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Wang W, Xu L, Zhang H. Childhood maltreatment and association with trajectories of depressive symptoms among older adults: a longitudinal study in China. Aging Ment Health 2024:1-9. [PMID: 38436285 DOI: 10.1080/13607863.2024.2323955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/20/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVES Childhood maltreatment has long-lasting effects on mental health. Existing evidence suggests that trajectories of depressive symptoms vary among individuals; however, little is known about how childhood maltreatment shapes these trajectory patterns. Therefore, this study investigated the impacts of childhood maltreatment on eight-year depressive trajectories among Chinese older adults. METHOD Five waves of longitudinal data from the China Health and Retirement Longitudinal Study were utilized. Growth Mixture Modelling was performed to identify distinct trajectories of depressive symptoms, and multinomial logistic regression was conducted to explore the associations between these trajectories and childhood maltreatment. RESULTS Four trajectories of depressive symptoms were identified: the 'no symptoms' class (61.83%), the 'increasing symptoms' class (14.49%), the 'decreasing symptoms' class (16.44%), and the 'chronic symptoms' class (7.24%). Older adults who experienced childhood physical abuse were more likely to be in the 'chronic symptoms' class than in the 'no symptoms' class, whereas emotional neglect did not show a significant association with three problematic trajectories. CONCLUSION This study provides empirical evidence that childhood physical abuse increases the likelihood of developing chronic depressive symptoms in later life. To mitigate this risk, it is crucial to institute comprehensive treatment plans that incorporate trauma-informed care principles, employ evidence-based therapies specifically designed to address the long-term effects of abuse, and prioritize regular screening and assessment of mental health among older adults.
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Affiliation(s)
- Weiwei Wang
- Center for Studies of Sociological Theory and Method, Renmin University of China, Beijing, China
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
| | - Ling Xu
- Office of Academic Research, Xingyi Normal University for Nationalities, Xingyi, China
| | - Huiping Zhang
- Center for Studies of Sociological Theory and Method, Renmin University of China, Beijing, China
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
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2
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Hu X, Ma W, Tong Y, Xiong M, He Z, Lei Q, Koenig HG, Wang Z. Longitudinal association of spirituality with depressive symptom trajectories among older adults in mainland China. Int J Geriatr Psychiatry 2024; 39:e6077. [PMID: 38468424 DOI: 10.1002/gps.6077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/03/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVES The relationship between spirituality and depressive symptoms among the Chinese elderly is not well known. The current study explores this relationship using longitudinal data and trajectory modeling of depressive symptoms. METHODS A longitudinal study design was used to measure depressive symptoms repeatedly from 2012 to 2021 using the Geriatric Depression Scale (GDS). Group-based trajectory modeling analysis was conducted to determine the trajectories of depressive symptoms, and multiple logistic regression was used to explore the association between spirituality and depressive symptom trajectories. RESULTS A total of 2333 participants completed at least two GDS measures, and these were included in the Group-based trajectory modeling analysis. An optimal model of three trajectories was derived: no depressive symptoms group (75.2%), new-onset depressive symptoms group (14.4%), and persistent depressive symptoms group (10.4%). Logistic regression modeling revealed that higher spirituality was associated with a lower risk of both new-onset depressive symptoms (OR = 0.68, 95% CI = 0.49-0.93) and persistent depressive symptoms (OR = 0.32, 95% CI = 0.23-0.45). CONCLUSIONS Spirituality predicts a lower risk of new-onset depressive symptoms and persistent symptoms among older adults in mainland China.
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Affiliation(s)
- Xue Hu
- Department of General Practice, School of Clinical Medicine at Guangdong Medical University, Dongguan, Guangdong Province, China
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University (Dongguan Key Laboratory of Chronic Noncommunicable Disease Prevention), Dongguan, Guangdong Province, China
| | - Wanrui Ma
- Department of General Practice, School of Clinical Medicine at Guangdong Medical University, Dongguan, Guangdong Province, China
| | - Yan Tong
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Mengyun Xiong
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University (Dongguan Key Laboratory of Chronic Noncommunicable Disease Prevention), Dongguan, Guangdong Province, China
| | - Zhehao He
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University (Dongguan Key Laboratory of Chronic Noncommunicable Disease Prevention), Dongguan, Guangdong Province, China
| | - Qiuhui Lei
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University (Dongguan Key Laboratory of Chronic Noncommunicable Disease Prevention), Dongguan, Guangdong Province, China
| | - Harold G Koenig
- Departments of Psychiatry and Medicine, Duke University Medical Center, Durham, North Carolina, USA
- Division of Psychiatry, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Zhizhong Wang
- Department of General Practice, School of Clinical Medicine at Guangdong Medical University, Dongguan, Guangdong Province, China
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University (Dongguan Key Laboratory of Chronic Noncommunicable Disease Prevention), Dongguan, Guangdong Province, China
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3
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Renn BN, Sams N, Areán PA, Raue PJ. A low-intensity behavioral intervention for depression in older adults delivered by lay coaches: proof-of-concept trial. Aging Ment Health 2023; 27:1403-1410. [PMID: 35694856 PMCID: PMC9741665 DOI: 10.1080/13607863.2022.2084709] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 05/27/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES A broader workforce is necessary to expand U.S. geriatric mental health services. We examined (1) feasibility of training undergraduate students to deliver Do More, Feel Better (DMFB), an evidence-informed program for depression; and (2) feasibility, acceptability, and outcomes in a single-arm proof-of-concept trial. METHOD In Study 1, we taught DMFB to 18 upper-level undergraduate students and assessed fidelity using role plays. In Study 2, four students delivered six weekly DMFB sessions to 12 community-dwelling older adults (M = 66.83 years old, SD = 10.39) with depression (PHQ ≥ 10). Patient outcomes were change in pre- to post-treatment depressive symptoms, disability, and the target mechanism of increased activity. RESULTS Fidelity was high in the course (Study 1; 82.4% of role plays rated as 'passing') and the trial (Study 2; 100% of 24 sessions rated as 'passing'). The majority (83.3%) of patients were retained and evidenced statistically and clinically significant improvement in depressive symptoms (Hamilton Rating Scale for Depression [HAM-D]), disability (World Health Organization's Disability Assessment Schedule 2.0 [WHODAS 2.0], and activity (Behavioral Activation for Depression Scale [BADS]). CONCLUSION It is feasible to train bachelor's-level students to deliver a brief, structured intervention for depression. Future research should consider implementation strategies and stakeholder feedback.
