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Li M, Zaki N, Zhang Y, Luo Q, Yang H, Long D, Gao W. The longitudinal association between physical health and depressive symptoms over eight years: Evidence from the health and retirement study. J Affect Disord 2024; 359:262-268. [PMID: 38795775 DOI: 10.1016/j.jad.2024.05.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/10/2024] [Accepted: 05/17/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND The bidirectional relationship between physical health (PH) and depressive symptoms (DS) remains unclear. METHODS Data were extracted from the Health and Retirement Study in the United States. PH was measured with a composite of chronic diseases, functional limitations and difficulties in basic and instrumental activities of daily living, and DS with a modified Center for Epidemiological Studies of Depression. Latent growth curve models (LGCM) were employed to examine how the change in PH or DS affected their mutual trajectories in later life. In addition, multilevel models were utilized. RESULTS There were 6144 participants included, with an average age of 69.82 ± 6.85 years at baseline, of whom 3686 (59.99 %) were women. PH scores increased from 5.65 in 2010 to 7.72 in 2018, while depression scores increased from 1.14 to 1.31. LGCM results showed that the initial levels of PH and DS were associated (β = 0.558, P < .001), and the initial level of PH could predict the trajectory of DS (β = 0.089, P < .001). Likewise, the initial level of DS was also related to initial PH (β = -0.563, P < .001) but couldn't predict the trajectory of PH. Furthermore, the slopes of PH and DS were predicted bidirectionally by each other. Two-level logistic models further demonstrated the bidirectional association between PH and DS. CONCLUSION There was a bidirectional association between physical health and depressive symptoms, which highlights the necessity of comprehensive health management for older adults with poor physical health or depression symptoms.
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Affiliation(s)
- Ming Li
- Institute of Health Statistics and Intelligent Analysis, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China; Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Noha Zaki
- Institute of Health Statistics and Intelligent Analysis, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China; Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Yuqi Zhang
- Institute of Health Statistics and Intelligent Analysis, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China; Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Qiuxia Luo
- Institute of Health Statistics and Intelligent Analysis, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China; Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Hong Yang
- Institute of Health Statistics and Intelligent Analysis, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China; Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Dan Long
- Institute of Health Statistics and Intelligent Analysis, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China; Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Wenlong Gao
- Institute of Health Statistics and Intelligent Analysis, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China; Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China.
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Cui Y, Choi M. Assessment of the Daily Living Activities of Older People (2004-2023): A Bibliometric and Visual Analysis. Healthcare (Basel) 2024; 12:1180. [PMID: 38921294 PMCID: PMC11203029 DOI: 10.3390/healthcare12121180] [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: 05/13/2024] [Revised: 06/05/2024] [Accepted: 06/07/2024] [Indexed: 06/27/2024] Open
Abstract
With a rapidly aging global population, comprehending the risks associated with older people's activities of daily living is increasingly important; yet, interdisciplinary analyses remain rare. By providing a bibliometric overview of the capability risks associated with older people's activities of daily living, in order to identify prevailing trends and future directions in the field, the study aims to fill this gap. Using CiteSpace software to analyze data from 928 articles published between 2004 and 2023, the study results demonstrate the growing interest in the capability risks of older people's activities of daily living, with the United States leading in the number of publications, and geriatrics emerging as the dominant discipline. Notably, Institut National de la Sante et de la Recherche Medicale (Inserm) in France emerges as a pivotal contributor in the field. Key research topics encompass risk factors associated with a decline in daily activities and disease-related studies, with emerging trends in cognitive function and instrumental activity research. Future research should prioritize the development of predictive mechanisms for daily living trends, exploration of caregiving solutions, and promotion of interdisciplinary collaboration. This study highlights promising avenues for further research, emphasizing the importance of predictive modeling, innovative caregiving strategies, and interdisciplinary cooperation in addressing capability risks in the activities of daily living of older people.
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Affiliation(s)
- Ying Cui
- Department of Public Health Science, Graduate School and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul 02841, Republic of Korea;
| | - Mankyu Choi
- School of Health Policy & Management, College of Public Health Science and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
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Asdaq SMB, Alshehri S, Alajlan SA, Almutiri AA, Alanazi AKR. Depression in persons with disabilities: a scoping review. Front Public Health 2024; 12:1383078. [PMID: 38779421 PMCID: PMC11110534 DOI: 10.3389/fpubh.2024.1383078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/25/2024] [Indexed: 05/25/2024] Open
Abstract
Individuals with disabilities are more vulnerable to depression development than the general population. This study sought to map the evidence on current knowledge of depression, intervention strategies, and assessment tools among people with disabilities. This review was conducted following Arksey and O'Malley's scoping review methodology framework. An electronic search was performed on four English databases: PubMed, Cochrane Library, PsycINFO, and Web of Science. The original search returned 1802 results, with 1,116 from Web of Science, 626 from PubMed, 25 from Cochrane, and 35 from PsycINFO. After removing duplicates, 786 articles were chosen for the title and abstract screening processes. Finally, 112 full-text publications were deemed eligible, with 41 papers being included in this scoping review for analysis. A large proportion (32; 78.04%) of the studies chosen were cross-sectional, 14 (34.14%) of them reported general disability, 12 (29.26%) used a patient health questionnaire (PHQ-9) to measure depression, and 14 (34.14%) had interventions, including cognitive behavioral therapy, psychological counseling, social support, and physical activity. All interventions successfully reduced the severity of the depression. Cognitive behavioral therapies and psychological counseling were widely used interventions that had a significant impact on reducing depression. More randomized controlled trials are required, and they should focus on individuals with specific disabilities to provide disability-specific care that can improve the quality of life for disabled individuals.
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Schuchman M, Brady TM, Glenn DA, Tuttle KR, Cara-Fuentes G, Levy RV, Gonzalez-Vicente A, Alakwaa FM, Srivastava T, Sethna CB. Association of mental health-related patient reported outcomes with blood pressure in adults and children with primary proteinuric glomerulopathies. J Nephrol 2024; 37:647-660. [PMID: 38512380 DOI: 10.1007/s40620-024-01919-6] [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: 09/26/2023] [Accepted: 02/01/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION The prevalence of mental health disorders including anxiety and depression is increasing and is linked to hypertension in healthy individuals. However, the relationship of psychosocial patient-reported outcomes on blood pressure (BP) in primary proteinuric glomerulopathies is not well characterized. This study explored longitudinal relationships between psychosocial patient-reported outcomes and BP status among individuals with proteinuric glomerulopathies. METHODS An observational cohort study was performed using data from 745 adults and children enrolled in the Nephrotic Syndrome Study Network (NEPTUNE). General Estimating Equations for linear regression and binary logistic analysis for odds ratios were performed to analyze relationships between the exposures, longitudinal Patient-Reported Outcome Measurement Information System (PROMIS) measures and BP and hypertension status as outcomes. RESULTS In adults, more anxiety was longitudinally associated with higher systolic and hypertensive BP. In children, fatigue was longitudinally associated with increased odds of hypertensive BP regardless of the PROMIS report method. More stress, anxiety, and depression were longitudinally associated with higher systolic BP index, higher diastolic BP index, and increased odds of hypertensive BP index in children with parent-proxy patient-reported outcomes. DISCUSSION/CONCLUSION Chronically poor psychosocial patient-reported outcomes may be significantly associated with higher BP and hypertension in adults and children with primary proteinuric glomerulopathies. This interaction appears strong in children but should be interpreted with caution, as multiple confounders related to glomerular disease may influence both mental health and BP independently. That said, access to mental health resources may help control BP, and proper disease and BP management may improve overall mental health.
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Affiliation(s)
- Matthew Schuchman
- Northwell, Cohen Children's Medical Center, Division of Pediatric Nephrology, New Hyde Park, NY, USA
| | - Tammy M Brady
- Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dorey A Glenn
- Division of Nephrology and Hypertension, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katherine R Tuttle
- Providence Medical Research Center, Providence Inland Northwest Health, Spokane, WA, USA
- Division of Nephrology, University of Washington School of Medicine, Spokane, WA, USA
| | - Gabriel Cara-Fuentes
- Section of Pediatric Nephrology, Children's Hospital Colorado, University of Colorado, Aurora, CO, USA
| | - Rebecca V Levy
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
- Division of Pediatric Nephrology, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Agustin Gonzalez-Vicente
- Department of Physiology and Biophysics, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Fadhl M Alakwaa
- Department of Internal Medicine, Nephrology Division, University of Michigan, Ann Arbor, MI, USA
| | - Tarak Srivastava
- Pediatric Nephrology, Children's Mercy Hospital, Kansas City, MO, USA
| | - Christine B Sethna
- Northwell, Cohen Children's Medical Center, Division of Pediatric Nephrology, New Hyde Park, NY, USA.
