12-item General Health Questionnaire (GHQ-12) is used to assess the mental health status. The Multi-level ordinary least squares regression was performed on a total of 4,405 samples to examine the relationships between living alone and the participants' mental health. Results Many participants lived alone during the COVID 19 pandemic. Living alone is negatively associated with mental health (p < 0.01) for EAFP. The effect of living alone on mental health is stronger for females than males and for people with a lover than those without a lover. It is also stronger for the seniors (aged 56-70) than younger ones (aged 16-35), and has no significant influence on the middle-aged population (36-55). The effect is significant for self-employed people and employees, and is not significant for unemployed ones. Furthermore, the right amount of online entertainment can lower the effect of living alone on mental health. Conclusion The results show that living alone strongly affected the mental health of EAFP during the COVID 19 pandemic. Moreover, this effect has generated new inequalities among different groups. In addition, to provide more public services to support people against the pandemic, the government should provide more psychological support to those who live alone and guide them to establish a correct view of marriage and love to reduce living alone negative effect and prevent them from mental health problems.
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Affiliation(s)
- Junzhou Xu
- Department of Economics and Management, Hubei Polytechnic University, Huangshi, China,Seoul School of Integrated Sciences and Technologies, Seoul, South Korea
| | - Ling Zhang
- School of Software and Internet of Things Engineering, Jiangxi University of Finance and Economics, Nanchang, China,*Correspondence: Ling Zhang
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Ballesio A, Zagaria A, Ottaviani C, Steptoe A, Lombardo C. Sleep disturbance, neuro-immune markers, and depressive symptoms in older age: Conditional process analysis from the English Longitudinal Study of Aging (ELSA). Psychoneuroendocrinology 2022; 142:105770. [PMID: 35490483 DOI: 10.1016/j.psyneuen.2022.105770] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/30/2022] [Accepted: 04/13/2022] [Indexed: 01/01/2023]
Abstract
This study aimed to investigate the long-term association between subjective sleep disturbance and depressive symptoms in older adults, and ascertain whether this association is partially mediated by neuro-immune markers, while testing the moderation of sex using conditional process analyses, i.e., combinations of mediation and moderation analyses. We analysed data of 2124 participants aged 50 and above from the English Longitudinal Study of Ageing (ELSA) across three waves of data collection. Sleep disturbance was assessed in 2008/9, serum levels of high sensitivity C-reactive protein (hs-CRP), insulin like growth factor-1 (IGF-1), white blood cell (WBC) count in 2012/2013, and self-reported depressive symptoms in 2016/2017. After accounting for health-related and psychosocial confounders, results showed that sleep disturbance significantly predicted depressive symptoms at follow-up in the whole sample and hs-CRP in women, but not in men. Hs-CRP also predicted depressive symptoms only in women. Moreover, hs-CRP significantly mediated the association between sleep disturbance and depressive symptoms in women, but not in men. The association between sleep disturbance and IFG-1was marginal, and the latter did not mediate the association between sleep and depressive symptoms neither in women nor in men. Results on WBC count were all non-significant. In conclusion, sleep disturbance resulted significantly associated with depressive symptoms in a long-term follow-up. Moreover, ELSA data provide preliminary evidence that increased inflammation may mediate this association in women. Future longitudinal studies may advance the knowledge in the field considering the mediating role of proinflammatory cytokines such as interleukin-6.
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Affiliation(s)
- Andrea Ballesio
- Department of Psychology, Sapienza University of Rome, Rome, Italy.
| | - Andrea Zagaria
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
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Lim YM, Baek J, Lee S, Kim JS. Association between Loneliness and Depression among Community-Dwelling Older Women Living Alone in South Korea: The Mediating Effects of Subjective Physical Health, Resilience, and Social Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159246. [PMID: 35954597 PMCID: PMC9368532 DOI: 10.3390/ijerph19159246] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/23/2022] [Accepted: 07/24/2022] [Indexed: 11/16/2022]
Abstract
Social isolation and loneliness are the key risk factors for depression in late life. Older adults living alone and socially isolated are at greater risk for physical and mental health. This study aims to examine the mediating effects of subjective physical health, resilience, and social support on the association between loneliness and depression among the elderly female population living alone in South Korea. We included a total of 308 older women aged 60 years or older who live alone in a medium-sized city in South Korea. The survey data was collected using the validated survey instruments between November 2015 and April 2016. A parallel mediation model was performed to investigate whether physical health, resilience, and social support had mediating effects on the association of loneliness with depression. The findings of this study showed that loneliness was directly and indirectly associated with depression through its association with the subjective physical health, resilience, and social support among the older female population living alone. Our results suggest the importance of supporting community-based programs to improve physical and mental health of the elderly people as a way to minimize the level of loneliness and prevent depression.
