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Kwok MK, Lee SY, Schooling CM. Identifying potentially depressed older Chinese adults in the community: Hong Kong's Elderly Health Service cohort. J Affect Disord 2024; 360:169-175. [PMID: 38797391 DOI: 10.1016/j.jad.2024.05.120] [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: 02/29/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Depression is common at older ages, but is under-recognized due to stigma, misperception, and under-diagnosis; its manifestations may vary by setting. Identifying older adults at risk of depression in the community is urgently needed for timely support and early interventions. We assessed the performance of an existing risk prediction model developed in a European setting (i.e., Depression Risk Assessment Tool (DRAT-up)), and developed a new model (i.e., EHS-Depress model) to predict 2-year risk of the onset of later life depressive symptoms in older Chinese adults. METHODS Among 185,538 participants aged ≥65 years from Hong Kong's Elderly Health Service (EHS) cohort, 174,806 without depressive symptoms at baseline were included. Two-thirds were randomly sampled for recalibration and new model development using Cox proportional-hazards models with backward elimination. Overall predictive performance, discrimination, and calibration were assessed using the remaining. RESULTS The original DRAT-up model underestimated the risk of developing depressive symptoms in older Chinese adults; recalibrating it improved calibration. The new EHS-Depress model had better discrimination (Harrell's C statistic 0.68 and D statistic 2.74) and similarly good calibration (calibration slope 1.18 and intercept -0.002) probably due to the inclusion of more specific health measures, socio-demographics, lifestyle factors, and regular social contact as predictors. LIMITATIONS Predictors of depressive symptoms included in our models depend on the data availability. CONCLUSIONS The EHS-Depress model predicted 2-year risk of developing depressive symptoms better than the original and recalibrated DRAT-up models. The setting-specific risk prediction model is more applicable to older Chinese adults in primary care settings.
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Affiliation(s)
- Man Ki Kwok
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Siu Yin Lee
- Department of Health, Hong Kong Government, Hong Kong, China
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; City University of New York Graduate School of Public Health and Health Policy, New York, United States
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2
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Fu C, Cao L, Yang F. Prevalence and determinants of depressive symptoms among community-dwelling older adults in China based on differences in living arrangements: a cross-sectional study. BMC Geriatr 2023; 23:640. [PMID: 37817063 PMCID: PMC10563220 DOI: 10.1186/s12877-023-04339-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 09/21/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Older adults with different living arrangements may have different mental health statuses and different factors that influence their mental health. The aim of the present study is to investigate the prevalence and determinants of depressive symptoms among community-dwelling older adults in China based on differences in their living arrangements. METHODS Participants were 6,055 older adults from the 2015 China Health and Retirement Longitudinal Study. Depressive symptoms and their determinants were evaluated using the 10-item Center for Epidemiologic Studies Depression Scale and multivariate logistic regression analysis, respectively. RESULTS The prevalence of depressive symptoms among older adults living alone, as a couple, and with children was 47.8%, 33.2%, and 39.5%, respectively. The common risk factors for depressive symptoms were shorter sleep duration, poorer activities of daily living, and poorer self-rated health. Women, those with lower educational levels, and those suffering from chronic diseases had a higher risk of depressive symptoms among older adults living as a couple and those living with children. Smoking and participation in economic activities were also risk factors of depressive symptoms among older adults living with children and those living alone, respectively. CONCLUSIONS The findings suggest that older adults living as couples had the lowest prevalence of depressive symptoms, while those living alone had the highest prevalence of depressive symptoms. The determinants of depressive symptoms differed by living arrangement; hence, they should be considered in future interventions.
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Affiliation(s)
- Chang Fu
- Department of Health Service and Management, School of Public Health and Management, Binzhou Medical University, No.346 Guanhai Road, Yantai, Shandong, 264003, China
| | - Lianmeng Cao
- Department of Gastrointestinal Surgery Bariatric and Metabolic Surgery, Binzhou Medical University Hospital, No.661 2nd Huanghe Road, Binzhou, Shandong, 256603, China
| | - Fan Yang
- Department of Information Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, 15th Jiefang Road, Xiangyang, Hubei, 441000, China.
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3
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Hashmi AN, Qamar R, Taj R, Zubair UB, Agha Z, Abbasi SA, Azam M. Contributing risk factors of common psychiatric disorders in the Pakistani population. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01545-y. [PMID: 36583741 DOI: 10.1007/s00406-022-01545-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
With an increasing incidence of psychiatric disorders worldwide, there is a need for a better understanding of the population-specific contributing risk factors that are associated with common psychiatric conditions. This study aimed to assess the correlation between socioeconomic, environmental and clinical features associated with major depression (MDD n = 479), bipolar disorder (BD n = 222) and schizophrenia (SHZ n = 146), in the Pakistani population. Multinomial logistic regression and Pearson's correlation were applied to assess the association and correlation between demographic, socioeconomic, environmental, and clinical features of MDD, BD and SHZ. In the present study, MDD was found to be more prevalent than BD and SHZ. The average age at onset (AAO), was observed to be earlier in females with BD and SHZ, in addition, females with a positive family history of MDD, BD and SHZ also had an earlier AAO. The fitted multinomial logistic regression model indicated a significant association of; aggression, tobacco use, drugs abuse, history of head injuries and family history with BD as compared to MDD, while insomnia and suicidality were significantly associated with MDD. Strong positive correlations were observed mainly between age/AAO, AAO/tobacco use and aggression/insomnia in all three cohorts. In conclusion, the present study identifies possible contributing socio-demographic, biological and environmental factors that are correlated and associated with the psychiatric conditions in the Pakistani population.
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Affiliation(s)
- Aisha Nasir Hashmi
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Tarlai Kalan, Park Road, Islamabad, 45600, Pakistan
| | - Raheel Qamar
- Science and Technology Sector, ICESCO, Rabat, Morocco.,Pakistan Academy of Sciences, Islamabad, Pakistan
| | - Rizwan Taj
- Department of Psychiatry, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Usama Bin Zubair
- Department of Psychiatry, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Zehra Agha
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Tarlai Kalan, Park Road, Islamabad, 45600, Pakistan
| | - Saddam Akber Abbasi
- Statistics Program, Department of Mathematics, Statistics & Physics, College of Arts and Science, Qatar University, Doha, Qatar. .,Statistical Consulting Unit, College of Arts and Science, Qatar University, 2713, Doha, Qatar.
| | - Maleeha Azam
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Tarlai Kalan, Park Road, Islamabad, 45600, Pakistan.
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Du X, Wu R, Kang L, Zhao L, Li C. Tobacco smoking and depressive symptoms in Chinese middle-aged and older adults: Handling missing values in panel data with multiple imputation. Front Public Health 2022; 10:913636. [PMID: 36091567 PMCID: PMC9458966 DOI: 10.3389/fpubh.2022.913636] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/09/2022] [Indexed: 01/22/2023] Open
Abstract
Introduction The high co-occurrence of tobacco smoking and depression is a major public health concern during the novel coronavirus disease-2019 pandemic. However, no studies have dealt with missing values when assessing depression. Therefore, the present study aimed to examine the effect of tobacco smoking on depressive symptoms using a multiple imputation technique. Methods This research was a longitudinal study using data from four waves of the China Health and Retirement Longitudinal Study conducted between 2011 and 2018, and the final sample consisted of 74,381 observations across all four waves of data collection. The present study employed a multiple imputation technique to deal with missing values, and a fixed effects logistic regression model was used for the analysis. Results The results of fixed effects logistic regression showed that heavy smokers had 20% higher odds of suffering from depressive symptoms than those who never smoked. Compared to those who never smoked, for short-term and moderate-term quitters, the odds of suffering from depressive symptoms increased by 30% and 22%, respectively. The magnitudes of the odds ratios for of the variables short-term quitters, moderate-term quitters, and long-term quitters decreased in absolute terms with increasing time-gaps since quitting. The sub-group analysis for men and women found that heavy male smokers, short-term and moderate-term male quitters had higher odds of suffering from depressive symptoms than those who never smoked. However, associations between smoking status and depressive symptoms were not significant for women. Conclusions The empirical findings suggested that among Chinese middle-aged and older adults, heavy smokers and short-term and moderate-term quitters have increased odds of suffering from depressive symptoms than those who never smoked. Moreover, former smokers reported that the probability of having depressive symptoms decreased with a longer duration since quitting. Nevertheless, the association between depressive symptoms and smoking among Chinese middle-aged and older adults is not straightforward and may vary according to gender. These results may have important implications that support the government in allocating more resources to smoking cessation programs to help middle-aged and older smokers, particularly in men.
