1
|
Liao X, Shi K, Zhang Y, Huang X, Wang N, Zhang L, Zhao X. Contribution of CKD to mortality in middle-aged and elderly people with diabetes: the China Health and Retirement Longitudinal Study : CKD was a chronic stressor for diabetics. Diabetol Metab Syndr 2023; 15:122. [PMID: 37291588 DOI: 10.1186/s13098-023-01083-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 05/08/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND The contribution of chronic kidney disease (CKD) to mortality in diabetic patients is unclear. This study aimed to explore the association between diabetics with CKD and mortality in middle-aged and elderly people of different ages. METHODS Data were obtained from the China Health and Retirement Longitudinal Study, including 1,715 diabetic individuals, 13.1% of whom also had CKD. Diabetes and CKD were assessed by combining the physical measurements and self-reports. We fitted Cox proportional hazards regression models to examine the effect of diabetics with CKD on mortality in middle-aged and elderly people. The risk factors for death were further predicted based on age stratification. RESULTS The mortality rate of diabetic patients with CKD (29.3%) was increased as compared to that of diabetic patients without CKD (12.4%). Diabetics with CKD were at a higher risk of all-cause mortality than those without CKD, with a hazard ratio of 1.921 (95% CI: 1.438, 2.566). Additionally, for participants 45 to 67 years of age, the hazard ratio was 2.530 (95% CI: 1.624, 3.943). CONCLUSIONS Our findings suggested that, for diabetics, CKD was a chronic stressor that led to death in middle-aged and elderly people, especially among participants aged 45 to 67 years.
Collapse
Affiliation(s)
- Xihong Liao
- Department of Obstetrics and Gynecology, Shanghai Songjiang District Central Hospital, Shanghai, China
| | - Ke Shi
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Yumeng Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Xiaoxu Huang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Ning Wang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Ling Zhang
- Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Xiaohuan Zhao
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- National Clinical Research Center for Eye Diseases, Shanghai, China.
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China.
| |
Collapse
|
2
|
Shared Activities With Parents During Adolescence Predicts Health Risk Across Multiple Biological Systems 22 Years Later. Psychosom Med 2023; 85:130-140. [PMID: 36728940 DOI: 10.1097/psy.0000000000001161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Although affectively focused dimensions of social relationships are associated with differences in health risk, less research has considered nonaffective features of relationships, such as engaging in shared activities. This study sought to test whether adolescents who engaged in more shared activities with their parents had lower health risk in early midlife across multiple biological markers. METHODS Using data from a nationally representative study ( N = 4801), prospective associations between shared activities with parents during adolescence and health risk classifications for measures of inflammation, renal function, glucose homeostasis, and cholesterol 22 years later were examined, along with the potentially confounding roles of childhood socioeconomic status and parent-child relationship satisfaction. Exploratory analyses considered possible indirect effects of cigarette use, alcohol use, and body mass index in adulthood. RESULTS Engaging in more shared activities with parents was associated with a reduced likelihood of being classified in a high-risk health category for markers of inflammation ( B = -0.02, standard error [SE] = 0.01, p = .040), renal function ( B = -0.08, SE = 002, p = .001), glucose ( B = -0.06, SE = 0.23, p = .011), and high-density lipoprotein ( B = - 0.03, SE = 0.01, p = .021), and overall allostatic load ( B = - 0.02, SE = 0.02, p = .001), beyond demographic and health covariates. Controlling for parental income and relationship satisfaction largely did not affect observed associations. Exploratory tests of indirect effects imply that health behaviors in adulthood may partially account for observed associations. CONCLUSIONS Engaging in more shared activities predicted more optimal health classifications 22 years later, suggesting that the amount of contact between parents and teenagers may have long-lasting beneficial health effects. Furthermore, consideration of nonaffective dimensions of family relationships may provide additional insight into associations between social relationships and health.