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Affiliation(s)
- Young Mi Lim
- Department of Nursing, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
| | - Juha Baek
- Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong-si 30146, Korea
- Correspondence:
| | - Sungmin Lee
- Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, TX 77840, USA;
| | - Jung Sug Kim
- Department of Nursing, Yeoju Institute of Technology, Yeoju 12652, Korea;
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Impact of COVID-19 on the social relationships and mental health of older adults living alone: A two-year prospective cohort study. PLoS One 2022; 17:e0270260. [PMID: 35793334 PMCID: PMC9258855 DOI: 10.1371/journal.pone.0270260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 06/07/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Owing to the COVID-19 outbreak, older adults living alone, who can only connect socially outside their homes, are at risk of social isolation and poor mental health. This study aimed to identify the changes, before and after COVID-19, by sex and age, in social relationships (social activity, social network, and social support) and mental health (depression and suicide ideation) among older adults living alone.
Methods
This is a prospective cohort study of community-dwelling older adults who were at least 65 years old and living alone in South Korea. The study was conducted during 2018–2020 with 2,291 participants (795, 771, and 725 for the 1st to 3rd waves, respectively). The data were collected via face-to-face interviews. A generalized linear mixed modeling framework was used to test for changes over three years.
Results
Social activity was reduced after the COVID-19, with an interaction effect of sex: older women (odds ratio [OR], 0.19; 95% confidence interval [CI], 0.15–0.23; p < .001) showed greater reduction than older men (OR, 0.50; 95% CI, 0.34–0.75; p < .001). Interaction with neighbors also reduced after the pandemic, but there was no significant evidence of interaction effects. Interaction with family members increased in both sexes during the pandemic, with the interaction effect of sex: older women (OR, 1.40; 95% CI, 1.11–1.76; p = .004) showed greater increase than men (OR, 1.55; 95% CI, 1.13–2.14; p = .007). Social support increased in both sexes during the pandemic, but there was no significant evidence of interaction effects. Depression and suicide ideation showed no significant differences before and after the pandemic.
Conclusions
The findings provide health administrators and health providers with explorative insights into the impact of the COVID-19 on social relationships and mental health among older adults living alone and can guide further studies of interventions considering specific properties of social relationships.
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Hossain B, Nagargoje VP, Sk MIK, Das J. Social exclusion and mental health among older adults: cross-sectional evidence from a population-based survey in India. BMC Psychiatry 2022; 22:409. [PMID: 35717142 PMCID: PMC9206346 DOI: 10.1186/s12888-022-04064-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/15/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Social exclusion has far-reaching consequences that extend beyond regular activities and access to resources and knowledge; social exclusion is a major social determinant of health. However, there is a lack of evidence on social exclusion and health outcomes among India's older adults. Thus, the current study investigates the association of social exclusion with depressive symptoms among Indian older adults. METHODS This study used information on 30,366 older adults from Longitudinal Ageing Study in India (LASI) wave-1, 2017-2018. Social exclusion scores were calculated, and two broad domains of social exclusion, i.e., exclusion from civic activity & social relations and exclusion from services, were considered in the study. The depressive symptom was calculated using the CES-D score. Using logistic regression models, the average marginal effects of selected covariates and domains of social exclusion on depressive symptoms were estimated to assess the links between social exclusion and depressive symptoms. RESULTS With the increase in the social exclusion score in the selected domains, the prevalence of depressive symptoms among older also increased. Elderly persons who do not vote or live alone in the domain of being excluded from civic & social activities and older adults excluded from services were observed to have a higher prevalence of depressive symptoms. Adjusting for sociodemographic factors, the average marginal effects suggested that older with four scores of civic activity & social relation exclusion, two scores of service exclusion and four scores of overall social exclusion were estimated to have a higher prevalence of depressive symptoms, respectively. CONCLUSIONS This study's findings shed light on social exclusion and its relationship to depressive symptoms among older Indians. Older health care services should be expanded in breadth while also addressing social exclusion, resulting in considerable improvements in older individuals' mental health.