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Affiliation(s)
- Xiahua Du
- College of Humanities Education, Inner Mongolia Medical University, Hohhot, China
| | - Rina Wu
- The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Lili Kang
- School of Health Management, Inner Mongolia Medical University, Hohhot, China
| | - Longlong Zhao
- School of Health Management, Inner Mongolia Medical University, Hohhot, China
| | - Changle Li
- School of Health Management, Inner Mongolia Medical University, Hohhot, China,*Correspondence: Changle Li
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Lai FTT, Mercer SW, Guthrie B, Yip BHK, Chung GKK, Zou D, Lee KP, Chau PYK, Chung RY, Wong ELY, Yeoh EK, Wong SYS. Sociodemographic moderation of the association between depression and stroke incidence in a retrospective cohort of 0.4 million primary care recipients with hypertension. Psychol Med 2022; 52:283-291. [PMID: 32524935 DOI: 10.1017/s0033291720001920] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Previous research has suggested an association between depression and subsequent acute stroke incidence, but few studies have examined any effect modification by sociodemographic factors. In addition, no studies have investigated this association among primary care recipients with hypertension. METHODS We examined the anonymized records of all public general outpatient visits by patients aged 45+ during January 2007-December 2010 in Hong Kong to extract primary care patients with hypertension for analysis. We took the last consultation date as the baseline and followed them up for 4 years (until 2011-2014) to observe any subsequent acute hospitalization due to stroke. Mixed-effects Cox models (random intercept across 74 included clinics) were implemented to examine the association between depression (ICPC diagnosis or anti-depressant prescription) at baseline and the hazard of acute stroke (ICD-9: 430-437.9). Effect modification by age, sex, and recipient status of social security assistance was examined in extended models with respective interaction terms specified. RESULTS In total, 396 858 eligible patients were included, with 9099 (2.3%) having depression, and 10 851 (2.7%) eventually hospitalized for stroke. From the adjusted analysis, baseline depression was associated with a 17% increased hazard of acute stroke hospitalization [95% confidence interval (CI) 1.03-1.32]. This association was suggested to be even stronger among men than among women (hazard ratio = 1.29, 95% CI 1.00-1.67). CONCLUSION Depression is more strongly associated with acute stroke incidence among male than female primary care patients with hypertension. More integrated services are warranted to address their needs.
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Affiliation(s)
- Francisco T T Lai
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, People's Republic of China
| | - Stewart W Mercer
- Usher Institute, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Bruce Guthrie
- Usher Institute, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Benjamin H K Yip
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, People's Republic of China
| | - Gary K K Chung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, People's Republic of China
| | - Dan Zou
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, People's Republic of China
| | - Kam-Pui Lee
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, People's Republic of China
| | - Patsy Y K Chau
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, People's Republic of China
| | - Roger Y Chung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, People's Republic of China
| | - Eliza L Y Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, People's Republic of China
| | - Eng-Kiong Yeoh
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, People's Republic of China
| | - Samuel Y S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, People's Republic of China
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6
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Monroe DC, McDowell CP, Kenny RA, Herring MP. Dynamic associations between anxiety, depression, and tobacco use in older adults: Results from The Irish Longitudinal Study on Ageing. J Psychiatr Res 2021; 139:99-105. [PMID: 34058656 PMCID: PMC8527842 DOI: 10.1016/j.jpsychires.2021.05.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/29/2021] [Accepted: 05/01/2021] [Indexed: 12/14/2022]
Abstract
Evidence supports moderate-to-large reductions in anxiety, depression, and perceived stress after smoking cessation; however, much of the available evidence has focused on young adults. Therefore, this study quantified associations between smoking and smoking cessation on prevalent and incident generalised anxiety disorder (GAD) and major depression (MDD) in a nationally representative sample of Irish older adults. Participants (n = 6201) were community dwelling adults aged ≥50 years resident in Ireland. Smoking status and self-reported doctor diagnosis of anxiety or depression prior to baseline were assessed at baseline (i.e., Wave 2). At baseline and 2-, 4-, and 6-year follow-up (i.e., Waves 3-5), GAD and MDD were assessed by the Composite International Diagnostic Interview Short-Form. Logistic regression quantified cross-sectional and prospective associations (odds ratios (ORs) and 95% confidence intervals (95%CIs)) between smoking status and mental health. Prevalence and incidence of GAD was 9.1% (n = 566) and 2.8% (n = 148), respectively. Prevalence and incidence of depression was 11.1% (n = 686) and 6.4% (n = 342), respectively. Following full adjustment, current smokers had higher odds of prevalent GAD (OR = 1.729, 1.332-2.449; p < 0.001) and MDD (OR = 1.967, 1.548-2.499; p < 0.001) than non-smokers. Former smokers had higher odds of prevalent GAD than non-smokers (OR = 1.276, 1.008-1.616; p < 0.001). Current smokers did not have higher odds of incident MDD (OR = 1.399, 0.984-1.990; p = 0.065) or GAD than non-smokers (1.039, 0.624-1.730; p = 0.881). Findings may have important implications for interventions designed to curb tobacco abuse, which tend to be less successful among those with anxiety and depression.
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Affiliation(s)
- Derek C. Monroe
- Department of Kinesiology, University of North Carolina at Greensboro, NC, USA,Department of Neurology, University of California-Irvine, Irvine, CA, USA
| | - Cillian P. McDowell
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland,School of Medicine, Trinity College Dublin, Ireland,Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland,School of Medicine, Trinity College Dublin, Ireland,Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
| | - Matthew P. Herring
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland,Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland,Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
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7
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Cui N, Cui J, Xu X, Aslam B, Bai L, Li D, Wu D, Ma Z, Sun J, Baloch Z. Health Conditions, Lifestyle Factors and Depression in Adults in Qingdao, China: A Cross-Sectional Study. Front Psychiatry 2021; 12:508810. [PMID: 34054589 PMCID: PMC8160228 DOI: 10.3389/fpsyt.2021.508810] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 04/07/2021] [Indexed: 01/19/2023] Open
Abstract
Background: Depression is a common mental illness. Previous studies suggested that health conditions and lifestyle factors were associated with depression. However, only few studies have explored the risk factors of depression in a large representative sample of the general population in the world. Methods: A population-based cross-sectional survey was conducted in the 2006 survey and 2009 survey in Qingdao, China. The participants with insufficient information were excluded: Zung score, body mass index (BMI), diabetes items, physical activity, smoking, or drinking. Finally, a total of 3,300 participants were included in this analysis. The category of depression was used in the Zung self-rating depression scale (ZSDS). The associations between different indicators of health conditions (diabetic status, BMI), lifestyle factors (physical activity, smoking, and alcohol consumption), and depression were assessed by the logistic regression model. Results: The mean Zung scores for all participants, male participants, and female participants were 29.73 ± 7.57, 28.89 ± 7.30, 30.30 ± 7.70, respectively. In all participants, those who were pre-diabetes status (OR: 1.53, 95% CI: 1.04-2.27), and irregular physical activity (OR: 0.39, 95% CI: 0.17-0.89) had an increased risk of depression. In man, the analysis showed an increased risk of depression those with pre-diabetes (OR: 2.49, 95% CI: 1.25-4.97), previously diagnosed diabetes (OR: 4.44, 95% CI: 1.58, 12.48), and in those irregular activities (OR: 0.07, 95% CI: 0.01-0.61). In women, those who were underweight (OR: 5.66, 95% CI: 1.04-30.71) had a greater risk of depression. Conclusions: These results suggested that health conditions and lifestyle factors were the potential risk factors for depression. Men with pre-diabetes, previously diagnosed diabetes, and irregular activity had an increased risk for depression; women with underweight status had a higher risk for depression.
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Affiliation(s)
- Nan Cui
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jing Cui
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Xinpeng Xu
- Research Center for Health Policy and Management, Nanjing University, Nanjing, China
| | - Bilal Aslam
- Biomedical Research Center, Northwest Minzu University, Lanzhou, China.,Department of Microbiology, Government College University, Faisalabad, Pakistan
| | - Lan Bai
- Research Center for Health Policy and Management, Nanjing University, Nanjing, China
| | - Decheng Li
- Research Center for Health Policy and Management, Nanjing University, Nanjing, China
| | - Di Wu
- Research Center for Health Policy and Management, Nanjing University, Nanjing, China
| | - Zhongren Ma
- Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Jianping Sun
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Zulqarnain Baloch
- Biomedical Research Center, Northwest Minzu University, Lanzhou, China
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8
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Nagasu M, Yamamoto I. Impact of socioeconomic- and lifestyle-related risk factors on poor mental health conditions: A nationwide longitudinal 5-wave panel study in Japan. PLoS One 2020; 15:e0240240. [PMID: 33035239 PMCID: PMC7546460 DOI: 10.1371/journal.pone.0240240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/22/2020] [Indexed: 11/23/2022] Open
Abstract
The association of socioeconomic status and lifestyle behaviours on mental health appears well-established in the literature, as several studies report that better socioeconomic status such as higher levels of disposable income and employment as well as practising healthy lifestyles can enhance mental well-being. However, the reliance on cross-sectional correlations and lack of adequate statistical controls are possible limitations. This study aims to add the evidence of longitudinal association to the literature by using Japanese representative longitudinal household panel data. We employed panel data analytical techniques such as the random-effects conditional logistic regression (RE-CLR) and the fixed-effects conditional logistic regression (FE-CLR) models with possible time variant confounders being controlled. Our sample was comprised of 14,717 observations of 3,501 individuals aged 22–59 years for five waves of the Japanese Household Panel Survey. We confirmed many of the factors associated with mental health reported in existing studies by analysing cross-sectional data. These significant associations are also longitudinal (within) associations estimated by the FE-CLR models. Such factors include unemployment, low household income, short nightly sleeping duration, and lack of exercise. However, we also found that several factors such as disposable income, living alone, and drinking habits are not significantly associated with mental health in the FE-CRL models. The results imply the reverse causality that poor mental health conditions cause lower disposal income, possibly due to the inability to exhibit higher productivity, but an increase in disposal income would not necessarily improve mental health conditions. In this case, aggressive policy interventions to increase the disposal income of people of lower socioeconomic backgrounds would not necessarily be effective to minimize health inequalities.
