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Song Q, Shu X, Zhao Y, Ge N, Yue J. Association of handgrip strength asymmetry and weakness with depression among middle-aged and older population in China: A cohort study. J Affect Disord 2024; 363:401-408. [PMID: 39029688 DOI: 10.1016/j.jad.2024.07.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/30/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Handgrip strength (HGS) weakness and asymmetry were recently reported to be associated with age-related health conditions. However, little is known about their combined effects on depression. We aimed to explore the joint association of HGS asymmetry and weakness with depressive symptoms in Chinese middle and older aged population. METHODS 8700 participants aged ≥45 years were enrolled from China Health and Retirement Longitudinal Study (2015-2018). HGS weakness was determined as maximal HGS < 28 kg in males and <18 kg in females. HGS asymmetry was measured by HGS ratio and was defined using two different rules. Specifically, HGS ratio < 0.90 or >1.10 (10 % rule) and <0.80 or >1.20 (20 % rule) were considered as asymmetry. Participants were classified into four groups: normal and symmetric HGS, asymmetry only, weakness only, and both weakness and asymmetry. Depressive symptoms were assessed by the 10-item Center for Epidemiologic Studies Depression Scale, with scores ≥12 defined as depression. The logistic regression and multiple linear regression models were conducted to estimate the associations between HGS status and depressive symptoms. RESULTS The three-year incidence of depression was 19.2 %. After adjusting for covariates, compared to normal and symmetric HGS, participants with both HGS asymmetry and weakness showed the greatest risk of incident depression (10 % rule: OR 1.55, 95 % CI 1.19-2.02; 20 % rule: OR 1.71, 95 % CI 1.16-2.50). The coexistence of asymmetry and weakness was related to a significant increase in depression score (10 % rule: β 0.96, 95 % CI 0.38-1.54; 20 % rule: β 0.94, 95 % CI 0.08-1.81). The complete case analysis supported the results, and the associations were not modified by age, sex, and hand dominance. LIMITATIONS Depressive assessment was based on self-reported screening instrument. CONCLUSIONS The presence of both HGS asymmetry and weakness was associated with a higher risk of depression. Examining HGS asymmetry along with weakness may aid in identifying individuals at risk of depression to enable early interventions.
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Affiliation(s)
- Quhong Song
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyu Shu
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yanli Zhao
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Ning Ge
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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Song W, Liu M, Ye T, Wang D, Yuan Q, Li F, Wang Q, Ma Y. Relationship between frailty and depressive symptoms in older adults: role of activities of daily living and sleep duration. Front Med (Lausanne) 2024; 11:1416173. [PMID: 38994345 PMCID: PMC11238213 DOI: 10.3389/fmed.2024.1416173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/17/2024] [Indexed: 07/13/2024] Open
Abstract
Introduction Previous studies have demonstrated that frailty is associated with depressive symptoms among older people and significantly increase the risk of difficulty in activities of daily living (ADL). However, uncertainties remain regarding the mechanisms behind such relationship. The aim of this study was to investigate the mediating effect of ADL in the relationship between frailty and depressive symptoms among older adults in China, and to explore to what extend sleep duration moderated the association between ADL and depressive symptoms. Methods In this study, we carried out cross-sectional descriptive analysis and 1,429 participants were included in the analysis. A survey was conducted using questionnaires and instruments measuring frailty, depressive symptoms, ADL and sleep duration. Bootstrap analyses served to explore the impact of ADL in mediating frailty and depressed symptoms, as well as the effect of sleep duration in moderating ADL and depressive symptoms. Results Compared to the robust group, the mediating effects of ADL between frailty and depressive symptoms were significant in the prefrail group and the frail group. The interaction term between sleep duration and ADL was significantly presented in the regression on depressive symptoms. Specifically, the Johnson-Neyman technique determined a range from 8.31 to 10.19 h for sleep duration, within which the detrimental effect of frailty on depressive symptoms was offset. Conclusion Sleep duration moderated the indirect effect of ADL on the association between frailty and depressive symptoms. This provides support for unraveling the underlying mechanism of the association between frailty and depressive symptoms. Encouraging older adults to enhance ADL and obtain appropriate sleep duration might improve depressive symptoms for older adults with frailty and prefrailty.
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Affiliation(s)
- Wei Song
- School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Manyu Liu
- School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Ting Ye
- School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Dong Wang
- School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Quan Yuan
- School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Fen Li
- Suzhou Xiangcheng Second People’s Hospital, Suzhou, Jiangsu, China
| | - Qiushi Wang
- Suzhou Xiangcheng Second People’s Hospital, Suzhou, Jiangsu, China
| | - Yana Ma
- School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
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Basu S, Maheshwari V, Sodhi B, Mannan P, Kukreti P. The prevalence of depression, determinants, and linkage with functional disability amongst postmenopausal women in India: Evidence from the Longitudinal Ageing Study in India. Asian J Psychiatr 2024; 96:104030. [PMID: 38598934 DOI: 10.1016/j.ajp.2024.104030] [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: 02/01/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND The study objective was estimating the prevalence and determinants of depression amongst postmenopausal women in India. Additionally, we used panel mediation analysis to model the extent to which multimorbidity was associated with depression after adjusting for the effects of functional disability in the participants. METHODS Data from 28,160 women aged 50 and above from the Longitudinal Aging Study in India (LASI) Wave 1 were analyzed. Depression was assessed using the Composite International Diagnostic Interview-Short Form (CIDI-SF), with multimorbidity and functional disability (ADL and IADL) considered as key predictor variables. Logistic regression and Karlson-Holm-Breen (KHB) mediation analysis were employed. RESULTS The weighted prevalence of depression among women aged ≥ 50 years was 21.76% (95% CI: 20.81, 22.73), significantly higher women aged < 50 years (17.60%, 95% CI: 16.33, 18.94). Factors independently associated with increased odds of depression included being unmarried, rural residence, and multimorbidity, while higher educational status was associated with lower odds of depression. The relationship between multimorbidity and depression was partially mediated by ADL and IADL disabilities. Notable regional (state) variations in the magnitude of depression were observed. CONCLUSIONS Nearly one in five postmenopausal women in India aged 50 years and older have clinical depression. Community screening for reaching the unreached with primary care mental health strengthening need enhanced policy focus.
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Affiliation(s)
- Saurav Basu
- Indian Institute of Public Health - Delhi, Public Health Foundation of India (PHFI), India
| | - Vansh Maheshwari
- Indian Institute of Public Health - Delhi, Public Health Foundation of India (PHFI), India
| | - Baani Sodhi
- Indian Institute of Public Health - Delhi, Public Health Foundation of India (PHFI), India
| | - Pallak Mannan
- Indian Institute of Public Health - Delhi, Public Health Foundation of India (PHFI), India
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Ye X, Wang X. Associations of multimorbidity with body pain, sleep duration, and depression among middle-aged and older adults in China. Health Qual Life Outcomes 2024; 22:23. [PMID: 38413940 PMCID: PMC10900654 DOI: 10.1186/s12955-024-02238-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/13/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Multimorbidity, body pain, sleep disturbance, and depression are major clinical and public health challenges. This paper aimed to examine the associations of multimorbidity with body pain, sleep duration, and depression; and whether the associations varied by socioeconomic status. METHODS Data was derived from four waves of the nationally representative China Health and Retirement Longitudinal Study (CHARLS), including participants aged 45 years and older in 2011. 12 physical non-communicable diseases and 1 mental chronic disease were used to measure multimorbidity. Educational attainment and annual per-capita household consumption expenditure were employed as proxies for socioeconomic status. RESULTS Of the 16,931 participants aged 45 + years old, the proportion of people with multimorbidity was 37.87% at baseline. The number of multimorbidity increased with older age and higher socioeconomic status. Multimorbidity was associated with more body pain (incidence rate ratio (IRR) = 1.53, 95% CI = 1.45-1.61), and decreased sleep duration (β = -0.26, 95% CI = -0.36--0.15). Furthermore, multimorbidity was associated with increased depression risks (odds ratio (OR) = 1.54, 95% CI = 1.44-1.64, adjusted for sociodemographic variables), with the mediating effects of the number of body pain and sleep duration. The associations between multimorbidity and depression persisted among different socioeconomic groups. CONCLUSIONS Multimorbidity was associated with increased body pain, decreased sleep duration, and further led to increased depression risks. It is necessary to pay attention to the multimorbidity of middle-aged and older adults, relieve their body pain, guarantee sufficient sleep, so as to reduce depression risks.