- Feinstein Institutes for Medical Research, Manhasset, NY, USA.
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Zhang J, Zhang Y, Wu Z, Fu X. Enhancing understanding of healthy aging based on time-varying dependencies among multidimensional health, life satisfaction, and health behaviors of older adults aged 60 years and over. BMC Public Health 2024; 24:192. [PMID: 38229050 PMCID: PMC10790531 DOI: 10.1186/s12889-024-17752-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/11/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Healthy aging is a process of not only achieving good health but also increasing the life satisfaction of older adults aged 60 years and over, in which health behaviors play an important role. There is a lack of research on the time-varying dependencies between health, life satisfaction, and health behaviors, impeding a deeper understanding of healthy aging. PURPOSE To develop an integrated framework for modeling the interrelationships among the components of healthy aging between multiple time slices. METHODS Based on the Chinese Longitudinal Healthy Living Survey (CLHLS) data in the three waves of 2011/2012, 2014, and 2017/2018, Bayesian network and dynamic Bayesian network are jointly employed to study the relationships among the components of healthy aging within one time slice, as well as to explore the time-varying dependencies among the components between time slices. RESULTS The results of structure learning reveal the direction of effects between different dimensions of health, with mental health and social health affecting physical health and self-rated health affecting both physical and mental health. In addition, health behaviors are found to affect mental health and social health, while self-rated health can influence life satisfaction. The parameters learned from the data show the magnitude and direction of concurrent effects, one-period lagged effects and two-period lagged effects between the factors, which find that the time-varying dependencies vary but are generally positive, long-term, and accumulative over time. In addition, the results of autoregressive effects show the positive predictive effects of health and life satisfaction. CONCLUSIONS It confirms the influence pathway from health behaviors to multidimensional health to life satisfaction, and the time-varying dependencies among the components of healthy aging, which facilitates a deeper understanding of healthy aging. Combining the results of autoregressive effects and descriptive statistics, it further indicates that healthy aging is a comprehensive result arising from interactions of multiple factors. Policymakers should guide older adults aged 60 years and over to adopt healthier behaviors and ensure the long-term sustainability and continuity of policies.
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Affiliation(s)
- Jianghua Zhang
- School of Management, Shandong University, Jinan, 250100, China
| | - Yunbao Zhang
- School of Management, Shandong University, Jinan, 250100, China
| | - Zhiyi Wu
- School of Management, Shandong University, Jinan, 250100, China
| | - Xuemei Fu
- School of Management, Shandong University, Jinan, 250100, China.
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Elhassan H, Robbins-Welty GA, Moxley J, Reid MC, Shalev D. Geriatric Psychiatrists' Perspectives on Palliative Care: Results From A National Survey. J Geriatr Psychiatry Neurol 2024; 37:3-13. [PMID: 37161303 PMCID: PMC10862371 DOI: 10.1177/08919887231175435] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVES Older adults with psychiatric illnesses often have medical comorbidities that require symptom management and impact prognosis. Geriatric psychiatrists are uniquely positioned to meet the palliative care needs of such patients. This study aims to characterize palliative care needs of geriatric psychiatry patients and utilization of primary palliative care skills and subspecialty referral among geriatric psychiatrists. METHODS National, cross-sectional survey study of geriatrics psychiatrists in the United States. RESULTS Respondents (n = 397) reported high palliative care needs among their patients (46-73% of patients). Respondents reported using all domains of palliative care in their clinical practice with varied comfort. In multivariate modeling, only frequency of skill use predicted comfort with skills. Respondents identified that a third of patients would benefit from referral to specialty palliative care. CONCLUSIONS Geriatric psychiatrists identify high palliative care needs in their patients. They meet these needs by utilizing primary palliative care skills and when available referral to subspecialty palliative care.
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Affiliation(s)
| | - Gregg A Robbins-Welty
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jerad Moxley
- Division of Geriatrics and Palliative Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - M Carrington Reid
- Division of Geriatrics and Palliative Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Daniel Shalev
- Division of Geriatrics and Palliative Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
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7
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Peng R, Li X, Guo Y, Ning H, Huang J, Jiang D, Feng H, Liu Q. Barriers and facilitators to acceptance and implementation of eMental-health intervention among older adults: A qualitative systematic review. Digit Health 2024; 10:20552076241234628. [PMID: 38444518 PMCID: PMC10913496 DOI: 10.1177/20552076241234628] [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] [Accepted: 01/29/2024] [Indexed: 03/07/2024] Open
Abstract
Objective Electronic mental health interventions are effective but not well promoted currently among older adults. This study sought to systematically review and summarize the barriers and facilitators of accepting and implementing electronic mental health interventions among older adults. Methods We comprehensively retrieved six electronic databases from January 2012 to September 2022: PubMed, Web of Science, Embase, Scopus, PsycINFO, and CINAHL. The JBI-QARI was used to assess the quality of the research methodology of each publication. Eligible studies underwent data coding and synthesis aligned to inductive and deductive methods. The Consolidated Framework for Implementation Research 2.0 was used as a deductive framework to guide a more structured analysis. Results The systematic review screened 4309 articles, 17 of which were included (eight with mixed methods and nine with qualitative methods). We identified and extracted the barriers and facilitators of accepting and implementing electronic mental health interventions among older adults: (1) innovation: technology challenges, optimized functions, and contents, security and privacy; (2) outer setting: community engagement and partnerships, financing; (3) inner setting: leadership engagement, available resources, incompatibility, intergenerational support, training and guidance; (4) individuals: perceptions, capability, motivation of older adults and healthcare providers; and (5) implementation process: recruit, external assistance, and team. Conclusion These findings are critical to optimizing, promoting, and expanding electronic mental health interventions among older adults. The systematic review also provides a reference for better evidence-based implementation strategies in the future.
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Affiliation(s)
- Ruotong Peng
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Xiaoyang Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Yongzhen Guo
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Hongting Ning
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jundan Huang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Dian Jiang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
- Oceanwide Health Management Institute, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Qingcai Liu
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Ige JJ, Hunt DF, Mitchell A, Eaton E, Walker A, Fearn R, Kirkham L, Staples A, Giles A, Wilson B. Improving the standardisation, timeliness and efficiency of the occupational therapy admission process in an older adult inpatient service. BMJ Open Qual 2023; 12:e002514. [PMID: 38097284 PMCID: PMC10729176 DOI: 10.1136/bmjoq-2023-002514] [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: 07/25/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
Occupational therapists (OTs) are at the forefront of providing recovery-oriented care for older people through timely assessments of patient's engagement in daily living activities among many other interventions. This aids a timely, safe and successful discharge from hospital.This project built on the foundations of previous work while considering the context and requirements of two older adult wards, the rates of admission and staff retention. The specific aim agreed was for 90% of patients admitted to the older adults' inpatient units to be assessed by the occupational therapy (OTY) team within days of admission by December 2022.The OTs worked in collaboration to initiate two tests of change with a total of five PDSA cycles.Our tests of change resulted in an increase of patients engaging in OTY initial assessments within seven days of admission from 47.65% (May to November 2021) to 78% (December 2021 to December 2022).Our team embarked on a quality improvement project to improve standardisation, efficiency and timeliness of the OTY process in an older adult inpatient service by using a pragmatic measure and tests of change evidenced in a previous study. This evidenced the generalisability of the findings of this study. While we were able to improve the timeliness of OTY initial assessments, we concluded that the overall impact on outcomes such as timely discharge was also dependent on other clinical and social factors.
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Affiliation(s)
| | - David Fancis Hunt
- Oxford Healthcare Improvement, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Amanda Mitchell
- Occupational Therapy, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Emma Eaton
- Occupational Therapy, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Anne Walker
- Occupational Therapy, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Rachael Fearn
- Occupational Therapy, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Lizzie Kirkham
- Occupational Therapy, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Abigail Staples
- Occupational Therapy, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Adam Giles
- Occupational Therapy, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Bethany Wilson
- Occupational Therapy, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
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da Silva TBL, Ordonez TN, da Silva GA, de Souza MAA, da Silva SA, Dos Santos G, Gutierrez BAO, Moreira APB, Costa LA, de Moraes LC, Lessa PP, Cardoso NP, Sakaguchi M, da Silva HS, Brucki SMD. The presence of depressive symptoms and cognitive performance among older individuals with and without self-reported chronic diseases. Dement Neuropsychol 2023; 17:e20230035. [PMID: 38053646 PMCID: PMC10695437 DOI: 10.1590/1980-5764-dn-2023-0035] [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: 06/23/2023] [Revised: 09/03/2023] [Accepted: 09/12/2023] [Indexed: 12/07/2023] Open
Abstract
Dementias secondary to cardiovascular diseases are the second cause of neurogenerative diseases. These conditions can be prevented by controlling risk factors, and it is necessary to observe the relationship between chronic diseases. Objective to know the influence of chronic non-communicable diseases on cognition and depressive symptoms in the elderly, amid the COVID-19 pandemic. Methods 578 older adults were evaluated using a sociodemographic questionnaire, the Brazilian Telephone version of the Mini Mental State Examination (Braztel-MMSE), the Geriatric Depression Scale (GDS-15) and an open questionnaire related to NCDs. Results the association of Non-Communicable Diseases (NCD) with age, depressive symptoms and schooling was confirmed. Conclusion no association with cognitive decline was evident due to the relationship of high schooling of participants and control of NCDs.