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Affiliation(s)
- Miwako Nagasu
- Faculty of Economics, Keio University, Tokyo, Japan
- * E-mail:
| | - Isamu Yamamoto
- Faculty of Business and Commerce, Keio University, Tokyo, Japan
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9
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Nagasu M, Kogi K, Yamamoto I. Association of socioeconomic and lifestyle-related risk factors with mental health conditions: a cross-sectional study. BMC Public Health 2019; 19:1759. [PMID: 31888559 PMCID: PMC6937976 DOI: 10.1186/s12889-019-8022-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 11/29/2019] [Indexed: 12/22/2022] Open
Abstract
Background There is rising public concern over the widening health inequalities in many countries. The aim of this study was to clarify the associations of socioeconomic status (SES)-related variables, such as levels of household disposable income and employment status, and lifestyle factors with mental health conditions among Japanese adults aged 40 to 69. Methods A cross-sectional study of 3085 participants (1527 males and 1558 females) was undertaken by using a self-administered questionnaire that included the Japanese version of the 12-item General Health Questionnaire (GHQ-12) and questions related to socioeconomic and lifestyle factors. Results The prevalence of poor mental health conditions, represented by a GHQ-12 score of 4 or more, was 33.4% among males and 40.4% among females. Males whose annual household disposable income was less than 2 million yen had significantly higher GHQ-12 scores than those with an annual household disposable income above 2 million yen. As per binary logistic regression analyses, short sleep duration and the absence of physical exercise were significantly related to poor mental health conditions among both males and females. Among females, a household disposable income of less than 2 million yen could be a risk factor for poor mental health conditions. Age and habitual drinking were inversely associated with poor mental health conditions. Conclusions Low levels of household disposable income and unhealthy lifestyle factors were significantly associated with mental health conditions. These results suggest the importance of improving unhealthy lifestyle behaviours and developing effective health promotion programmes. In addition, there is a need for social security systems for people from different socioeconomic backgrounds.
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Affiliation(s)
- Miwako Nagasu
- Faculty of Economics, Keio University, 〒108-8345 Tokyo-to, Minato-ku, Mita 2-15-45, Tokyo, Japan.
| | - Kazutaka Kogi
- The Ohara Memorial Institute for Science of Labour, Tokyo, Japan
| | - Isamu Yamamoto
- Faculty of Business and Commerce, Keio University, Tokyo, Japan
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10
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Feng Z, Cramm JM, Nieboer AP. A healthy diet and physical activity are important to promote healthy ageing among older Chinese people. J Int Med Res 2019; 47:6061-6081. [PMID: 31709866 PMCID: PMC7045665 DOI: 10.1177/0300060519882590] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 09/24/2019] [Indexed: 11/17/2022] Open
Abstract
Objective To examine the associations between multiple health behaviours and health outcomes among older Chinese adults. Methods Data from the World Health Organization’s Study on global AGEing and adult health Wave 1 (2007–2010), collected among the older Chinese population, were included in this study. Smoking, diet, and physical activity were analysed by linear regression for any associations with depressive symptoms, quality of life (QoL), cognitive function, and physical function. Results A total of 13 367 participants aged >49 years were included in the analyses. After controlling for key socioeconomic factors, healthy diet was significantly associated with higher QoL (β = 0.099) and better cognitive function (β = 0.023). Physical activity was significantly associated with fewer depressive symptoms (β = –0.020), higher QoL (β = 0.086), better cognitive function (β = 0.072), and better physical function (β = –0.155 [higher scores = poorer physical function]). No relationship was found between smoking and any health-related outcome included in this study. Conclusion This study demonstrates the importance of healthy diet and physical activity for health outcomes in the older Chinese population.
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Affiliation(s)
- Zeyun Feng
- Department of Socio-Medical Sciences, Erasmus School of Health
Policy & Management, Erasmus University Rotterdam, Rotterdam, The
Netherlands
- Department of Health Technology Assessment, Shanghai Health
Development Research Centre (Shanghai Medical Information Centre), Shanghai,
China
| | - Jane Murray Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health
Policy & Management, Erasmus University Rotterdam, Rotterdam, The
Netherlands
| | - Anna Petra Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health
Policy & Management, Erasmus University Rotterdam, Rotterdam, The
Netherlands
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11
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Helbich M, Yao Y, Liu Y, Zhang J, Liu P, Wang R. Using deep learning to examine street view green and blue spaces and their associations with geriatric depression in Beijing, China. ENVIRONMENT INTERNATIONAL 2019; 126:107-117. [PMID: 30797100 PMCID: PMC6437315 DOI: 10.1016/j.envint.2019.02.013] [Citation(s) in RCA: 139] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 01/31/2019] [Accepted: 02/03/2019] [Indexed: 04/14/2023]
Abstract
BACKGROUND Residential green and blue spaces may be therapeutic for the mental health. However, solid evidence on the linkage between exposure to green and blue spaces and mental health among the elderly in non-Western countries is scarce and limited to exposure metrics based on remote sensing images (i.e., land cover and vegetation indices). Such overhead-view measures may fail to capture how people perceive the environment on the site. OBJECTIVE This study aimed to compare streetscape metrics derived from street view images with satellite-derived ones for the assessment of green and blue space; and to examine associations between exposure to green and blue spaces as well as geriatric depression in Beijing, China. METHODS Questionnaire data on 1190 participants aged 60 or above were analyzed cross-sectionally. Depressive symptoms were assessed through the shortened Geriatric Depression Scale (GDS-15). Streetscape green and blue spaces were extracted from Tencent Street View data by a fully convolutional neural network. Indicators derived from street view images were compared with a satellite-based normalized difference vegetation index (NDVI), a normalized difference water index (NDWI), and those derived from GlobeLand30 land cover data on a neighborhood level. Multilevel regressions with neighborhood-level random effects were fitted to assess correlations between GDS-15 scores and these green and blue spaces exposure metrics. RESULTS The average cumulative GDS-15 score was 3.4 (i.e., no depressive symptoms). Metrics of green and blue space derived from street view images were not correlated with satellite-based ones. While NDVI was highly correlated with GlobeLand30 green space, NDWI was moderately correlated with GlobeLand30 blue space. Multilevel regressions showed that both street view green and blue spaces were inversely associated with GDS-15 scores and achieved the highest model goodness-of-fit. No significant associations were found with NDVI, NDWI, and GlobeLand30 green and blue space. Our results passed robustness tests. CONCLUSION Our findings provide support that street view green and blue spaces are protective against depression for the elderly in China, yet longitudinal confirmation to infer causality is necessary. Street view and satellite-derived green and blue space measures represent different aspects of natural environments. Both street view data and deep learning are valuable tools for automated environmental exposure assessments for health-related studies.
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Affiliation(s)
- Marco Helbich
- Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands.
| | - Yao Yao
- School of Information Engineering, China University of Geosciences, Wuhan, China.
| | - Ye Liu
- School of Geography and Planning, Sun Yat-Sen University, Guangzhou, China; Guangdong Key Laboratory for Urbanization and Geo-Simulation, Sun Yat-Sen University, Guangzhou, China
| | - Jinbao Zhang
- School of Geography and Planning, Sun Yat-Sen University, Guangzhou, China; Guangdong Key Laboratory for Urbanization and Geo-Simulation, Sun Yat-Sen University, Guangzhou, China
| | - Penghua Liu
- School of Geography and Planning, Sun Yat-Sen University, Guangzhou, China; Guangdong Key Laboratory for Urbanization and Geo-Simulation, Sun Yat-Sen University, Guangzhou, China
| | - Ruoyu Wang
- School of Information Engineering, China University of Geosciences, Wuhan, China; School of Geography and Planning, Sun Yat-Sen University, Guangzhou, China; Guangdong Key Laboratory for Urbanization and Geo-Simulation, Sun Yat-Sen University, Guangzhou, China.
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Zhang XC, Woud ML, Becker ES, Margraf J. Do health-related factors predict major depression? A longitudinal epidemiologic study. Clin Psychol Psychother 2018; 25:378-387. [PMID: 29315965 DOI: 10.1002/cpp.2171] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 12/02/2017] [Accepted: 12/03/2017] [Indexed: 01/25/2023]
Abstract
Major depressive disorder (MDD) is a leading cause of global disease burden. Hence, examining the role of risk and protective factors for MDD is an important target in psychological research. Various studies showed that obesity, smoking, and alcohol consumption are related to depressive symptoms. In contrast, physical activity has been found to be a protective factor. The present population-based study tested whether these health-related factors are prospectively associated with incidence of MDD. Data were taken from the Dresden Predictor Study, which was designed to investigate risk and protective factors of mental health in young women. It included two assessments approximately 17 months apart. Results of single logistic regression analyses showed that being overweight, being a smoker, and being in a high-risk drinking group at baseline were predictive of developing MDD at follow-up. Engaging in regular physical activity and having good physical health were found to be protective factors of MDD. However, being in a medium-risk drinking group was not predictive of incidence of MDD, and irregular physical activity was not a protective factor. This is the first prospective, longitudinal study to show that obesity, smoking, and high-risk drinking are predictive of new onsets of MDD and that physical health is a protective factor. These data provide promising avenues for future research.