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Affiliation(s)
- Brenna N Renn
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Nichole Sams
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Patricia A Areán
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Patrick J Raue
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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4
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Distinct depressive symptom trajectories are associated with incident diabetes among Chinese middle-aged and older adults: The China Health and Retirement Longitudinal Study. J Psychosom Res 2023; 164:111082. [PMID: 36379076 DOI: 10.1016/j.jpsychores.2022.111082] [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: 06/05/2022] [Revised: 11/05/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Previous studies have reported that depression and depressive symptom are associated with diabetes incident. However, the association between long-term depressive symptom patterns and risk of diabetes remains unknown. The aim of present study was to evaluate the association between depressive symptom trajectories and risk of diabetes. METHODS We used data of 8806 participants (≥45 years old) from the China Health and Retirement Longitudinal Study (CHARLS). Trajectories of depressive symptom were identified by latent mixture modeling. Multivariable logistic regression model was used to examine the association of depressive symptom trajectories with diabetes. RESULTS Five depressive symptom trajectories were identified, characterizing by maintaining a low CES-D scores throughout the follow-up (low-stable; 3227 participants [36.65%]); maintaining a moderate CES-D scores throughout the follow-up (moderate-stable; 3402 participants [38.63%]); moderate starting CES-D scores then increasing scores (moderate-increasing; 681 participants [7.73%%]); high starting CES-D scores but then decreasing scores (high-decreasing; 1061 participants [12.05%]); and maintained high CES-D scores throughout the follow-up (high-stable; 435 participants [4.94%]). During 2015 to 2018 (Wave 3 to Wave 4), a total of 312 respondents experienced diabetes. Compared with participants in the low-stable depressive symptom trajectory, those following a high-decreasing (ORs = 2.04; 95%CIs 1.48-2.98) and high-stable depressive symptom trajectories (ORs = 3.26; 95%CIs 2.06-5.16) were at substantially higher risk of developing diabetes. CONCLUSIONS Individuals with high-decreasing and high-stable depressive symptom trajectories over time were associated with increased risk of incident diabetes. Long-term depressive symptom may be a strong predictor of having diabetes.
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5
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Wang C, Chen H, Liu P, Zou Z, Shang S. Determinants of depressive symptom trajectories in self-reported chronic obstructive pulmonary disease patients. BMC Pulm Med 2022; 22:274. [PMID: 35843947 PMCID: PMC9288686 DOI: 10.1186/s12890-022-02060-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/04/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The depressive symptom trajectories of COPD individuals and its’ predictors remain to be established. Therefore, this study aimed to explore the trajectories of depressive symptoms and predictors thereof in COPD patients.
Methods
A total of 1286 individuals over 45 years of age with self-reported COPD were assessed. Depressive symptoms were evaluated using the Center for Epidemiological Studies Depression Scale short form, with depressive symptom trajectories being identified via latent class growth analysis. The predictors of depressive symptom trajectories were then identified through multinomial logistic regression.
Results
Finally, three depressive symptom trajectories were identified: “steadily high”, “consistently moderate”, and “consistently low”. Old age, longer night-time sleep duration, and high BMI were found to be associated with individuals being classified under the “consistently moderate” trajectory. Moreover, participants exhibiting more than two chronic conditions were more likely to be classified under the “consistently moderate” trajectory. Higher education and lower hand grip strength were important predictors of individuals classified in the “steadily high” trajectory.
Conclusions
To conclude, three depressive symptom trajectories were identified in self-reported COPD individuals. To ensure timely intervention aimed at preventing the worsening of depressive symptom progression among COPD individuals, health-care workers should regular analyze depressive symptoms and provide appropriate interventions when possible.
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Kolaitis NA, Gao Y, Soong A, Greenland JR, Hays SR, Golden JA, Venado A, Leard LE, Shah RJ, Kleinhenz ME, Katz PP, Kukreja J, Blanc PD, Smith PJ, Singer JP. Depressive symptoms in lung transplant recipients: trajectory and association with mortality and allograft dysfunction. Thorax 2022; 77:891-899. [PMID: 35354643 DOI: 10.1136/thoraxjnl-2021-217612] [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: 05/11/2021] [Accepted: 03/08/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Most studies observing an association between depressive symptoms following lung transplantation and mortality are limited to depressive symptom measurement at a single time point, unrelated to allograft function. We aimed to test the association of depressive symptoms over multiple assessments with allograft dysfunction and with mortality. METHODS We assessed depressive symptoms before and serially up to 3 years after lung transplantation in lung transplant recipients. We quantified depressive symptoms with the Geriatric Depression Scale (GDS; range 0-15; minimally important difference (MID): 2). We quantified changes in GDS using linear mixed effects models and tested the association with mortality using Cox proportional hazards models with GDS as a time-dependent predictor. To determine if worsening in GDS preceded declines in lung function, we tested the association of GDS as a time-dependent predictor with the lagged outcome of FEV1 at the following study visit. RESULTS Among 266 participants, depressive symptoms improved early after transplantation. Worsening in post-transplant GDS by the MID was associated with mortality (HR 1.25, 95% CI 1.05 to 1.50), and in lagged outcome analyses with decreased per cent predicted FEV1 (Δ, -1.62%, 95% CI -2.49 to -0.76). Visual analyses of temporal changes in GDS demonstrated that worsening depressive symptoms could precede chronic lung allograft dysfunction. CONCLUSIONS Depressive symptoms generally improve after lung transplantation. When they worsen, however, there is an association with declines in lung function and mortality. Depression is one of the few, potentially modifiable, risk factors for chronic lung allograft dysfunction and death.
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Affiliation(s)
- Nicholas A Kolaitis
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Ying Gao
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Allison Soong
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - John R Greenland
- Department of Medicine, University of California San Francisco, San Francisco, California, USA.,Medicine, San Francisco VA Medical Center, San Francisco, California, USA
| | - Steven R Hays
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jeffrey A Golden
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Aida Venado
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Lorriana E Leard
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Rupal J Shah
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Mary Ellen Kleinhenz
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Patricia P Katz
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jasleen Kukreja
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Paul D Blanc
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Patrick J Smith
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Jonathan Paul Singer
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
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7
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Wu T, Li C, Zhu Y, Ma Y, Hua R, Zhong B, Xie W. The trajectories of depressive symptoms and subsequent incident dementia, coronary heart diseases, stroke and all-cause mortality. J Affect Disord 2022; 312:9-16. [PMID: 35690126 DOI: 10.1016/j.jad.2022.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/23/2022] [Accepted: 06/06/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Evidence suggests the occurrence of depressive symptoms in mid- to late-life inflates the risk for ageing-related morbidity compared to people without depressive symptoms. The eventual association between depressive symptoms in mid- to late-life and long-term (over 10-year) risks for incident dementia, coronary heart disease (CHD), stroke, and morbidity is to be established. METHODS This longitudinal cohort study utilized Health and Retirement Study (HRS) of U.S residents aged ≥ 50 years who were interviewed every 2-year during follow-up (average follow-up: 11.6 ± 2.85 years). Trajectories of depressive symptoms were assessed by the Center for Epidemiologic Studies Depression (CES-D) scale from 1994 to 2000 at baseline. Incident dementia, CHD, stroke and all-cause mortality were determined from 2000 to 2018. RESULTS Among 7810 individuals who were free from dementia, CHD and stroke, five trajectories of depressive symptoms were identified: non-depressed (36.7 %), mild (48.8 %), worsening (7.8 %), improving (4.1 %) and persistent (2.7 %). Compared with those in the non-depressed group, participants with mild, worsening and persistent depressive symptoms had significantly greater hazards of incident dementia (multivariable adjusted hazard ratios and 95 % confidence intervals: 1.32 [1.17-1.48], 1.58 [1.30-1.93], 2.82 [2.17-3.67], respectively), CHD (1.13 [1.03-1.24], 1.47 [1.25-1.73], 1.34 [1.03-1.74], respectively), stroke (1.30 [1.12-1.52], 1.58 [1.23-2.04], 1.71 [1.16-2.53], respectively) and all-cause mortality (1.17 [1.07-1.27], 1.46 [1.27-1.68], 1.66 [1.35-2.06], respectively). The hazards of incident events, except for CHD, were not significantly greater in individuals with improving depressive symptoms. CONCLUSIONS The present findings suggest even sub-clinical threshold depressive symptoms were associated with the hazards of ageing related diseases while such associations were not significant with managed depressive symptoms.