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Affiliation(s)
- Thaís Bento Lima da Silva
- Universidade de São Paulo, School of Arts, Science and Humanities, São Paulo SP, Brazil
- Universidade de São Paulo, School of Medicine, Group of Cognitive and Behavioral Neurology, São Paulo SP, Brazil
| | | | | | | | | | - Gabriela Dos Santos
- Universidade de São Paulo, School of Arts, Science and Humanities, São Paulo SP, Brazil
| | | | | | - Laydiane Alves Costa
- Universidade de São Paulo, School of Arts, Science and Humanities, São Paulo SP, Brazil
| | | | | | | | | | | | - Sonia Maria Dozzi Brucki
- Universidade de São Paulo, School of Medicine, Group of Cognitive and Behavioral Neurology, São Paulo SP, Brazil
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Han Q, Hu W, Sun N, Chu J, Chen X, Li T, He Q, Feng Z, Shen Y. Bidirectional Associations Between Sleep Quality and Grip Strength and the Mediating Role of Depression: Evidence From Two Nationally Representative Cohorts. J Gerontol A Biol Sci Med Sci 2023; 78:2449-2457. [PMID: 36934351 DOI: 10.1093/gerona/glad084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Indexed: 03/20/2023] Open
Abstract
BACKGROUND Although studies have demonstrated associations between sleep quality (SQ) and grip strength (GS) in older adults, the direction and underlying mechanisms of this relationship are yet to be better delineated. We aimed to longitudinally investigate the bidirectional association between SQ and GS and the mediating role of depression in this association. METHODS Based on 2 nationally representative samples with people aged ≥50 years from the China Health and Retirement Longitudinal Study (CHARLS; 4 200 participants) and English Longitudinal Study of Ageing (ELSA; 5 922 participants), cross-lagged panel models were employed to examine the potential bidirectional relationships between objectively measured GS and self-reported SQ. RESULTS We observed a GS-SQ bidirectional association dominated by GS. After adjusting for potential confounders, a higher GS at T1 predicted better SQ at T2 (ELSA: β = 0.075; CHARLS: β = 0.104, p < .001) and vice versa (ELSA: β = 0.034; CHARLS: β = 0.030, p < .01). Moreover, depression partially mediated the impact of GS on subsequent SQ (ELSA, indirect effect: 0.0057, 95% confidence interval [CI]: 0.0035-0.0084; CHARLS, indirect effect: 0.0086, 95% CI: 0.0051, 0.0131), but not vice versa. CONCLUSIONS The results regarding data from both cohorts consistently supported a bidirectional association between GS and SQ and the mediating role of depression in the dominant pathway of this bidirectional relationship. Older adults with a low GS should be made aware of a potentially vicious cycle related to depression that can affect their sleep. Regular screening for depression may help to break this cycle.
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Affiliation(s)
- Qiang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Wei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Na Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jiadong Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xuanli Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Tongxing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qida He
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Zhaolong Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
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Lau E, Adams YJ. Predictors of Postpartum Depression Among Women with Low Incomes in the United States. MCN Am J Matern Child Nurs 2023; 48:326-333. [PMID: 37589952 DOI: 10.1097/nmc.0000000000000955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
PURPOSE To evaluate the predictors of postpartum depression and to examine the effects of maternal racial identity on postpartum depression among women with low incomes in the United States. STUDY DESIGN AND METHODS We conducted a secondary data analysis using baseline data from the Baby's First Years study, including postpartum women living below the federal poverty line who were recruited from four diverse communities in the United States. Postpartum depression symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regressions were performed to identify associations between pre-identified postpartum depression risk factors and postpartum depression among participants, followed by predictive margins analyses to elaborate on probability of postpartum depression across different racial identity groups in the sample. RESULTS The sample included 1,051 postpartum women. Almost one-half of participants identified as Black (45.9%), followed by White (20.7%), American Indian (1.8%), and Asian (1.3%). Prevalence of postpartum depression in the sample was 24%. Financial insecurity and alcohol use were positively associated with postpartum depression, whereas level of education and reported physical health were negatively associated with postpartum depression. Mothers who identified as Black had an 8.3% higher probability of postpartum depression than that of White mothers in the sample. CLINICAL IMPLICATIONS Nurses working with populations with low income should assess social determinants of health to provide holistic mental health care. Women with low incomes should be referred to resources which account for their financial burden. Racial disparities exist in perinatal care, and birth and postpartum mental health outcomes. It is crucial to address the systemic racism faced by Black mothers experiencing postpartum depression.
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Navarra GA, Tabacchi G, Scardina A, Agnese M, Thomas E, Bianco A, Palma A, Bellafiore M. Functional fitness, lifestyle and demographic factors as predictors of perceived physical and mental health in older adults: A structural equation model. PLoS One 2023; 18:e0290258. [PMID: 37672501 PMCID: PMC10482288 DOI: 10.1371/journal.pone.0290258] [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: 04/04/2023] [Accepted: 08/03/2023] [Indexed: 09/08/2023] Open
Abstract
Over the past 50 years, socioeconomic development has brought a reduction in birth rates, an increase in life expectancy and consequently in the elderly population. For this reason, there has been an increasing focus on physical and mental health of the elderly, promoting the concept of healthy aging. The aim of this study was to explore the associations between perceived physical and mental health of older adults and a variety of determinants, such as demographic factors, physical functional fitness, physical activity level, adherence to the Mediterranean diet and anthropometric indices, through a structural equation modeling (SEM). A cross-sectional observational study involved 208 elderly (24 men and 184 women) over the age of 60, fully independent and autonomous. Perceived physical and mental health were assessed with the Short Form 12 questionnaire. Basic sociodemographic information was collected; anthropometric features were directly measured, functional fitness was assessed with the Senior Fitness Test, and physical activity level was determined through the International Physical Activity Questionnaire; adherence to Mediterranean Diet (MD) was also collected through the MEDAS questionnaire. The SEM analysis revealed that functional fitness, which was a latent variable of the model described by the six administered fitness tests, was a strong predictor both of perceived physical and perceived mental health in the sample of elderly. Physical activity level was as predictor of the perceived physical component, but not of the mental health, while score of metabolic equivalent task did not result a predictor, as well as the sociodemographic factors and adherence to MD. The present findings suggest that it would be strongly recommended for elderly subjects to engage in physical activity specifically targeted to aged populations, in order to enhance their fitness abilities and enable them to improve the perception of their own health status.
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Affiliation(s)
- Giovanni Angelo Navarra
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Garden Tabacchi
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Antonino Scardina
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Massimiliano Agnese
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Ewan Thomas
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Marianna Bellafiore
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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Rhubart D, Kowalkowski J, Wincott L. The Built Environment and Social and Emotional Support among Rural Older Adults: The Case for Social Infrastructure and Attention to Ethnoracial Differences. RURAL SOCIOLOGY 2023; 88:731-762. [PMID: 37829666 PMCID: PMC10567077 DOI: 10.1111/ruso.12491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 05/01/2023] [Indexed: 10/14/2023]
Abstract
Social and emotional support (SaES) is essential for older adult mental health and is shaped by individual-level factors and the built environment. However, much of the focus on the built environment, and specifically social infrastructure - the physical places that facilitate social interaction and social tie formation - relies heavily on urban settings or samples with limited diversity. Consequently, there is little understanding if social infrastructure matters for the SaES of older adults in rural America, and across race and ethnicity. Therefore, we use social cohesion as a conceptual lens and the community gerontology framework to determine if availability of social infrastructure is associated with SaES among older adults in rural America and if this relationship varies across race and ethnicity. Using data from 110,850 rural older adults from the Behavioral Risk Factors Surveillance System and data from the National Neighborhood Data Archive, we show that among rural ethnoracial minority older adults, higher densities of social infrastructure are associated with higher SaES. This is not true for rural non-Hispanic White older adults. Results highlight the importance of accounting for both social infrastructure as part of the built environment and heterogeneity across race and ethnicity in studies that examine older adult mental and emotional health.