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Affiliation(s)
- Xiao Chi Zhang
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Marcella L Woud
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Eni S Becker
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
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Moreira-Santos TM, Godoy I, de Godoy I. Psychological distress related to smoking cessation in patients with acute myocardial infarction. J Bras Pneumol 2016; 42:61-7. [PMID: 26982043 PMCID: PMC4805389 DOI: 10.1590/s1806-37562016000000101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 01/27/2016] [Indexed: 11/22/2022] Open
Abstract
Among all causes of preventable deaths, smoking is responsible for the greatest number of deaths worldwide and predisposes to fatal, noncommunicable diseases, especially cardiovascular diseases. Lifestyle changes are effective in the treatment of patients with smoking-related diseases and assist in the prevention of premature mortality. Our objective was to investigate the available scientific evidence regarding the psychological distress related to smoking cessation in patients who have had acute myocardial infarction. To that end, we conducted an integrative review of the literature in order to summarize relevant studies on this topic. The selected databases were Scopus, PubMed Central, Institute for Scientific Information Web of Science (Core Collection), ScienceDirect, EMBASE, SciELO, LILACS e PsycINFO. On the basis of the inclusion and exclusion criteria adopted for this study, 14 articles were selected for analysis. Those studies showed that the prevalence of psychological distress is higher among smokers than among nonsmokers, and distress-related symptoms are much more common in smokers with acute myocardial infarction than in those without. Smoking cessation depends on the active participation of the smoker, whose major motivation is the underlying disease. Most studies have shown that there is a need to create treatment subgroups as a means of improving the treatment provided. This review article expands the knowledge regarding smoking cessation and shows the need to invest in future research that investigates subgroups of smokers diagnosed with the major smoking-related comorbidities, such as acute myocardial infarction, in order to develop specific interventions and psychological support strategies.
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Affiliation(s)
| | - Irma Godoy
- Departamento de Clínica Médica, Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, SP, Brasil
| | - Ilda de Godoy
- Departamento de Enfermagem, Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, SP, Brasil
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Wong CM, Lai HK, Tsang H, Thach TQ, Thomas GN, Lam KBH, Chan KP, Yang L, Lau AKH, Ayres JG, Lee SY, Chan WM, Hedley AJ, Lam TH. Satellite-Based Estimates of Long-Term Exposure to Fine Particles and Association with Mortality in Elderly Hong Kong Residents. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:1167-72. [PMID: 25910279 PMCID: PMC4629733 DOI: 10.1289/ehp.1408264] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 04/22/2015] [Indexed: 05/02/2023]
Abstract
BACKGROUND A limited number of studies on long-term effects of particulate matter with aerodynamic diameter < 2.5 μm (PM2.5) on health suggest it can be an important cause of morbidity and mortality. In Asia where air quality is poor and deteriorating, local data on long-term effects of PM2.5 to support policy on air quality management are scarce. OBJECTIVES We assessed long-term effects of PM2.5 on the mortality in a single Asian city. METHODS For 10-13 years, we followed up a cohort of 66,820 participants ≥ 65 years of age who were enrolled and interviewed in all 18 Elderly Health Centres of the Department of Health, Hong Kong, in 1998-2001. Their residential addresses were geocoded into x- and y-coordinates, and their proxy exposures to PM2.5 at their addresses in 1 × 1 km grids were estimated from the U.S. National Aeronautics and Space Administration (NASA) satellite data. We used Cox regression models to calculate hazard ratios (HRs) of mortality associated with PM2.5. RESULTS Mortality HRs per 10-μg/m3 increase in PM2.5 were 1.14 (95% CI: 1.07, 1.22) for all natural causes, 1.22 (95% CI: 1.08, 1.39) for cardiovascular causes, 1.42 (95% CI: 1.16, 1.73) for ischemic heart disease, 1.24 (95% CI: 1.00, 1.53) for cerebrovascular disease, and 1.05 (95% CI: 0.90, 1.22) for respiratory causes. CONCLUSIONS Our methods in using NASA satellite data provide a readily accessible and affordable approach to estimation of a sufficient range of individual PM2.5 exposures in a single city. This approach can expand the capacity to conduct environmental accountability studies in areas with few measurements of fine particles. CITATION Wong CM, Lai HK, Tsang H, Thach TQ, Thomas GN, Lam KB, Chan KP, Yang L, Lau AK, Ayres JG, Lee SY, Chan WM, Hedley AJ, Lam TH. 2015. Satellite-based estimates of long-term exposure to fine particles and association with mortality in elderly Hong Kong residents. Environ Health Perspect 123:1167-1172; http://dx.doi.org/10.1289/ehp.1408264.
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Affiliation(s)
- Chit Ming Wong
- School of Public Health, The University of Hong Kong, Hong Kong, China
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Giloyan A, Harutyunyan T, Petrosyan V. Visual impairment and depression among socially vulnerable older adults in Armenia. Aging Ment Health 2015; 19:175-81. [PMID: 24898137 DOI: 10.1080/13607863.2014.920298] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Visual impairment in older adults is a major public health problem. Untreated visual impairment might negatively impact physical and psychological health. This study assessed the association between visual impairment and depression among socially vulnerable older adults (those aged 50 and above) in Armenia. METHOD The survey and eye screenings were carried out among 339 participants who were the residents of retirement homes and single older adults in the households. The study team used Golovin-Sivtsev chart and cycloplegic skiascopy to measure visual impairment and Center for Epidemiologic Studies Depression scale to measure depression. RESULTS The prevalence of visual impairment in the sample was 13.3%. Almost 24.0% of participants reported depression symptoms. Participants living in the retirement homes had substantially higher rates of visual impairment (21.5%) and depression (28.0%) than those living in households (9.3% and 15.0%, respectively). The odds of having depression were higher among those with visual impairment compared to those without after adjusting for confounders (OR = 2.75; 95% CI: 1.29-5.87). Having at least one non-communicable disease was associated with depression (OR = 2.47; 95% CI: 1.28-4.75). Living in the retirement home was marginally significantly associated with having depression. Other confounders included age, gender, education, physical activity, and smoking. CONCLUSION Visual impairment was significantly associated with depression in socially vulnerable older adults in Armenia. Timely eye screenings in similar population groups could lead to early detection of visual impairment and prevention of visual loss and associated mental health problems.
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Affiliation(s)
- Aida Giloyan
- a Garo Meghrigian Institute for Preventive Ophthalmology , School of Public Health , American University of Armenia , Yerevan , Armenia
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16
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Lyu J, Lee SH, Kim HY. Associations between healthy lifestyles and health outcomes among older Koreans. Geriatr Gerontol Int 2015; 16:663-9. [DOI: 10.1111/ggi.12531] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Jiyoung Lyu
- BK21PLUS Program in Embodiment: Health-Society Interaction; Department of Public Health Sciences; Graduate School; Korea University; Seoul Korea
| | - Seungah H Lee
- Department of Gerontology; University of Massachusetts Boston; Boston USA
| | - Hae-Young Kim
- BK21PLUS Program in Embodiment: Health-Society Interaction; Department of Public Health Sciences; Graduate School; Korea University; Seoul Korea
- Department of Health Policy and Management; College of Health Sciences; Korea University; Seoul Korea
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17
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Luger TM, Suls J, Vander Weg MW. How robust is the association between smoking and depression in adults? A meta-analysis using linear mixed-effects models. Addict Behav 2014; 39:1418-29. [PMID: 24935795 DOI: 10.1016/j.addbeh.2014.05.011] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 04/29/2014] [Accepted: 05/21/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Our objective was to use meta-analytic techniques to assess the strength of the overall relationship and role of potential moderators in the association between smoking and depression in adults. METHODS Two popular health and social science databases (PubMed and PsycINFO) were systematically searched to identify studies which examined the association between adult smoking behavior and major depressive disorder (MDD) or depressive symptoms. A total of 85 relevant studies were selected for inclusion. Studies were analyzed using a linear mixed effects modeling package ("lme4" for R) and the Comprehensive Meta-Analysis program version 2. RESULTS Multiple nested linear mixed-effects models were compared. The best fitting models were those that included only random study effects and smoking status. In cross-sectional studies, current smokers were more likely to be depressed than never smokers (OR=1.50, CI=1.39-1.60), and current smokers were more likely to be depressed than former smokers (OR=1.76, CI=1.48-2.09). The few available prospective studies, that used the requisite statistical adjustments, also showed smokers at baseline had greater odds of incident depression at follow-up than never smokers (OR=1.62, CI=1.10-2.40). CONCLUSIONS In cross-sectional studies, smoking was associated with a nearly two-fold increased risk of depression relative to both never smokers and former smokers. In the smaller set of prospective studies, the odds of subsequent depression were also higher for current than never smokers. Attesting to its robustness, the relationship between smoking and depression was exhibited across several moderators. Findings could help health care providers to more effectively anticipate co-occurring health issues of their patients. Several methodological recommendations for future research are offered.