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Affiliation(s)
- Xin Ye
- Institute for Global Public Policy, Fudan University, 220 Handan Road, Yangpu District, 200433, Shanghai, China.
- LSE-Fudan Research Centre for Global Public Policy, Fudan University, 220 Handan Road, Yangpu District, 200433, Shanghai, China.
| | - Xinfeng Wang
- Institute for Global Public Policy, Fudan University, 220 Handan Road, Yangpu District, 200433, Shanghai, China
- LSE-Fudan Research Centre for Global Public Policy, Fudan University, 220 Handan Road, Yangpu District, 200433, Shanghai, China
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Yan Z, Luan X, Meng L, Wu Y, Qu W, Zhang S, Wei H, Wu S. Longitudinal relationship between social participation, depressive symptoms, and activity impairment among older patients with arthritis: a moderated mediation analysis. BMC Geriatr 2024; 24:139. [PMID: 38326792 PMCID: PMC10851568 DOI: 10.1186/s12877-024-04735-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Arthritis primarily affects older people and is a prominent cause of their activity impairment. This study aimed to examine the mediating role of depressive symptoms in the relationship between social participation and activity impairment, as well as to determine whether sex moderated the mediating effect. METHODS A total of 2247 older patients with arthritis were included from the China Health and Retirement Longitudinal Study between 2015 and 2018. We first examined a simple mediation model where depressive symptoms were a mediator between social participation and activity impairment. Furthermore, sex was systematically integrated into the model as a moderator. The mediation model and moderated mediation model were analyzed using PROCESS macro. RESULTS Mediation analysis revealed that the association between social participation and activity impairment was partially mediated by depressive symptoms (B = -0.10, 95% CI = [-0.14, -0.06]) with intermediary effect of 28.6%. Moderated mediation analysis indicated that mediation model was moderated by sex. The indirect effect of social participation on activity impairment among female patients (B = -0.15, 95% CI = [-0.21, -0.09]) was stronger than male patients (B = -0.04, 95% CI = [-0.09, -0.01]). CONCLUSION Social participation was the key protective factor associated with depressive symptoms and activity impairment among arthritis patients. Encouraging arthritis patients to social participation and improving the depressive symptoms might avoid activity impairment, especially for female patients.
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Affiliation(s)
- Zeping Yan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, China
| | | | - LiJun Meng
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Yu Wu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, China
| | - Wenran Qu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Simeng Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Huimin Wei
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shicai Wu
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China.
- University of Health and Rehabilitation Sciences, Qingdao, China.
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Wang Y, Wang X, Zhu X, Sun Y, Han B, Chen T. Physical activity, physical frailty and depressive symptoms among Chinese male and female older adults: do different indicators make a difference? Front Public Health 2023; 11:1280952. [PMID: 38089035 PMCID: PMC10711064 DOI: 10.3389/fpubh.2023.1280952] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
Objectives Older adults become more inactive and frailer with aging. Physical status is closely linked to mental health, but it is unclear which physical indicator is more strongly associated with depressive symptoms in older adults. The present study aimed to compare relationships between self-reported physical activity, physical frailty (muscle mass, muscle strength, and gait ability) and depressive symptoms in community male and female older adults. Methods A total of 1,180 adults aged 60 years and older were recruited to participate in this study from a Chinese community receiving annual check-up service from September 2018 to May 2019. Physical activity was assessed by the International Physical Activity Questionnaire (IPAQ). The Bio-electrical Impedance Analyzer was used to determine the muscle mass. As the indicators of muscle function, grip strength and gait ability were assessed by the dynamometer and Timed Up and Go Test (TUGT), respectively. The 15-item version of Geriatric Depression Scale (GDS-15) was used to examine depressive symptoms. Demographic variables, health status and sleep quality were collected using questionnaire. Results 11.8% men and 11.9% women reported depressive symptoms. Logistic regression showed that depressive symptoms was associated with low grip strength (OR = 2.42, 95% CI: 1.04-5.63), slow gait ability (OR = 3.60, 95% CI: 1.28-10.13) in older males, and associated with low level of self-reported physical activity (OR = 3.85, 95% CI: 2.00-7.42) in older females. No significant association was found between muscle mass and depressive symptoms. Conclusion There were gender differences in the relationship between physical activity, physical frailty, and depressive symptoms. Grip strength and gait ability may be a better indicator of frailty for predicting depressive symptoms in older men while physical activity may be useful in predicting depressive symptoms in older women.
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Affiliation(s)
- Ying Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xue Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- Department of Rehabilitation, General Hospital of Tianjin Medical University, Tianjin, China
| | - Xinyu Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yawen Sun
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Buxin Han
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Tianyong Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Han Y, Wang S. Disability risk prediction model based on machine learning among Chinese healthy older adults: results from the China Health and Retirement Longitudinal Study. Front Public Health 2023; 11:1271595. [PMID: 38026309 PMCID: PMC10665855 DOI: 10.3389/fpubh.2023.1271595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Background Predicting disability risk in healthy older adults in China is essential for timely preventive interventions, improving their quality of life, and providing scientific evidence for disability prevention. Therefore, developing a machine learning model capable of evaluating disability risk based on longitudinal research data is crucial. Methods We conducted a prospective cohort study of 2,175 older adults enrolled in the China Health and Retirement Longitudinal Study (CHARLS) between 2015 and 2018 to develop and validate this prediction model. Several machine learning algorithms (logistic regression, k-nearest neighbors, naive Bayes, multilayer perceptron, random forest, and XGBoost) were used to assess the 3-year risk of developing disability. The optimal cutoff points and adjustment parameters are explored in the training set, the prediction accuracy of the models is compared in the testing set, and the best-performing models are further interpreted. Results During a 3-year follow-up period, a total of 505 (23.22%) healthy older adult individuals developed disabilities. Among the 43 features examined, the LASSO regression identified 11 features as significant for model establishment. When comparing six different machine learning models on the testing set, the XGBoost model demonstrated the best performance across various evaluation metrics, including the highest area under the ROC curve (0.803), accuracy (0.757), sensitivity (0.790), and F1 score (0.789), while its specificity was 0.712. The decision curve analysis (DCA) indicated showed that XGBoost had the highest net benefit in most of the threshold ranges. Based on the importance of features determined by SHAP (model interpretation method), the top five important features were identified as right-hand grip strength, depressive symptoms, marital status, respiratory function, and age. Moreover, the SHAP summary plot was used to illustrate the positive or negative effects attributed to the features influenced by XGBoost. The SHAP dependence plot explained how individual features affected the output of the predictive model. Conclusion Machine learning-based prediction models can accurately evaluate the likelihood of disability in healthy older adults over a period of 3 years. A combination of XGBoost and SHAP can provide clear explanations for personalized risk prediction and offer a more intuitive understanding of the effect of key features in the model.
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Affiliation(s)
| | - Shaobing Wang
- School of Public Health, Hubei University of Medicine, Shiyan, Hubei, China
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Fujii K, Lee S, Katayama O, Makino K, Harada K, Tomida K, Morikawa M, Yamaguchi R, Nishijima C, Misu Y, Shimada H. Difference in employment status and onset of disability among Japanese community-dwelling older adults: a prospective cohort study. Int Arch Occup Environ Health 2023; 96:1225-1234. [PMID: 37486376 DOI: 10.1007/s00420-023-02000-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE This prospective cohort study investigates the relationship between the onset of disability and employment status. METHODS We investigated 3,741 community-dwelling adults aged 70 or older, who participated in a population-based cohort study in Japan. Their onset of disability was monitored monthly using the long-term care insurance certification registration system, for five years from baseline. Based on an employment status questionnaire, we categorized participants into three groups: (1) employee, (2) self-employed, and (3) not working. Covariates included demographic information, medical history, number of medications, educational level, living alone, social group engagement, smoking status, walking speed, instrumental activities of daily living, global cognitive function, and depressive symptoms. Missing values were managed using multiple imputation. Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for incident disability risk by employment status. RESULTS The disability incidence rates were 15.3/1,000 (95% CIs: 10.7-22.0) person-years among employees, and 33.0/1000 (95% CIs: 24.4-44.6) and 39.6/1000 (95% CIs: 36.5-43.0) person-years among self-employed and non-working participants, respectively. The adjusted HRs for the onset of disability among non-working and self-employed participants were 1.69 (95% CIs: 1.16-2.46, p = 0.007) and 1.63 (95% CIs: 1.01-2.62, p = 0.044) compared with employees, respectively. Similar results were found among men. Among women, disability onset was not associated with employment status. CONCLUSIONS Older adults' risk of disability onset differed according to their employment status. Older employees had a lower risk of disability onset than those not working or self-employed.