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Affiliation(s)
- Tao Wu
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Chenglong Li
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Yidan Zhu
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Yanjun Ma
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Rong Hua
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Baoliang Zhong
- Department of Geriatric Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Wuxiang Xie
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China.
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8
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Madero-Cabib I, Azar A, Guerra J. Simultaneous employment and depressive symptom trajectories around retirement age in Chile. Aging Ment Health 2022; 26:1143-1152. [PMID: 34151648 DOI: 10.1080/13607863.2021.1929065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: Over the last decade, an increasing number of empirical studies have examined long-term patterns of depression among adults around retirement age and identified employment status as a crucial determinant. However, most research has examined associations between cross-sectional measures of employment and prospective depression patterns, overlooking the changing nature of employment statuses, particularly close to retirement age. Furthermore, most knowledge in this field comes from studies conducted in developed countries in Western Europe and North America. To address these gaps, this study examined simultaneous trajectories in the employment and depressive symptom domains among two age groups of Chileans before and after the standard retirement age. Method: Using population-representative data and longitudinal statistical methods, we identified different trajectory types among two age groups (one aged 56-65 and another aged 66-75, at baseline) and characterized them according to social and health characteristics.Results: We found that trajectories defined by permanent employment were accompanied by lower depressive symptoms than trajectories indicating either retirement or inactivity. However, trajectories combining employment and the absence of depressive symptoms were primarily followed by individuals with advantaged health and social statuses at the baseline. Conclusion: Public policies aimed at promoting the mental health of older adults through their labor market integration risk forcing individuals who have accumulated social and health disadvantages across the life course to work longer.
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Affiliation(s)
- Ignacio Madero-Cabib
- Instituto de Sociología & Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile.,Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Santiago, Chile
| | - Ariel Azar
- Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Santiago, Chile.,Department of Sociology, The University of Chicago, Chicago, IL, USA
| | - Josefa Guerra
- Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Santiago, Chile
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9
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Gender differences in the association of depression trajectories with executive and memory functions: Evidence from the longitudinal study of the Survey of Health, Ageing and Retirement in Europe (2004-2017). J Psychiatr Res 2022; 149:177-184. [PMID: 35278782 DOI: 10.1016/j.jpsychires.2022.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/25/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2022]
Abstract
Gender differences in depression trajectories and their effects on cognitive function are poorly understood. This article aims to identify depression trajectories in both genders and further explore the association of depression trajectories with executive and memory functions by gender. A total 3990 participants aged 50 years or older with repeated measurements from waves 1 to 7 (wave 3 excluded) of the Study of the Survey of Health, Ageing and Retirement in Europe (SHARE) were included. Group-based trajectory modeling (GBTM) was conducted to identify the optimal number of depression trajectories. Generalized estimating equation (GEE) models were used to examine the relation of depression trajectories to cognitive function after stratification by gender. Three distinct depression trajectories were identified in both genders, but the patterns of trajectories among genders were nonidentical. The trajectories of depression in males were characterized by non-low, moderate, persistent-depressive symptoms but with an unstable trend, while in females, they were characterized by non-low, moderate, persistent-depressive symptoms and with a worsening trend. The prevalence of persistent high depression in women (20.08%) was higher than that in men (3.13%). Moderate and persistent high depression trajectories were negatively associated with episodic memory (β = -0.53 and -0.72, respectively, p < 0.001) and verbal fluency in females (β = -0.96 and -1.47, p=0.01 and < 0.001, respectively). Older women had a greater frequency of developing depression than older men. Gender differences in depression trajectories existed. Moderate and persistent high depression trajectories exerted a negative effect on some domains of cognitive impairment only in females.
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Agustini B, Lotfaliany M, Mohebbi M, Woods RL, McNeil JJ, Nelson MR, Shah RC, Murray AM, Reid CM, Tonkin A, Ryan J, Williams LJ, Forbes MP, Berk M. Trajectories of depressive symptoms in older adults and associated health outcomes. NATURE AGING 2022; 2:295-302. [PMID: 37117752 DOI: 10.1038/s43587-022-00203-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 03/10/2022] [Indexed: 04/30/2023]
Abstract
With the progressive aging of the world's population, prolongation of a healthy lifespan in old age has become a medical research priority. The presence of depressive symptoms in later life is associated with poor health prognosis and increased mortality1,2. Here we explore distinct trajectories of depressive symptoms in later life and their association with several health-related outcomes in 19,110 older individuals followed for a median of 4.7 years. Using a latent class, mixed-modeling approach we identified four distinct trajectories of depressive symptoms with scoring patterns of consistently low, moderate, emerging and persistently high. Compared to those with minimal depressive symptoms, membership of any other class was associated with specific patterns of baseline sociodemographic and medical factors. Membership of any group with depressive symptoms was associated with a higher likelihood of health events, including physical disability, cancer and major bleeding episodes. Membership of the persistently depressed class was associated with increased mortality, while a diagnosis of dementia was generally limited to the class with initially low and progressively rising symptoms. The course of depressive symptoms in older individuals can vary widely and depend on several factors. The presence of depressive symptoms, including those that do not meet criteria for major depression, can flag a poor prognosis and risk for specific health conditions. Systematic assessment of depressive symptoms may facilitate early identification of at-risk populations.