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He Q, Yang L, Shi S, Gao J, Tao M, Zhang K, Gao C, Yang L, Li K, Shi J, Wang G, Liu L, Zhang J, Du B, Jiang G, Shen J, Zhang Z, Liang W, Sun J, Hu J, Liu T, Wang X, Miao G, Meng H, Li Y, Hu C, Li Y, Huang G, Li G, Ha B, Deng H, Mei Q, Zhong H, Gao S, Sang H, Zhang Y, Fang X, Yu F, Yang D, Liu T, Chen Y, Hong X, Wu W, Chen G, Cai M, Song Y, Pan J, Dong J, Pan R, Zhang W, Shen Z, Liu Z, Gu D, Wang X, Liu Y, Liu X, Zhang Q, Li Y, Chen Y, Kendler KS, Wang X, Li Y, Flint J. Smoking and major depressive disorder in Chinese women. PLoS One 2014; 9:e106287. [PMID: 25180682 PMCID: PMC4152240 DOI: 10.1371/journal.pone.0106287] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 08/05/2014] [Indexed: 02/05/2023] Open
Abstract
Objective To investigate the risk factors that contribute to smoking in female patients with major depressive disorder (MDD) and the clinical features in depressed smokers. Methods We examined the smoking status and clinical features in 6120 Han Chinese women with MDD (DSM-IV) between 30 and 60 years of age across China. Logistic regression was used to determine the association between clinical features of MDD and smoking status and between risk factors for MDD and smoking status. Results Among the recurrent MDD patients there were 216(3.6%) current smokers, 117 (2.0%) former smokers and 333(5.6%) lifetime smokers. Lifetime smokers had a slightly more severe illness, characterized by more episodes, longer duration, more comorbid illness (panic and phobias), with more DSM-IV A criteria and reported more symptoms of fatigue and suicidal ideation or attempts than never smokers. Some known risk factors for MDD were also differentially represented among smokers compared to non-smokers. Smokers reported more stressful life events, were more likely to report childhood sexual abuse, had higher levels of neuroticism and an increased rate of familial MDD. Only neuroticism was significantly related to nicotine dependence. Conclusions Although depressed women smokers experience more severe illness, smoking rates remain low in MDD patients. Family history of MDD and environmental factors contribute to lifetime smoking in Chinese women, consistent with the hypothesis that the association of smoking and depression may be caused by common underlying factors.
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Affiliation(s)
- Qiang He
- ShengJing Hospital of China Medical University, Heping District, Shenyang, Liaoning, P. R. China
| | - Lei Yang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Shenxun Shi
- Shanghai Mental Health Center, Shanghai, P. R. China
- Huashan Hospital of Fudan University, Shanghai, P. R. China
| | - Jingfang Gao
- Chinese Traditional Hospital of Zhejiang, Hangzhou, Zhejiang, P. R. China
| | - Ming Tao
- Xinhua Hospital of Zhejiang Province, Hangzhou, Zhejiang, P. R. China
| | - Kerang Zhang
- No. 1 Hospital of Shanxi Medical University, Taiyuan, Shanxi, P. R. China
| | - Chengge Gao
- No. 1 Hospital of Medical College of Xian Jiaotong University, Xian, Shaanxi, P. R. China
| | - Lijun Yang
- Jilin Brain Hospital, Siping, Jilin, P. R. China
| | - Kan Li
- Mental Hospital of Jiangxi Province, Nanchang, Jiangxi, P. R. China
| | - Jianguo Shi
- Xian Mental Health Center, New Qujiang District, Xian, Shaanxi, P. R. China
| | - Gang Wang
- Beijing Anding Hospital of Capital University of Medical Sciences, Deshengmen wai, Xicheng District, Beijing, P. R. China
| | - Lanfen Liu
- Shandong Mental Health Center, Jinan, Shandong, P. R. China
| | - Jinbei Zhang
- No. 3 Hospital of Sun Yat-sen University, Tianhe District, Guangzhou, Guangdong, P. R. China
| | - Bo Du
- Hebei Mental Health Center, Baoding, Hebei, P. R. China
| | - Guoqing Jiang
- Chongqing Mental Health Center, Jiangbei District, Chongqing, P. R. China
| | - Jianhua Shen
- Tianjin Anding Hospital, Hexi District, Tianjin, P. R. China
| | - Zhen Zhang
- No. 4 Hospital of Jiangsu University, Zhenjiang, Jiangsu, P. R. China
| | - Wei Liang
- Psychiatric Hospital of Henan Province, Xinxiang, Henan, P. R. China
| | - Jing Sun
- Nanjing Brain Hospital, Nanjing, Jiangsu, P. R. China
| | - Jian Hu
- Harbin Medical University, Nangang District, Haerbin, Heilongjiang, P. R. China
| | - Tiebang Liu
- Shenzhen Kang Ning Hospital, Luohu District, Shenzhen, Guangdong, P. R. China
| | - Xueyi Wang
- First Hospital of Hebei Medical University, Shijiazhuang, Hebei, P. R. China
| | - Guodong Miao
- Guangzhou Brain Hospital (Guangzhou Psychiatric Hospital), Liwan District, Guangzhou, Guangdong, P. R. China
| | - Huaqing Meng
- No. 1 Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong District, Chongqing, P. R. China
| | - Yi Li
- Dalian No. 7 Hospital, Ganjingzi District, Dalian, Liaoning, P. R. China
| | - Chunmei Hu
- No. 3 Hospital of Heilongjiang Province, Beian, Heilongjiang, P. R. China
| | - Yi Li
- Wuhan Mental Health Center, Wuhan, Hubei, P. R. China
| | - Guoping Huang
- Sichuan Mental Health Center, Mianyang, Sichuan, P. R. China
| | - Gongying Li
- Mental Health Institute of Jining Medical College, Dai Zhuang, Bei Jiao, Jining, Shandong, P. R. China
| | - Baowei Ha
- Liaocheng No. 4 Hospital, Liaocheng, Shandong, P. R. China
| | - Hong Deng
- Mental Health Center of West China Hospital of Sichuan University, Wuhou District, Chengdu, Sichuan, P. R. China
| | - Qiyi Mei
- Suzhou Guangji Hospital, Suzhou, Jiangsu, P. R. China
| | - Hui Zhong
- Anhui Mental Health Center, Hefei, Anhui, P. R. China
| | - Shugui Gao
- Ningbo Kang Ning Hospital, Zhenhai District, Ningbo, Zhejiang, P. R. China
| | - Hong Sang
- Changchun Mental Hospital, Changchun, Jilin, P. R. China
| | - Yutang Zhang
- No. 2 Hospital of Lanzhou University, Lanzhou, Gansu, P. R. China
| | - Xiang Fang
- Fuzhou Psychiatric Hospital, Cangshan District, Fuzhou, Fujian, P. R. China
| | - Fengyu Yu
- Harbin No. 1 Special Hospital, Haerbin, Heilongjiang, P. R. China
| | - Donglin Yang
- Jining Psychiatric Hospital, North Dai Zhuang, Rencheng District, Jining, Shandong, P. R. China
| | - Tieqiao Liu
- No. 2 Xiangya Hospital of Zhongnan University, Furong District, Changsha, Hunan, P. R. China
| | - Yunchun Chen
- Xijing Hospital of No. 4 Military Medical University, Xian, Shaanxi, P. R. China
| | - Xiaohong Hong
- Mental Health Center of Shantou University, Shantou, Guangdong, P. R. China
| | - Wenyuan Wu
- Tongji University Hospital, Shanghai, P. R. China
| | - Guibing Chen
- Huaian No. 3 Hospital, Huaian, Jiangsu, P. R. China
| | - Min Cai
- Huzhou No. 3 Hospital, Huzhou, Zhejiang, P. R. China
| | - Yan Song
- Mudanjiang Psychiatric Hospital of Heilongjiang Province, Xinglong, Mudanjiang, Heilongjiang, P. R. China
| | - Jiyang Pan
- No. 1 Hospital of Jinan University, Guangzhou, Guangdong, P. R. China
| | - Jicheng Dong
- Qingdao Mental Health Center, Shibei District, Qingdao, Shandong, P. R. China
| | - Runde Pan
- Guangxi Longquanshan Hospital, Yufeng District, Liuzhou, P. R. China
| | - Wei Zhang
- Daqing No. 3 Hospital of Heilongjiang Province, Ranghulu district, Daqing, Heilongjiang, P. R. China
| | - Zhenming Shen
- Tangshan No. 5 Hospital, Lunan District, Tangshan, Hebei, P. R. China
| | - Zhengrong Liu
- Anshan Psychiatric Rehabilitation Hospital, Lishan District, Anshan, Liaoning, P. R. China
| | - Danhua Gu
- Weihai Mental Health Center, ETDZ, Weihai, Shandong, P. R. China
| | - Xiaoping Wang
- Renmin Hospital of Wuhan University, Wuchang District, Wuhan, Hubei, P. R. China
| | - Ying Liu
- The First Hospital of China Medical University, Heping District, Shenyang, Liaoning, P. R. China
| | - Xiaojuan Liu
- Tianjin First Center Hospital, Hedong District, Tianjin, P. R. China
| | - Qiwen Zhang
- Hainan Anning Hospital, Haikou, Hainan, P. R. China
| | - Yihan Li
- Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom
| | - Yiping Chen
- Clinical Trial Service Unit, Richard Doll Building, Oxford, United Kingdom
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Xumei Wang
- ShengJing Hospital of China Medical University, Heping District, Shenyang, Liaoning, P. R. China
- * E-mail: (XW); (YL); (JF)
| | - Youhui Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China
- * E-mail: (XW); (YL); (JF)
| | - Jonathan Flint
- Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom
- * E-mail: (XW); (YL); (JF)
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Khalaila R, Litwin H. Changes in health behaviors and their associations with depressive symptoms among Israelis aged 50+. J Aging Health 2014; 26:401-21. [PMID: 24401321 DOI: 10.1177/0898264313516997] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the longitudinal association between changes in health behaviors and depression and determine the mediating effect of health characteristics on this association. METHOD Based on the first and second waves of the Survey of Health, Aging and Retirement in Europe (SHARE)-Israel, depressive symptoms of 1,524 Israelis aged 50 or older were analyzed using logistic regression. RESULTS Changes in physical activity and body weight are associated with depressive symptoms after adjusting for confounders. However, after adding measures of health, the respective correlations of weight gain and commenced physical activity with depression disappear, and the correlation between continued activity and depression is reduced. DISCUSSION Changes in health behaviors are related to mental health in late life, but their effect is mediated by physical and functional health. Future interventions should nevertheless target older individuals who stop physical activity and those who remain inactive to lessen the risk of depression.