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Affiliation(s)
- Kazuya Fujii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan.
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
- Japan Society for the Promotion of Science, Chiyoda-Ku, Tokyo, Japan
| | - Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
- Japan Society for the Promotion of Science, Chiyoda-Ku, Tokyo, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Kouki Tomida
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Ryo Yamaguchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Chiharu Nishijima
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Yuka Misu
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
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Widagdo TMM, Widyaningsih BD, Layuklinggi S. Predictors of depression among the elderly persons with disabilities in Indonesia. J Family Community Med 2023; 30:188-196. [PMID: 37675206 PMCID: PMC10479030 DOI: 10.4103/jfcm.jfcm_57_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/01/2023] [Accepted: 06/13/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Depression is a major mental problem in the elderly, particularly those with disability. This study's aim was to identify variables that predict depression in the elderly with disabilities. MATERIALS AND METHODS This cross-sectional study was conducted in Gunungkidul Regency and Yogyakarta City from April to June 2021. The study participants were community-dwelling elderly aged 60 years and above with disabilities, who could communicate verbally without any apparent cognitive impairment. Data was collected by interviewing participants using structured questionnaire on following sections: Demographic characteristics, Mini-Mental State Examination (MMSE), Washington Group Short Set (WG-SS), Barthel Index of activities of daily living (ADL), Lawton Instrumental ADL (IADL) Scale, and Geriatric Depression Scale-30 (GDS-30). Multivariate linear regression analysis applied to identify variables significantly correlated with depression. Multinomial logistic regression analysis performed to obtain the odds ratio (OR). RESULTS Study included 115 elderly persons with disabilities. Most of them had mobility impairment. Higher independence in ADL and being married were related with lower risk of depression, whereas increased age at disability increased the risk of depression (P = 0.001). The elderly who had greater independence with daily activities were less likely to have depression (OR = 0.639 for mild depression and OR = 0.589 for severe depression). Those who were not married were more likely to have mild depression (OR = 3.203) and severe depression (OR = 29.119). compared to the married elderly. Age at acquiring disability was associated with higher risk for mild depression (OR = 1.025) and severe depression (OR = 1.053). Higher independence in ADL and being married were related with lower risk of depression, whereas increased age at disability increased the risk of depression (P = 0.001). CONCLUSION Independence in the ADL, being married, and being disabled as a young adult are negative predictors of depression in the elderly with disability.
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Affiliation(s)
- The Maria M. Widagdo
- Department of Public Health, Faculty of Medicine, Duta Wacana Christian University, Yogyakarta, Indonesia
| | | | - Setywanty Layuklinggi
- Department of Public Health, Faculty of Medicine, Duta Wacana Christian University, Yogyakarta, Indonesia
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Hung YC, Lao WL, Yeh CJ, Lee MC. The mediating effect of leisure activities in the relationship between depression and cognitive decline in middle age and older adults in Taiwan. BMC Geriatr 2023; 23:315. [PMID: 37217889 DOI: 10.1186/s12877-023-03984-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/19/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Depression can affect the development of cognitive functions, and there are many people with depressive symptoms and cognitive decline in the aging population. The role of mediators between depressive symptoms and the subsequent cognitive decline remains unclear. We aimed to investigate whether depressive symptoms can slow down cognitive decline through a mediator. METHODS A total of 3,135 samples were collected in 2003, 2007, and 2011. This study used the CES-D10 and SPMSQ (Short Portable Mental State Questionnaire) to measure depression and cognitive functions. The effect of depression trajectory on the subsequent cognitive dysfunction was analyzed using multivariable logistic regression, and the mediating effect was analyzed using the Sobel test. RESULTS The results of the multivariable linear regression analysis showed that after including different variables in each model, such as leisure activities and mobility in 2003 and 2007, women had a higher percentage of depressive symptoms in each model, compared to men. The effect of depression in 2003 on cognitive decline in 2011 was mediated by intellectual leisure activities in 2007 in men (Z=-2.01) and physical activity limitation in 2007 in women (Z=-3.02). CONCLUSIONS The mediation effect of this study shows that people with depressive symptoms will reduce their participation in leisure activities, which will lead to the degeneration of cognitive function. We suggest that if depressive symptoms are addressed as early as possible, people will have the ability and motivation to delay the decline of cognitive function through participation in leisure activities.
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Affiliation(s)
- Yu-Chan Hung
- Department of Public Health, Chung Shan Medical University, No.110, Sec.1, Jianguo N.Rd, Taichung City, 40201, Taiwan
| | - Wai-Lam Lao
- Department of Public Health, Chung Shan Medical University, No.110, Sec.1, Jianguo N.Rd, Taichung City, 40201, Taiwan
| | - Chih-Jung Yeh
- Department of Public Health, Chung Shan Medical University, No.110, Sec.1, Jianguo N.Rd, Taichung City, 40201, Taiwan.
| | - Meng-Chih Lee
- Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, No. 199, Section 1, Sanmin Rd, West District, 403, Taichung City, Taiwan.
- Institute of Medicine, Chung Shan Medical University, No.110, Sec.1, Jianguo N.Rd, Taichung City, 40201, Taiwan.
- Institute of Population Health Sciences, National Health Research Institutes, No.35, Keyan Road, Zhunan Town, Miaoli County, 35053, Taiwan.
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Wu Y, Li S, Han D, Zhang M, Zhao J, Liao H, Ma Y, Yan C, Wang J. The Mediating Role of Depression in Association Between Total Sleep Time and Instrumental Activities of Daily Living in China. Int J Public Health 2023; 68:1605678. [PMID: 37081904 PMCID: PMC10110912 DOI: 10.3389/ijph.2023.1605678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/15/2023] [Indexed: 04/07/2023] Open
Abstract
Objectives: This study aims to investigate the mediating role of depression and the moderating effect of gender in the relationship between total sleep time (TST) and instrumental activities of daily living (IADL) in middle-aged and elderly people (aged 45 or above).Methods: The data used in this study is from the China Health and Retirement Longitudinal Study (CHARLS), including a total of 10,460 respondents. Associations between TST, IADL, depression, and gender were analyzed using logistic regression and Karlson, Holm, and Breen (KHB) methods.Results: Short (OR = 1.42, 95% CI = 1.28–1.58 of ≤6 h) and long TST (OR = 1.16, 95% CI = 1.02–1.32 of 8–9 h; OR = 1.35, 95% CI = 1.19–1.54 of >9 h) were both associated with IADL. The mediation effect analyses observed that depression explained 64.80% of the total effect of short TST (≤6 h) and IADL, but was insignificant in long TST (8–9 h and >9 h). Meanwhile, gender has moderating effects on the mediation effect model.Conclusion: The study suggests that health interventions that focused on the dimensions of TST and depression are crucial for preventing functional disability while accounting for gender differences.