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Affiliation(s)
- Babul Hossain
- International Institute for Population Sciences, Mumbai, 400088, India.
| | - Varsha P. Nagargoje
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
| | - Md Illias Kanchan Sk
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
| | - Jyoti Das
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
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Investigation Of The Dentists' Fear Of Covid And Psychological Status During Covid-19 Pandemic. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2022. [DOI: 10.21673/anadoluklin.1038361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Amaç: Araştırmamızda Covid-19 salgını sürecinde hastalarıyla yakından temas ederek çalışmaya devam eden diş hekimlerinin koronavirüs korkusu, depresyon, anksiyete ve stres düzeyleri ile bunlarla ilişkili faktörlerin incelenmesi amaçlanmıştır.
Yöntemler: Gözlemsel ve kesitsel tasarımda olan bu araştırma Covid-19 pandemi sürecinde aktif çalışmakta olan ve araştırmaya gönüllü diş hekimlerini kapsamaktadır. Pandemi tedbirleri nedeni ile elektronik ortamda kolayda örnekleme ile ulaşılan 376 diş hekiminin katılımı ile gerçekleşmiştir. Sosyodemografik Bilgi Formu, Covid-19 Korkusu Ölçeği ve Depresyon Anksiyete Stres-21 Ölçeği kullanılmıştır.
Bulgular: Katılımcıların 226’sı (%60,1) salgın sürecinde bulaşma ve ölüm korkusu yaşamaktaydı. Covid korkusu, depresyon, anksiyete, stres ölçekleri ve DASS toplam skoru kadın grup ortalamaları erkek grup ortalamasından anlamlı derecede yüksek bulundu (p
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Jung S, Tak SH. Factors of Functional Disability in the Social Participation of Older Adults Living Alone With Fall Experience. J Appl Gerontol 2022; 41:2197-2204. [DOI: 10.1177/07334648221104791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The fall experiences of older adults living alone lead to restrictions in their social participation. This study aimed to examine the factors that influence functional disability in social participation (FSP) among older adults who live alone and have experienced falls. This study used secondary data of 493 older adults living alone who experienced a fall, which were collected from the 2017 National Survey of Older Koreans. Multiple linear regression analyses were performed. Factors, such as old age, sex, economic status, frequency of drinking, and number of acquaintances, significantly related to functional disability in terms of social participation. In addition, poor muscle strength, depression, and cognitive decline comprised predictors of FSP. The findings of this study revealed that it is important to comprehensively evaluate the social participation of older adults who live alone and have experienced falls.
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Affiliation(s)
- SuJung Jung
- Department of Nursing, College of Healthcare & Biotechnology, Semyung UniversityJecheon, South Korea
| | - Sunghee H. Tak
- The Research Institute of Nursing Science, College of Nursing, Seoul National UniversitySeoul, South Korea
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Zhang H, Liao Y, Han X, Fan B, Liu Y, Lui LMW, Lee Y, Subramaniapillai M, Li L, Guo L, Lu C, McIntyre RS. Screening Depressive Symptoms and Incident Major Depressive Disorder Among Chinese Community Residents Using a Mobile App-Based Integrated Mental Health Care Model: Cohort Study. J Med Internet Res 2022; 24:e30907. [PMID: 35594137 PMCID: PMC9166637 DOI: 10.2196/30907] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 02/18/2022] [Accepted: 03/30/2022] [Indexed: 02/06/2023] Open
Abstract
Background Depression is associated with significant morbidity and human capital costs globally. Early screening for depressive symptoms and timely depressive disorder case identification and intervention may improve health outcomes and cost-effectiveness among affected individuals. China’s public and academic communities have reached a consensus on the need to improve access to early screening, diagnosis, and treatment of depression. Objective This study aims to estimate the screening prevalence and associated factors of subthreshold depressive symptoms among Chinese residents enrolled in the cohort study using a mobile app–based integrated mental health care model and investigate the 12-month incidence rate and related factors of major depressive disorder (MDD) among those with subthreshold depressive symptoms. Methods Data were drawn from the Depression Cohort in China (DCC) study. A total of 4243 community residents aged 18 to 64 years living in Nanshan district, Shenzhen city, in Guangdong province, China, were encouraged to participate in the DCC study when visiting the participating primary health care centers, and 4066 (95.83%) residents