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Wu L, Shen M, Chen H, Zhang T, Cao Z, Xiang H, Wang Y. The relationship between elder mistreatment and suicidal ideation in rural older adults in China. Am J Geriatr Psychiatry 2013; 21:1020-8. [PMID: 23567377 DOI: 10.1016/j.jagp.2013.01.036] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Revised: 03/25/2012] [Accepted: 05/21/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to examine the association of elder mistreatment subtypes and suicidal ideation in adults age 60 years and older residing in a Chinese rural community. METHODS We conducted a population-based cross-sectional survey in 2010 and 2,039 adults age 60 and older, living in Macheng city of Hubei province, China, were interviewed face-to-face using a structured questionnaire. Multivariate logistic regression analyses were used to determine the independent effect of elder mistreatment to suicidal ideation among older adults. RESULTS Older adults who endorsed mistreatment had a significantly higher rate of suicidal ideation than those without elder mistreatment both in men (17.4% versus 2.4%; χ(2) = 58.04, p <0.01) and women (15.8% versus 4.0%; χ(2) = 50.24, p <0.01). After adjusting for potential confounding factors, psychological mistreatment (OR: 5.0; 95% CI: 2.5-9.8) and financial mistreatment (OR: 4.1; 95% CI: 1.2-14.7) were positively associated with suicidal ideation. Among men, psychological mistreatment (OR: 5.4; 95% CI: 2.6-11.2) and financial mistreatment (OR: 4.2; 95% CI: 1.1-16.2) were positively associated with suicidal ideation. Among women, physical mistreatment (OR: 4.5; 95% CI: 2.2-9.2) and psychological mistreatment (OR: 2.6; 95% CI: 1.5-4.4) were positively associated with suicidal ideation. CONCLUSION This is the first study that demonstrates that elder adults who experienced mistreatment are at increased risk for suicidal ideation. Our findings suggest that clinicians need to consider mistreatment exposure in older patients who have suicidal ideation. Victims of elder mistreatment should be the targets for suicide monitoring and prevention programs.
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Affiliation(s)
- Li Wu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Tongji Center of Injury Prevention, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Feng L, Yap KB, Ng TP. Depressive symptoms in older adults with chronic kidney disease: mortality, quality of life outcomes, and correlates. Am J Geriatr Psychiatry 2013; 21:570-9. [PMID: 23567405 DOI: 10.1016/j.jagp.2012.12.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 11/27/2011] [Accepted: 12/27/2011] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Among patients with chronic kidney disease (CKD), we investigated the prevalence of depressive symptoms, their impact on mortality and quality of life, and correlates of depressive symptoms. DESIGN Prospective cohort study, followed up to 4 years. SETTING General community. PARTICIPANTS A total of 362 older adults with CKD (Stages 3 and 4 assessed from estimated glomerular filtration rate [eGFR]) drawn from the Singapore Longitudinal Aging Study cohort. MEASUREMENTS Scores on the Geriatric Depression Scale (GDS) and the prevalence of depressive symptoms (GDS ≥5) and other variables were assessed at baseline, and SF-12 quality of life (QOL) (at 2 years) and mortality determined from 4 years of follow-up. RESULTS Depressive symptoms were present in 13% of the participants at baseline, and were associated with poorer SF-12 QOL scores (up to 30 percentage point differences). There was a significant association between depressive symptoms and increased mortality risk (odds ratio: 3.17; 95% confidence interval: 1.17-8.61; χ(2) = 5.11; df = 1; p = 0.023), which was statistically significant in unadjusted analysis, but not in multivariate analysis that accounted for covariates (odds ratio: 2.62; 95% confidence interval: 0.77-8.89; χ(2) = 2.37; df = 1; p = 0.13). Baseline cognitive impairment, functional disability, and other chronic illness were significantly associated with both increasing GDS scores and depressive symptoms. No relationship between eGFR and depressive symptoms was observed. CONCLUSION Depression among individuals with CKD was significantly associated with poorer quality of life, but not with increased mortality in predialysis CKD patients. More prospective studies are needed to establish the effects of depression on adverse CKD outcomes in predialysis CKD patients.
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Affiliation(s)
- Liang Feng
- Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of PsychologicalMedicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Arslantas D, Ünsal A, Ozbabalık D. Prevalence of depression and associated risk factors among the elderly in Middle Anatolia, Turkey. Geriatr Gerontol Int 2013; 14:100-8. [DOI: 10.1111/ggi.12065] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Didem Arslantas
- Department of Public Health; Eskisehir Osmangazi University Medical Faculty; Meselik-Eskisehir Turkey
| | - Alaettin Ünsal
- Department of Public Health; Eskisehir Osmangazi University Medical Faculty; Meselik-Eskisehir Turkey
| | - Demet Ozbabalık
- Department of Neurology; Eskisehir Osmangazi University Medical Faculty; Meselik-Eskisehir Turkey
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Association of smoking and nicotine dependence with severity and course of symptoms in patients with depressive or anxiety disorder. Drug Alcohol Depend 2012; 126:138-46. [PMID: 22633368 DOI: 10.1016/j.drugalcdep.2012.05.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Revised: 05/02/2012] [Accepted: 05/03/2012] [Indexed: 11/22/2022]
Abstract
BACKGROUND Previous research has indicated a strong association of smoking with depression and anxiety disorders, but the direction of the relationship is uncertain. Most research has been done in general population samples. We investigated the effect of smoking and nicotine dependence on the severity and course of depressive and anxiety symptoms in psychiatric patients. METHODS Data came from the Netherlands Study of Depression and Anxiety (NESDA) including participants with a current diagnosis of depression and/or an anxiety disorder (N=1725). The course of smoking status and symptoms of depression, general anxiety, social anxiety, and agoraphobia were measured at baseline and after one and two years. Age, gender, education, alcohol use, physical activity, and negative life events were treated as covariates. RESULTS At baseline, the symptoms of depression, general anxiety, and agoraphobia were more severe in nicotine-dependent smokers than in never-smokers, former smokers, and non-dependent smokers. These differences remained after adjusting for covariates. Smaller differences were observed for severity of social anxiety which were no longer significant after controlling for covariates. Over a two-year follow-up, the improvement of depressive and anxiety symptoms was slower in nicotine-dependent smokers than in the other groups even after controlling for covariates. There were no differences between the groups in the course of symptoms of social anxiety and agoraphobia over time. CONCLUSIONS In psychiatric patients, smoking is associated with higher severity of depressive and anxiety symptoms, and with slower recovery, but only when smokers are nicotine-dependent.