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Affiliation(s)
- Yunyi Wu
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sangsang Li
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dan Han
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mei Zhang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jie Zhao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Liao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Ma
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chaoyang Yan
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- The Key Research Institute of Humanities and Social Science of Hubei Province, Huazhong University of Science and Technology, Wuhan, China
- Institute for Poverty Reduction and Development, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Jing Wang,
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Kim Y, Kim J, Kim M, Song K, Choi M. Association of Depressive Mood and Frailty With Mortality and Health Care Utilization: Korean National Cohort Study. J Am Med Dir Assoc 2023; 24:504-510. [PMID: 36878262 DOI: 10.1016/j.jamda.2023.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVES To investigate the association of depressive mood and frailty with mortality and health care utilization (HCU) and identify the coexisting effect of depressive mood and frailty in older adults. DESIGN A retrospective study using nationwide longitudinal cohort data. SETTING AND PARTICIPANTS A total of 27,818 older adults age 66 years from the National Screening Program for Transitional Ages between 2007 and 2008, part of the National Health Insurance Service-Senior cohort. METHODS Depressive mood and frailty were measured by the Geriatric Depression Scale and Timed Up and Go test, respectively. Outcomes were mortality and HCU, including long-term care services (LTCS), hospital admissions, and total length of stay (LOS) from the index date to December 31, 2015. Cox proportional hazards regression and zero-inflated negative binomial regression were performed to identify differences in outcomes by depressive mood and frailty. RESULTS Participants with depressive mood and frailty represented 50.9% and 2.4%, respectively. The prevalence of mortality and LTCS use in the overall participants was 7.1% and 3.0%, respectively. More than 3 hospital admissions (36.7%) and total LOS above 15 days (53.2%) were the most common. Depressive mood was associated with LTCS use [hazard ratio (HR) 1.22, 95% confidence interval (CI) 1.05-1.42] and hospital admissions [incidence rate ratio (IRR) 1.05, 95% CI 1.02-1.08]. Frailty had associations with mortality risk (HR 1.96, 95% CI 1.44-2.68), LTCS use (HR 4.86, 95% CI 3.45-6.84), and LOS (IRR 1.30, 95% CI 1.06-1.60). The coexistence of depressive mood and frailty was associated with increased LOS (IRR 1.55, 95% CI 1.16-2.07). CONCLUSIONS AND IMPLICATIONS Our findings highlight the need to focus on depressive mood and frailty to reduce mortality and HCU. Identifying combined problems early in older adults may contribute to healthy aging by reducing adverse health outcomes and the burden of health care costs.
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Affiliation(s)
- Yesol Kim
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Jeewuan Kim
- Department of Statistics and Data Science, Yonsei University, Seoul, Republic of Korea
| | - Mihui Kim
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Kijun Song
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Mona Choi
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea.
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13
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Botoseneanu A, Elman MR, Allore HG, Dorr DA, Newsom JT, Nagel CL, Quiñones AR. Depressive Multimorbidity and Trajectories of Functional Status among Older Americans: Differences by Racial/Ethnic Group. J Am Med Dir Assoc 2023; 24:250-257.e3. [PMID: 36535384 PMCID: PMC10280885 DOI: 10.1016/j.jamda.2022.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 10/08/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study aims to evaluate the impact of depressive multimorbidity (ie, including depressive symptoms) on the long-term development of activities of daily living (ADL) and instrumental activities of daily living (IADL) limitations according to racial/ethnic group in a representative sample of US older adults. DESIGN Prospective, observational, population-based 16-year follow-up study of nationally representative sample. SETTING AND PARTICIPANTS Sample of older non-Hispanic Black, Hispanic, and nonHispanic White Americans from the Health and Retirement Study (2000‒2016, N = 16,364, community-dwelling adults ≥65 years of age). METHODS Data from 9 biennial assessments were used to evaluate the accumulation of ADL-IADL limitations (range 0‒11) among participants with depressive (8-item Center for Epidemiologic Studies Depression score≥4) vs somatic (ie, physical conditions only) multimorbidity vs those without multimorbidity (no or 1 condition). Generalized estimating equations included race/ethnicity (non-Hispanic Black, Hispanic, non-Hispanic White), baseline age, sex, body mass index, education, partnered, and net worth. RESULTS Depressive and somatic multimorbidity were associated with 5.18 and 2.95 times greater accumulation of functional limitations, respectively, relative to no disease [incidence rate ratio (IRR) = 5.18, 95% confidence interval, CI (4.38,6.13), IRR = 2.95, 95% CI (2.51,3.48)]. Hispanic and Black respondents experienced greater accumulation of ADL-IADL limitations than White respondents [IRR = 1.27, 95% CI (1.14, 1.41), IRR = 1.31, 95% CI (1.20, 1.43), respectively]. CONCLUSIONS AND IMPLICATIONS Combinations of somatic diseases and high depressive symptoms are associated with greatest accumulation of functional limitations over time in adults ages 65 and older. There is a more rapid growth in functional limitations among individuals from racial/ethnic minority groups. Given the high prevalence of multimorbidity and depressive symptomatology among older adults and the availability of treatment options for depression, these results highlight the importance of screening/treatment for depression, particularly among older adults with socioeconomic vulnerabilities, to slow the progression of functional decline in later life.
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Affiliation(s)
- Anda Botoseneanu
- Department of Health and Human Services, University of Michigan, Dearborn, MI, USA; Institute of Gerontology, University of Michigan, Ann Arbor, MI, USA.
| | - Miriam R Elman
- OHSU-PSU School of Public Health, Oregon Health and Science University, Portland, OR, USA
| | - Heather G Allore
- Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT, USA; Department of Biostatistics, School of Public Health, Yale University, New Haven, CT, USA
| | - David A Dorr
- Department of Medical Informatics and Clinical Epidemiology, OHSU, Portland, OR, USA
| | - Jason T Newsom
- Department of Psychology, Portland State University, Portland, OR, USA
| | - Corey L Nagel
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ana R Quiñones
- OHSU-PSU School of Public Health, Oregon Health and Science University, Portland, OR, USA; Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA
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14
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Gender Variation and Late-life Depression: Findings from a National Survey in the USA. AGEING INTERNATIONAL 2023; 48:263-280. [PMID: 34776562 PMCID: PMC8573074 DOI: 10.1007/s12126-021-09471-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 11/30/2022]
Abstract
Based on the Wave 3 National Social Life, Health, and Aging Project (2015-2016), this study has extensive breadth in examining the roles of multiple stressors (i.e., health-related, social relationship, community) and coping resources (i.e., social participation and social support from family and friends) in explaining depressive symptomatology among a recent cohort of the U.S. national sample of community-dwelling older men (n = 1,431) and women (n = 1,673). Statistical additive and interactive models were tested. Results from this pre-COVID study serve as a baseline, and show that gender had significant independent and joint effects on stress and coping factors in explaining depressive symptoms. Parallel regression analyses were conducted for each group. Findings suggest that significantly more women (26.9%) reported depressive symptoms than men (19.9%) (CESD-11 score ≥ 9). Multivariate analyses show that unique predictors for older men's depression include less support from friends, more cognitive challenges, and feeling less control in life. For women, less social participation, less emotional support from spouse, greater IADL impairment, and family disharmony were more significantly associated with their depressive symptoms than men's. Contrary to the literature, community factors were not statistically significant in predicting depressive symptoms. Findings suggest that correlates of depressive symptoms impact older women and men differently. Results point to the need for gender-sensitive mental health services and programs to protect community-dwelling older adults in USA against depression, especially in light of the recent COVID era social proximity restrictions.