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Affiliation(s)
- Danielle Rhubart
- The Pennsylvania State University, Biobehavioral Health Building, University Park PA 16802, USA
| | - Jennifer Kowalkowski
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - Logan Wincott
- The Pennsylvania State University, University Park, PA, USA
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14
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Lee G, Arieli R, Ryou YJ, Martin P. The bidirectional relationship between depressive symptoms and functional limitations among centenarian survivors in their 80s: Testing bivariate latent change score models. Aging Ment Health 2023; 27:1720-1728. [PMID: 36786734 DOI: 10.1080/13607863.2023.2177830] [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: 08/28/2022] [Accepted: 01/31/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES The purpose of the study was to examine a bivariate latent change score model of depressive symptoms and functional limitations (activities of daily living) among centenarian or near-centenarian survivors over four waves using the Health and Retirement Study. METHOD Four hundred and sixty participants who eventually survived to age 98 or older were included by calculating their death age. Data from the time when the participants were in their 80s were analyzed. The mean age at baseline (1994) was 85.5 years. The observation interval was 2 years, from 1994 to 2000. Including age, gender, and education as a covariate, eight different models were conducted to examine the bivariate effects among depressive symptoms and functional limitations. RESULTS Of the eight models, the bivariate model of depressive symptoms predicting change in functional limitations fitted the data best. The parameter estimates of the final model indicated significant predictive pathways from depressive symptoms to subsequent changes in depressive symptoms and functional limitations. CONCLUSION This study tested the bidirectional relationship between depressive symptoms and functional limitations among centenarian survivors in their 80s, which uncovered that depressive symptoms is a dominant variable among the two constructs. Our findings add to a lacking number of longitudinal studies with oldest old adults.
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Affiliation(s)
- Gina Lee
- Iowa State University, Ames, IA, USA
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15
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Hu W, Chu J, Zhu Y, Chen X, Sun N, Han Q, Li T, Feng Z, He Q, Wu J, Shen Y. The Longitudinal Association Between Frailty, Cognition, and Quality of Life in Older Europeans. J Gerontol B Psychol Sci Soc Sci 2023; 78:809-818. [PMID: 36702742 PMCID: PMC10413812 DOI: 10.1093/geronb/gbad013] [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: 09/15/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Evidence on the association between frailty and quality of life (QoL) is mostly limited to cross-sectional studies. Thus, the temporal order and potential mechanisms of this association are largely unknown. Our study examines both the directionality of this association and the role of cognition in this association in longitudinal data. METHODS Cross-lagged panel models were employed to examine the temporal relationship between frailty and QoL, as well as cognition's role among 19,649 older adults in Europe. Frailty, QoL, and cognition were assessed using the health deficit index, CASP-12, and 3 standard cognitive tests, respectively. RESULTS We observed a bidirectional association between frailty and QoL and their dynamics. High initial levels of frailty predicted poorer QoL later and vice versa (β = -0.151 and -0.052, p < .001). The early change in frailty predicted the late change in QoL, and vice versa (β = -0.093 and -0.061, p < .001). Frailty or its early change drives this interrelationship. Cognition at Wave 5 partially mediated frailty's effect at Wave 4 on QoL at Wave 6 (indirect effect: β = -0.005, 95% confidence interval = -0.006, -0.004). DISCUSSION Our findings supported that early prevention of frailty and its risk factors may have more influential protective effects on later physical and mental health, as well as the need for ongoing screening for mental health in aging population. Also, the maintenance of good cognitive performance may help interrupt this possible vicious cycle linking frailty and QoL decline.
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Affiliation(s)
- Wei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jiadong Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yixian Zhu
- School of Radiation Medicine and Protection, Soochow University, Medical College of Soochow University, Suzhou, China
| | - Xuanli Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Na Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qiang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Tongxing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Zhaolong Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qida He
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jun Wu
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
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16
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Amate-Fortes I, Guarnido-Rueda A, Martínez-Navarro D, Oliver-Márquez FJ. Social Isolation, Healthy Habits, Inequality and Mental Health in the United States. APPLIED RESEARCH IN QUALITY OF LIFE 2023; 18:1-27. [PMID: 37359221 PMCID: PMC9999329 DOI: 10.1007/s11482-023-10155-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/15/2023] [Indexed: 06/28/2023]
Abstract
The objective of this work is to deepen the analysis of the socioeconomic determinants of mental health, paying special attention to the impact of inequality, not only in income distribution but also in gender, racial, health and education inequality, social isolation, including new variables to measure loneliness, and healthy habits, on the mental health status. For this purpose, a cross-sectional model for a sample of 2735 counties in the United States is estimated using Ordinary Least Squares in its robust version to solve the detected heteroscedasticity problems. The results obtained show that inequality, social isolation and certain lifestyles, such as smoking or insomnia, are detrimental to mental health, while sexual activity prevents mental distress. On the other hand, poor counties suffer more cases of suicide, with food insecurity being the main problem for mental health. Finally, we found detrimental effects of pollution on mental health.
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Affiliation(s)
- Ignacio Amate-Fortes
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120 Almeria, Spain
| | - Almudena Guarnido-Rueda
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120 Almeria, Spain
| | - Diego Martínez-Navarro
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120 Almeria, Spain
| | - Francisco J. Oliver-Márquez
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120 Almeria, Spain
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17
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Li C, Wu M, Qiao G, Gao X, Hu T, Zhao X, Zhu X, Yang F. Effectiveness of continuity of care in reducing depression symptoms in elderly: A systematic review and meta-analysis. Int J Geriatr Psychiatry 2023; 38:e5894. [PMID: 36814066 DOI: 10.1002/gps.5894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 02/19/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Depression affects 10%-20% of older adults worldwide. The course of late-life depression (LLD) is often chronic, with a poor long-term prognosis. Lower treatment adherence, stigma, and suicide risk lead to significant challenges in the continuity of care (COC) for patients with LLD. Elderly patients with chronic diseases can benefit from COC. As a common chronic disease of the elderly, whether depression can also benefit from COC has not been systematically reviewed. METHODS Systematic literature search in Embase, Cochrane Library, Web of Science, Ovid, PubMed and Medline. Randomized Controlled Trials (RCTs) on the intervention effects of COC and LLD, published on 12 April 2022, were selected. Two independent researchers made research choices based on consensus. An RCT with COC as an intervention measure for the elderly with depression 60 years old was the inclusion criteria. RESULTS A total of 10 RCTs involving 1557 participants were identified in this study. The findings showed that: (1) COC significantly reduced depressive symptoms compared to usual care (standardized mean difference [SMD] = -0.47, 95% confidence interval: -0.63 to -0.31), with the best improvement at 3- to 6-month follow-up; (2) The reduction in depressive symptoms was more pronounced for patients with comorbid chronic conditions with LLD (SMD = -0.93, 95% CI: -1.18 to -0.68); (3) COC was more effective than other regions for LLD in Europe and the Americas (SMD = -0.84, 95% CI: -1.07 to -0.61); and (4) COC had a positive impact on the quality of life of patients with LLD (SMD = 0.21, 95% CI: 0.02-0.40). LIMITATIONS The included studies included several multi-component interventions with widely varying methods. Therefore, it was almost impossible to analyze which of these interventions had an impact on the assessed outcomes. CONCLUSIONS This meta-analysis shows that COC can significantly reduce depressive symptoms and improve quality of life in patients with LLD. However, when treating and caring for patients with LLD, health care providers should also pay attention to timely adjustments of intervention plans according to follow-up, synergistic interventions for multiple co-morbidities, and actively learning from advanced COC programs at home and abroad to improve the quality and effectiveness of services.
