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Wen Z, Wang H, Liang Q, Liu L, Zhang W, Zhang X. Mediating effect of social support and resilience between loneliness and depression in older adults: A systematic review and meta-analytic structural equation modeling. J Affect Disord 2024; 365:246-257. [PMID: 39147150 DOI: 10.1016/j.jad.2024.08.062] [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: 12/07/2023] [Revised: 08/11/2024] [Accepted: 08/12/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Loneliness is a powerful stressor for depression in older adults, and resilience and social support may mediate this relationship, while the evidence is limited. Hence, our study aims to explore the mediating role of social support and resilience between loneliness and depression and to test possible moderators. METHODS We searched 12 databases without language and publish time restrictions and obtained the correlation coefficients. This review constructed two-stage meta-analytical structural equality modeling (MASEA) to test the mediating effect of social support and resilience. Additionally, use one-stage MASEA to test the moderator effect of women proportion, published year, and country of study. RESULTS This study included 53 studies and 40, 929 older adults. Loneliness directly affected depression (β = 0.28, 95 % CI: 0.20, 0.36). Social support (β = 0.06, 95 % CI: 0.02, 0.09) and resilience (β = 0.15, 95 % CI: 0.12, 0.18) mediated the relationship. The proportion of women in the sample was moderator (χ2(5) = 11.10, p = 0.05). When the proportion exceeded 60 %, the path coefficient of loneliness and social support (β = -0.45, SE = 0.055) was larger than that of the subgroup below 60 % (β = -0.32, SE = 0.041). LIMITATIONS It was indefinite whether the evidence would be supported in longitudinal designs. Influenced by the original research data, it is impossible to calculate the model parameters of gender discrepancy. CONCLUSIONS Health aging policy-makers adopting social support and resilience intervention will help strengthen the coping skills of older adults confronting loneliness and reduce the risk of depression.
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Affiliation(s)
- Zhifei Wen
- Department of Dermatological, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hongyan Wang
- Dean Office, Si Chuan Nursing Vocational College, Chengdu, China
| | - Qingfang Liang
- School of Nursing, Chengdu university of Traditional Chinese Medicine, Chengdu, China
| | - Linfeng Liu
- Dean Office, Si Chuan Nursing Vocational College, Chengdu, China
| | - Wen Zhang
- Dean Office, Si Chuan Nursing Vocational College, Chengdu, China
| | - Xiangeng Zhang
- Dean Office, Si Chuan Nursing Vocational College, Chengdu, China.
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Luo Y, Zhou L, Zhang W. Help or Hurt? The Impact of Digital Finance on the Physical Health of the Elderly in China. Healthcare (Basel) 2024; 12:1299. [PMID: 38998834 PMCID: PMC11241007 DOI: 10.3390/healthcare12131299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/17/2024] [Accepted: 06/27/2024] [Indexed: 07/14/2024] Open
Abstract
Under the backdrop of global aging, the escalating number of elderly individuals in poor health poses a growing social burden and impacts economic development and social stability. A fundamental question arises as to whether the advancements of digital finance (DF) can effectively enhance the physical health of the elderly. This study aims to investigate the impact of DF on the physical health of the elderly by utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2013, 2015, and 2018. The results reveal a significant positive impact of DF on enhancing the physical health of the elderly. Furthermore, the study demonstrates that this impact is particularly pronounced among the elderly with higher educational attainment, stronger intergenerational links, and those residing in central cities. A mechanism analysis further reveals that DF contributes to improving the physical health of the elderly by augmenting household disposable income, alleviating liquidity constraints, and enhancing the utilization of medical services. These findings offer valuable insights for the future development of DF and the implementation of policies promoting healthy aging and active aging.
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Affiliation(s)
- Yaling Luo
- School of Public Administration, Sichuan University, Chengdu 610041, China
| | - Lei Zhou
- School of Public Administration, Sichuan University, Chengdu 610041, China
| | - Weike Zhang
- School of Public Administration, Sichuan University, Chengdu 610041, China
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Qiu B, Zhu R, Huang X, Qi Z, Zhang L. Associations between eating alone, its transition and depressive symptoms among Chinese middle-aged and older adults: evidence from two national cohorts. BMC Psychiatry 2024; 24:458. [PMID: 38898438 PMCID: PMC11186271 DOI: 10.1186/s12888-024-05909-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 06/13/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Few studies have explored the longitudinal association between eating alone and depressive symptoms, and have focused on the effect of eating alone transition. This study aims to explore the longitudinal association between eating alone, its transition and depressive symptoms among two national surveys using a cohort study design. METHODS The participants aged ≥ 45 years were recruited for the 2016 to 2018 waves China Family Panel Data (CFPS) and 2015 to 2018 waves China Health and Retirement Longitudinal Study (CHARLS). Eating alone was assessed by self-reported. Depressive symptoms were evaluated by Center for Epidemiologic Studies Depression Scale. Cox hazard regression was used to explore the associations between eating alone, its transition and depressive symptoms after adjusting for covariates. RESULTS A total of 21,476 participants were included in this study. The Cox model showed that compared with commensality, eating alone was associated with a higher risk of depressive symptoms, both in the CFPS, CHARLS and pooled analysis. In addition, compared with commensality consistently, the transition from commensality to alone and eating alone consistently were associated with a higher risk of depressive symptoms. The sensitivity analyses showed that the association remained robust. CONCLUSIONS Eating alone and a change from commensality to eating alone were associated with higher risks of depressive symptoms among Chinese middle-aged and older adults in two cohorts. This study suggested that providing eating partners may be an effective intervention method to prevent depressive symptoms in middle-aged and older adults.