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Yan Y, Du Y, Li X, Ping W, Chang Y. Physical function, ADL, and depressive symptoms in Chinese elderly: Evidence from the CHARLS. Front Public Health 2023; 11:1017689. [PMID: 36923048 PMCID: PMC10010774 DOI: 10.3389/fpubh.2023.1017689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 02/03/2023] [Indexed: 02/24/2023] Open
Abstract
Background Depressive symptoms are a serious public health problem that affects the mental health of older adults. However, current knowledge of the association between ADL disability and physical dysfunction and depressive symptoms in Chinese adults is insufficient. We intend to analyze the association between physical function, ADL, and depressive symptoms in older Chinese adults. Methods The data obtained from the China Health and Retirement Longitudinal Survey (2015 and 2018) (CHARLS). This includes 3,431 in 2015 and 3,258 in 2018 over the age of 60. Comparing 2015 and 2018 data, multivariate logistic regression models were used to explore the relationship between physical function, ADL, and depressive symptoms in urban and rural older adults, adjusting for sociodemographic factors associated with depression in older adults. Results The prevalence of depressive symptoms among older adults in China was 33.8 percent in 2015 and 50.6 percent in 2018. In baseline data from 2015 and 2018, residence, gender, marital status, drinking, physical function, ADL, and self-rated health were all found to be significantly associated with depressive symptoms in older adults. The differences in physical function, ADL and depressive symptoms among older adults in 2015 and 2018 were further analyzed based on urban and rural stratification. Both physical dysfunction and ADL disability were significantly associated with depressive symptoms in rural older adults in 2015 and 2018. And in urban areas, ADL was found to be significantly associated with depressive symptoms in urban older adults. Multivariate logistic regression analysis demonstrated that ADL disability was significantly associated with depressive symptoms among older adults in both urban and rural areas. Physical dysfunction was only significant in rural areas with depressive symptoms. The alpha level was instead set to 0.05 for all statistical tests. Conclusion Rural, female, 60-70 years of age, primary school or below, married, non-smoking, non-drinking, physical dysfunction, ADL disability and self-rated poor health make-up a higher proportion of depressed older adults. ADL disability and physical dysfunction were more likely to be associated with depressive symptoms in rural Chinese older adults. Therefore, the physical and mental health of rural elderly should be of concern. The rural older adults should receive additional support from the government and society.
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Affiliation(s)
- Yumeng Yan
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yiqian Du
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, China
| | - Xue Li
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Weiwei Ping
- School of Public Health, Shanxi Medical University, Taiyuan, China.,Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, China
| | - Yunqi Chang
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, China
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Kim T, Park SY, Oh IH. Health-related factors leading to disabilities in Korea: Survival analysis. Front Public Health 2022; 10:1048044. [PMID: 36620295 PMCID: PMC9813747 DOI: 10.3389/fpubh.2022.1048044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
The purpose of this study is to analyze (a) population and socioeconomic factors affecting disability, excluding the occurrence of disability due to accidents and congenital diseases, and (b) health-related behavioral factors and factors that can prevent and reduce the cause of disability due to disease in Korea. This study was a longitudinal research. Data were obtained from The 2018 Korean Health Panel (KHP) is a survey jointly conducted by the Korea Institute of Health and Social Affairs and the National Health Insurance Service. A total of 7, 372 (Mage = 52.14, SD = 21.39; Male = 47.52%) were analyzed in this study. People with Higher education attainments and more income levels were associated with lower hazard of developing new disabilities (all p < 0.05). In this study, the health factors that could be related to the occurrence of new disabilities were smoking, alcohol consumption, physical activity, and stress (all p < 0.0001). However, physical activity was negatively associated with the risk of developing a disability at all follow-ups (p < 0.05). Higher scores on the number of chronic diseases (valid scores = 0, 1, 2, 3, or more) represented a greater level of newly developing disability present at all follow-ups (all p < 0.0001). This longitudinal study confirmed the relationship between health-related factors and specific chronic diseases. Its findings can be used as a crucial foundation for establishing healthcare policies and services that can lower and prevent disability by preventing and reducing specific negative health behaviors and unhealthy behavioral factors, and alleviating chronic diseases in Korea.
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Affiliation(s)
- TaeEung Kim
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - So-Youn Park
- Department of Medical Education and Humanities, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea,*Correspondence: In-Hwan Oh ✉
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Nguyen VC, Moon S, Oh E, Hong GRS. Factors Associated With Functional Limitations in Daily Living Among Older Adults in Korea: A Cross-Sectional Study. Int J Public Health 2022; 67:1605155. [PMID: 36570875 PMCID: PMC9780261 DOI: 10.3389/ijph.2022.1605155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
Objective: This paper assesses the relationship between demographics, health parameters, and functional limitations among older adults in Korea, including limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Methods: We analyzed data from the Korean Longitudinal Study of Aging survey in 2020 and included only participants aged 65 and older. Multinomial logistic regression models were conducted to evaluate the factors that predicted functional limitations. Results: The prevalence of at least one ADL and IADL limitations were 6.14% (severe 1.94% and moderate 4.20%) and 15.49% (severe 3.11% and moderate 12.38%), respectively. People aged 85 and older had high rates of severe disability with 7.37% for ADLs and 12.06% for IADLs. High rates also occurred among people with low education, underweight, physical inactivity, depression, and three or more chronic diseases. Conclusion: Factors associated with functional limitations were age, educational status, body mass index, physical activity, depression, and chronic diseases. To prevent and improve functional limitations in the older populations, active and applicable interventions should be considered for modifiable factors such as physical activity, depression, and abnormal weight.
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Affiliation(s)
| | - SeolHawa Moon
- Research Institute of Nursing Science, Hanyang University, Seoul, South Korea
| | - Eunmi Oh
- Research Institute of Nursing Science, Hanyang University, Seoul, South Korea
| | - Gwi-Ryung Son Hong
- College of Nursing, Hanyang University, Seoul, South Korea,*Correspondence: Gwi-Ryung Son Hong,
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Pengpid S, Peltzer K. Mental distress and incident functional disability among a rural ageing population in South Africa. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5840. [PMID: 36371616 PMCID: PMC9828020 DOI: 10.1002/gps.5840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 11/02/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The aim of the study was to investigate the association between mental symptoms and incident functional disability among middle-age and older adults in South Africa. METHODS Longitudinal data from two consecutive population surveys (2014/2015-2018/2019) in Agincourt, South Africa, were analysed. RESULTS In total, 298 of 3813 participants without functional disability in wave 1 (8.8%) had functional disability in wave 2. The prevalence of baseline functional disability was 9.1%. In the fully adjusted models for people without functional disability at baseline, depressive symptoms (AOR: 1.74, 95% CI: 1.08-2.80) among men and lower life satisfaction among men (AOR: 0.86, 95% CI: 0.80-0.93) and among women (AOR: 0.90, 95% CI: 0.83-0.98) increased the odds of incident functional disability. Posttraumatic stress disorder symptoms, poor sleep quality, restless sleep, and loneliness were not significantly associated with incident functional disability. CONCLUSIONS Depressive symptoms among men and lower life satisfaction among both sexes were independently associated with incident functional disability in ageing rural South Africans.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral SciencesFaculty of Public HealthMahidol UniversityBangkokThailand
- Department of Public HealthSefako Makgatho Health Sciences UniversityPretoriaSouth Africa
- Department of Healthcare AdministrationCollege of Medical and Health ScienceAsia UniversityTaichungTaiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral SciencesFaculty of Public HealthMahidol UniversityBangkokThailand
- Department of PsychologyUniversity of the Free StateBloemfonteinSouth Africa
- Department of PsychologyCollege of Medical and Health ScienceAsia UniversityTaichungTaiwan
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Fu X, Su Y, Zeng C, Liu L, Guo Y, Wu Y. The mediation and interaction of depressive symptoms in activities of daily living and active aging in rural elderly: A cross-sectional survey. Front Public Health 2022; 10:942311. [PMID: 36187612 PMCID: PMC9517948 DOI: 10.3389/fpubh.2022.942311] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/19/2022] [Indexed: 01/25/2023] Open
Abstract
Background Compared with urban areas, old adults in rural areas have limited access to medical and health resources in China. Active of daily living ability (ADL) decline and depressive symptoms are common in rural older adults. In particular, the depressive symptoms of the elderly in rural areas are often ignored. Thus, it is difficult to realize high-level active aging at the individual level. In order to explore the effects of ADL and depressive symptoms on the active aging of rural elderly, we conducted a survey and analyzed the mediation and interaction effects of depressive symptoms of ADL on active aging. Methods From July to November 2019, a cross-sectional study of 945 elderly rural individuals was conducted in three townships in Xiangtan County, China. Active aging, ADL, and depressive symptoms were assessed using the positive aging questionnaire (PAEQ), ADL scale, and depression in old age scale (DIA-S), respectively. PROCESS macro program model 4 and logistic regression were used to explore the mediation and interaction between ADL and depressive symptoms on active aging. Results The proportions of rural elderly with an active aging level were 23.5% (well above average), 50.9% (above average), 24.1% (below average), 1.5% (well below average), respectively. The rates of ADL decline and depressive symptoms were 44.7 and 19.7%, respectively. Mediated effect analysis showed that the relationship between ADL and active aging could be partly mediated by depressive symptoms (ab = -0.2382, boot SE = 0.0437), and the 95% confidence interval was [-0.3311, -0.1584]. The mediating effect proportion of the total effect was 30.7%. Logistic regression showed that ADL and depressive symptoms have an interactive additive effect on active aging. The relative excess risk of interaction (RERI), the attributable proportion due to interaction (API), and the synergy index (SI) scores were 13.109, 0.621, and 2.871, respectively. Older adults with ADL decline and depressive symptoms had higher (OR = 21.115) odds of well-below-average active aging compared with older adults with ADL decline (OR = 3.258) or only depressive symptoms (OR = 5.749). Conclusion The findings suggest that the association between ADL and active aging is persistent and partly mediated by depressive symptoms, and comorbid depressive symptoms and ADL decline have an additive effect on active aging. Maintaining independence is an important factor for realizing active aging. However, for the rural elderly with ADL decline and low-level active aging, we can promote the realization of high-level active aging at the individual level through the prevention and treatment of depressive symptoms based on multidisciplinary care.