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Wu L, Chen H, Hu Y, Xiang H, Yu X, Zhang T, Cao Z, Wang Y. Prevalence and associated factors of elder mistreatment in a rural community in People's Republic of China: a cross-sectional study. PLoS One 2012; 7:e33857. [PMID: 22448276 PMCID: PMC3309016 DOI: 10.1371/journal.pone.0033857] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 02/22/2012] [Indexed: 11/24/2022] Open
Abstract
Background Current knowledge about elder mistreatment is mainly derived from studies done in Western countries, which indicate that this problem is related to risk factors such as a shared living situation, social isolation, disease burden, and caregiver strain. We know little about prevalence and risk factors for elder mistreatment and mistreatment subtypes in rural China where the elder population is the most vulnerable. Methods In 2010, we conducted a cross-sectional survey among older adults aged 60 or older in three rural communities in Macheng, a city in Hubei province, China. Of 2245 people initially identified, 2039 were available for interview and this was completed in 2000. A structured questionnaire was used to collect data regarding mistreatment and covariates. Logistic regression analysis was used to identify factors related to elder mistreatment and subtypes of mistreatment. Results Elder mistreatment was reported by 36.2% (95% CI: 34.1%–38.3%) of the participants. Prevalence rates of psychological mistreatment, caregiver neglect, physical mistreatment, and financial mistreatment were 27.3% (95% CI: 25.3%–29.2%), 15.8% (95% CI: 14.2%–17.4%), 4.9% (95% CI: 3.9%–5.8%) and 2.0% (95% CI: 1.3%–2.6%), respectively. The multivariate logistic regression analysis revealed that depression, being widowed/divorced/single/separated, having a physical disability, having a labor intensive job, depending solely on self-made income, and living alone were risk factors for elder mistreatment. Different types of elder mistreatment were associated with different risk factors, and depression was the consistent risk factor for the three most common mistreatment subtypes. Conclusion Older adults in rural China self-report a higher rate of mistreatment than their counterparts in Western countries. Depression is a main risk factor associated with most subtypes of mistreatment. Our findings suggest that prevention and management of elder mistreatment is a challenge facing a rapidly aging Chinese population.
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Affiliation(s)
- Li Wu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Chen
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Tongji Center of Injury Prevention, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Hu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Tongji Center of Injury Prevention, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiyun Xiang
- Center for Injury Research and Policy, The Ohio State University, Columbus, Ohio, United States of America
| | - Xiang Yu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Tongji Center of Injury Prevention, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhongqiang Cao
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Youjie Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Tongji Center of Injury Prevention, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- * E-mail:
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Xu L, Chan WM, Hui YF, Lam TH. Association between HbA1c and cardiovascular disease mortality in older Hong Kong Chinese with diabetes. Diabet Med 2012; 29:393-8. [PMID: 21916977 DOI: 10.1111/j.1464-5491.2011.03456.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine the association between baseline HbA(1c) level and mortality attributable to all-cause, cardiovascular disease, coronary heart disease and stroke. METHODS A total of 2137 Chinese aged 65 years or above attending the Elderly Health Service, Department of Health, Hong Kong, with diagnosed diabetes had HbA(1c) measured during 1998 to 2000 and were followed up to 2009. Information on socio-economic position, lifestyle factors and disease history was collected. Hazard ratios and 95% confidence intervals with adjustment for potential confounders were calculated using Cox's proportional hazards models. RESULTS After an average of 7.9 years of follow-up, 540 participants had died. After adjusting for potential confounders, higher HbA(1c) (≥ 69 mmol/mol, 8.5%) increased the risk of cardiovascular disease (hazard ratio 2.11;95% CI 1.37-3.25) and stroke mortality (hazard ratio 2.43; 95% CI 1.06-5.55) compared with HbA(1c) of 58-68 mmol/mol (7.5-8.4%), and increased the risk of all-cause (hazard ratio 1.41; 95% CI 1.06-1.86) and coronary heart disease mortality (hazard ratio 2.44; 95% CI 1.11-5.37) compared with HbA(1c) of 48 mmol/mol (6.5%) or less. Analysis of HbA(1c) as a continuous variable showed that every XX mmol/mol (1%) increase in HbA(1c) decreased stroke mortality risk by 51% in those with HbA(1c) level less than 48 mmol/mol (6.5%) and increased stroke mortality risk by 30% in those with an HbA(1c) level of 48 mmol/mol (6.5%) or higher, suggesting a U-shaped association between HbA(1c) and stroke mortality. CONCLUSION High HbA(1c) predicted excess risk of all-cause, cardiovascular disease, coronary heart disease and stroke mortality. The question of whether low HbA(1c) increases mortality in older patients with diabetes needs further investigation.
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Affiliation(s)
- L Xu
- Department of Community Medicine and School of Public Health, University of Hong Kong, Hong Kong, China
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Jamal M, Does AJWVD, Penninx BWJH, Cuijpers P. Age at Smoking Onset and the Onset of Depression and Anxiety Disorders. Nicotine Tob Res 2011; 13:809-19. [DOI: 10.1093/ntr/ntr077] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Sachs-Ericsson N, Collins N, Schmidt B, Zvolensky M. Older adults and smoking: Characteristics, nicotine dependence and prevalence of DSM-IV 12-month disorders. Aging Ment Health 2011; 15:132-41. [PMID: 20924817 DOI: 10.1080/13607863.2010.505230] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES There are few studies investigating the characteristics of older smokers. Research on younger adults has determined that (1) the diagnostic and statistical manual (DSM) diagnosis of nicotine dependence (ND) excludes a sizable portion of the smoking population, and (2) younger smokers have high rates of comorbid DSM disorders. In this study, we sought to replicate these results in an older population. METHOD Based on a large representative sample, we examined the smoking patterns in adults aged 50 and over (N = 2139). We describe the characteristics of the current smokers (n = 410). We identified differences in smoking characteristics and prevalence rates of DSM-IV 12-month diagnoses by smoking severity. RESULTS Most smokers did not meet the criteria for DSM 12-month ND. Older smokers identified as having ND were first diagnosed at a relatively older age. Smokers with ND differed from smokers without a diagnosis in several ways: they smoked more; they had more symptoms of ND and had substantially higher rates of comorbid DSM 12-month disorders. Nonetheless, there were a number of older smokers with dependency symptoms who continue to smoke throughout their lifetimes, but never meet the criteria for ND. CONCLUSION Smokers without ND are most likely to have a mood disorder whereas those smokers with ND are most likely to have an anxiety or substance use disorder. Smokers without ND still have relatively high rates of dependency symptoms. Given the late onset of ND, smoking dependence may be a progressive disorder. High rates of psychiatric disorders may interfere with smoking cessation.
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Luk JW, Tsoh JY. Moderation of gender on smoking and depression in Chinese Americans. Addict Behav 2010; 35:1040-3. [PMID: 20655665 DOI: 10.1016/j.addbeh.2010.06.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2010] [Revised: 05/10/2010] [Accepted: 06/14/2010] [Indexed: 10/19/2022]
Abstract
This study examined the moderating role of gender in the association between smoking status and depression in a nationwide convenience sample of Chinese American current, former, and never smokers (N=1393). Participants were recruited in smoker-supporter dyads. Multilevel modeling was used to take into account the dyadic nature of the data. Depressive symptoms were measured by a 10-item CES-D (Center of Epidemiological Studies-Depression Scale). Results showed significant effects of smoking status by gender interaction and smoking status on depression after adjusting for acculturation and social support. Among Chinese females, current smokers reported elevated depression level than both former and never smokers. Among Chinese males, current smokers reported more depressive symptoms when compared to former smokers only. Chinese females reported higher depression level than males among current smokers; no gender difference in depression was observed among former or never smokers. The association between smoking and depression is moderated by gender among Chinese Americans where substantial gender difference in smoking prevalence exists. Findings highlight the importance of addressing depression in treating tobacco use among Chinese American smokers, especially among females.
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Nanri A, Mizoue T, Matsushita Y, Sasaki S, Ohta M, Sato M, Mishima N. Serum folate and homocysteine and depressive symptoms among Japanese men and women. Eur J Clin Nutr 2010; 64:289-96. [PMID: 20087384 DOI: 10.1038/ejcn.2009.143] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Folate and homocysteine have been implicated to have a role in depression. However, results of epidemiologic studies on this issue have been inconsistent. The objective of this study was to clarify the association between serum folate and homocysteine concentrations and depressive symptoms in Japanese adults. SUBJECTS/METHODS We analyzed cross-sectional data for 530 municipal employees (313 men and 217 women), aged 21-67 years, who participated in a health survey at the time of periodic checkup. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Logistic regression analysis was used to estimate odds ratios of depressive symptoms (CES-D scale scores of >or=16) with adjustment for potential confounding variables. RESULTS In total, 113 men (36.1%) and 79 women (36.4%) had depressive symptoms. A higher serum folate was associated with a decreased prevalence of depressive symptoms in men. The multivariate-adjusted odds ratios (95% confidence interval) of depressive symptoms for the lowest to highest quartiles of serum folate were 1.00 (reference), 0.53 (0.27-1.03), 0.33 (0.16-0.68) and 0.51 (0.25-1.03), respectively (trend P=0.03). Furthermore, the data suggested a positive association between serum homocysteine and depressive symptoms in men (trend P=0.06). In women, neither folate nor homocysteine was associated with depressive symptoms. CONCLUSIONS Low serum folate may be related to an increased prevalence of depressive symptoms in Japanese men.
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Affiliation(s)
- A Nanri
- Department of Epidemiology and International Health, Research Institute, International Medical Center of Japan, Tokyo, Japan.