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Affiliation(s)
- Baohua Qiu
- Shiquan Community Health Service Center, Tongji University School of Medicine, Shanghai, China
- Shanghai Putuo District Health Affairs Management Center, Shanghai, China
| | - Rongyu Zhu
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, China
- School of Public Health and General Practice, Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Xinlu Huang
- Shiquan Community Health Service Center, Tongji University School of Medicine, Shanghai, China
| | - Zhijuan Qi
- Shiquan Community Health Service Center, Tongji University School of Medicine, Shanghai, China.
| | - Lijuan Zhang
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, China.
- School of Public Health and General Practice, Tongji University School of Medicine, Tongji University, Shanghai, China.
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Ding X, Qi LX, Sun DY. Differences in insomnia-related self-reported outcomes among elderly hospitalized patients. World J Psychiatry 2024; 14:686-694. [PMID: 38808082 PMCID: PMC11129157 DOI: 10.5498/wjp.v14.i5.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/20/2024] [Accepted: 03/29/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Insomnia is among the most common sleep disorders worldwide. Insomnia in older adults is a social and public health problem. Insomnia affects the physical and mental health of elderly hospitalized patients and can aggravate or induce physical illnesses. Understanding subjective feelings and providing reasonable and standardized care for elderly hospitalized patients with insomnia are urgent issues. AIM To explore the differences in self-reported outcomes associated with insomnia among elderly hospitalized patients. METHODS One hundred patients admitted to the geriatric unit of our hospital between June 2021 and December 2021 were included in this study. Self-reported symptoms were assessed using the Athens Insomnia Scale (AIS), Generalized Anxiety Disorder Scale-7 (GAD-7), Geriatric Depression Scale-15 (GDS-15), Memorial University of Newfoundland Scale of Happiness (MUNSH), Barthel Index Evaluation (BI), Morse Fall Scale (MFS), Mini-Mental State Examination, and the Short Form 36 Health Survey Questionnaire (SF-36). Correlation coefficients were used to analyze the correlation between sleep quality and self-reported symptoms. Effects of insomnia was analyzed using Logistic regression analysis. RESULTS Nineteen patients with AIS ≥ 6 were included in the insomnia group, and the incidence of insomnia was 19% (19/100). The remaining 81 patients were assigned to the non-insomnia group. There were significant differences between the two groups in the GDA-7, GDS-15, MUNSH, BI, MFS, and SF-36 items (P < 0.05). Patients in the insomnia group were more likely to experience anxiety, depression, and other mental illnesses, as well as difficulties with everyday tasks and a greater risk of falling (P < 0.05). Subjective well-being and quality of life were poorer in the insomnia group than in the control group. The AIS scores positively correlated with the GAD-7, GDS-15, and MFS scores in elderly hospitalized patients with insomnia (P < 0.05). Logistic regression analysis showed that GDS-15 ≥ 5 was an independent risk factor for insomnia in elderly hospitalized patients (P < 0.05). CONCLUSION The number of self-reported symptoms was higher among elderly hospitalized patients with insomnia. Therefore, we should focus on the main complaints of patients to meet their care needs.
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Affiliation(s)
- Xia Ding
- Department of Gangzha General Medical Center, The Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu Province, China
| | - Ling-Xia Qi
- Department of Anesthesiology and Surgery, The Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu Province, China
| | - Dong-Yun Sun
- Department of Ophthalmic Surgery Room, The Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu Province, China
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Xu J, Wang Y, Cheung JC, Yin Y. Analysis of the chain mediation effect between intergenerational support and mental health of older adults in urban China: a structural equation model. BMC Geriatr 2024; 24:323. [PMID: 38589808 PMCID: PMC11003019 DOI: 10.1186/s12877-024-04883-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 03/11/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND This study aimed investigate the impact of intergenerational support on the mental health of older adults in urban China. It also sought to evaluate the chain mediation effect of attitudes toward younger people and willingness to interact with younger people within a non-familial context between intergenerational support and mental health. METHODS Data were derived from a community survey that adopted quota sampling in mainland China in 2022 (N = 780). Structural equation modeling was used to analyze the data, and the bootstrap technique was used to test the mediation effect. RESULTS A significant positive association was found between intergenerational support and the mental health of older adults in urban China (B = 0.852, 95% confidence interval CI [0.157,1.617]). Intergenerational support had a specific indirect effect on mental health through older adults' attitudes toward younger people within a non-familial context (B = 0.665, 95% CI [0.443,1.046]). There was a chain mediation effect (B = 0.126, 95% CI [0.069,0.224]) in relation to attitudes toward younger people and the willingness to interact with younger people between intergenerational support and mental health. Mediation accounted for 44.44% of the total effects in the model. CONCLUSION These findings help identify modifiable factors that can improve the mental health of older adults. In line with the proposed serial multiple mediation model, this study provides theoretical and practical insights concerning the synergistic effect of intergenerational support at the family level and intergenerational interaction at the community level. Policy and social service implications are also discussed.