Collapse
|
3
|
Park JH, Prochnow T, Amo C, Curran L, Smith ML. Differences in Physical Activity, Sedentary Behavior, and Mental Health of the Older Population in South Korea Based on Marital Status and Gender. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1726. [PMID: 36767094 PMCID: PMC9914888 DOI: 10.3390/ijerph20031726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
The primary purpose of the present study was to assess differences in physical activity (PA), sedentary behavior (SB), and mental health (i.e., depression, suicidal thoughts, and cognitive function) by marital status (i.e., married and widowed) within an aging population in South Korea. PA, SB, and mental health were evaluated in 9092 older adults by comparing the married group (n = 5773, 73.2 ± 5.9 years, 63.5%) to the widowed group (n = 3319, 75.8 ± 6.8 years, 36.5%). Between-group differences in PA, SB, depression, and cognitive function were tested using independent t-tests, and the association between marital status and gender was evaluated using two-way ANOVA. Suicidal thoughts were analyzed using a Mann-Whitney U-test. Older adults in the widowed group participated in significantly less PA (p < 0.001) and had higher SB (p < 0.001) per week, especially the widows, who had significantly less PA (p < 0.01) and had higher SB (p < 0.001) compared to married women. Participants in the widowed group experienced more depression (p < 0.001) and suicidal thoughts (p < 0.001) and had significantly lower cognitive function compared to participants in the married group (p < 0.001). Between the two groups, widowers were more vulnerable to all mental health factors compared to those in the married group. At the same time, widows were only more vulnerable to depression and cognitive function compared to women in the married group. Findings indicated that the presence of a spouse is strongly associated with higher PA levels, lower SB, and better mental health among older adults. Spouses are the primary social supports and play a major role in the health and emotional well-being of the aging population. Given the importance of the spouse, our study suggests that health educators working with older widows should prioritize several different forms of social support to benefit their physical and mental health.
Collapse
|
4
|
Meng J, Liu E, Xiang N, Yue Z. Can community-based care moderate widowhood's health impact? -A longitudinal study among older Chinese adults. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5725-e5734. [PMID: 36200763 DOI: 10.1111/hsc.14002] [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: 02/03/2022] [Revised: 06/29/2022] [Accepted: 08/20/2022] [Indexed: 06/16/2023]
Abstract
The plethora of pathways leading to health problems of later life has made the causal assessment of widowhood on the health of older adults difficult. This research aimed to assess the short-term impact of widowhood on the objective health of older adults and to the moderating role of community-based care (CBC) in improving the health outcomes of older adults. In this study, the activities of daily living (ADLs) and number of hospitalisations of older adults were measured, and PSM-DID models were conducted. Widowhood had a significant negative impact on the objective health of older adults. Widowed adults had higher ADL scores (B = 0.569, 95 percent CI: 0.295 to 0.844) and more hospitalisations (B = 2.551, 95 percent CI: 1.189 to 3.914) than nonwidowed adults. Meanwhile, CBC in urban areas can significantly reduce ADL scores (B = -0.154, SE = 0.082) and the number of hospitalisations (B = -1.402, SE = 0.348) in older adults, whereas CBC in rural areas can only significantly reduce ADL scores (B = -0.197, SE = 0.087). Taken together, there is an urgent need to focus on the health of widowed and older adults and to provide CBC in both urban and rural areas equally.