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Affiliation(s)
- Chaoyang Li
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Man Wu
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Guiyuan Qiao
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xiaolian Gao
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ting Hu
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xueyang Zhao
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xinhong Zhu
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Fen Yang
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
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18
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Grelle K, Shrestha N, Ximenes M, Perrotte J, Cordaro M, Deason RG, Howard K. The Generation Gap Revisited: Generational Differences in Mental Health, Maladaptive Coping Behaviors, and Pandemic-Related Concerns During the Initial COVID-19 Pandemic. JOURNAL OF ADULT DEVELOPMENT 2023; 30:1-12. [PMID: 36811122 PMCID: PMC9934502 DOI: 10.1007/s10804-023-09442-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 02/18/2023]
Abstract
The purpose of this study was to assess differences in mental health symptoms, pandemic-related concerns, and maladaptive coping behaviors among adults in the United States across generations during the initial period of the COVID-19 pandemic. A social media campaign was used to recruit 2696 U.S. individuals to participate in an online survey in April 2020, assessing various validated psychosocial factors, including major depressive disorder, generalized anxiety disorder (GAD), perceived stress, loneliness, quality of life, and fatigue, along with pandemic-specific concerns and changes in alcohol use and substance use. Participants were grouped based on generation status (Gen Z, Millennial, Gen X, and Baby Boomer) and statistical comparisons were conducted based on demographics, psychosocial factors, pandemic-related concerns, and substance use. During the initial period of the COVID-19 pandemic, the younger cohorts (Gen Z and Millennials) rated significantly worse on mental health indices, including major depression, GAD, perceived stress, loneliness, quality of life, and fatigue. Further, the participants in the Gen Z and Millennial generational groups exhibited greater increase in maladaptive coping with substance use, specifically alcohol use and increased use of sleep aids. Our results indicate that during the initial period of the COVID-19 pandemic, members of the Gen Z and Millennial generational cohorts were considered a psychologically vulnerable population due to their mental health and maladaptive coping behaviors. Improving access to mental health resources during early stages of a pandemic is an emerging public health concern.
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Affiliation(s)
- Kaitlin Grelle
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Neha Shrestha
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Megan Ximenes
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Jessica Perrotte
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Millie Cordaro
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Rebecca G. Deason
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Krista Howard
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
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19
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Rhubart D, Kowalkowski J, Yerger J. Rural-Urban disparities in self-reported physical/mental multimorbidity: A cross-sectional study of self-reported mental health and physical health among working age adults in the U.S. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231218560. [PMID: 38024542 PMCID: PMC10666663 DOI: 10.1177/26335565231218560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023]
Abstract
Purpose Self-rated physical health (SRPH) and self-rated mental health (SRMH) are both linked to excess morbidity and premature mortality and can vary across rural and urban contexts. This can be particularly problematic for rural residents who have less access to important health care infrastructure. In this paper, we assess the prevalence of and rural-urban disparities at the intersection of SRPH and SRMH, specifically self-rated physical/mental multimorbidity (SRPMM) overall and across rural-urban contexts. Methods Using a cross-sectional demographically representative national dataset of over 4000 working age adults in the U.S., we expose rural-urban differences in the prevalence of SRPMM and explore individual-level factors that may explain this disparity. Results Approximately 15 percent of working age adults reported SRPMM, but rural adults were at higher risk than their urban counterparts. However, this disadvantage disappeared for remote rural working-age adults and was attenuated for metro-adjacent rural working-age adults when we controlled for the fact that rural adults had lower household incomes. Conclusion Findings reveal a higher risk of SRPMM among rural adults, in part because of lower incomes among this group. This work acts as the foundation for facilitating research on and addressing rural-urban disparities in SRPMM.
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Affiliation(s)
- Danielle Rhubart
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - Jennifer Kowalkowski
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - Jordan Yerger
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
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20
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Ikram M, Shaikh NF, Vishwanatha JK, Sambamoorthi U. Leading Predictors of COVID-19-Related Poor Mental Health in Adult Asian Indians: An Application of Extreme Gradient Boosting and Shapley Additive Explanations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:775. [PMID: 36613095 PMCID: PMC9819341 DOI: 10.3390/ijerph20010775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
During the COVID-19 pandemic, an increase in poor mental health among Asian Indians was observed in the United States. However, the leading predictors of poor mental health during the COVID-19 pandemic in Asian Indians remained unknown. A cross-sectional online survey was administered to self-identified Asian Indians aged 18 and older (N = 289). Survey collected information on demographic and socio-economic characteristics and the COVID-19 burden. Two novel machine learning techniques-eXtreme Gradient Boosting and Shapley Additive exPlanations (SHAP) were used to identify the leading predictors and explain their associations with poor mental health. A majority of the study participants were female (65.1%), below 50 years of age (73.3%), and had income ≥ $75,000 (81.0%). The six leading predictors of poor mental health among Asian Indians were sleep disturbance, age, general health, income, wearing a mask, and self-reported discrimination. SHAP plots indicated that higher age, wearing a mask, and maintaining social distancing all the time were negatively associated with poor mental health while having sleep disturbance and imputed income levels were positively associated with poor mental health. The model performance metrics indicated high accuracy (0.77), precision (0.78), F1 score (0.77), recall (0.77), and AUROC (0.87). Nearly one in two adults reported poor mental health, and one in five reported sleep disturbance. Findings from our study suggest a paradoxical relationship between income and poor mental health; further studies are needed to confirm our study findings. Sleep disturbance and perceived discrimination can be targeted through tailored intervention to reduce the risk of poor mental health in Asian Indians.
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Affiliation(s)
- Mohammad Ikram
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Robert C. Byrd Health Sciences Center [North], P.O. Box 9510, Morgantown, WV 26506-9510, USA
| | - Nazneen Fatima Shaikh
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Robert C. Byrd Health Sciences Center [North], P.O. Box 9510, Morgantown, WV 26506-9510, USA
| | - Jamboor K. Vishwanatha
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Usha Sambamoorthi
- Department of Pharmacotherapy, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
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Prepandemic Mental Health and Well-being: Differences Within the Health Care Workforce and the Need for Targeted Resources. J Occup Environ Med 2022; 64:1025-1035. [PMID: 36472564 PMCID: PMC9722331 DOI: 10.1097/jom.0000000000002630] [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: 12/12/2022]
Abstract
BACKGROUND Occupational stress and diminished well-being among health care workers were concerning even before the coronavirus disease 2019 pandemic exacerbated existing stressors and created new challenges for this workforce. Research on the mental health of health care workers has focused on physicians and nurses, with less attention to other occupations. METHODS To assess pre-coronavirus disease mental health and well-being among workers in multiple health care occupations, we used 2017 to 2019 data from the Behavioral Risk Factor Surveillance System. RESULTS Across the health care workforce, insufficient sleep (41.0%) and diagnosed depression (18.9%) were the most common conditions reported. Counselors had the highest prevalence of diagnosed depression. Health care support workers had elevated prevalences for most adverse health conditions. CONCLUSIONS Ensuring a robust health care workforce necessitates identifying and implementing effective occupation-specific prevention, intervention, and mitigation strategies that address organizational and personal conditions adversely affecting mental health.
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Fonseca C, Ramos A, Pinho LG, Morgado B, Oliveira H, Lopes M. Functional Profile of Older Adults Hospitalized in Rehabilitation Units of the National Network of Integrated Continuous Care of Portugal: A Longitudinal Study. J Pers Med 2022; 12:1937. [PMID: 36422113 PMCID: PMC9697554 DOI: 10.3390/jpm12111937] [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] [Received: 08/16/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The success of healthy aging depends on the ability of countries to study and act on frailty in the elderly, control chronic diseases, improve functional capacity and prevent cognitive decline and social interaction. AIM (1) to evaluate the functional profile of older adults hospitalized in a Unit of the National Network of Integrated Continuous Care of Portugal; and (2) to assess the relationship between functional profile and age, gender, level of education and emotional state. METHODS Longitudinal study with a population of 59,013 older adults (65 years or older) hospitalized in Medium-Term Care and Rehabilitation Units in Portugal. RESULTS Older age (≥85 years), no school attendance, low body mass index and presence of sad or depressed mood were predictive factors for a deficit in functional capacity. We identified significant improvements in rehabilitation, but after 210 days of hospitalization, older people incurred a loss of functionality. Total compensation needs were typified by severe deficits in self-care and functional capacity: 47.1%. A moderate deficit was present in 43.1%, and a slight self-care and functional deficit occurred in 9.8% of the individuals. CONCLUSIONS Knowing the determinants of functional capacity and self-care needs will make it possible to define priority intervention groups and implement quality and financing models based on gains in functionality.