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Affiliation(s)
- Jiahong Xu
- Department of Sociology, Zhou Enlai School of Government, Nankai University, Tianjin, China
| | - Youwei Wang
- School of Sociology & Anthropology, Sun Yat-sen University, No. 135, Xingang West Road, Haizhu District, Guangzhou, Guangdong Province, China.
| | - Justin C Cheung
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
| | - Yanlong Yin
- Department of Social Security, School of Public Administration, Hebei University of Economics and Business, Shijiazhuang, China
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Sharifi S, Babaei Khorzoughi K, Rahmati M. The association between intergenerational relationships and depression among older adults: A comprehensive systematic literature review. Arch Gerontol Geriatr 2024; 119:105313. [PMID: 38101113 DOI: 10.1016/j.archger.2023.105313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE This systematic review aims to comprehensively examine the relationship between intergenerational relationships and depression among older adults in Eastern Asian countries. METHODS For this research, a systematic search was conducted on several electronic databases including PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar search engine up until June 2023. RESULTS Out of 953 articles initially identified, 33 met the inclusion criteria. Emotional support and financial support emerged as crucial factors that can significantly reduce depressive symptoms among older individuals. However, there are diverse and sometimes contradictory results regarding the impact of intergenerational instrumental support on depression in older adults. CONCLUSION Promoting positive intergenerational relationships and enhancing support systems can greatly benefit the mental health of older adults by addressing depression within this population. This review enhances our understanding of the complex relationship between intergenerational relationships and depression among older adults. The diverse findings on intergenerational instrumental support and depression in older adults suggest the need for further research to clarify this relationship and its nuances. This research may have practical implications for policies and interventions aimed at improving the mental well-being of older adults in Eastern Asian countries.
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Affiliation(s)
- Sina Sharifi
- Department of geriatric and psychiatric nursing, School of nursing and midwifery, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran.
| | - Kimia Babaei Khorzoughi
- Faculty of education and psychology, Islamic Azad University Isfahan (khorasgan) branch, Isfahan, Iran
| | - Mahmoud Rahmati
- Department of geriatric and psychiatric nursing, School of nursing and midwifery, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
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Zhao IY, Leung AYM, Deng SY, Ho MH, Saravanakumar P, Montayre J, Molassiotis A. Intergenerational reciprocity and WHO function ability domains predict loneliness in older Chinese adults. Australas J Ageing 2024; 43:112-122. [PMID: 37845812 DOI: 10.1111/ajag.13250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 09/07/2023] [Accepted: 09/15/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES To examine loneliness in old age and whether intergenerational reciprocity and WHO functional ability predicted loneliness. METHODS Using the China Health and Retirement Longitudinal Study Wave 4 (2018) database (CHARLS), logistic regression models were adopted to investigate the relationships. RESULTS The prevalence of loneliness was 28% in older people in China. Corresponding to the five domains of functional abilities, providing financial support to adult children (adj. OR 0.83, 95% CI 0.70-0.99), self-perceived health (adj. OR 1.30, 95% CI 1.19-1.41), having a retirement pension (adj. OR 0.73, 95% CI 0.57-0.93), the ability to decide on taking medications (adj. OR 1.32, 95% CI 1.10-1.58), as well as being able to get up from a chair (adj. OR 1.15, 95% CI 1.02-1.3), and having paid work (adj. OR 0.72, 95% CI 0.54-0.95) were associated with less loneliness. On the contrary, infrequent contact (once a month) with adult children (adj. OR 1.18, 95% CI 1.01-1.38), troubling body pain (adj. OR 1.16, 95% CI 1.10-1.23) and falling since the last interview (adj. OR .23, 95% CI 1.04-1.45) were positively associated with loneliness. CONCLUSIONS In this study, functional abilities of meeting basic needs, making decisions, being mobile and contributing to the support of adult children and society were protective factors for experiencing loneliness in late life. We need to rethink interventions for addressing loneliness in the context of healthy ageing and specific cultural values, taking into account not only providing services to older adults but also supporting them to gain values by contributing to society.
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Affiliation(s)
- Ivy Yan Zhao
- World Health Organization Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Angela Y M Leung
- World Health Organization Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Sasha Yuanjie Deng
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Mu-Hsing Ho
- LKS Faculty of Medicine, School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Priya Saravanakumar
- School of Nursing and Midwifery, University of Technology Sydney, Broadway, New South Wales, Australia
| | - Jed Montayre
- World Health Organization Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Alex Molassiotis
- College of Arts, Humanities and Education, University of Derby, Derby, UK
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Deng R, Yan S, Zhang L, Hou Y, Wang H, Zhang W, Yao J. How is intergenerational emotional cohesion linked to depression among older internal migrants in China: the mediating roles of loneliness and perceived stress. BMC Psychol 2024; 12:92. [PMID: 38395928 PMCID: PMC10893609 DOI: 10.1186/s40359-024-01579-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Late-life internal migration is frequently associated with a higher risk of depression in older parents. This research delves into the impact of intergenerational emotional cohesion (IEC) on depression in older internal migrants and the underlying mechanisms within the contemporary Chinese context. METHODS Obtained from a cross-sectional survey in Nanjing, China, the research involved 654 older internal migrants (66.97% female; mean age = 66.05 years; SD = 4.67). Variables were assessed using the Intergenerational Solidarity Inventory, 3-item R-UCLA Loneliness Scale, Perceived Stress Scale, and 9-item Patient Health Questionnaire (PHQ-9). For mediation exploration, a serial mediation model was utilized, and the Bootstrap method was employed to test the signifcance of these mediation effects. RESULTS IEC demonstrates a negative correlation with depression. Through IEC, three significant mediation pathways were identified that directly affect depression: (1) loneliness (β=-0.06; Ratio=17.14%), (2) perceived stress (β=-0.09; Ratio=25.71%), and (3) loneliness and perceived stress (β=-0.03; Ratio=8.57%). CONCLUSIONS IEC can impact the depression of older internal migrants by mitigating negative psychological emotions during the migration process. This finding provides valuable theoretical insights for the prevention of mental health problems among this demographic.