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Affiliation(s)
- Xuelian Fu
- School of Nursing, Xiangtan Medicine and Health Vocational College, Xiangtan, China
| | - Yinli Su
- School of Nursing, Xiangtan Medicine and Health Vocational College, Xiangtan, China
| | - Chunyan Zeng
- School of Nursing, Xiangtan Medicine and Health Vocational College, Xiangtan, China
| | - Liqiong Liu
- School of Nursing, Xiangtan Medicine and Health Vocational College, Xiangtan, China
| | - Yang Guo
- School of Nursing, Xiangtan Medicine and Health Vocational College, Xiangtan, China
| | - Yuanyuan Wu
- Nursing Department, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
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Numbers K, Jang S, Brodaty H, Sachdev PS, Draper B, Reppermund S. Instrumental Activities of Daily Living by Subjective and Objective Measures: The Impact of Depression and Personality. Front Aging Neurosci 2022; 14:829544. [PMID: 35936773 PMCID: PMC9353936 DOI: 10.3389/fnagi.2022.829544] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Previous research shows that depression and personality are independently associated with self- and informant-reports of the ability to perform instrumental activities of daily living (IADLs). However, less is known about the association between depression and personality and performance-based measures of IADLs. We aimed to determine how depression and personality predict self-and informant-reports of IADL compared to performance-based measures of IADLs in a sample of older adults with normal cognition (NC) and Mild Cognitive Impairment (MCI). Methods Participants consisted of 385 older adults with NC (n = 235), or a diagnosis of MCI (n = 150), aged between 76 and 99-years from the Sydney Memory and Ageing Study. Participants underwent comprehensive neuropsychological and clinical assessments to determine global cognition and clinical diagnoses. Personality traits were measured by the NEO Five-Factor Inventory (NEO-FFI) and depression by the Geriatric Depression Scale (GDS). Subjective IADLs were self- and informant-reported Bayer Activities of Daily Living (B-ADL) scales and objective IADL was the Sydney Test of Activities of Daily Living in Memory Disorders (STAM). Linear regressions examined the relationship between depression and personality and the three types of IADL measures, controlling for all covariates and global cognition. Results Participant-reported IADL, although associated with global cognition, was more strongly associated with GDS and NEO-FFI scores (conscientiousness and neuroticism). Informant-reported IADL was strongly associated with both global cognition and participants' GDS scores. STAM scores were not associated with participants' GDS or NEO-FFI scores; instead, they were predicted by demographics and global cognition. Conclusion These results suggest that performance-based measures of IADL may provide more objective and reliable insight into an individual's underlying functional ability and are less impacted by the participants' mood and personality compared to subjectively reported IADL. We argue that performance-based IADL measures are preferable when trying to accurately assess everyday functional ability and its relationship to cognitive status. Where performance-based measures are not available (e.g., in some clinical settings), informant ratings should be sought as they are less influenced by the participant's personality and mood compared to self-reports.
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Affiliation(s)
- Katya Numbers
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Sujin Jang
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Brian Draper
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Simone Reppermund
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Department of Developmental Disability Neuropsychiatry, Faculty of Medicine and Health, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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Early strong predictors of decline in instrumental activities of daily living in community-dwelling older Japanese people. PLoS One 2022; 17:e0266614. [PMID: 35381051 PMCID: PMC8982840 DOI: 10.1371/journal.pone.0266614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 03/23/2022] [Indexed: 11/19/2022] Open
Abstract
Objective Our aim is to determine the strong predictors of the onset of instrumental activities of daily living (IADL) decline in community-dwelling older people. Design A prospective cohort study with a two-year follow-up. Setting Kashiwa City, Chiba Prefecture, Japan and Toshima Ward, Tokyo Metropolitan, Japan. Participants The data were acquired from two cohorts. The final sample comprised 1,523 community-dwelling older people aged 65–94 years (681 men, 842 women). They were individuals who were independent in IADL at baseline and participated in follow-up IADL assessments two years later. Measurements At baseline, comprehensive assessments were performed including: health interview, gait function, hand-grip strength, skeletal muscle mass, balance function, oral function, dietary lifestyle, cognitive function, quality of life, mental status, and social network. When the two-year follow-up was performed, IADL declines were observed in 53 out of 1,523 people. The association of each Z-transformed parameter with the occurrence of IADL decline was examined by employing a binominal logistic regression model adjusting for age, gender, body weight, body height, and medical history. An odds ratio (OR) and a 95% confidence interval were calculated and compared between different parameters. Results A decrease in walking speed and one-legged stance time, whereas an increased timed up & go test time was associated with significant ORs for the occurrence of IADL decline. Conclusion Gait-related parameters appear to be the strong predictors of the onset of IADL decline in community-dwelling older people.
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Nomogram for predicting the 12-year risk of ADL disability among older adults. Aging Clin Exp Res 2022; 34:1583-1591. [PMID: 35301701 DOI: 10.1007/s40520-022-02105-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/24/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Previous studies have identified plenty of risk factors for activities of daily living (ADL). However, there are no reliable and widely available prediction models for ADL disability up to now. This study aimed to develop and validate a nomogram for predicting the 12-year risk of ADL disability in older adults. METHODS Data from 4,809 participants in the English Longitudinal Study of Ageing (ELSA) and 18,620 participants in the Survey of Health, Ageing and Retirement in Europe (SHARE) were used as training set and validation set, respectively. We used the least absolute shrinkage and selection operator (LASSO) and Cox regression to screen the predictors and develop the nomogram. The P value, concordance index (C-index), integrated area under the ROC (receiver operating characteristic) curve (AUC) and calibration curves were used to validate the nomogram. RESULTS During 12 years, 30.0% (n = 1,441) participants developed ADL disability in the training set, while the corresponding percentages were 18.5% in the validation set (n = 3,445). After screening, 13 variables were contained in the final prediction model. In ADL nomogram, the C-index and AUC were 0.744 ± 0.013 and 0.793 in internal valid ation, respectively, while in external validation, the C-index and AUC were 0.755 ± 0.009 and 0.796. CONCLUSIONS This study developed and validated a nomogram that predicts functional disability. The application of the predictive model could have important implications for patient prognosis and health care.