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Affiliation(s)
- Bruno Agustini
- Deakin University, iMPACT the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Victoria, Australia.
| | - Mojtaba Lotfaliany
- Deakin University, iMPACT the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | | | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John J McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Raj C Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Anne M Murray
- Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Hennepin Healthcare, Minneapolis, MN, USA
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Andrew Tonkin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lana J Williams
- Deakin University, iMPACT the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Malcolm P Forbes
- Deakin University, iMPACT the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Michael Berk
- Deakin University, iMPACT the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Psychiatry, Orygen, the National Centre of Excellence in Youth Health, and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia
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11
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Astorga-Aliaga A, Díaz-Arroyo F, Carreazo NY, Caballero KC, Rodríguez-Cuba MA, Runzer-Colmenares F, Parodi-García J. Depression Symptoms and Mortality in Elderly Peruvian Navy Veterans: A Retrospective Cohort Study. ADVANCES IN GERONTOLOGY 2022. [PMCID: PMC8966854 DOI: 10.1134/s2079057022010039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Our study was design to determine the association between depressive symptoms and mortality in adults over 60 years old Navy Peruvian Veterans. We performed a retrospective cohort study based on a previous cohort study. A total of 1681 patients over 60 years old were included between 2010–2015. Demographic information, self-reported information about falls, physical frailty assessment, tobacco consumption, hypertension, Type 2 Diabetes Mellitus, Chronic Obstructive Pulmonary Disease and was collected. Depression was assessed by the short form of the Geriatric Depression Scale. We found that depressive symptoms were present in 24.9% of the participants and 40.5% of them died. Mortality risk in patients with depressive symptoms, physical frailty, and male sex was: RR of 23.1 (95% CI: 11.7–45.7), 3.84 (95% CI: 2.16–6.82), and 1.37 (95% CI: 1.07–1.75) respectively. We concluded that depressive symptoms in Peruvian retired military personnel and their immediate relatives are high and are significatively associated with mortality. Also, being male and frail was associated with an increased risk of death. This reinforces that early detection and assessment of depressive symptoms could be an opportunity to improve the health status of older adults.
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Affiliation(s)
| | | | | | - K. C. Caballero
- Universidad Científica del Sur, Lima, Perú
- CHANGE Research Working Group, Carrera de Medicina Humana, Universidad Científica del Sur, EL Salvador, Perú
| | - M. A. Rodríguez-Cuba
- Universidad Científica del Sur, Lima, Perú
- CHANGE Research Working Group, Carrera de Medicina Humana, Universidad Científica del Sur, EL Salvador, Perú
| | - F. Runzer-Colmenares
- Universidad Científica del Sur, Lima, Perú
- CHANGE Research Working Group, Carrera de Medicina Humana, Universidad Científica del Sur, EL Salvador, Perú
- Universidad de San Martín de Porres, Centro de Investigación del Envejecimiento (CIEN), Lima, Perú
| | - J. Parodi-García
- Universidad de San Martín de Porres, Centro de Investigación del Envejecimiento (CIEN), Lima, Perú
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12
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Zhou Y, Wu Q, Li C, Ding L. Association between community environment and depressive symptoms among Chinese middle-aged and older adults: evidence from national longitudinal surveys from 2011 to 2018. J Gerontol A Biol Sci Med Sci 2022; 77:2265-2271. [PMID: 35137075 DOI: 10.1093/gerona/glac032] [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: 05/17/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Despite the growing evidence on the relationship between community environment and depressive symptoms, little is known about the longitudinal relationship in older adults. This study aimed to examine the longitudinal association between community environment and depressive symptoms based on a nationally representative survey among Chinese middle-aged and older adults. METHODS A total of 6872 participants from the latest four waves (2011, 2013, 2015 and 2018) of China Health and Retirement Longitudinal Study were included. The Centre for Epidemiologic Studies Depression scale was used to measure depressive symptoms, and Cox proportional hazards regression models were conducted to investigate the longitudinal association between community environment and depressive symptoms after adjusting included covariates. RESULTS Both community infrastructure and organisations were significantly associated with depression, and infrastructure was associated with higher risk reduction in depression (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.66-0.89). Furthermore, we estimated the heterogeneous effects of community infrastructure and organisations for vulnerable populations. Additionally, family-based elder-care centre (HR, 0.63; 95% CI, 0.46-0.86) and outdoor exercise facilities (HR, 0.76; 95% CI, 0.68-0.84) were found as significant correlates associated with lower depressive symptom risk. CONCLUSIONS Our findings indicated that targeted and specific measures should be taken to improve the construction of community infrastructure and strengthen the role of community organisations. Specifically, providing a family-based elder-care centre and establishing outdoor exercise facilities might be effective methods to reduce the risk of depression and relieve related public health burdens among Chinese middle-aged and older adults.
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Affiliation(s)
- Ying Zhou
- Center for Smart and Healthy Buildings, Huazhong Univ. of Science and Technology, Wuhan, Hubei, China
| | - Qi Wu
- Center for Smart and Healthy Buildings, Huazhong Univ. of Science and Technology, Wuhan, Hubei, China
| | - Chenshuang Li
- Center for Smart and Healthy Buildings, Huazhong Univ. of Science and Technology, Wuhan, Hubei, China
| | - Lieyun Ding
- Center for Smart and Healthy Buildings, Huazhong Univ. of Science and Technology, Wuhan, Hubei, China
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13
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Mallett J, Redican E, Doherty AS, Shevlin M, Adamson G. Depression trajectories among older community dwelling adults: Results from the Irish Longitudinal Study on Ageing (TILDA). J Affect Disord 2022; 298:345-354. [PMID: 34715192 DOI: 10.1016/j.jad.2021.10.114] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/20/2021] [Accepted: 10/24/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study investigated the role of a large range psychological, attitudinal and health related variables as predictors of depression trajectories amongst older adults over a 4-year time period. METHODS Data from three consecutive waves of the TILDA survey of older community dwelling adults aged 50+ in Ireland were combined for analysis. Depression symptom scores were assessed using the Center for Epidemiological Studies- Depression scale (CES-D). Changes in depression scores over three time points were modelled as distinct trajectory classes using group-based trajectory modelling, whilst simultaneously controlling for demographic, attitudinal and health related predictors of these trajectory classes using multinomial regression. RESULTS Four distinct depression trajectories were identified as (1) a stable low symptom level group (79%), (2) a moderate but deteriorating symptoms group (7.6%), (3) a moderate but improving group (10.1%) and (4) a vulnerable group with consistently high symptoms (3.1%). Multinomial logistic regression indicated that limiting pain, mobility impairments, perceived stress and loneliness predicted membership of the moderate and higher depressive symptom classes. Retirement status and higher reported levels of worry were associated with a greater likelihood of membership of the moderate symptom classes only. LIMITATIONS Use of the CES-D is open to bias due to subjective nature of respondent reporting. CONCLUSIONS Results concur with previous studies on the development of depression among older people and highlight the key health related and psychological variables that may inform interventions aimed at mitigating risks of developing depression among older adults.