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Affiliation(s)
- Ruyue Deng
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Shiyuan Yan
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Lin Zhang
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Yanjie Hou
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Hao Wang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Wenjing Zhang
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Jun Yao
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China.
- School of Nursing, Nanjing Medical University, Nanjing, China.
- Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China.
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Wang H, Huang J. Impacts of grandparenting on older Chinese adults' mental health: a cross-sectional study. BMC Geriatr 2023; 23:660. [PMID: 37833646 PMCID: PMC10571259 DOI: 10.1186/s12877-023-04396-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 10/09/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The practice of grandparenting has been growing in popularity worldwide, particularly in Asian societies. Nevertheless, there is a lack of thorough studies investigating the mental health effects of grandchild care on grandparents, particularly within the family context. The present study aimed to explore the impact of grandparenting on depressive symptoms in older Chinese adults, taking into account the functional role of intergenerational support. METHODS Using the China Longitudinal Aging Social Survey (CLASS, 2014 and 2018, N = 9,486), we employed the Pooled Ordinary Least Square method (POLS) to explore the association between depressive symptoms and grandparenting intensity as well as include the interaction terms to investigate the role of intergenerational support among grandparents aged from 60 to 80. RESULTS After adjusting for control variables, both non-intensive (-0.17; 95% CI: -0.30, -0.03) and intensive (-0.69; 95% CI: -0.95, -0.43) childcare, as well as giving financial support to adult children (-0.06; 95% CI: -0.08, -0.04) and emotional closeness with them (-0.94; 95% CI: -1.15, -0.72), were found to have a positive impact on the mental health of grandparents. Giving financial support (non-intensive: -0.04, 95% CI: -0.07, -0.01; intensive: -0.06, 95% CI: -0.13, -0.01) and providing instrumental support to adult children (non-intensive: -0.12, 95% CI: -0.24, -0.01; intensive: -0.19, 95% CI: -0.37, -0.02) moderated the association between grandparenting and the mental health of older adults, regardless of care intensity. However, the moderating role of receiving financial support (-0.07; 95% CI: -0.12, -0.02) only existed when non-intensive childcare was provided. CONCLUSION Grandchild care predicted better mental health in grandparents, mainly when they engaged in intensive grandparenting. Emotional closeness and providing financial support to adult children brought mental health benefits to grandparents involved in childcare. Giving financial support and providing instrumental support to adult children moderated the association between grandparenting and the mental health of older adults. However, the moderating role of receiving financial support from adult children only existed when non-intensive childcare was provided.
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Affiliation(s)
- Huan Wang
- Institute of Population Research, Hohai University, No.8 Focheng Road, Nanjing, Jiangsu Province, China.
| | - Jianyuan Huang
- Institute of Population Research, Hohai University, No.8 Focheng Road, Nanjing, Jiangsu Province, China
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Han T, Han M, Moreira P, Song H, Li P, Zhang Z. Association between specific social activities and depressive symptoms among older adults: A study of urban-rural differences in China. Front Public Health 2023; 11:1099260. [PMID: 37064675 PMCID: PMC10102908 DOI: 10.3389/fpubh.2023.1099260] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/03/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundEngaging in social activities can help older persons with their depressed symptoms. Few studies, however, have looked into the connection between social interactions and depressed symptoms in Chinese older persons. The aim of this study was to investigate differences in older Chinese individuals' social activity involvement and depressive symptoms across urban and rural settings.MethodsA cross-sectional investigation using information from the 2018 China Health and Retirement Longitudinal Study (CHARLS), which was limited to older individuals aged 60 and over. Generalized linear models were constructed to assess the effects of participants' characteristics and specific social activities on CES-D scores. The association between specific social activities and depressed symptoms was investigated using multivariate logistic regression analysis.ResultsIn this study, it was discovered that older individuals had a prevalence of depressed symptoms of 36.2%, with rural older adults having a greater prevalence of depressive symptoms (39.7%) than urban older adults (30.9%). Our results showed that for urban respondents, providing help to others (not regularly. OR = 0.753, 95% CI: 0.579–0.980, P = 0.035), going to a sport (not regularly. OR = 0.685, 95% CI: 0.508–0.924, P = 0.013), and using the Internet (not regular. OR = 0.613, 95% CI: 0.477–0.789, P < 0.001; almost weekly. OR = 0.196, 95% CI: 0.060–0.645, P = 0.007) were all significantly and negatively associated with depressive symptoms, while for rural respondents, interacting with friends (not regularly. OR = 1.205, 95% CI: 1.028–01.412, P = 0.021) and using the Internet (not regularly. OR = 0.441, 95% CI: 0.278–0.698, P < 0.001) were significantly and negatively associated with depressive symptoms.ConclusionsAccording to our research, there is a cross-sectional relationship between participating in a specific social activity and depressed symptoms in Chinese older adults, and this relationship varies across urban and rural older adults. This suggests that taking part in specific social activities may be crucial for reducing depression symptoms in older persons, developing more focused interventions that might support healthy aging, and offering a guide for policymakers and activists working to improve the mental health of seniors.