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Affiliation(s)
- César Fonseca
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| | - Ana Ramos
- Hospital Center of Medium Tejo, 2304-909 Tomar, Portugal
| | - Lara Guedes Pinho
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| | - Bruno Morgado
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
- Hospital Garcia de Orta, 2805-267 Almada, Portugal
| | - Henrique Oliveira
- Institute of Telecommunications, 1049-001 Lisbon, Portugal
- Polytechnic Institute of Beja, 7800-295 Beja, Portugal
| | - Manuel Lopes
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
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Liu N, He Y, Li Z. The Relationship between Internet Use and Self-Rated Health among Older Adults in China: The Mediating Role of Social Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14785. [PMID: 36429504 PMCID: PMC9690403 DOI: 10.3390/ijerph192214785] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
The development of Internet technology has significantly impacted how people live their daily lives. How this disparity in Internet use affects the self-rated health of older adults needs to be further explored. This paper studies the impact of Internet use on self-rated health, aiming to examine the effect of Internet use and social support on the self-rated health of older adults in China. This study used data from the 2017 China General Social Survey (CGSS) to verify the effect of Internet use on older adults' self-rated health. The results showed that Chinese elderly who used the Internet had a higher self-rated health, and social support from relatives and friends significantly improved the elderly's self-rated health. This social support played a critical, partially mediating role between Internet use and self-rated health. In China, the effect of Internet use on older adults' self-rated health was heterogeneous. Among them, the impact of Internet use was more significant for the male elderly, younger elderly, and rural elderly. The results suggest that the government should formulate targeted policies to improve the utilization of the Internet and maintain a good Internet environment to enhance the well-being of older adults according to the trend of population aging and the popularity of the Internet.
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Affiliation(s)
- Ningning Liu
- School of Public Administration, Central South University, Changsha 410083, China
| | - Yujing He
- School of Architecture and Art, Central South University, Changsha 410083, China
| | - Zhirong Li
- School of Architecture and Art, Central South University, Changsha 410083, China
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Li H, Pang M, Wang J, Xu J, Kong F. Effects of Health Service Utilization and Informal Social Support on Depression, Anxiety, and Stress among the Internal Migrant Elderly following Children in Weifang, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14640. [PMID: 36429375 PMCID: PMC9691240 DOI: 10.3390/ijerph192214640] [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: 09/02/2022] [Revised: 10/23/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
This study explored the relationship between health service utilization, informal social support and depression, anxiety and stress among the internal migrant elderly following children (IMEFC) in Weifang, China. A total of 613 IMEFC were selected using multistage cluster random sampling. The Depression Anxiety and Stress Scale 21 (DASS-21) was used to assess the depression, anxiety and stress of the IMEFC. Descriptive analysis and univariate and binary logistic regression analyses were used to clarify the correlation between health service utilization and social support and depression, anxiety and stress of the IMEFC. The prevalence of depression, anxiety and stress of the IMEFC was 6.9%, 7.7% and 3.4%, respectively. Logistic regression analysis showed that the IMEFC who having financial stress on medical costs were more likely to feel depressed than those haven't financial stress on medical costs (OR = 6.557), while those unemployed and having no income were less likely to feel depressed than those employed (OR = 0.262), having children support were less likely to feel depressed than those haven't children support (OR = 0.257) and having comfort support were less likely to feel depressed than haven't comfort support (OR = 0.018). Trans-city migration were more likely to feel anxious than trans-county migration (OR = 3.198), having outpatient service were more likely to feel anxious than haven't experienced inpatient service (OR = 3.818), having financial stress on medical costs were more likely to feel anxious than haven't financial stress on medical costs (OR = 3.726), while having children support were less likely to feel anxious than haven't children support (OR = 0.198). Those who migrate to cure disease or rehabilitation were more likely to feel stressed than those migrated to taking care of grandchildren (OR = 12.702) and having financial stress on medical costs were more likely to feel stressed than haven't financial stress on medical costs (OR = 32.155), while having children support were less likely to feel stressed than haven't children support (OR = 0.055) and having economic support in troubles were less likely to feel stressed than haven't economic support in troubles (OR = 0.012). More effective measures should be taken to improve the accessibility and efficiency of cross-regional health insurance reimbursement, and family members should spend more time with the IMEFC to lower their psychological tension in a new environment.
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Affiliation(s)
- Hexian Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Mingli Pang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Jieru Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Jing Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
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Martínez-Rodríguez A, Cuestas-Calero BJ, García de Frutos JM, Yáñez-Sepúlveda R, Marcos-Pardo PJ. Effect of aquatic resistance interval training and dietary education program on physical and psychological health in older women: Randomized controlled trial. Front Nutr 2022; 9:980788. [DOI: 10.3389/fnut.2022.980788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Due to demographic changes, the world’s population is progressively aging. The physiological deterioration of the older adult may lead to reduced balance capacity and increased risk of falls, among others, due to the prevalence of degenerative diseases. Physical exercise can be effective in reducing the risk of disease and slowing functional decline in older people. The aim of the research is to test the effects of aquatic resistance training and dietary education on health indicators, strength, balance, functional autonomy, perception of satisfaction with life. Thirty-four participants aged 69 ± 4 years were randomly assigned into two groups: experimental (aquatic resistance interval training) and control group (no intervention). The intervention consisted of resistance training in an aquatic environment carried out for 14 weeks (three sessions per week: 60 min each). All variables were analyzed twice; pre - post intervention. Aquatic resistance training has positive effects on strength (p < 0.001), functional self-sufficiency (p < 0.001) and aerobic capacity (p < 0.001), however, no significant differences were observed in the perception of satisfaction with life and balance. Research results suggest that older women who engage in regular, scheduled aquatic resistance training have greater autonomy in performing activities of daily living, agility, gait control, and body composition variables (lower fat compartment and greater muscle mass).
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Plys E, Beam R, Boxer RS, Portz JD. Behavioral Health Services with Short-Stay Residents in Skilled Nursing Facilities: A Qualitative Study of Clinicians and Administrators. Clin Gerontol 2022; 45:1189-1200. [PMID: 34128773 PMCID: PMC8671564 DOI: 10.1080/07317115.2021.1937425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The perspectives of professionals involved in behavioral health (BH) services with short-stay residents in skilled nursing facilities (SNFs) are rarely captured in the literature. This study examines the real-world experiences of BH clinicians and administrators in post-acute/subacute care units in SNFs. METHODS This qualitative study used semi-structured interviews with 18 clinicians (e.g., psychologists and social workers) and five administrators (e.g., directors of social services or BH company executives) involved in BH services with short-stay SNF residents. Interviews were recorded, transcribed, and analyzed by two independent coders using conventional thematic content analysis. RESULTS Three themes emerged from the data: (1) BH needs are high among short-stay residents and families during post-acute care transitions; (2) BH services offer multiple unique opportunities to enhance post-acute/subacute care in SNFs; and (3) barriers to providing optimal BH care exist at multiple levels and require action from BH clinicians and stakeholders. CONCLUSIONS Variability in clinician roles and barriers to optimized care suggest the need for future research targeting best practices and implementation strategies for BH services with short-stay SNF residents. CLINICAL IMPLICATIONS Results identified multiple ways in which BH services may enhance resident, family, and staff outcomes, as well as the milieu in SNFs.
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Affiliation(s)
- Evan Plys
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus
- Division of General Internal Medicine, University of Colorado School of Medicine, Anschutz Medical Campus
| | | | | | - Jennifer D. Portz
- Division of General Internal Medicine, University of Colorado School of Medicine, Anschutz Medical Campus
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Mediating role of functional limitations in the association of urinary incontinence with depressive symptoms among middle-aged and older adults: The English Longitudinal Study of Aging. J Affect Disord 2022; 313:158-162. [PMID: 35793770 DOI: 10.1016/j.jad.2022.06.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/17/2022] [Accepted: 06/23/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the association of urinary incontinence with depressive symptoms, and to explore the mediating effect of functional limitations on this association. METHODS This cross-sectional study included 7039 adults aged 50 and over from the English Longitudinal Study of Aging (Wave 8). Urinary incontinence was defined as whether the participants experienced urinary incontinence in the past 12 months. Depressive symptoms were assessed based on the Center for Epidemiologic Studies-Depression Scale. Functional limitations included disability of activities of daily living, instrumental activities of daily living, mobility and large muscle groups limitation of the participants. Logistic regression based on Karlson/Holm/Breen (KHB) method was applied to estimate the association of urinary incontinence with depressive symptoms and explore the mediating effect of functional limitations. RESULTS Urinary incontinence was significantly associated with increased risk of depressive symptoms after controlling covariates (odds ratio = 1.75, 95 % confidence interval: 1.45-2.11). Functional limitations explained 36.96 % of this association. CONCLUSION Urinary incontinence might be associated with an increased risk of depressive symptoms among middle-aged and older adults and functional limitations partially mediate this association. Improving physically functional capacity might play an important role in preventing and managing depressive symptoms in elderly people with urinary incontinence.