Collapse
Affiliation(s)
- Jia Meng
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Erpeng Liu
- Institute of Income Distribution and Public Finance, Zhongnan University of Economics and Law, Wuhan, China
| | - Nan Xiang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Zhang Yue
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| |
Collapse
|
5
|
Zhu Z, Wang Z, Wu Y, Chen X, Liu H, Zhang J, Liu M, Liu Y. The Widowhood Effect on Mortality in Older Patients with Hip Fracture. Int J Gen Med 2022; 15:7693-7700. [PMID: 36238540 PMCID: PMC9552787 DOI: 10.2147/ijgm.s384862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
Objective Widowed people have increased mortality than married people of the same age, a phenomenon known as the widowhood effect. This study aimed to investigate whether this effect exists in older patients with hip fracture. Methods Using our own hip fracture database, a total of 1101 hip fracture patients were consecutively included from January 2014 to December 2021. Marital status was stratified as married (n = 793) and widowed (n = 308). Patients survival status was obtained from medical records or telephone follow-ups, and the outcomes were all-cause mortality at 30 days, 1 year and at latest follow-up. Univariate and multivariate Cox proportional hazard models were used to assess the association between marital status and mortality, and subgroup analyses according to sex were also conducted. Results Compared with married patients, widowed patients were more likely to be older, female and intertrochanteric fracture, and were less likely to be urban area, smoking, drinking, and surgical treatment (P < 0.05). After a median follow-up of 37.1 months, the 30-day mortality was 4.3% (n = 47), 1-year mortality was 19.3% (n = 178), and total mortality was 34.2% (n = 376). Multivariate Cox analysis showed that widowed marital status remained an independent risk factor for 1-year mortality (HR = 1.437, 95% CI: 1.054–1.959, P = 0.022), and total mortality (HR = 1.296, 95% CI: 1.038–1.618, P = 0.022), whereas this association was not found in 30-day mortality (HR = 1.200, 95% CI: 0.607–2.376, P = 0.599). Moreover, subgroup analyses also found that the widowhood effect on mortality was present in both male and female. Conclusion Widowed marital status seems to be an independent risk factor for long-term mortality in older patients with hip fracture.
Collapse
Affiliation(s)
- Zhonglun Zhu
- Department of Orthopedics, People’s Hospital of Deyang City, Deyang, People’s Republic of China
| | - Zhicong Wang
- Department of Orthopedics, People’s Hospital of Deyang City, Deyang, People’s Republic of China,Department of Orthopedics, The First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Yuxuan Wu
- Department of Orthopedics, People’s Hospital of Deyang City, Deyang, People’s Republic of China
| | - Xi Chen
- Department of Orthopedics, People’s Hospital of Deyang City, Deyang, People’s Republic of China
| | - Hailong Liu
- Department of Orthopedics, People’s Hospital of Deyang City, Deyang, People’s Republic of China
| | - Jianjun Zhang
- Department of Orthopedics, People’s Hospital of Deyang City, Deyang, People’s Republic of China
| | - Mozhen Liu
- Department of Orthopedics, The First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Yuehong Liu
- Department of Orthopedics, People’s Hospital of Deyang City, Deyang, People’s Republic of China,Correspondence: Yuehong Liu, Department of Orthopedics, People’s Hospital of Deyang City, Deyang, People’s Republic of China, Email
| |
Collapse
|
6
|
Karl S, Johar H, Ladwig KH, Peters A, Lederbogen F. Dysregulated diurnal cortisol patterns are associated with cardiovascular mortality: Findings from the KORA-F3 study. Psychoneuroendocrinology 2022; 141:105753. [PMID: 35395560 DOI: 10.1016/j.psyneuen.2022.105753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/12/2022] [Accepted: 03/28/2022] [Indexed: 12/23/2022]
Abstract
Psychosocial stress has been associated with an increased risk for cardiovascular disease and death. Dysregulated diurnal cortisol slopes, which have also been associated with stress, might mediate this association. However, existing evidence on the cardiovascular health consequences of dysregulated cortisol slopes remains limited and inconclusive. To elucidate whether dysregulated diurnal cortisol slopes are related to cardiovascular mortality, we assessed salivary cortisol and cardiovascular morbidity and mortality in 1090 participants from the KORA-F3 study, a prospective, observational cohort study of a random representative sample from the general population. Eighty-seven deaths were registered during the mean follow-up period of approximately 11 years, 31 of which were classified as cardiovascular deaths. A more pronounced cortisol awakening response was associated with a lower risk of cardiovascular mortality in the adjusted Cox proportional hazards analysis (HR 0.59 [95-%-CI 0.36-0.96], p = 0.03). A greater diurnal cortisol peak-to-bedtime ratio at baseline also predicted a decreased risk of cardiovascular mortality (HR 0.50 [95-%-CI 0.34-0.73], p 0.01) and a decreased risk of stroke (HR 0.71 [95-%-CI 0.55-0.92], p 0.01). Increased levels of late night salivary cortisol predicted a higher risk of cardiovascular mortality (HR 1.49 [95-%-CI 1.13-1.97], p 0.01) and an increased risk of stroke (HR 1.24 [95-%-CI 1.01-1.52], p = 0.04). There was no association between measures of cortisol and non-cardiovascular related mortality. In conclusion, dysregulated diurnal cortisol patterns are associated with cardiovascular mortality, while greater diurnal cortisol variation seems to have a protective effect. This adds evidence to suggest a pathophysiological role of diurnal cortisol secretion patterns in cardiovascular health.