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Affiliation(s)
- Tanqian Han
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Mei Han
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
- *Correspondence: Mei Han
| | - Paulo Moreira
- International Healthcare Management Research and Development Centre, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
- Atlantica Instituto Universitario, Gestao em Saude, Oeiras, Portugal
| | - Hongxia Song
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Ping Li
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Zhenlong Zhang
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
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Gallardo-Peralta LP, Sánchez-Moreno E, Rodríguez Rodríguez V, García Martín M. [Studying loneliness and social support networks among older people: a systematic review in Europe.]. Rev Esp Salud Publica 2023; 97:e202301006. [PMID: 36700292 PMCID: PMC10540907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE During the ageing process the loss of family and social relationships is frequent which conditions loneliness, similarly the current COVID-19 pandemic has generated more social limitations in this age group and has increased the risk factors to trigger feelings of loneliness. This paper aimed to examine how loneliness among older people had been studied in Europe over the last ten years. Specific objectives were: i) to describe the methodological aspects; ii) to identify the scales or questions for the assessment of loneliness; iii) what were the main variables or dimensions that were related to loneliness in old age. METHODS A total of 1,591 articles were found in WoS and Scopus digital platforms. After initial assessment of titles and abstracts, full text reading and review of the established criteria, 42 scientific articles were finally included in the systematic review. RESULTS The countries that had carried out the most studies were the Netherlands and Spain. Most of the research was quantitative and uses the De Jong Gierveld Loneliness Scale (DJGLS) and the University of California at Los Angeles (UCLA) Loneliness Scale. The most analysed variables were: marital status, household structure, social support networks, social participation, depression, health problems, co-morbidity and physical functioning. CONCLUSIONS The scientific interest in studying loneliness, with a focus on social support networks, in older people in Europe and strategically addressing loneliness as a public health problem is confirmed.
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Affiliation(s)
- Lorena P. Gallardo-Peralta
- Facultad de Trabajo Social, Universidad Complutense de MadridUniversidad Complutense de MadridMadridSpain
| | - Esteban Sánchez-Moreno
- Instituto Universitario de Desarrollo y Cooperación (IUDC-UCM), Universidad Complutense de MadridUniversidad Complutense de MadridMadridSpain
| | - Vicente Rodríguez Rodríguez
- Instituto de Economía, Geografía y Demografía, Consejo Superior de Investigaciones CientíficasConsejo Superior de Investigaciones CientíficasMadridSpain
| | - María García Martín
- Instituto Universitario de Desarrollo y Cooperación (IUDC-UCM), Universidad Complutense de MadridUniversidad Complutense de MadridMadridSpain
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Yang M, Wang H, Yao J. Relationship between Intergenerational Emotional Support and Subjective Well-Being among Elderly Migrants in China: The Mediating Role of Loneliness and Self-Esteem. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14567. [PMID: 36361447 PMCID: PMC9656508 DOI: 10.3390/ijerph192114567] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 10/29/2022] [Accepted: 10/30/2022] [Indexed: 06/16/2023]
Abstract
With the augmentation of family migration, the number and proportion of elderly migrants have increased dramatically in China. The well-being of this group has a profound impact on the whole society. Subjective well-being is a comprehensive reflection of whether a person's needs are met. In this cross-sectional study, we established a multiple mediation model to evaluate the mediating effects of loneliness and self-esteem on intergenerational emotional support and, consequently, on subjective well-being in elderly migrants. The study population consisted of 728 elderly migrants living in Nanjing (Jiangsu, China), including 219 men (30.1%) and 509 women (69.9%). The participants' loneliness and self-esteem were measured using the R-UCLA Loneliness Scale, the Rosenberg Self-Esteem Scale, and the Philadelphia Senior Center Confidence Scale. Multiple regression analyses revealed a significant correlation between intergenerational emotional support and subjective well-being, and mediation analysis revealed that intergenerational emotional support indirectly influenced subjective well-being through three mediators: loneliness (mediating effect, 0.149), self-esteem (mediating effect, 0.136), and loneliness and self-esteem (mediating effect, 0.041). We conclude that loneliness and self-esteem mediate the relationship between intergenerational emotional support and subjective well-being in elderly migrants and can be regulated to improve elderly migrants' subjective well-being. Great attention should be paid to the emotional needs of elderly migrants, and communication and exchange with elderly migrants should be emphasized to enhance their subjective sense of well-being.