who met the DCC study criteria were screened for subthreshold depressive symptoms using the Patient Health Questionnaire-9 at baseline. Of the 4066 screened residents, 3168 (77.91%) with subthreshold depressive symptoms were referred to hospitals to receive a psychiatric diagnosis of MDD within 12 months. Sleep duration, anxiety symptoms, well-being, insomnia symptoms, and resilience were also investigated. The diagnosis of MDD was provided by trained psychiatrists using the Mini-International Neuropsychiatric Interview. Univariate and multivariate logistic regression models were performed to explore the potential factors related to subthreshold depressive symptoms at baseline, and Cox proportional hazards models were performed to explore the potential factors related to incident MDD. Results Anxiety symptoms (adjusted odds ratio [AOR] 1.63, 95% CI 1.42-1.87) and insomnia symptoms (AOR 1.13, 95% CI 1.05-1.22) were associated with an increased risk of subthreshold depressive symptoms, whereas well-being (AOR 0.93, 95% CI 0.87-0.99) was negatively associated with depressive symptoms. During the follow-up period, the 12-month incidence rate of MDD among participants with subthreshold depressive symptoms was 5.97% (189/3168). After incorporating all significant variables from the univariate analyses, the multivariate Cox proportional hazards model reported that a history of comorbidities (adjusted hazard ratio [AHR] 1.49, 95% CI 1.04-2.14) and anxiety symptoms (AHR 1.13, 95% CI 1.09-1.17) were independently associated with an increased risk of incident MDD. The 5-item World Health Organization Well-Being Index was associated with a decreased risk of incident MDD (AHR 0.90, 95% CI 0.86-0.94). Conclusions Elevated anxiety symptoms and unfavorable general well-being were significantly associated with subthreshold depressive symptoms and incident MDD among Chinese residents in Shenzhen. Early screening for subthreshold depressive symptoms and related factors may be helpful for identifying populations at high risk of incident MDD.
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Affiliation(s)
- Huimin Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Yuhua Liao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Xue Han
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Beifang Fan
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Yifeng Liu
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Leanna M W Lui
- Mood Disorders Psychopharmacology Unit, University Health Network, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Mehala Subramaniapillai
- Mood Disorders Psychopharmacology Unit, University Health Network, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Lingjiang Li
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology, University of Toronto, Toronto, ON, Canada
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Huarcaya-Victoria J, Villarreal-Rao B, Luna M, Rojas-Mendoza W, Alarcon-Ruiz CA, Villarreal-Zegarra D, Vilela-Estrada AL, Ramírez S. Factors Associated with Mental Health Outcomes in Hospital Workers during the COVID-19 Pandemic: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095346. [PMID: 35564741 PMCID: PMC9103531 DOI: 10.3390/ijerph19095346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/30/2022]
Abstract
Background: We investigated some of the factors associated with depression, perceived stress, and anxiety in clinical and nonclinical healthcare workers of two hospitals. Methods: A mixed-methods approach was used. The sample included clinical (physicians, nurses, and others) and nonclinical (security and cleaning staff) healthcare workers of two tertiary hospitals in Peru. Participants completed an online self-survey. In the qualitative analysis, data were subjected to thematic analysis. Results: We analyzed data from 613 participants, of which 8.6%, 9.0%, and 78.2% had moderate-to-severe anxiety, depression, and perceived stress, respectively. Having a previous mental health problem, being concerned about losing one’s job, having at least two COVID-19 symptoms in the preceding two weeks, and being afraid of infecting family members increased the prevalence of experiencing moderate-to-severe depression and anxiety. The qualitative analysis allowed us to identify five recurring factors that caused a negative impact on workers’ lives during the pandemic: emotional distress linked to hospital experiences of suffering and death, modification of routines, fear of COVID-19, exacerbation of mental disorders, and physical problems associated with emotional distress. Conclusions: Clinical and nonclinical healthcare workers in Peru have experienced depression, anxiety, and stress during the COVID-19 pandemic. Future research and interventions are necessary to improve psychological support for hospital workers.