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Miyawaki CE, Liu M, Park VT, Tran MT, Markides KS. Social support as a moderator of physical disability and mental health in older Vietnamese immigrants in the U.S.: Results from the Vietnamese aging and care survey (VACS). Geriatr Nurs 2022; 44:151-158. [DOI: 10.1016/j.gerinurse.2022.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 01/03/2023]
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Chen X, Chu NM, Basyal PS, Vihokrut W, Crews D, Brennan DC, Andrews SR, Vannorsdall TD, Segev DL, McAdams-DeMarco MA. Depressive Symptoms at Kidney Transplant Evaluation and Access to the Kidney Transplant Waitlist. Kidney Int Rep 2022; 7:1306-1317. [PMID: 35694557 PMCID: PMC9174041 DOI: 10.1016/j.ekir.2022.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 12/11/2022] Open
Abstract
Introduction Depressive symptoms, even without a clinical diagnosis of depression, are common in kidney failure patients and may be a barrier to completing the complex process of kidney transplant (KT) evaluation. We assessed depressive symptom burden and association between depressive symptoms and access to KT waitlist by age. Methods In a prospective cohort of 3728 KT patients (aged 18–88 years), the Center for Epidemiologic Studies—Depression (CES-D) scale was used to measure depressive symptoms at evaluation. Depressive symptom severity was defined as follows: none: 0; minimal: 1 to 15; mild: 16 to 20; moderate: 21 to 25; severe: 26 to 60. Hazard ratios (HRs) of active listing within 1 year after evaluation were estimated using Cox proportional hazards models, adjusted for clinical and social factors. Results At evaluation, 85.8% of the patients reported at least minimal depressive symptoms; the proportion was lower among older patients: 18 to 29 years = 92.0%; 30 to 39 years = 88.3%; 40 to 49 years = 87.2%; 50 to 59 years = 87.0%; 60 to 69 years = 83.4%; and ≥70 years = 82.0%. Chance of active listing decreased with more severe depressive symptoms (log-rank, P < 0.001). After adjustment, every 5-point higher CES-D score (more depressive symptoms) was associated with a 13% lower chance of listing (HR = 0.87, 95% CI: 0.85–0.90); the strongest association was found among patients aged ≥70 years (adjusted HR [aHR] = 0.73, 95% CI: 0.62–0.86). Furthermore, minimal (HR = 0.69, 95% CI: 0.60–0.79), mild (HR = 0.57, 95% CI: 0.44–0.72), moderate (HR = 0.53, 95% CI: 0.39–0.71), and severe (HR = 0.44, 95% CI: 0.34–0.57) depressive symptoms were all associated with a lower chance of listing. Conclusion Older candidates were less likely to report depressive symptoms at KT evaluation. Regardless of age, candidates who did report depressive symptoms, and even minimal symptoms, had a lower chance of listing. Transplant centers should routinely screen patients for depressive symptoms and refer the affected patients to mental health services to improve access to KT.
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Affiliation(s)
- Xiaomeng Chen
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nadia M. Chu
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Pragyashree Sharma Basyal
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Wasurut Vihokrut
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Deidra Crews
- Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Daniel C. Brennan
- Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sarah R. Andrews
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Tracy D. Vannorsdall
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dorry L. Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Surgery, NYU Grossman School of Medicine, NYU Langone Health, New York, New York, USA
| | - Mara A. McAdams-DeMarco
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Surgery, NYU Grossman School of Medicine, NYU Langone Health, New York, New York, USA
- Correspondence: Mara A. McAdams-DeMarco, Department of Surgery, NYU Grossman School of Medicine, NYU Langone Health, 1 Park Ave, 6-704, New York, New York 10016, USA.
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Xiao S, Shi L, Xue Y, Zheng X, Zhang J, Chang J, Lin H, Zhang R, Zhang C. The relationship between activities of daily living and psychological distress among Chinese older adults: A serial multiple mediation model. J Affect Disord 2022; 300:462-468. [PMID: 34954333 DOI: 10.1016/j.jad.2021.12.069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/20/2021] [Accepted: 12/19/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Few studies have shed light on the mechanisms underlying the link between activities of daily living (ADL) and psychological distress. This study aimed to explore the multiple mediating roles of loneliness and sleep quality in this relationship among Chinese older adults. METHODS A total of 3250 older adults completed the Barthel Index, UCLA 20-item Loneliness Scale, Pittsburgh Sleep Quality Index, and Depression, Anxiety, and Stress Scale Questionnaire. Serial multiple mediation analysis was conducted using Hayes' PROCESS macro. RESULTS ADL was found to directly impact psychological distress through three significant mediation pathways: (1) loneliness (B=-0.124, 95% CI=-0.140, -0.109), which accounted for 23.98% of the total effect, (2) sleep quality (B=-0.050, 95% CI=-0.063, -0.039), which accounted for 9.67% of the total effect, and (3) loneliness and sleep quality (B=-0.015, 95% CI=-0.020, -0.012), accounting for 2.91% of the total effect. The total mediating effect was 36.56%. LIMITATIONS The cross-sectional design we used limited causal interpretations. Future studies could examine longitudinal changes in outcome measures. CONCLUSIONS These findings highlight the role of loneliness and sleep quality as serial mediators of the relationship between ADL and psychological distress. Thus, for the early detection and prevention of psychological distress, it is necessary to conduct loneliness and sleep quality interventions for older adults with ADL limitations.
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Affiliation(s)
- Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China; School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China; School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Jinghui Chang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Huang Lin
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Ruibin Zhang
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China; Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Institute of Health Management, Southern Medical University, Guangzhou, Guangdong, China.
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Zhao D, Li J, Gao T, Sun J, Wang Y, Wang Q, Zhou C. Do older adults with multimorbidity prefer institutional care than those without multimorbidity? The role of functional limitation. BMC Geriatr 2022; 22:126. [PMID: 35164697 PMCID: PMC8845225 DOI: 10.1186/s12877-022-02812-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/31/2022] [Indexed: 01/06/2023] Open
Abstract
Background Population ageing and social transformation present tremendous challenges to the informal support system of older adults, which engendered institutional care in China. This study aimed to examine the association between multimorbidity and institutional care willingness, and investigate whether there is an interaction effects between multimorbidity and functional limitations on institutional care willingness among Chinese older adults. Methods Data were obtained from the sixth National Health Service Survey of Shandong province, China. The sample included 8583 older adults (age ≥ 60 years; 51.7% women), 44.8% without chronic diseases, 34.8% and 20.4% with one chronic condition and multimorbidity, respectively. Multivariable logistic regression models and marginal effects analysis were used to the interaction effects analysis. Results A total of 666 (7.8%) participants had institutional care willingness in Shandong, China. Participants with multimorbidity were more likely to have institutional care willingness than their peers without chronic condition (OR = 1.25, 95% CI = 1.06, 1.55) after adjusted for confounders. Marginal effect analysis showed that under the condition that other variables remain unchanged, the probability of them with multimorbidity choosing institutional care for older adults with functional limitations was 6.9% lower than those without multimorbidity (95% CI = -0.128, -0.010, P = 0.023). The interaction effect between chronic health conditions and functional limitation for older adults to choose institutional care was statistically significant, and the average interaction effect was 4.83% (Z = -2.70, \documentclass[12pt]{minimal}
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\begin{document}$${S}_{\overline{x} }$$\end{document}Sx¯ = 0.0189, P < 0.05). Conclusions This relationship between multimorbidity and institutional care willingness varied by functional limitations. To better meet the care needs among older adults with multimorbidity and functional limitations, more resources and incentives should be provided to encourage the building-up of eldercare institutions. The governments should also establish long-term care system and to provide better home-based care for older adults, as older adults who prefer home care remain the majority. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02812-2.
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Affiliation(s)
- Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Jie Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Tingting Gao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Jingjie Sun
- Shandong Health Commission Medical Management Service Center, Jinan, 250012, China
| | - Yi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Qiong Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China. .,NHC Key Lab of Health Economics and Policy Research, Shandong University, 250012, Jinan, China.
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Ning H, Du Y, Zhao Y, Liu Q, Li X, Zhang H, Jiang D, Feng H. Longitudinal impact of metabolic syndrome and depressive symptoms on subsequent functional disability among middle-aged and older adults in China. J Affect Disord 2022; 296:216-223. [PMID: 34614438 DOI: 10.1016/j.jad.2021.09.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Few studies examining the impact of metabolic syndrome and depressive symptoms on subsequent functional disability are available. OBJECTIVES To determine the impact of baseline metabolic syndrome and depressive symptoms on subsequent functional disability. METHODS This study used data from the 2011 baseline and 2013, 2015 and 2018 follow-up waves of the China Health and Retirement Longitudinal Study (CHARLS). Functional status was assessed by activities of daily living (ADLs) and instrumental ADLs (IADLs). Analyses were restricted to middle-aged and older adults (≥50 years) free of functional disability at baseline. Metabolic syndrome, depressive symptoms, and covariates were measured at baseline. New-onset ADL and IADL disability were obtained in follow-up measurements. Competitive risks based on survival analysis were conducted to examine the impact of baseline metabolic syndrome and depressive symptoms on subsequent functional disability after covariates were controlled. RESULTS Baseline depressive symptoms significantly predicted functional disability over a 7-year follow-up after adjusting for covariates (Hazard ratio [HR] = 1.54, 95% confidence intervals [CI] = 1.40-1.70 for ADL disability; HR=1.36, 95% CI=1.25-1.48 for IADL disability). Metabolic syndrome significantly predicted ADL disability (HR=1.25, 95% CI=1.14-1.38) but not IADL disability (HR=1.02, 95% CI=0.94-1.10). No significant additive interaction between metabolic syndrome and depressive symptoms on functional disability was found. CONCLUSION The current study found that baseline depressive symptoms were significantly associated with both ADL and IADL disabilities, while metabolic syndrome significantly predicted ADL disability. In addition, some indications showed that the effect in those with both conditions was greater than the sum of the effects separately.