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Affiliation(s)
- Man Yang
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Hao Wang
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Jun Yao
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
- School of Health Policy and Management, Nanjing Medical University, Nanjing 211166, China
- Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing 211166, China
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13
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Fu Y, Chen M. Intergenerational relationship quality and activity profiles among older adults in China. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1885-e1897. [PMID: 34708475 DOI: 10.1111/hsc.13619] [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: 04/01/2021] [Revised: 08/28/2021] [Accepted: 10/09/2021] [Indexed: 06/13/2023]
Abstract
Currently, very few studies have comprehensively investigated how intergenerational relationship quality (IRQ) between older parents and adult children is related to older adults' activity engagement. To fill this gap, this study endeavoured to examine the associations between IRQ and older adults' activity profiles, not only considering the overall IRQ but also different dimensions of IRQ. We also aimed to reveal the different roles of IRQ with son(s) and with daughter(s). This study made use of survey data collected in Yibin City, Sichuan Province of China in 2018 (N = 4,211). We adopted hierarchical cluster analysis to identify activity profiles, and performed multinomial logistic regressions to assess the association between IRQ and the profiles. We identified five activity profiles among older adults: "caregiving-oriented", "employment-oriented", "social withdrawal", "diverse engagement" and "physically active". Those with greater IRQ were more likely to be "caregiving-oriented" and have "diverse engagement" relative to "social withdrawal". It also showed that structural-associational solidarity and affectual closeness were more predictive of the activity profiles, compared to consensual-normative solidarity and intergenerational conflict. Children's gender plays an important role in the relationship between IRQ and activity engagement profiles. Good intergenerational relationships might not narrow down older adults' activity domains, and instead might actually promote their participation in diverse domains. Promoting structural-associational solidarity and affectual closeness was likely to reduce social withdrawal among older adults in China.
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Affiliation(s)
- Yuanyuan Fu
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Mengni Chen
- Department of Sociology, University of Copenhagen, København, Denmark
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14
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Zhou JJ, Bai X. Influence of intergenerational relationships on depressive symptoms in ageing Chinese adults in Hong Kong: Mediating effects of sense of loneliness. BMC Geriatr 2022; 22:587. [PMID: 35840878 PMCID: PMC9287879 DOI: 10.1186/s12877-022-03269-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background Mental health of older adults could be positively predicted by harmonious parent–adult children relationships, although the mechanism has not been sufficiently demonstrated. This study employed sense of loneliness as mediator to examine the influence of multiple domains of intergenerational relationships on depressive symptoms in ageing Chinese adults. Methods Data was extracted from a representative survey in Hong Kong among Chinese adults aged over 50 with at least one adult child (n = 801). Four key domains (structural–associational, consensual–normative, affectual closeness, and intergenerational conflict) were adopted to measure the intergenerational relationship quality. Depressive symptoms were assessed using the five-item Geriatric Depression Scale. The mediating role of sense of loneliness in the association between intergenerational relationships and depressive symptoms were tested by the PROCESS macro in SPSS. Results The influence of overall intergenerational relationship quality and its four subdomains on depressive symptoms were significantly mediated by sense of loneliness. Among the four domains, affectual closeness presented the strongest association with older people’s depressive symptoms. The effect of intergenerational conflict on depressive symptoms was completely mediated by sense of loneliness, and the effects of remaining three domains were partially mediated. The domain of consensual–normative solidarity received the lowest rating by Chinese older adults. Conclusion The psychological pathway that loneliness links intergenerational relationships and depressive symptoms was supported in this study. With respect to improving intergenerational relationships, enhancing affectual connection between older parents and adult children was essential to prevent mental problems. This study calls for more attention to the protective role of diverse social relationships in improving mental health through multiple pathways.
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Affiliation(s)
- Jia-Jia Zhou
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xue Bai
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China. .,Institute of Active Ageing, The Hong Kong Polytechnic University, Hong Kong, China.
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15
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Fu Y, Ji X. Productive engagement, sleep-wake disturbances, and loneliness: SEM analysis of depressive symptoms of community-dwelling Chinese elders. Aging Ment Health 2022; 26:345-354. [PMID: 33410331 DOI: 10.1080/13607863.2020.1867824] [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] [Indexed: 01/20/2023]
Abstract
OBJECTIVES This study set out to examine the bidirectional relationship between loneliness and productive engagement, delineate the association between different dimensions of productive engagement and depression, and explore the potential mediating effect of sleep-wake disturbances in the relationship between loneliness and/or productive engagement and depression. METHOD Data from a total of 4427 older adults in China were included in the analysis. Factor analysis was conducted to explore a set of discrete dimensions of productive engagement (recreational activities, group artistic and learning activities, sportive activities, paid work, volunteering, and family caregiving). Structural equation modeling was used to assess the potential relationships between loneliness, multidimensional productive engagement, sleep-wake disturbances, and depression. RESULTS All dimensions of productive engagement were found to be negatively associated with loneliness, except for paid work which was associated with elevated level of self-reported loneliness. Sleep-wake disturbances mediated the relationship between leisure activities and depression but this was not significantly related to other forms of productive engagement. The direct effect of productive engagement on depression varied, in that leisure activities and family caregiving were negatively associated with depressive symptoms, while doing paid work was positively associated with depressive symptoms. Volunteering was not significantly related to depressive symptoms. DISCUSSION This study makes an important contribution to the research on the relationship between loneliness, productive engagement, sleep-wake disturbances, and depression, by distinguishing the different effects of different dimensions of productive engagement. The findings provide a robust stimulus for intervention programs and other forms of social work practice seeking to mitigate depressive symptoms in older adults.