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Sachs-Ericsson N, Schmidt NB, Zvolensky MJ, Mitchell M, Collins N, Blazer DG. Smoking cessation behavior in older adults by race and gender: the role of health problems and psychological distress. Nicotine Tob Res 2009; 11:433-43. [PMID: 19299410 PMCID: PMC2670367 DOI: 10.1093/ntr/ntp002] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2008] [Accepted: 09/17/2008] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Initial research on older smokers suggests that a subgroup of smokers with higher levels of psychological distress and health problems may be more likely to quit smoking than older smokers with fewer such problems. The present study, based on prospective data from a biracial sample of older adults (N = 4,162), examined characteristics of older adult smokers by race and gender. METHODS The present study uses both cross-sectional and prospective data to examine the association between smoking behavior, smoking cessation, health functioning, and psychological distress in a biracial sample of community-dwelling older adults. RESULTS We found baseline psychological distress to be associated with poor health functioning. Consistent with hypotheses, baseline (Time 1) psychological distress predicted smoking cessation 3 years later (Time 2). Moreover, the change in health problems between Time 1 and Time 2 fully mediated the association between Time 1 distress and smoking cessation. DISCUSSION Smoking cessation behavior of older adults is best explained by higher levels of distress and health problems regardless of race or gender. These findings may have important treatment implications regarding smoking cessation programs among older adults. Older adult smokers with higher levels of psychological distress and health problems may be more motivated to quit smoking than those with fewer such problems. These difficulties should be targeted within the context of the smoking cessation protocol. Also, we identified a subgroup of older smokers who are reporting fairly good health and lower levels of distress and who are less likely to quit smoking. Motivational methods may need to be developed to engage this group in smoking cessation treatment.
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Sánchez-Villegas A, Serrano-Martínez M, Alonso A, de Irala J, Tortosa A, Martínez-González MA. [Role of tobacco use on the incidence of depression in the SUN cohort study]. Med Clin (Barc) 2008; 130:405-9. [PMID: 18394364 DOI: 10.1157/13117850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Several investigations, most of them cross-sectional, have analyzed the association between smoking and depression, but there are not enough evidences to establish the direction of the association. Our objective was to prospectively assess the association between smoking habit and depression incidence in the SUN (Seguimiento Universidad de Navarra) cohort. SUBJECTS AND METHOD Dynamic cohort study (recruitment permanently open) based on 8,556 graduate participants where depression incidence was ascertained during 6 years of follow-up. Depression was defined as the presence of a self-reported physician diagnosis and/or use of antidepressant medication in at least one of the 2-year, 4-year or 6-year follow-up questionnaires. The association between smoking and depression incidence was estimated through the calculation of hazard ratios (HR) and their 95% confidence intervals (CI) using Cox regression models (proportional hazards). RESULTS The mean follow-up period was 47.4 months. One hundred and ninety participants initially free of depression reported a physician diagnosis of depression during follow-up. A significantly higher risk was found for smokers (HR = 1.39; 95% CI, 1.00-1.93) when they were compared to non smokers, whereas an inverse association was found for ex-smokers who had quit smoking more than 10 years ago (HR = 0.42; 95% CI, 0.19-0.94). CONCLUSIONS This study supports, with a prospective design, an increased risk of depression associated to smoking.
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Affiliation(s)
- Almudena Sánchez-Villegas
- Departamento de Ciencias Clínicas, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, Spain.
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Goldacre MJ, Wotton CJ, Yeates D, Seagroatt V, Flint J. Cancer in people with depression or anxiety: record-linkage study. Soc Psychiatry Psychiatr Epidemiol 2007; 42:683-9. [PMID: 17530150 DOI: 10.1007/s00127-007-0211-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/24/2007] [Indexed: 11/28/2022]
Abstract
BACKGROUND It has been suggested that the risk of cancer may be higher in people with psychological disorders, like depression and anxiety, than in the general population. AIMS To determine cancer risk in cohorts of people with depression or anxiety, compared with that in a control cohort. METHOD Analysis of linked statistical records of hospital admission and mortality. RESULTS Lung cancer was more common in those with depression (risk ratio 1.36, 95% confidence intervals 1.19-1.54) or anxiety (1.29, 1.12-1.48) than in others. Excluding lung cancer, the risk ratio for all other cancers combined was 0.98 (0.92-1.04) in the depression cohort and 1.01 (0.95-1.07) in the anxiety cohort. There was a significant association, in the short-term only, between depression, anxiety and the subsequent diagnosis of brain tumours. CONCLUSIONS With the exception of lung and brain tumours, cancer risk was not increased in people with depression or anxiety.
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Affiliation(s)
- Michael J Goldacre
- Unit of Health-Care Epidemiology, Dept. of Public Health, University of Oxford, Old Road Campus, Old Road, Oxford, OX3 7LF, UK.
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Li ZB, Lam TH, Ho SY, Chan WM, Ho KS, Li MP, Leung GM, Fielding R. Age- versus time-comparative self-rated health in Hong Kong Chinese older adults. Int J Geriatr Psychiatry 2006; 21:729-39. [PMID: 16858746 DOI: 10.1002/gps.1553] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The main objectives were to examine the relation between age-comparative (self vs others of same age) self-rated health (SRH) and time-comparative (self this year vs last year) SRH, and to evaluate which was more strongly associated with specific physical health problems. METHODS Cross-sectional data on two SRH measures and various physical health problems from 18749 male and 37413 female clients aged 65 or over from 18 Elderly Health Centres in Hong Kong were analysed using logistic regression with adjustment for potential confounders. RESULTS Men were more likely to report 'better' and less likely to report 'worse' SRH than women. 'Normal' was the most common option but the proportions choosing this decreased with age on both SRH measures. There was a fairly weak but statistically significant correlation between these two measures, with Kappa coefficients of 0.125 and 0.167 for men and women, respectively. For both men and women, there were significantly positive linear trends between age-comparative SRH options from 'better' to 'worse' and physical health problems, such as respiratory diseases, musculoskeletal diseases, any active chronic diseases, functional disability, depressive symptoms, taking medication regularly, and admission to hospital last year. However, for time-comparative SRH, those who rated 'normal' had the smallest odds ratios in all of the physical health problems above than those who rated 'better' or 'worse'. CONCLUSIONS The two SRH measures correlated with each other weakly but significantly. Age-comparative SRH was linearly, and time-comparative SRH was curvilinearly associated with physical health problems.
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Affiliation(s)
- Zhi Bin Li
- Department of Community Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
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Sundquist K, Li X. Alcohol abuse partly mediates the association between coronary heart disease and affective or psychotic disorders: a follow-up study in Sweden. Acta Psychiatr Scand 2006; 113:283-9. [PMID: 16638072 DOI: 10.1111/j.1600-0447.2006.00774.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To analyse whether hospitalization for affective or psychotic disorders predicts coronary heart disease (CHD) after accounting for occupation, region and alcohol-related disorders. METHOD National registers were used to identify all individuals in Sweden aged 25-64 years at first hospitalization for affective or psychotic disorders and aged 25-79 years at first hospitalization for CHD between 1987 and 2001. Standardized incidence ratios (SIRs) were calculated. RESULTS The association between CHD and affective or psychotic disorders was strongest in the youngest age groups. The overall SIRs varied between 1.39 and 1.68. They were strongly attenuated but remained significant after adjustment for hospitalization because of alcohol-related disorders, especially among women. CONCLUSION Hospitalization because of affective or psychotic disorders predicts CHD. These associations are partly mediated by alcohol abuse. Clinicians and decision makers should be aware of the increased risk of CHD in these patient groups.
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Affiliation(s)
- K Sundquist
- Center for Family and Community Medicine, Karolinska Institute, Huddinge, Sweden.
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Klungsøyr O, Nygård JF, Sørensen T, Sandanger I. Cigarette smoking and incidence of first depressive episode: an 11-year, population-based follow-up study. Am J Epidemiol 2006; 163:421-32. [PMID: 16394201 DOI: 10.1093/aje/kwj058] [Citation(s) in RCA: 196] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Smoking has been found to be associated with depression. Biologic hypotheses support causation in both directions. This study examined the association between cigarette smoking and a subsequent first depression. In 1990, 2,014 adults in Norway were interviewed about their lifestyle and mental health. A 2001 reinterview by trained interviewers defined the study cohort of 1,190 participants. The cases were those who experienced a first depression whose onset was estimated to occur during the follow-up period, based on retrospective assessment by the Composite International Diagnostic Interview (International Classification of Diseases, Tenth Revision). Cox regression was used to estimate the hazard rate of depression during follow-up. Alternative explanations for a direct causal influence from smoking on subsequent depression were assessed, and a sensitivity analysis was performed. The risk of depression was four times as high for heavy smokers compared with never smokers. A dose-response relation with an increasing hazard for past smokers and for an increasing number of cigarettes smoked per day for current smokers was found. Similarly, increasing smoking time was associated with increasing risk. Failure of other plausible alternatives to explain the observed association between smoking and depression might reflect a direct causal influence of smoking on depression.
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Affiliation(s)
- Ole Klungsøyr
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
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