Collapse
Affiliation(s)
- Sebastian Karl
- Central Institute of Mental Health, University of Heidelberg / Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
| | - Hamimatunnisa Johar
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor, Malaysia; Department of Psychosomatic Medicine and Psychotherapy, University of Gießen and Marburg, Gießen, Germany; Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Karl-Heinz Ladwig
- German Centre for Cardiovascular Research (DZHK e.V.), Partner Site Munich Heart Alliance, Munich, Germany; Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; German Centre for Cardiovascular Research (DZHK e.V.), Partner Site Munich Heart Alliance, Munich, Germany; Chair of Epidemiology, Ludwig-Maximilians Universität München, Munich, Germany
| | - Florian Lederbogen
- Central Institute of Mental Health, University of Heidelberg / Medical Faculty Mannheim, J5, 68159 Mannheim, Germany
| |
Collapse
|
7
|
Petrican R, Fornito A, Jones N. Psychological Resilience and Neurodegenerative Risk: A Connectomics-Transcriptomics Investigation in Healthy Adolescent and Middle-Aged Females. Neuroimage 2022; 255:119209. [PMID: 35429627 DOI: 10.1016/j.neuroimage.2022.119209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 11/25/2022] Open
Abstract
Adverse life events can inflict substantial long-term damage, which, paradoxically, has been posited to stem from initially adaptative responses to the challenges encountered in one's environment. Thus, identification of the mechanisms linking resilience against recent stressors to longer-term psychological vulnerability is key to understanding optimal functioning across multiple timescales. To address this issue, our study tested the relevance of neuro-reproductive maturation and senescence, respectively, to both resilience and longer-term risk for pathologies characterised by accelerated brain aging, specifically, Alzheimer's Disease (AD). Graph theoretical and partial least squares analyses were conducted on multimodal imaging, reported biological aging and recent adverse experience data from the Lifespan Human Connectome Project (HCP). Availability of reproductive maturation/senescence measures restricted our investigation to adolescent (N =178) and middle-aged (N=146) females. Psychological resilience was linked to age-specific brain senescence patterns suggestive of precocious functional development of somatomotor and control-relevant networks (adolescence) and earlier aging of default mode and salience/ventral attention systems (middle adulthood). Biological aging showed complementary associations with the neural patterns relevant to resilience in adolescence (positive relationship) versus middle-age (negative relationship). Transcriptomic and expression quantitative trait locus data analyses linked the neural aging patterns correlated with psychological resilience in middle adulthood to gene expression patterns suggestive of increased AD risk. Our results imply a partially antagonistic relationship between resilience against proximal stressors and longer-term psychological adjustment in later life. They thus underscore the importance of fine-tuning extant views on successful coping by considering the multiple timescales across which age-specific processes may unfold.
Collapse
Affiliation(s)
- Raluca Petrican
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, United Kingdom.
| | - Alex Fornito
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging, Monash University, Melbourne, VIC, Australia
| | - Natalie Jones
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, United Kingdom
| |
Collapse
|
8
|
Farrell AK, Stanton SCE, Sbarra DA. Good Theories in Need of Better Data: Combining Clinical and Social Psychological Approaches to Study the Mechanisms Linking Relationships and Health. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2021; 17:863-883. [PMID: 34878961 DOI: 10.1177/17456916211027563] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The study of intimate relationships and health is a fast-growing discipline with numerous well-developed theories, many of which outline specific interpersonal behaviors and psychological pathways that may give rise to good or poor health. In this article, we argue that the study of relationships and health can move toward interrogating these mechanisms with greater precision and detail, but doing so will require a shift in the nature of commonly used research methods in this area. Accordingly, we draw heavily on the science of behavior change and discuss six key methodologies that may galvanize the mechanistic study of relationships and health: dismantling studies, factorial studies, experimental therapeutics, experimental mediation research, multiple assessments, and recursive modeling. We provide empirical examples for each strategy and outline new ways in which a given approach may be used to study the mechanisms linking intimate relationships and health. We conclude by discussing the key challenges and limitations for using these research strategies as well as novel ideas about how to integrate this work into existing paradigms within the field.