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Affiliation(s)
- Jeff Huarcaya-Victoria
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima 15033, Peru; (B.V.-R.); (M.L.)
- Correspondence:
| | - Beltran Villarreal-Rao
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima 15033, Peru; (B.V.-R.); (M.L.)
| | - Matilde Luna
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima 15033, Peru; (B.V.-R.); (M.L.)
| | - Wendoline Rojas-Mendoza
- Departamento de Salud Mental, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima 15072, Peru;
| | | | - David Villarreal-Zegarra
- Dirección de Investigación, Desarrollo e Innovación, Instituto Peruano de Orientación Psicológica, Lima 15046, Peru; (D.V.-Z.); (A.L.V.-E.)
| | - Ana L. Vilela-Estrada
- Dirección de Investigación, Desarrollo e Innovación, Instituto Peruano de Orientación Psicológica, Lima 15046, Peru; (D.V.-Z.); (A.L.V.-E.)
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Lu N, Wu B. Perceived neighborhood environment, social capital and life satisfaction among older adults in Shanghai, China. Sci Rep 2022; 12:6686. [PMID: 35461348 PMCID: PMC9035143 DOI: 10.1038/s41598-022-10742-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/31/2022] [Indexed: 11/09/2022] Open
Abstract
This study examined the mediator role of social capital on the association between perceived neighborhood environment and life satisfaction among older adults in urban China, and further tested the moderating effect of gender in the above paths (i.e., from neighborhood environment to life satisfaction; from neighborhood environment to social capital; from social capital to life satisfaction). We used quota sampling approach to recruit 472 respondents aged 60 years old or older in Shanghai in 2020. From the perspective of structural equation modeling, multiple group analysis was conducted to examine the proposed hypotheses. The measurement model of social capital was well established in urban Chinese community contexts. Based on the whole sample, the results of the mediation model showed that social capital played a mediation role in the association between neighborhood environment and life satisfaction. Furthermore, the results of multiple group analysis showed that the association between neighborhood environment and cognitive social capital was only significant among older women. The findings highlight the role of neighborhood environment and social capital in building age-friendly communities.
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Affiliation(s)
- Nan Lu
- Department of Social Work and Social Policy, School of Sociology and Population Studies, Renmin University of China, Beijing, China.,Sau Po Centre on Ageing, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Bei Wu
- Rory Meyers College of Nursing and NYU Aging Incubator, New York University, 433 First Avenue, New York, NY, 10010, USA.
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46
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Cheng C, DU Y, Bai J. Physical multimorbidity and psychological distress among Chinese older adults: Findings from Chinese Longitudinal Healthy Longevity Survey. Asian J Psychiatr 2022; 70:103022. [PMID: 35189472 DOI: 10.1016/j.ajp.2022.103022] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 02/06/2022] [Accepted: 02/11/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Research has linked multimorbidity with psychological distress among people with multimorbidity but the available findings are inconsistent. This study was to investigate the prevalence of multimorbidity and incidence of psychological distress in a nationally representative sample of Chinese older adults and examine the association between multimorbidity and psychological distress in this population. METHODS This study was a cross-sectional, secondary analysis using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Participants' socio-demographic characteristics and clinical information were obtained. Psychological distress including anxiety and depression were assessed by the Generalized Anxiety Disorder-7 (GAD-7) and the Center for Epidemiologic Studies Depression Scale (10-item CES-D). Binary logistic regression was used to ascertain the association between multimorbidity and psychological distress with covariates adjustment. RESULTS Compared with those without physical chronic conditions, having five or more physical chronic conditions was associated with the likelihood of depression after covariates adjustment. CONCLUSION Psychological distress is a common health issue among Chinese older adults with multimorbidity. Having multimorbidity might not be associated with psychological distress represented by anxiety and depression. Management of multimorbidity among this population would benefit from more attention on the mental health domain.