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Affiliation(s)
- John Mallett
- School of Psychology, Ulster University, Cromore Road, Coleraine BT52 1SA, United Kingdom.
| | - Enya Redican
- School of Psychology, Ulster University, Cromore Road, Coleraine BT52 1SA, United Kingdom
| | - Ann Sinéad Doherty
- Department of General Practice, RCSI University of Medicine and Health Sciences, 123St. Stephen's Green, Dublin 2, Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Cromore Road, Coleraine BT52 1SA, United Kingdom
| | - Gary Adamson
- School of Psychology, Ulster University, Cromore Road, Coleraine BT52 1SA, United Kingdom
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14
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Han L, Shen S, Wu Y, Zhong C, Zheng X. Trajectories of depressive symptoms and risk of cardiovascular disease: Evidence from the China Health and Retirement Longitudinal Study. J Psychiatr Res 2021; 145:137-143. [PMID: 34922097 DOI: 10.1016/j.jpsychires.2021.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/23/2021] [Accepted: 12/10/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Previous studies have reported that depression is associated with higher risk of cardiovascular disease (CVD). However, the association between long-term depressive symptom patterns and the risk of CVD was not well characterized. METHODS A total of 8621 participants with three Center for Epidemiological Studies Depression Scale (CES-D) measurements from the China Health and Retirement Longitudinal Study were included. Trajectories of depressive symptoms were identified by latent mixture modeling. Cox proportional hazards regression models were used to examine the association of depressive symptom trajectories with CVD (stroke or cardiac events), and accounting for mortality as a competing risk for CVD. RESULTS We identified four distinct depressive symptoms trajectories, characterized by maintaining low CES-D score throughout the follow-up (no depressive symptoms; 5642 participants [65.44%]); high starting CES-D scores but then decreasing scores (decreasing depressive symptoms; 1329 participants [14.91%]); low starting CES-D scores then increasing scores (increasing depressive symptoms; 1154 participants [13.39%]) and maintained high CES-D scores throughout the follow-up (persistent depressive symptoms; 496 participants [6.26%]). During the follow-up period, 853 CVD events (including 362 strokes and 535 cardiac events) were recorded. Compared to participants in the no depressive symptom trajectory, those in the increasing depressive symptoms and persistent depressive symptom trajectories had an increased risk of CVD, with multiple-adjusted hazard ratios (95% confidence intervals) of 1.53 (1.28-1.82) and 1.68 (1.34-2.12), respectively. Individuals with increasing and persistent depressive symptoms trajectories also had higher risks of stroke and cardiac events. CONCLUSIONS Individuals with increasing and persistent depressive symptom over time were associated with increased risk of incident CVD.
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Affiliation(s)
- Longyang Han
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Suwen Shen
- Wuxi Municipal Center for Disease Control and Prevention, Wuxi, Jiangsu, 214023, China
| | - Yu Wu
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, 215000, China.
| | - Xiaowei Zheng
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, Wuxi, Jiangsu, 214122, China.
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15
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Brupbacher G, Zander-Schellenberg T, Straus D, Porschke H, Infanger D, Gerber M, von Känel R, Schmidt-Trucksäss A. The Acute Effects of Aerobic Exercise on Nocturnal and Pre-Sleep Arousal in Patients with Unipolar Depression: Preplanned Secondary Analysis of a Randomized Controlled Trial. J Clin Med 2021; 10:jcm10174028. [PMID: 34501476 PMCID: PMC8432550 DOI: 10.3390/jcm10174028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/03/2021] [Accepted: 09/03/2021] [Indexed: 12/28/2022] Open
Abstract
Unipolar depression is associated with insomnia and autonomic arousal. The aim of this study was to quantify the effect of a single bout of aerobic exercise on nocturnal heart rate variability and pre-sleep arousal in patients with depression. This study was designed as a two-arm, parallel-group, randomized, outcome assessor-blinded, controlled, superiority trial. Patients with a primary diagnosis of unipolar depression aged 18-65 years were included. The intervention consisted of a single 30 min moderate-intensity aerobic exercise bout. The control group sat and read for 30 min. The primary outcome of interest was RMSSD during the sleep period assessed with polysomnography. Secondary outcomes were additional heart rate variability outcomes during the sleep and pre-sleep period as well as subjective pre-sleep arousal. A total of 92 patients were randomized to either the exercise (N = 46) or the control (N = 46) group. Intent-to-treat analysis ANCOVA of follow-up sleep period RMSSD, adjusted for baseline levels and minimization factors, did not detect a significant effect of the allocation (β = 0.12, p = 0.94). There was no evidence for significant differences between both groups in any other heart rate variability measure nor in measures of cognitive or somatic pre-sleep arousal. As this is the first trial of its kind in this population, the findings need to be confirmed in further studies. Patients with depression should be encouraged to exercise regularly in order to profit from the known benefits on sleep and depressive symptoms, which are supported by extensive literature.
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Affiliation(s)
- Gavin Brupbacher
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland; (D.I.); (A.S.-T.)
- OBERWAID AG, Rorschacher Strasse 311, 9016 St. Gallen, Switzerland; (D.S.); (H.P.)
- Correspondence:
| | - Thea Zander-Schellenberg
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, 4055 Basel, Switzerland;
| | - Doris Straus
- OBERWAID AG, Rorschacher Strasse 311, 9016 St. Gallen, Switzerland; (D.S.); (H.P.)
| | - Hildburg Porschke
- OBERWAID AG, Rorschacher Strasse 311, 9016 St. Gallen, Switzerland; (D.S.); (H.P.)
| | - Denis Infanger
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland; (D.I.); (A.S.-T.)
| | - Markus Gerber
- Division of Sport and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland;
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Culmannstrasse 8, 8091 Zurich, Switzerland;
| | - Arno Schmidt-Trucksäss
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland; (D.I.); (A.S.-T.)
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16
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Kim O, Kim SY, Kim SS, Dan H, Kim B, Kim M, Pang Y. Depressive symptom trajectories and their relation to body mass index in women of child-bearing age: The Korea Nurses' Health Study. J Affect Disord 2021; 292:114-120. [PMID: 34118610 DOI: 10.1016/j.jad.2021.05.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 05/12/2021] [Accepted: 05/19/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND This study investigated the sub-trajectory groups of depressive symptoms in women of child-bearing age and the factors impacting latent class membership. Moreover, differences in body mass index (BMI) as an outcome variable were identified among the sub-trajectory groups. METHODS Data from the Korea Nurses' Health Study (KNHS) were analyzed, comprising that from 6,918 participants who filled out surveys during modules 1, 5, and 7. The growth mixture model with individually varying observation times was used to identify latent subgroups of depressive symptom trajectories. RESULTS Three classes of depressive symptom trajectories were identified: increasing over time, stable/low, and decreasing over time. Older participants had a higher probability of belonging to the stable/low class. Married participants were more likely to belong to the stable/low class than to the increasing over time class or decreasing over time class. Participants who worked shifts had a higher chance of belonging to the decreasing over time class than the stable/low class. There was a significant difference between mean BMI across latent classes in module 1 (χ2(df=2,N=6918)=155.16, p<0.001) and in module 7 (χ2(df=2,N=6918)=149.68, p<0.001). LIMITATIONS The findings of this study should not be generalized to all women of childbearing age, because the study population only included nurses. CONCLUSIONS The results suggest that interventions designed to manage depressive symptoms in women who are younger, unmarried, and who perform shift work may be beneficial. This study identified a relationship between increasing severity of depressive symptoms and increasing BMI.