Collapse
|
9
|
Guo Y, Ge T, Mei L, Wang L, Li J. Widowhood and Health Status Among Chinese Older Adults: The Mediation Effects of Different Types of Support. Front Public Health 2021; 9:745073. [PMID: 34869158 PMCID: PMC8637908 DOI: 10.3389/fpubh.2021.745073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/25/2021] [Indexed: 11/28/2022] Open
Abstract
Although many studies have suggested that widowhood is related to worse health conditions among older adults, few have examined the mediation effects of social support between widowhood and health. Employing mediation analysis to a sample of data from the 2014 wave of China Longitudinal Aging Social Survey (CLASS), this study examined the mediation effects of social support, including emotional support, instrumental support, and companionship, in the widowhood-health association among older adults. The results indicated that the negative effect of widowhood on older adults' health was in part attributable to decreased emotional support and companionship. Specifically, emotional support exerted a significant role in the widowhood-mental health association, and companionship exerted a significant role in widowhood-physical health and widowhood-mental health associations. In the subsample analysis, the mediation effects were only significant among female older adults, and among rural older adults. Our findings highlight the importance of emotional support and companionship in maintaining health among widowed older adults and strategies should pay more attention to female and rural widowed older adults.
Collapse
Affiliation(s)
- Yu Guo
- School of Public Policy and Administration, Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, China
| | - Tingshuai Ge
- School of Public Policy and Administration, Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, China
| | - Li Mei
- School of Public Policy and Administration, Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, China
| | - Lina Wang
- School of Public Policy and Administration, Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, China
| | - Jingbo Li
- School of Labor Economics, Capital University of Economics and Business, Beijing, China
| |
Collapse
|
10
|
Schutter N, Holwerda TJ, Comijs HC, Naarding P, Van RHL, Dekker JJM, Stek ML, Rhebergen D. Loneliness, social network size, and mortality in older adults and the role of cortisol. Aging Ment Health 2021; 25:2246-2254. [PMID: 33147982 DOI: 10.1080/13607863.2020.1843001] [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] [Indexed: 10/23/2022]
Abstract
BACKGROUND Loneliness and social isolation have both been found to be associated with increased mortality in previous studies. One potential underlying mechanism is via the hypothalamic-pituitary-adrenal axis. OBJECTIVE This study aimed to examine the association between social network size and cortisol, to analyze the associations between both loneliness and social network size and mortality, and to examine to what extent the association between network size and/or loneliness and mortality is mediated by cortisol. DESIGN The study group consisted of 443 depressed and non-depressed participants of the Netherlands Study of Depression in the Elderly (NESDO). Cross-sectional analysis of the association between social network size and cortisol measures was followed by a survival analysis of the associations between both social network size and loneliness and mortality. RESULTS There were no significant associations between social network size and cortisol measures. Loneliness and small social network size were not associated with mortality. Age and partner status were more important predictors of mortality. CONCLUSION As people grow older the variety of factors that influence mortality risk increases, diminishing the effect of a single factor. Prevention of early morbidity and mortality in older adults should be tailored to specific needs and risks, instead of aiming at one specific factor.