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Affiliation(s)
- Yuanyuan Fu
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Xiaowen Ji
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
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16
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Liu Y, Li L, Miao G, Yang X, Wu Y, Xu Y, Gao Y, Zhan Y, Zhong Y, Yang S. Relationship between Children's Intergenerational Emotional Support and Subjective Well-Being among Middle-Aged and Elderly People in China: The Mediation Role of the Sense of Social Fairness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:389. [PMID: 35010647 PMCID: PMC8751110 DOI: 10.3390/ijerph19010389] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/25/2021] [Accepted: 12/26/2021] [Indexed: 11/16/2022]
Abstract
This study explored the relations between children's intergenerational emotional support and subjective well-being (SWB) among Chinese middle-aged (45-60 years old) and elderly people (over 60 years old) and the mediation effect of the sense of social fairness between such associations. Using the 2017 Chinese General Social Survey dataset, a nationally representative survey, we selected 2413 middle-aged and elderly people who are 45 years and older, who suited the study requirements with 1097 males and 1316 females, which accounts for 45.5% and 54.5%, respectively. The average of age was 61.62 years old (SD = 10.45). The mediation analyses were conducted by multivariate regression and the SPSS macro PROCESS program. The results indicated that there was a significant association between children's intergenerational emotional support and subjective well-being of middle-aged and elderly people (β = 0.0819, p < 0.001). Children's intergenerational emotional support also had an indirect impact on subjective well-being through one path: the mediating role of the sense of social fairness (0.012). Direct effect (0.0699) and mediation effect (0.012) accounting for the total effect proportion was 85.35% and 14.65%, respectively. The findings may offer some meaningful implications for improving subjective well-being of middle-aged and elderly people. Future research should pay attention to the aforementioned factors with more detailed and comprehensive studies.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Shujuan Yang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130021, China; (Y.L.); (L.L.); (G.M.); (X.Y.); (Y.W.); (Y.X.); (Y.G.); (Y.Z.); (Y.Z.)
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17
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Simonelli G, Petit D, Delage JP, Michaud X, Lavoie MD, Morin CM, Godbout R, Robillard R, Vallières A, Carrier J, Bastien C. Sleep in times of crises: A scoping review in the early days of the COVID-19 crisis. Sleep Med Rev 2021; 60:101545. [PMID: 34571477 PMCID: PMC8461524 DOI: 10.1016/j.smrv.2021.101545] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/09/2021] [Accepted: 08/30/2021] [Indexed: 01/14/2023]
Abstract
During the early days of the pandemic and in the context of a seemingly unknown global threat, several potential major sleep disruptors were identified by sleep researchers and practitioners across the globe. The COVID-19 pandemic combined several features that, individually, had been shown to negatively affect sleep health in the general population. Those features included state of crisis, restrictions on in-person social interactions, as well as financial adversity. To address the lack of a comprehensive summary of sleep research across these three distinctive domains, we undertook three parallel systematic reviews based on the following themes: 1) Sleep in times of crises; 2) Sleep and social isolation; and 3) Sleep and economic uncertainty. Using a scoping review framework, we systematically identified and summarized findings from these three separated bodies of works. Potential moderating factors such as age, sex, ethnicity, socioeconomic status, psychological predisposition, occupation and other personal circumstances are also discussed. To conclude, we propose novel lines of research necessary to alleviate the short- and long-term impacts of the COVID-19 crises and highlight the need to prepare the deployment of sleep solutions in future crises.
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Affiliation(s)
- Guido Simonelli
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux Du Nord-de-l'île-de-Montréal, Montreal (Quebec) Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal (Quebec), Canada; Department of Psychology, Université de Montréal, Montreal (Quebec), Canada
| | - Dominique Petit
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux Du Nord-de-l'île-de-Montréal, Montreal (Quebec) Canada; Department of Psychiatry and Addictology, Université de Montréal, Montreal (Quebec), Canada
| | | | - Xavier Michaud
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux Du Nord-de-l'île-de-Montréal, Montreal (Quebec) Canada; Department of Psychology, Université de Montréal, Montreal (Quebec), Canada
| | | | - Charles M Morin
- École de Psychologie, Université Laval, Québec (Québec), Canada; CERVO Brain Research Center, Université Laval, Canada
| | - Roger Godbout
- Department of Psychiatry and Addictology, Université de Montréal, Montreal (Quebec), Canada; Sleep Laboratory & Clinic, Hôpital en Santé Mentale Rivière-des-Prairies, Montreal (Quebec), Canada
| | - Rebecca Robillard
- Sleep Research Unit, Royal Ottawa Institute of Mental Health Research, Ottawa (Ontario), Canada
| | - Annie Vallières
- École de Psychologie, Université Laval, Québec (Québec), Canada; CERVO Brain Research Center, Université Laval, Canada
| | - Julie Carrier
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux Du Nord-de-l'île-de-Montréal, Montreal (Quebec) Canada; Department of Psychology, Université de Montréal, Montreal (Quebec), Canada
| | - Célyne Bastien
- École de Psychologie, Université Laval, Québec (Québec), Canada; CERVO Brain Research Center, Université Laval, Canada.
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18
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Jiang C, Jiang S. Elder mistreatment and life satisfaction of older adults: mediating roles of emotional closeness with children and loneliness. J Elder Abuse Negl 2021; 33:351-367. [PMID: 34530689 DOI: 10.1080/08946566.2021.1980171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Elder mistreatment is a risk factor in the life satisfaction of older adults, yet understanding of its underlying mechanisms remains limited. This study investigates the mediating role of emotional closeness and loneliness in the association between elder mistreatment and life satisfaction. A sample of 8,717 Chinese older adults is obtained from the 2018 China Longitudinal Aging Social Survey. Results reveal that emotional mistreatment has a negative effect on the life satisfaction of older adults. Moreover, emotional mistreatment is associated with a low level of emotional closeness and a high degree of loneliness, which further decreases life satisfaction. However, emotional closeness with children did not significantly mediate the association between physical mistreatment and life satisfaction. This study advances the comprehension of the influencing path on how elder mistreatment affects the life satisfaction of older adults. Implications for policy and intervention programs are discussed.