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Affiliation(s)
- Oksoo Kim
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, South Korea
| | - Su-Young Kim
- Department of Psychology, Ewha Womans University, Seoul, South Korea
| | - Suk-Sun Kim
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, South Korea
| | - Hyunju Dan
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, South Korea
| | - Bohye Kim
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, South Korea
| | - Minjoo Kim
- Department of Psychology, Ewha Womans University, Seoul, South Korea
| | - Yanghee Pang
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, South Korea.
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17
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Pruchno R, Wilson-Genderson M, Heid A, Cartwright F. Trajectories of Depressive Symptoms Experienced by Older People: Effects of Time, Hurricane Sandy, and the Great Recession. J Gerontol B Psychol Sci Soc Sci 2021; 76:974-985. [PMID: 33170926 PMCID: PMC8063679 DOI: 10.1093/geronb/gbaa198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To examine depressive symptom trajectories as a function of time and exposure to Hurricane Sandy, accounting for the effects of the Great Recession. METHODS We analyzed 6 waves of data from a 12-year panel using latent class growth models and multinomial logistic regression. RESULTS We identified 4 groups of people experiencing different trajectories of depressive symptoms. The groups differed on baseline characteristics (gender, age, education, income, race), history of diagnosed depression, and initial level of depressive symptoms. The group with the highest levels of depressive symptoms reported greater levels of peri-traumatic stress exposure to Hurricane Sandy. DISCUSSION Depressive symptoms increased as a function of the Great Recession, but exposure to Hurricane Sandy was not associated with subsequent increases in depressive symptoms for any of the 4 groups. People who consistently experienced high levels of depressive symptoms over time reported the highest levels of peri-traumatic stress during Hurricane Sandy. Findings highlight the importance of accounting for historical trends when studying the effects of disaster, identify people likely to be at risk during a disaster, and provide novel information about the causal relationship between exposure to disaster and depressive symptoms.
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Affiliation(s)
- Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford
| | | | - Allison Heid
- Independent Research Consultant, Ardmore, Pennsylvania
| | - Francine Cartwright
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford
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18
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Li H, Qian F, Hou C, Li X, Gao Q, Luo Y, Tao L, Yang X, Wang W, Zheng D, Guo X. Longitudinal Changes in Depressive Symptoms and Risks of Cardiovascular Disease and All-Cause Mortality: A Nationwide Population-Based Cohort Study. J Gerontol A Biol Sci Med Sci 2021; 75:2200-2206. [PMID: 31588954 DOI: 10.1093/gerona/glz228] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND There remains a relative paucity of evidence for the association between changes in depressive symptoms with cardiovascular disease (CVD) and mortality. This study aimed to evaluate the association of change in depressive symptoms and incident CVD and mortality in a large prospective cohort of middle-aged and older adults. METHODS A total of 6,810 participants free of CVD in the China Health and Retirement Longitudinal Study with two assessments of depressive symptoms at wave 1 (2011-2012) and wave 2 (2013-2014) were included. Elevated depressive symptoms were defined as a score of ≥12 on the 10-item Center for Epidemiologic Studies Depression scale. We used a modified Poisson regression to examine the association of changes in depressive symptoms (never, onset, remitted, and persistent) and incident CVD (a composite endpoint of heart disease or stroke) and mortality at wave 3 (2015-2016). RESULTS During follow-up, 457 CVDs and 148 deaths occurred. Multivariable analyses revealed that persistent depressive symptoms were associated with an elevated risk of CVD (risk ratio = 1.77, 95% confidence interval = 1.38-2.26) and mortality (risk ratio = 1.63, 95% confidence interval = 1.01-2.64) compared with participants without any depressive symptoms. New-onset depressive symptoms increased the mortality risk (risk ratio = 2.37, 95% confidence interval = 1.52-3.69), but not CVD (risk ratio = 1.15, 95% confidence interval = 0.84-1.58). Remitted depressive symptoms were associated with a 35% and 13% excess risk of CVD and mortality, respectively. CONCLUSION Persistent and remitted depressive symptoms were associated with an increased risk of CVD. New-onset depressive symptoms predicted elevated mortality risk.
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Affiliation(s)
- Haibin Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, China
| | - Frank Qian
- Department of Medicine, University of Chicago, Illinois
| | - Chenbei Hou
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Bundoora, Victoria, Australia
| | - Qi Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, China
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, China
| | - Xinghua Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, China
| | - Wei Wang
- Global Health and Genomics, School of Medical Sciences and Health, Edith Cowan University, Perth, Western Australia, Australia
| | - Deqiang Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, China
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19
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Welsh J, Banks E, Joshy G, Butterworth P, Strazdins L, Korda RJ. Does psychological distress directly increase risk of incident cardiovascular disease? Evidence from a prospective cohort study using a longer-term measure of distress. BMJ Open 2021; 11:e039628. [PMID: 33593764 PMCID: PMC7888372 DOI: 10.1136/bmjopen-2020-039628] [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] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Cardiovascular disease (CVD) incidence is elevated among people with psychological distress. However, whether the relationship is causal is unclear, partly due to methodological limitations, including limited evidence relating to longer-term rather than single time-point measures of distress. We compared CVD relative risks for psychological distress using single time-point and multi-time-point assessments using data from a large-scale cohort study. DESIGN We used questionnaire data, with data collection at two time-points (time 1: between 2006 and 2009; time 2: between 2010 and 2015), from CVD-free and cancer-free 45 and Up Study participants, linked to hospitalisation and death records. The follow-up period began at time 2 and ended on 30 November 2017. Psychological distress was measured at both time-points using Kessler 10 (K10), allowing assessment of single time-point (at time 2: high (K10 score: 22-50) vs low (K10 score: <12)) and multi-time-point (high distress (K10 score: 22-50) at both time-points vs low distress (K10 score: <12) at both time-points) measures of distress. Cox regression quantified the association between distress and major CVD, with and without adjustment for sociodemographic and health-related characteristics, including functional limitations. RESULTS Among 83 906 respondents, 7350 CVD events occurred over 410 719 follow-up person-years (rate: 17.9 per 1000 person-years). Age-adjusted and sex-adjusted rates of major CVD were elevated by 50%-60% among those with high versus low distress for both the multi-time-point (HR=1.63, 95% CI 1.40 to 1.90) and single time-point (HR=1.53, 95% CI 1.39 to 1.69) assessments. HRs for both measures of distress attenuated with adjustment for sociodemographic and health-related characteristics, and there was little evidence of an association when functional limitations were taken into account (multi-time-point HR=1.09, 95% CI 0.93 to 1.27; single time-point HR=1.14, 95% CI 1.02 to 1.26). CONCLUSION Irrespective of whether a single time-point or multi-time-point measure is used, the distress-CVD relationship is substantively explained by sociodemographic characteristics and pre-existing physical health-related factors.