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Affiliation(s)
- Cheng Cheng
- School of Nursing, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Yinjun DU
- Ningbo Yinzhou No.2 Hospital, Ningbo, Zhejiang, China
| | - Jie Bai
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
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Aikens JE, Valenstein M, Plegue MA, Sen A, Marinec N, Achtyes E, Piette JD. Technology-Facilitated Depression Self-Management Linked with Lay Supporters and Primary Care Clinics: Randomized Controlled Trial in a Low-Income Sample. Telemed J E Health 2022; 28:399-406. [PMID: 34086485 PMCID: PMC8968843 DOI: 10.1089/tmj.2021.0042] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: To test whether technology-facilitated self-management support improves depression in primary care settings. Methods: We randomized 204 low-income primary care patients who had at least moderate depressive symptoms to intervention or control. Intervention participants received 12 months of weekly automated interactive voice response telephone calls that assessed their symptom severity and provided self-management strategies. Their patient-nominated supporter (CarePartner) received corresponding guidance on self-management support, and their primary care team received urgent notifications. Those randomized to enhanced usual care received printed generic self-management instructions. Results: One-year attrition rate was 14%. By month 6, symptom severity on the Patient Health Questionnaire-9 (PHQ-9) decreased 2.5 points more in the intervention arm than in the control arm (95% CI -4.2 to -0.8, p = 0.003). This benefit was similar at month 12 (p = 0.004). Intervention was also over twice as likely to lead to ≥50% reduction in symptom severity by month 6 (OR = 2.2 (1.1, 4.7)) and a decrease of ≥5 PHQ-9 points by month 12 (OR = 2.3 (1.2, 4.4)). Conclusions: Technology-facilitated self-management guidance with lay support and clinician notifications improves depression for primary care patients. Subsequent research should examine implementation and generalization to other chronic conditions. clinicaltrials.gov, identifier NCT01834534.
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Affiliation(s)
- James E. Aikens
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Address correspondence to: James Aikens, PhD, Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI 48104-1213, USA
| | - Marcia Valenstein
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA.,VA Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, USA
| | - Melissa A. Plegue
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Ananda Sen
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicolle Marinec
- VA Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, USA.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Eric Achtyes
- Cherry Health, Heart of the City Health Center, Grand Rapids, Michigan, USA.,Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Lansing, Michigan, USA
| | - John D. Piette
- VA Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, USA.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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48
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Lee S. Does Living Alone Affect Self-Perceptions of Aging? Findings From Two Waves of the Health and Retirement Study. Gerontol Geriatr Med 2022; 8:23337214221077798. [PMID: 35224138 PMCID: PMC8874172 DOI: 10.1177/23337214221077798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The current study examined if living alone is associated with self-perceptions of aging (SPA). The study used two-wave longitudinal data, sampled from the Health and Retirement Study (HRS), and collected in 2014 and 2018. In total, 6506 older adults aged 60–99 years at baseline were followed up with a 4-year lag. Results indicated that there was no significant change in SPA at follow-up regardless of changes in living arrangements. However, at follow-up, there was a significant cross-sectional difference in SPA between older adults who remained in partnership and those who transitioned to living alone due to widowhood or separation/divorce over a 4-year period. Findings suggest that SPA is relatively stable over time and is barely affected by living alone.
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Affiliation(s)
- Sunwoo Lee
- The Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
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49
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Cristóbal-Narváez P, Haro JM, Koyanagi A. Longitudinal association between perceived stress and depression among community-dwelling older adults: Findings from the Irish Longitudinal Study on Ageing. J Affect Disord 2022; 299:457-462. [PMID: 34942218 DOI: 10.1016/j.jad.2021.12.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/08/2021] [Accepted: 12/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Older adults may be particularly vulnerable to the negative effects of stress on depression. However, the impact of perceived stress on late-life depression is understudied in large community samples. Thus, the present study used data from a population-based sample of Irish older adults to examine the longitudinal association between perceived stress and late-life depression. METHODS Data from Wave 1 (2009-2011) and Wave 2 (2012-2013) of the Irish Longitudinal Study on Ageing (TILDA) were analyzed. Depression was assessed with the Center for Epidemiologic Studies Depression (CES-D), while the 4-item version of the Perceived Stress Scale was used for perceived stress. Multivariable logistic regression was used to assess the association between perceived stress (exposure) and depression (outcome). RESULTS The analytical sample consisted of 5238 individuals aged ≥50 years [mean (SD) age 63.2 (9.1) years; 49.4% females] who did not have depression at Wave 1. The mean perceived stress score at baseline was much lower among those who did not develop depression at Wave 2 compared to those who did (3.85 vs. 6.33). Compared to those in the lowest quartile of levels of perceived stress at baseline, those in the highest quartile had 2.65 (95%CI=1.56-4.49) times higher risk for depression onset. LIMITATIONS Some baseline information including that of perceived stress could have changed within the two-year follow-up period. CONCLUSIONS Greater levels of perceived stress at baseline was associated with higher risk for depression onset at two-year follow-up among older adults in Ireland. Individualized interventions addressing stress may be beneficial in the prevention of depression among older adults.