Collapse
Affiliation(s)
- Natasja Schutter
- Department of Geriatric Psychiatry, Arkin Mental Health Care, Amsterdam, the Netherlands
| | - Tjalling J Holwerda
- Department of Psychiatry, Arkin Mental Health Care, Amsterdam, the Netherlands
| | - Hannie C Comijs
- GGZ InGeest, Amsterdam, the Netherlands.,Department of Psychiatry and the Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Paul Naarding
- General Psychiatry Residency Training Program, GGNet, Apeldoorn, the Netherlands.,Department of Geriatric Psychiatry, Apeldoorn, the Netherlands
| | - Rien H L Van
- Department of General Psychiatry Residency Training, Netherlands Psychoanalytical Institute, Arkin Mental Health Care, Amsterdam, the Netherlands
| | - Jack J M Dekker
- Department of Clinical Research, Arkin Mental Health Care, VU University Amsterdam, Amsterdam, the Netherlands.,Department of Psychology, Arkin Mental Health Care, VU University Amsterdam, Amsterdam, the Netherlands
| | - Max L Stek
- GGZ InGeest, Amsterdam, the Netherlands.,Department of Psychiatry and the Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Didi Rhebergen
- GGZ InGeest, Amsterdam, the Netherlands.,Department of Psychiatry and the Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
11
|
Abell JG, Steptoe A. Why is living alone in older age related to increased mortality risk? A longitudinal cohort study. Age Ageing 2021; 50:2019-2024. [PMID: 34304269 PMCID: PMC8675439 DOI: 10.1093/ageing/afab155] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Living alone has been associated with increased mortality risk, but it is unclear whether this is a result of a selection effect or the impact of stressful life changes such as widowhood or divorce leading to changes in living arrangements. We therefore examined the association between living alone, transitions in living arrangements and all-cause mortality. METHOD We analysed data from 4,888 individuals who participated in both wave 2 (2004-2005) and wave 4 (2008-2009) of the English Longitudinal Study of Ageing. Transitions in living arrangements over this period were identified. Mortality status was ascertained from linked national mortality registers. Cox proportional hazards analysis was used to examine the association between living alone and mortality over an average 8.5 year follow-up period. RESULTS An association was found between living alone at wave 4 and mortality (hazard ratio (HR): 1.20, 95% CI 1.04-1.38) in a model adjusted for multiple factors including socioeconomic status, physical health, health behaviours and loneliness. We also found that participants who moved to living alone after divorce or bereavement had a higher risk of mortality compared with those who lived with others at both time points (HR: 1.34, 95% CI 1.01-1.79), while those who moved to living alone for other reasons did not show an increased mortality risk. CONCLUSIONS The relationship between living alone and mortality is complicated by the reasons underlying not living with others. A greater understanding of these dynamics will help to identify the individuals who are at particular health risk because of their living arrangements.
Collapse
Affiliation(s)
- Jessica G Abell
- Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| |
Collapse
|
12
|
Jakubowska K, Wysokiński M, Chruściel P. Place of Residence and Marital Status as Variables Differentiating a Sense of Self-Efficacy in the Elderly-A Descriptive Cross-Sectional Survey. Healthcare (Basel) 2020; 8:healthcare8030300. [PMID: 32858817 PMCID: PMC7551759 DOI: 10.3390/healthcare8030300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/20/2020] [Accepted: 08/25/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Studies on the self-efficacy of the elderly are still being conducted to a very limited extent. Nevertheless, they can provide relevant information for specialists to use in many disciplines of science, as well as for practitioners, especially gerontologists, geriatricians, psychologists and other people associated with prophylaxis and health promotion. The aim of the study is to assess the impact of the place of residence and marital status on the self-efficacy in the elderly. Methods: A diagnostic survey method was used for the study and within the method, the authors' sociodemographic data questionnaire and the generalized self-efficacy scale (GSES) were applied. The study was carried out in a group of 171 females and 130 males under nursing care in the home environment or in nursing-home care in Poland. Results: The average level of generalized sense of self-efficacy in the research cohort was M = 26.69, SD = 8.49. A relatively high percentage of the group (48.9%) showed a sense of self-efficacy at a high level. The level of a sense of self-efficacy was low in 38.2% of the cohort, while its average intensity in the remaining ones constituted 12.9% of the total. A statistically significant impact of a place of residence (Z = -2.940; p = 0.003) and marital status (H = 12.000; p = 0.007) on the sense of efficacy in the research cohort was proven in favor of those from the rural environment and the respondents having spouses. Conclusions: On the scale of the studied group, the results of a sense of self-efficacy are optimistic, as older people with high levels predominated. However, the results of the cohort whose self-efficacy is insufficient to cope with their old age should be considered carefully, especially in the case of lonely people living in the urban environment and NHC (nursing-home care) residents.
Collapse
|