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Affiliation(s)
- Jennifer Welsh
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Emily Banks
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- The Sax Institute, Sydney, New South Wales, Australia
| | - Grace Joshy
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Peter Butterworth
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, Victoria, Australia
| | - Lyndall Strazdins
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Rosemary J Korda
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
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20
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Abstract
OBJECTIVE To review the currently available data on the use of ketamine in the treatment of depression among older adults from randomized controlled studies. DESIGN Randomized controlled trials. SETTING Variable. PARTICIPANTS 60 years and older with depression. INTERVENTION Ketamine. MEASUREMENTS Change in Montgomery-Asberg Depression Rating Scale (MADRS) scores. RESULTS Two studies met the inclusion criteria. The first study showed a significant reduction in depression symptoms with use of repeated subcutaneous ketamine administration among older adults with depression. The second study failed to achieve significance on its primary outcome measure but did show a decrease in MADRS scores with intranasal ketamine along with a higher response and remission rates in esketamine group compared with the placebo group. The adverse effects from ketamine generally lasted only a few hours and abated spontaneously. No cognitive adverse effects were noted in either trial from the use of ketamine. CONCLUSIONS The current evidence for use of ketamine among older adults with depression indicates some benefits with one positive and one negative trial. Although one of the trials did not achieve significance on the primary outcome measure, it still showed benefit of ketamine in reducing depressive symptoms. Ketamine was well tolerated in both studies with adverse effects being mild and transient.
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21
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Factors Influencing the Impact of Depressive Symptoms on Physical Functional Capacity After Cardiac Rehabilitation. Rehabil Nurs 2020; 45:348-357. [PMID: 33332796 DOI: 10.1097/rnj.0000000000000227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aims to determine (1) if depressive symptoms in the year following completion of cardiac rehabilitation impact physical functional capacity and (2) if exercise, perceived benefits and barriers, self-efficacy, and social support moderate this relationship. DESIGN This longitudinal correlational secondary data analysis included 379 cardiovascular rehabilitation patients. METHODS Participants completed measures of depression and potential moderating variables at baseline, 2 months, 6 months, and 12 months and 6-minute work test at baseline and 12 months and wore heart rate monitors to measure exercise for 12 months. FINDINGS Poorer physical functional capacity was predicted by depressed mood score. This relationship was moderated by the percentage of time exercising in target heart rate zone and family support of exercise, but not by perceived benefits and barriers or self-efficacy for exercise. CONCLUSIONS Depressive symptoms negatively impact physical functional capacity, and this relationship is moderated by family support and the percentage of time exercising in target heart rate zone. CLINICAL RELEVANCE Improving percentage of time exercising in target heart rate zone may be a mechanism by which patients with depressed mood can optimize physical functional capacity.
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22
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Formánek T, Csajbók Z, Wolfová K, Kučera M, Tom S, Aarsland D, Cermakova P. Trajectories of depressive symptoms and associated patterns of cognitive decline. Sci Rep 2020; 10:20888. [PMID: 33257789 PMCID: PMC7705007 DOI: 10.1038/s41598-020-77866-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 11/13/2020] [Indexed: 01/27/2023] Open
Abstract
The aim was to investigate the pattern and rate of cognitive decline across distinctive trajectories of depressive symptoms in older adults. In this prospective multinational cohort study on 69,066 participants (on average 64 years at baseline, 55% women), assessments of cognitive functions (immediate recall, delayed recall, verbal fluency) and depressive symptoms (EURO-D scale) were conducted at 2-year intervals. The trajectories of depressive symptoms were obtained using latent growth mixture modelling, cognitive decline was assessed using smoothing splines and linear mixed effects models. Four distinct trajectories of depressive symptoms were identified: constantly low (n = 49,660), constantly high (n = 2999), increasing (n = 6828) and decreasing (n = 9579). Individuals with increasing and constantly high depressive symptoms showed linear cognitive decline, while those with constantly low and decreasing depressive symptoms had fluctuating cognition. Participants with increasing depressive symptoms had the fastest decline, while those with decreasing symptoms were spared from decline in cognition. This study suggests that the pattern as well as the rate of cognitive decline co-occurs with specific patterns of changes in depressive symptoms over time. The most pronounced cognitive decline is present in individuals, in whom depressive symptoms increase late in life. Unique mechanisms of cognitive decline may exist for subgroups of the population, and are associated with the trajectory of depressive symptoms.
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Affiliation(s)
- Tomáš Formánek
- National Institute of Mental Health, Klecany, Czech Republic
| | - Zsófia Csajbók
- National Institute of Mental Health, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Prague 10, Czech Republic
| | - Katrin Wolfová
- National Institute of Mental Health, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Prague 10, Czech Republic
| | - Matěj Kučera
- National Institute of Mental Health, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Prague 10, Czech Republic
| | - Sarah Tom
- Departments of Neurology and Epidemiology, Columbia University, New York, USA
| | - Dag Aarsland
- Department of Old Age Psychiatry Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Centre of Age-Related Medicine, University Hospital Stavanger, Stavanger, Norway
| | - Pavla Cermakova
- National Institute of Mental Health, Klecany, Czech Republic. .,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Prague 10, Czech Republic. .,Second Faculty of Medicine, Charles University, Prague, Czech Republic.
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23
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Ikram MA, Brusselle G, Ghanbari M, Goedegebure A, Ikram MK, Kavousi M, Kieboom BCT, Klaver CCW, de Knegt RJ, Luik AI, Nijsten TEC, Peeters RP, van Rooij FJA, Stricker BH, Uitterlinden AG, Vernooij MW, Voortman T. Objectives, design and main findings until 2020 from the Rotterdam Study. Eur J Epidemiol 2020; 35:483-517. [PMID: 32367290 PMCID: PMC7250962 DOI: 10.1007/s10654-020-00640-5] [Citation(s) in RCA: 291] [Impact Index Per Article: 72.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/23/2020] [Indexed: 12/19/2022]
Abstract
The Rotterdam Study is an ongoing prospective cohort study that started in 1990 in the city of Rotterdam, The Netherlands. The study aims to unravel etiology, preclinical course, natural history and potential targets for intervention for chronic diseases in mid-life and late-life. The study focuses on cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, otolaryngological, locomotor, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. Since 2016, the cohort is being expanded by persons aged 40 years and over. The findings of the Rotterdam Study have been presented in over 1700 research articles and reports. This article provides an update on the rationale and design of the study. It also presents a summary of the major findings from the preceding 3 years and outlines developments for the coming period.