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Sha S, Pan Y, Xu Y, Chen L. Associations between loneliness and frailty among older adults: Evidence from the China Health and Retirement Longitudinal Study. BMC Geriatr 2022; 22:537. [PMID: 35773656 PMCID: PMC9247968 DOI: 10.1186/s12877-022-03044-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/01/2022] [Indexed: 11/30/2022] Open
Abstract
Background Previous studies have demonstrated the associations between loneliness and frailty in late life. However, there is a lack of consensus on the direction of the relationship. The present study aimed to examine the interdependencies between loneliness and frailty over time. Methods Data on participants aged 60 years old and above were collected from the 2011, 2013, and 2015 samples of the China Health and Retirement Longitudinal Study (CHARLS). Loneliness was measured by a single question from the Centre for Epidemiological Studies Depression scale, and frailty was assessed by the Physical Frailty Phenotype (PFP) scale. Cross-lagged panel models were utilized to examine the potential bidirectional relationship between loneliness and frailty. Results Reciprocal associations were found between loneliness and frailty. Furthermore, we found that baseline frailty and early change in frailty had a significant predictive effect on late change in loneliness. Higher baseline loneliness in older adults may create a potentially vicious cycle that influenced early change in frailty and continued to cause late change in loneliness. Conclusion A bidirectional relationship may exist between loneliness and frailty among older Chinese adults over 60 years old. Lonely older adults should be alerted to the potential self-reinforcing cycle of loneliness that affects their health. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03044-0.
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Affiliation(s)
- Sha Sha
- School of Sociology and Population Studies, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Yao Pan
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Yuebin Xu
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai, China
| | - Lin Chen
- Beijing Normal University at Zhuhai, Zhuhai, China.
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Cohen O, Shapira S, Furman E. Long-Term Health Impacts of Wildfire Exposure: A Retrospective Study Exploring Hospitalization Dynamics Following the 2016 Wave of Fires in Israel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095012. [PMID: 35564404 PMCID: PMC9099700 DOI: 10.3390/ijerph19095012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 01/27/2023]
Abstract
Background: Climate-related events, including wildfires, which adversely affect human health, are gaining the growing attention of public-health officials and researchers. Israel has experienced several disastrous fires, including the wave of fires in November 2016 that led to the evacuation of 75,000 people. The fires lasted six days (22–27 November) with no loss of life or significant immediate health impacts. The objective of this study is to explore the long-term hospitalization dynamics in a population exposed to this large-scale fire, including the effects of underlying morbidity and socio-economic status (SES). Methods: This is a retrospective crossover study, conducted in 2020, analyzing the electronic medical records of residents from areas exposed to a wildfire in northern Israel. The study spans from one year before exposure to two years after it (22 November 2015–27 November 2018). The hospitalization days during the study period were analyzed using the Poisson regression model. The rate of hospitalization days along with 95% confidence intervals (CIs) were plotted. Results: The study included 106,595 participants. The median age was 37 (IQR = 17–56), with a mean socio-economic ranking of 6.47 out of 10 (SD = 2.01). Analysis revealed that people with underlying morbidity were at greater risk of experiencing long-term effects following fires, which was manifested in higher hospitalization rates that remained elevated for two years post-exposure. This was also evident among individuals of low socio-economic status without these background illnesses. Conclusions: Healthcare services should prepare for increased hospitalization rates during the two years following wildfires for populations with underlying morbidity and those of low socio-economic status. Implementing preventive-medicine approaches may increase the resiliency of communities in the face of extreme climate-related events and prevent future health burdens. Additional research should focus on the specific mechanisms underpinning the long-term effects of wildfire exposure.
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Affiliation(s)
- Odeya Cohen
- Department of Nursing, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer Sheva 8410501, Israel
- Correspondence: ; Tel.: +972-86477737
| | - Stav Shapira
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer Sheva 8410501, Israel;
| | - Eyal Furman
- Maccabi Healthcare Services, Haifa 3508510, Israel;
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Mu TY, Xu RX, Xu JY, Dong D, Zhou ZN, Dai JN, Shen CZ. Association between self-care disability and depressive symptoms among middle-aged and elderly Chinese people. PLoS One 2022; 17:e0266950. [PMID: 35404987 PMCID: PMC9000112 DOI: 10.1371/journal.pone.0266950] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/22/2022] [Indexed: 12/16/2022] Open
Abstract
Objective In the context of an increased focus on geriatric depression in recent years, this study examined the associations between different types of self-care disability, the number of self-care disabilities, and depressive symptoms among middle-aged and elderly Chinese people. Method The data for this study were extracted from the follow-up survey (conducted in 2018) of the China Health and Retirement Longitudinal Study (CHARLS). The sample comprised 10808 participants aged 45 years and older. The Activities of Daily Living (ADL) scale and the Center for Epidemiological Studies Depression (CESD-10) Scale were used to assess self-care disability and depressive symptoms, respectively. Result The prevalence of depressive symptoms and self-care disability among the surveyed residents was 45.1% and 23.4%, respectively. Overall, there was a significant positive association between self-care disability and depressive symptoms. Participants who reported having a self-care disability in relation dressing, bathing, transferring in and out of bed, using the toilet, and controlling urination and defecation were found to have a significantly higher risk of depressive symptoms. In addition, participants with a greater cumulative quantity of self-care disabilities had a higher risk of depressive symptoms, and higher CESD-10 scores. Conclusion Self-care disability is a risk factor for depressive symptoms among middle-aged and elderly Chinese people. A positive correlation between the number of self-care disabilities and the risk of depressive symptoms was found.
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Affiliation(s)
- Ting-Yu Mu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
- Nursing College, Anhui University of Chinese Medicine, Hefei, Anhui Province, China
| | - Ri-Xiang Xu
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
- * E-mail: (CZS); (RXX)
| | - Jia-Yi Xu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Die Dong
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Zhi-Nan Zhou
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Jia-Ning Dai
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Cui-Zhen Shen
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
- * E-mail: (CZS); (RXX)
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Lu W, Pai M, Scholes S, Xue B. Do depressive symptoms link chronic diseases to cognition among older adults? Evidence from the Health and Retirement Study in the United States. J Affect Disord 2021; 294:357-365. [PMID: 34315097 DOI: 10.1016/j.jad.2021.07.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 06/05/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Few studies have assessed psychological pathways that connect the association between non-psychotropic chronic disease and cognition. We assessed the extent to which the association between the two was mediated by depressive symptoms in older adults. METHODS Data came from waves 10-13 (2010-2016) of the Health and Retirement Study in the United States (7,651 men and 10,248 women). Multilevel path analysis, allowing for random intercepts and slopes, was employed to estimate the extent to which depressive symptoms mediated the total effect of a chronic disease on cognition. RESULTS We found that the presence of stroke, high blood pressure, diabetes, heart problems, and comorbidity, in both men and women, and lung disease in women, was associated with lower levels of cognition. The total effects of chronic diseases on cognition were partially mediated through depressive symptoms. Depressive symptoms mediated approximately 19%-39% and 23%-54% of the total effects of chronic diseases on cognition in men and women, respectively. LIMITATIONS We relied on self-reported diagnoses of diseases and depressive symptoms. Our use of a multilevel path analysis with random slopes precluded the inclusion of binary/categorical dependent variables, and the estimation of standardized beta values. CONCLUSIONS To understand the cognitive challenges that chronically ill older adults face, practitioners and policymakers should consider not just the direct symptoms related to chronic diseases, but also the often overlooked psychological conditions faced by older adults.
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Affiliation(s)
- Wentian Lu
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom.
| | - Manacy Pai
- Department of Sociology, Kent State University, Kent, Ohio, United States of America
| | - Shaun Scholes
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Baowen Xue
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Sánchez-González JL, Sánchez-Rodríguez JL, Martín-Vallejo J, Martel-Martel A, González-Sarmiento R. Effects of Physical Exercise on Cognition and Telomere Length in Healthy Older Women. Brain Sci 2021; 11:1417. [PMID: 34827416 PMCID: PMC8615568 DOI: 10.3390/brainsci11111417] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/18/2021] [Accepted: 10/26/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Physical exercise is an effective measure for preventing the onset of cognitive decline and has a direct influence on the aging process. The purpose of this study was to assess the effect of a 6-month physical exercise program on cognition and telomere length in adults over 65 years of age. METHOD Seventy-four healthy women were separated into two groups: 41 were included in the intervention group (IG) (72.70 ± 4.127 years and 8.18 ± 1.551 years of education) and 33 in the control group (CG) (71.21 ± 4.127 years and 8.42 ± 2.562). The participants included within the IG carried out three sessions of physical exercise per week for six months. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), the Stroop test and the Trail Making Test (TMT). Saliva samples were taken and analyzed and relative telomere length was calculated. Those conducting the analysis were blind to the group to which the participants had been assigned. RESULTS An improvement was observed in global cognitive function, in both attentional and executive functions, in the group of adults doing physical exercise as compared to the control group. Six months after the physical exercise program had finished, relative telomere length was found to have increased in the participants in the intervention group. CONCLUSION Physical exercise programs can lead to an improvement in both cognitive functions and telomere length.