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Affiliation(s)
- Chaoxin Jiang
- Department of Social Welfare and Risk Management, School of Public Affairs, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shan Jiang
- Department of Sociology, Zhejiang University, Hangzhou, Zhejiang, China
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19
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Zhang X, Silverstein M. Intergenerational Emotional Cohesion and Psychological Well-being of Older Adults in Rural China: A Moderated Mediation Model of Loneliness and Friendship Ties. J Gerontol B Psychol Sci Soc Sci 2021; 77:525-535. [PMID: 34214164 DOI: 10.1093/geronb/gbab122] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Although researchers have linked intergenerational emotional cohesion (IEC) to psychological well-being (PWB) among older adults, the mechanisms and conditions under which IEC is related to PWB-particularly in rural areas-are less well understood. This study analyzed data from rural China to examine whether loneliness mediated the relation between IEC and PWB, and whether friendship ties moderated the strength of the direct and indirect relationships between IEC and PWB. METHODS Mediation and moderated mediation models were tested using a sample of rural adults age 60 and older (N = 958) from the Longitudinal Study of Older Adults in Anhui Province, China. Measures included IEC, friendship ties, loneliness, and two PWB indicators-depressive symptoms and life satisfaction. RESULTS The results revealed that IEC was negatively related to loneliness, which in turn was associated with depressive symptoms and life satisfaction. Further, this indirect pathway linking IEC and depressive symptoms (but not life satisfaction) was positively conditioned on the size of friendship ties. DISCUSSION This study advances our understanding of the mechanism through which IEC influences PWB in older adults. Alleviating loneliness could help boost PWB. Other implications for practice and future research are discussed.
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20
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Yang JJ, Cai H, Xia L, Nie W, Zhang Y, Wang S, Shi Y, Ng CH, Liu H, Xiang YT. The Prevalence of Depressive and Insomnia Symptoms, and Their Association With Quality of Life Among Older Adults in Rural Areas in China. Front Psychiatry 2021; 12:727939. [PMID: 34658962 PMCID: PMC8515482 DOI: 10.3389/fpsyt.2021.727939] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/24/2021] [Indexed: 01/13/2023] Open
Abstract
Background: There are few studies on the epidemiology of depression, insomnia, and their association with quality of life (QOL) in older adults living in rural China. This study examined the prevalence of depressive and insomnia symptoms, and their association with QOL in community-dwelling older adults in a rural area in Anhui province, China. Methods: This was a cross-sectional study conducted in the rural areas of four cities (Hefei, Huaibei, Anqing, and Xuancheng) in Anhui province between July and October, 2019 using random sampling method. All community-dwelling residents from the selected villages who met the study entry criteria were invited to participate in this study. Depressive and insomnia symptoms and QOL were assessed with the Chinese version of self-reported Center for Epidemiological Survey Depression Scale (CES-D), the Insomnia Severity Index (ISI) and the 26-item World Health Organization Quality of Life Brief version (WHOQOL-BREF), respectively. Results: A total of 871 older adults were included. The prevalence of overall depressive symptoms, insomnia symptoms, and comorbid depressive and insomnia symptoms were 34.0% [95% confidence intervals (95% CI): 30.8-37.1%], 45.7% (95% CI: 42.4-49.0%) and 20.3% (95% CI: 17.6-23.0%), respectively. Older adults with depressive symptoms, insomnia symptoms, and comorbid depressive and insomnia symptoms had lower scores in QOL compared to those without. Depressive symptoms were positively associated with living with families [Odd Ratio (OR) = 1.82, 95% CI: 1.31-2.54] and negatively associated with current drinking (OR = 0.49, 95% CI: 0.33-0.72). Insomnia symptoms were negatively associated with fair and good financial status (fair: OR = 0.53, 95% CI = 0.38-0.75; good: OR = 0.30, 95% CI = 0.14-0.64) and current drinking (OR = 0.64, 95% CI = 0.45-0.93), and positively associated with more frequent major medical conditions (OR = 1.32, 95% CI = 1.16-1.51). Comorbid depressive and insomnia symptoms were positively associated with living with families (OR = 2.02, 95% CI = 1.36-3.00), and negatively associated with fair and good financial status (fair: OR = 0.61, 95% CI = 0.41-0.89; good: OR = 0.34, 95% CI = 0.12-0.95) and current drinking (OR = 0.57, 95% CI = 0.35-0.92). Conclusion: Depressive and insomnia symptoms were common in older adults living in rural areas in China. Considering the negative health outcomes caused by depressive and insomnia symptoms, regular screening and effective treatments should be developed for this population.
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Affiliation(s)
- Juan-Juan Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Hong Cai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao, SAR China.,Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macao, SAR China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Taipa, Macao, SAR China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Weicheng Nie
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yulong Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Song Wang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yudong Shi
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VA, Australia
| | - Huanzhong Liu
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao, SAR China.,Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macao, SAR China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Taipa, Macao, SAR China
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