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Affiliation(s)
- Paula Cristóbal-Narváez
- Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Catalonia, Spain; Centre for Biomedical Research Network on Mental Health, Instituto de Salud Carlos III (CIBERSAM), Madrid, Spain.
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Catalonia, Spain; Centre for Biomedical Research Network on Mental Health, Instituto de Salud Carlos III (CIBERSAM), Madrid, Spain
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Catalonia, Spain; Centre for Biomedical Research Network on Mental Health, Instituto de Salud Carlos III (CIBERSAM), Madrid, Spain; ICREA, Pg. Lluis Companys 23, Barcelona 08010, Spain
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50
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Cai W, Zhang K, Wang GT, Li J, Wei XY, Ma W, Li YJ, Wang B, Shen WD. Effects and safety of auricular acupressure on depression and anxiety in isolated COVID-19 patients: A single-blind randomized controlled trial. Front Psychiatry 2022; 13:1041829. [PMID: 36545041 PMCID: PMC9760812 DOI: 10.3389/fpsyt.2022.1041829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Psychological distress such as depression and anxiety resulted from coronavirus disease 2019 (COVID-19) have attracted increasing attention. The aim of this randomized controlled trial is to evaluate the effects and safety of auricular acupressure on depression and anxiety in isolated COVID-19 patients. METHODS 68 participants diagnosed with COVID-19 pneumonia (18-80 years old, SDS ≥ 50, SAS ≥ 45) were recruited and randomly allocated to the auricular acupressure group and the sham auricular acupressure group by a computer-generated random number sequence from 9th June to 30th June 2022. The group allocation was only blinded to the participants. Those in the auricular acupressure group were attached magnetic beads against 4 auricular points Shenmen, Subcortex, Liver and Endocrine, while sham group used four irrelevant auricular points. Outcomes were measured by Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Depression Scale (SAS) before and after treatment in both groups through electronic questionnaire in mobile phones. RESULTS After treatment, statistically significant differences were found in scores of SAS in both groups (P < 0.001 in auricular acupressure group; P = 0.003 in sham group), and SDS scores reduced significantly in the auricular acupressure group (P = 0.002). Significant reduced SAS and SDS scores were achieved in the auricular acupressure group than that in the sham group (F = 4.008, P = 0.049, MD -7.70 95% CI: -9.00, -6.40, SMD -2.79 95% CI: -3.47, -2.11 in SDS; F = 10.186, P = 0.002, MD -14.00 95% CI: -15.47, -12.53, SMD -4.46 95% CI: -5.37, -3.56 in SAS). No adverse events were found in either group during the whole study. CONCLUSION Auricular acupressure is an effective and safe treatment for alleviating symptoms of depressive and anxiety in patients with COVID-19. CLINICAL TRIAL REGISTRATION https://www.chictr.org.cn//, identifier ChiCTR2200061351.
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Affiliation(s)
- Wa Cai
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Kun Zhang
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guan-Tao Wang
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jin Li
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiang-Yu Wei
- Institute of Acupuncture and Anesthesia, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wen Ma
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ya-Juan Li
- Department of Traditional Chinese Medicine, Lianyang Community Health Service Center, Shanghai, China
| | - Bo Wang
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei-Dong Shen
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Institute of Acupuncture and Anesthesia, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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