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Affiliation(s)
- Juan Luis Sánchez-González
- Department of Nursery and Physiotherapy, Faculty of Nursery and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
| | - Juan Luis Sánchez-Rodríguez
- Department of Basic Psychology, Psychobiology and Methodology, Faculty of Psychology, University of Salamanca, 37005 Salamanca, Spain;
| | - Javier Martín-Vallejo
- Department of Statistics, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
| | - Abel Martel-Martel
- Department of Medicine, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain; (A.M.-M.); (R.G.-S.)
| | - Rogelio González-Sarmiento
- Department of Medicine, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain; (A.M.-M.); (R.G.-S.)
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Wilson J, Heinsch M, Betts D, Booth D, Kay-Lambkin F. Barriers and facilitators to the use of e-health by older adults: a scoping review. BMC Public Health 2021; 21:1556. [PMID: 34399716 PMCID: PMC8369710 DOI: 10.1186/s12889-021-11623-w] [Citation(s) in RCA: 138] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/11/2021] [Indexed: 11/29/2022] Open
Abstract
Background Limited attention has been paid to how and why older adults choose to engage with technology-facilitated health care (e-health), and the factors that impact on this. This scoping review sought to address this gap. Methods Databases were searched for papers reporting on the use of e-health services by older adults, defined as being aged 60 years or older, with specific reference to barriers and facilitators to e-health use. Result 14 papers were included and synthesised into five thematic categories and related subthemes. Results are discussed with reference to the Unified Theory of Acceptance and Use of Technology2. The most prevalent barriers to e-health engagement were a lack of self-efficacy, knowledge, support, functionality, and information provision about the benefits of e-health for older adults. Key facilitators were active engagement of the target end users in the design and delivery of e-health programs, support for overcoming concerns privacy and enhancing self-efficacy in the use of technology, and integration of e-health programs across health services to accommodate the multi-morbidity with which older adults typically present. Conclusion E-health offers a potential solution to overcome the barriers faced by older adults to access timely, effective, and acceptable health care for physical and mental health. However, unless the barriers and facilitators identified in this review are addressed, this potential will not be realised. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11623-w.
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Affiliation(s)
- Jessica Wilson
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Milena Heinsch
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - David Betts
- School of Humanities and Social Science, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Debbie Booth
- University Library, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Frances Kay-Lambkin
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW, 2308, Australia
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McGraw C, Pekarek J, Redmond D, Vogel R, Tanner A, Bar-Or D. Is preexisting mental illness associated with lower patient satisfaction for older trauma patients? A cross-sectional descriptive study. BMC Psychiatry 2021; 21:67. [PMID: 33516194 PMCID: PMC7847564 DOI: 10.1186/s12888-021-03071-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine if satisfaction with care differs among older trauma patients with and without preexisting mental illness (PMI+/PMI-). METHODS Data from two level I trauma centers were examined from 11/2016 through 12/2017. Trauma patients ≥55 years were included and satisfaction of those who had a diagnosis of mental illness prior to the trauma admission (PMI+) to those without a diagnosis (PMI-) (n = 299; 62 PMI+ and 237 PMI-) were compared. Enrolled patients completed the Family Satisfaction with Advanced Care Cancer Scale Patient Survey (FAMCARE-P13) prior to discharge. Associations between mental illness status and patient baseline characteristics, overall mean satisfaction, and mean satisfaction by question were compared. Generalized linear models adjusted for differences in patient satisfaction by mental illness status. Analyses were stratified by hospital to account for the interaction between hospital and mental illness status. RESULTS Compared to PMI- patients, PMI+ patients were more likely to be younger, female, have multiple comorbidities, and to report lower overall satisfaction with care. Among PMI+ patients, the most common diagnoses were depression and anxiety. After adjustment, PMI+ was associated with lower patient satisfaction at hospital 1; after examining individual questions lower satisfaction was associated with information provided on procedures and questions surrounding "Physical care." Conversely, PMI+ did not affect satisfaction at hospital 2 after adjustment. CONCLUSIONS At hospital 1, room for improvement was identified in providing information about prognosis and procedures, symptom management, and continuity of care. Reexamining practices for older PMI+ trauma patients is warranted.
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Affiliation(s)
- Constance McGraw
- Trauma Research Department, St. Anthony Hospital, CO, Lakewood, USA
- Trauma Research Department, Penrose-St. Francis Health Services, Colorado Springs, CO, USA
| | - Jennifer Pekarek
- Trauma Research Department, St. Anthony Hospital, CO, Lakewood, USA
| | - Diane Redmond
- Trauma Research Department, Penrose-St. Francis Health Services, Colorado Springs, CO, USA
| | - Rebecca Vogel
- Trauma Services Department, St. Anthony Hospital, Lakewood, CO, USA
| | - Allen Tanner
- Trauma Services Department, Penrose St.-Francis Health Services, Colorado Springs, CO, USA
| | - David Bar-Or
- Trauma Research Department, St. Anthony Hospital, CO, Lakewood, USA.
- Trauma Research Department, Penrose-St. Francis Health Services, Colorado Springs, CO, USA.
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Sun J, Xiao T, Lyu S, Zhao R. The Relationship Between Social Capital and Depressive Symptoms Among the Elderly in China: The Mediating Role of Life Satisfaction. Risk Manag Healthc Policy 2020; 13:205-213. [PMID: 32256133 PMCID: PMC7090211 DOI: 10.2147/rmhp.s247355] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 03/06/2020] [Indexed: 11/25/2022] Open
Abstract
Background and Aim Depression has become a serious health and social issue in recent years in China. This study aims to explore the relationship between social capital and depressive symptoms among the elderly in China, with a particular focus on the mediating role of life satisfaction. Methods The data of this study were sourced from the 2016 wave of China Family Panel Studies (CFPS), involving 1243 older adults aged 60 and above. A multiple linear regression model was used to explore the impact of social capital on depressive symptoms. Moreover, the add-on PROCESS macro for SPSS was employed to measure the mediating effect of life satisfaction on the relationship between social capital and depressive symptoms. Results The regression results suggest that CES-D score was associated with trust (coefficient = −0.1013, p < 0.01). In addition, the protective role of trust was significantly stronger for older adults aged 70–79, women, the poorest 1/3, and the elderly who live in rural areas. Moreover, the mediation analysis results suggest that the effect of trust on depressive symptoms was fully mediated by life satisfaction. Conclusion This study reveals that social capital has a positive effect on depressive symptoms among the elderly, and the positive health effect shows significant age, gender, income, and location inequalities. Furthermore, this study also provides new evidence indicating that life satisfaction fully mediates the relationship between social capital and depressive symptoms. Improving social capital could be a promising way for China to promote healthy aging in the future.
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Affiliation(s)
- Jian Sun
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai 200030, People's Republic of China
| | - Tong Xiao
- School of Project Management and Real Estate, Henan University of Economics and Law, Zhengzhou, Henan 450046, People's Republic of China
| | - Shoujun Lyu
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai 200030, People's Republic of China.,China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai 200030, People's Republic of China
| | - Rui Zhao
- Affiliated Hospital of Hebei University, Baoding, Hebei 071000, People's Republic of China
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Multi-Level Factors Associated with Social Participation among Stroke Survivors: China's Health and Retirement Longitudinal Study (2011-2015). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245121. [PMID: 31847437 PMCID: PMC6950688 DOI: 10.3390/ijerph16245121] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/06/2019] [Accepted: 12/10/2019] [Indexed: 11/23/2022]
Abstract
Background: This study aims to examine the impact of individual-level and community-based factors on popular social participation activities of Chinese middle-aged and older adults post-stroke. Methods: Sub-samples of survivors of stroke (2011: n = 413, 2013: n = 395, 2015: n = 441) recruited by the China Health and Retirement Longitudinal Study (CHARLS) were included in the analysis. Zero-inflated Poisson and multi-level logistic regression models were used to explore factors associated with social participation. Results: More than half of individuals (55.0%) had no social participation and 23.4% participated in multiple social activities. The most popular social activities that individuals participated in were interacting with friends (32.6%) and going to a community club to play table games (22.7%). Multiple individual-level factors were negatively related to social participation (e.g., depressive symptoms and multiple measures of functional limitations) while the allocation of an outdoor exercise facility in the community/village was positively associated with going to a community club to play table games. Conclusion: Stroke survivors are at high risk of limited social participation. Policymakers and other key stakeholders should consider community design among other potential solutions when identifying ways to link at-risk stroke survivors to both opportunities for rehabilitation (e.g., physical function) and social participation.
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