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Affiliation(s)
- M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Guy Brusselle
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Brenda C T Kieboom
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Caroline C W Klaver
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robert J de Knegt
- Department of Gastroenterology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Tamar E C Nijsten
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robin P Peeters
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frank J A van Rooij
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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24
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Meneguci J, Meneguci CAG, Moreira MM, Pereira KR, Tribess S, Sasaki JE, Virtuoso Júnior JS. Prevalência de sintomatologia depressiva em idosos brasileiros: uma revisão sistemática com metanálise. JORNAL BRASILEIRO DE PSIQUIATRIA 2019. [DOI: 10.1590/0047-2085000000250] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivo Estimar a prevalência de sintomatologia depressiva em idosos brasileiros residentes na comunidade. Métodos Foi realizada uma revisão sistemática nas bases de dados Medline, SciELO, Web of Science, Scopus e CINAHL, sendo selecionados estudos com idosos brasileiros que identificaram a prevalência de sintomatologia depressiva. De forma independente, dois pesquisadores selecionaram os estudos, extraíram os dados e avaliaram a qualidade metodológica. A metanálise foi realizada para estimar a prevalência de sintomatologia depressiva usando um modelo de efeito aleatório. Resultados Foram identificados 176 artigos e 33 foram incluídos na revisão, que investigaram 34 prevalências, com um total de 39.431 idosos. A distribuição geográfica dos estudos indicou pesquisas em todas as regiões do Brasil. A versão curta da Escala de Depressão Geriátrica foi a mais utilizada. A prevalência estimada de sintomatologia depressiva foi de 21,0% (IC de 95%: 18,0-25,0; I2 = 98,3%). As análises de subgrupos revelaram elevada heterogeneidade em todas as categorias analisadas. A metarregressão não identificou as causas da heterogeneidade. Conclusão Apesar da heterogeneidade entre os estudos analisados, os resultados indicam a necessidade de estratégias de intervenção para reduzir a prevalência de sintomatologia depressiva.
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25
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Xiang X, Cheng J. Trajectories of major depression in middle-aged and older adults: A population-based study. Int J Geriatr Psychiatry 2019; 34:1506-1514. [PMID: 31179582 PMCID: PMC6742519 DOI: 10.1002/gps.5161] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/01/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVES This study aimed to examine depression trajectories and correlates in a nationally representative sample of middle-aged and older adults in the United States. METHODS The study sample consisted of 15 661 participants aged over 50 years from the US Health and Retirement Study. Major depression was assessed using the Composite International Diagnostic Interview (CIDI-SF). Depression trajectories were identified using a group-based trajectory modeling enhanced to account for nonrandom attrition. Multinomial logistic regression was conducted to investigate predictors of depression trajectories. RESULTS Four depression trajectory groups were identified: "never" (85.8%), "increasing" (6.3%), "decreasing" (3.2%), and "persistently moderate/high" (4.7%). Baseline depressive symptom severity was a strong predictor of depression trajectories. Older age, male sex, and non-Hispanic African American race were associated with a lower risk of the three trajectories with small to high depression burden, whereas chronic disease count was associated with a higher risk of these trajectories. The risk of being on the increasing trajectory increased with mobility difficulties. Difficulties in household activities predicted membership in the persistently moderate/high group. CONCLUSIONS A small but nonignorable proportion of middle-aged and older adults have chronic major depression. Initial symptom severity and chronic disease burden are consistent risk factors for unfavorable depression trajectories and potential targets for screening and intervention.
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Affiliation(s)
- Xiaoling Xiang
- School of Social WorkUniversity of Michigan Ann Arbor MI
| | - Jianjia Cheng
- School of Social WorkUniversity of Michigan Ann Arbor MI
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26
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Xiang X. Seven-Year Trajectories of Depressive Symptoms and Their Predictors Among Older Americans. J Aging Health 2019; 32:795-806. [PMID: 31169060 DOI: 10.1177/0898264319852835] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective: This study examined the trajectories of depressive symptoms and associated factors in older adults using an enhanced group-based trajectory modeling. Method: The study sample consisted of 7,573 adults aged ≥65 years from the National Health and Aging Trends Study (Rounds 1-7). Depressive trajectories were estimated using a group-based trajectory modeling accounting for nonrandom attrition. Results: A four-trajectory model including "persistently low" (77.7%), "increasing" (7.9%), "declining," (5.5%), and "persistently high" (8.9%) was the best fit using methods accounting for nonrandom attrition. In comparison, methods not accounting for attrition estimated that only 3.2% of older adults were on the "persistently high" trajectory. There were significant differences in depressive trajectories by age, race/ethnicity, sex, physical, and cognitive functioning, and social connections. Discussion: Persistently high depressive symptoms affected a larger proportion of older adults than previously estimated. Depression had a more long-term and increasing course in the oldest-old.
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27
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Li H, Wang A, Feng W, Zheng D, Gao Q, Tao L, Guo J, Wang X, Li X, Wang W, Guo X. Prospective Study of Glycated Hemoglobin and Trajectories of Depressive Symptoms: The China Health and Retirement Longitudinal Study. Aging Dis 2019; 10:249-257. [PMID: 31011476 PMCID: PMC6457062 DOI: 10.14336/ad.2018.0410] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 04/10/2018] [Indexed: 12/19/2022] Open
Abstract
The longitudinal association between glycated hemoglobin (HbA1c) and different courses of depressive symptoms is understudied. This study aimed to identify different trajectories of depressive symptoms and investigate the relation of HbA1c with the risk of increasing and high-stable depressive symptoms. In the China Health and Retirement Longitudinal Study, depressive symptoms were measured using the 10-item Center for Epidemiological Studies-Depression scale in three visits (years: 2011, 2013 and 2015) among 9804 participants (mean age 60.0 ± 9.0 years). Group-based trajectory modeling was used to identify trajectories of depressive symptoms. HbA1c was measured at baseline and categorized five groups according to the respective quintile. Multinomial logistic regression was fitted to examine this relationship. Four distinct trajectories of depressive symptoms were identified: low symptoms (n=6401, 65.29%); decreasing symptoms (n=1362, 13.89%); increasing symptoms (n=1452, 14.81%); and high symptoms (n=1452, 14.81%). Adjusting for demographic, health-related, and cognitive factors, the risk ratio (95% confidence interval) pertaining to the highest HbA1c (Quintile 5) for decreasing, increasing, and high symptoms of depression versus low symptoms was 1.01 (0.82-1.25), 1.12 (0.92-1.36), and 1.39 (1.04-1.86) compared with the lowest HbA1c (Quintile 1), respectively. We observed a J-shaped relationship between HbA1c and high depressive symptoms, with the lowest risk at a HbA1c concentration of 5.0%. In summary, in this large population-based cohort, high levels of glycated hemoglobin concentrations were associated with a higher risk of increasing and high-stable symptoms of depression.
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Affiliation(s)
- Haibin Li
- 1Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,2Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Anxin Wang
- 1Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,2Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Wei Feng
- 1Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,2Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Deqiang Zheng
- 1Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,2Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Qi Gao
- 1Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,2Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Lixin Tao
- 1Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,2Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Jin Guo
- 3Greenwood Medical Company, 300 Highway Burwood, Melbourne, Melbourne, Victoria, Australia
| | - Xiaonan Wang
- 1Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,2Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xia Li
- 4Department of Mathematics and Statistics, La Trobe University, Victoria, Australia
| | - Wei Wang
- 5Global Health and Genomics, School of Medical Sciences and Health, Edith Cowan University, Perth, Western Australia, Australia
| | - Xiuhua Guo
- 1Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,2Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
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