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Affiliation(s)
- Hongting Ning
- Xiangya School of Nursing, Central South University. Changsha, Hunan, China
| | - Yan Du
- School of Nursing, University of Texas Health Science Center at San Antonio. San Antonio, TX, United States
| | - Yinan Zhao
- Xiangya School of Nursing, Central South University. Changsha, Hunan, China
| | - Qingcai Liu
- Xiangya School of Nursing, Central South University. Changsha, Hunan, China
| | - Xiaoyang Li
- Xiangya School of Nursing, Central South University. Changsha, Hunan, China
| | - Hongyu Zhang
- Xiangya School of Nursing, Central South University. Changsha, Hunan, China
| | - Dian Jiang
- Xiangya School of Nursing, Central South University. Changsha, Hunan, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University. Changsha, Hunan, China; Xiangya-Oceanwide Health Management Research Institute, Central South University. Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China.
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Vasquez-Goñi GA, Papuico-Romero BM, Urrunaga-Pastor D, Runzer-Colmenares FM, Parodi JF. The depressed frail phenotype as a risk factor for mortality in older adults: A prospective cohort in Peru. Heliyon 2022; 8:e08640. [PMID: 35028442 PMCID: PMC8741456 DOI: 10.1016/j.heliyon.2021.e08640] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/23/2021] [Accepted: 12/16/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Frailty and depression can coexist as depressed frail phenotype, useful for the comprehensive evaluation of older adults and prevention of adverse outcomes. The objective of this study was to evaluate the role of the depressed frail phenotype and its components as risk factors for mortality in older adults of the Centro Médico Naval (CEMENA) of Peru during 2010-2015. MATERIAL AND METHODS We carried out a secondary data analysis of a prospective cohort that included older adults (60 years and older) treated in the Geriatrics service of CEMENA between the years 2010-2015. Frailty was defined as the presence of three or more Fried phenotype criteria and depression was determined using a Yesavage ultrashort scale score of three or more. The presence of both conditions was defined as depressed frail phenotype. In addition, sociodemographic characteristics, medical and personal history, and performance-based measures were included. We employed crude and adjusted Cox regression models to evaluate the association of interest and estimate Hazard Ratios (HR) with their respective 95% confidence intervals (95% CI). RESULTS 946 older adults were included in the analysis, with a mean age of 78.0 ± 8.5 years. 559 (59.1%) were male, 148 (15.6%) were found to be frail, 231 (24.4%) had depressive symptoms, 105 (11.1%) had depressed frail phenotype, and 79 (8.3%) participants died during follow-up. The adjusted Cox regression analysis revealed that depressed frail phenotype (HR = 3.53; 95%CI: 2.07-6.00; p < 0.001) was a risk factor for mortality in older adults. CONCLUSIONS The depressed frail phenotype was associated with a higher risk of mortality in older adults. It is necessary to develop longitudinal studies that allow estimating this phenotype's impact on mortality and evaluate interventions to improve quality of life and reduce the risk of adverse outcomes.
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Affiliation(s)
- Gabriel A.J. Vasquez-Goñi
- Universidad Científica del Sur, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Lima, Perú
| | - Basilio M. Papuico-Romero
- Universidad Científica del Sur, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Lima, Perú
| | - Diego Urrunaga-Pastor
- Universidad Científica del Sur, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Lima, Perú
| | - Fernando M. Runzer-Colmenares
- Universidad Científica del Sur, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Lima, Perú
- Universidad de San Martin de Porres, Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Lima, Perú
| | - José F. Parodi
- Universidad de San Martin de Porres, Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Lima, Perú
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Dong CH, Gao CN, An XH, Li N, Yang L, Li DC, Tan Q. Nocturnal dexmedetomidine alleviates post-intensive care syndrome following cardiac surgery: a prospective randomized controlled clinical trial. BMC Med 2021; 19:306. [PMID: 34865637 PMCID: PMC8647374 DOI: 10.1186/s12916-021-02175-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dexmedetomidine is a sedative agent that may have the potential to reduce the risk of post-intensive care syndrome (PICS). This study aimed to establish whether prophylactic nocturnal dexmedetomidine safely reduces postoperative PICS incidence and to develop an easy-to-use model for predicting the risk of PICS following cardiac surgery. METHODS This was a single-center, double-blind, randomized, prospective, placebo-controlled trial. Patients undergoing cardiac surgery were randomly assigned (1:1) to dexmedetomidine or placebo (normal saline) groups between January 2019 and July 2020. Dexmedetomidine or a similar volume of saline was administered, with an infusion rate up to 1.2 μg/kg/h until the RASS remained between - 1 and 0. The primary study endpoint was PICS incidence at 6 months follow-up, as defined by cognitive, physical, or psychological impairments. RESULTS We assessed 703 individuals for eligibility, of whom 508 were enrolled. Of these, there were 251 in the dexmedetomidine group and 257 in the placebo group that received the trial agent, forming a modified intention-to-treat population. PICS incidence at 6-month follow-up was significantly decreased in the dexmedetomidine group (54/251, 21.5%) relative to the placebo group (80/257, 31.1%) (odds ratio [OR] 0.793, 95% CI 0.665-0.945; p = 0.014). Psychological impairment was significantly reduced in the dexmedetomidine group relative to the placebo group (18.7% vs. 26.8%, OR 0.806, CI 0.672-0.967, p = 0.029). However, dexmedetomidine treatment was associated with a higher rate of hypotension. A nomogram revealed that age, education, a medical history of diabetes and smoking, dexmedetomidine treatment, postoperative atrial fibrillation, and sequential organ failure assessment scores at 8 h post-surgery were independent predictors of PICS. CONCLUSIONS Prophylactic nocturnal dexmedetomidine administration significantly reduced PICS incidence by a marked reduction in psychological impairment within a 6-month follow-up period. TRIAL REGISTRATION ChiCTR, ChiCTR1800014314 . Registered 5 January 2018, http://www.chictr.org.cn/index.aspx.
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Affiliation(s)
- Chun-hui Dong
- Department of Cardiac Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 9677 Jingshi Road, Jinan, 250021 Shandong China
| | - Chao-nan Gao
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China
- Healthcare Big Data Institute of Shandong University, Jinan, 250000 Shandong China
| | - Xiao-hua An
- Department of Anesthesiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 Shandong China
| | - Na Li
- Department of Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 Shandong China
| | - Le Yang
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 Shandong China
| | - De-cai Li
- Department of Cardiac Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 9677 Jingshi Road, Jinan, 250021 Shandong China
| | - Qi Tan
- Department of Cardiac Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 9677 Jingshi Road, Jinan, 250021 Shandong China
- Department of Cardiac Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021 Shandong China
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Rong J, Wang X, Ge Y, Chen G, Ding H. Association between functional disability and depressive symptoms among older adults in rural China: a cross-sectional study. BMJ Open 2021. [PMCID: PMC8719149 DOI: 10.1136/bmjopen-2020-047939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
ObjectivesThe aim of this study was to explore the relationship between functional disability and depressive symptoms, focusing on whether an interaction exists between functional disability, demographic characteristics and depressive symptoms among older adults in rural China.DesignA cross-sectional study using multistage, stratified random sampling.SettingData from 18 villages in Anhui Province of China between January to July 2018.Participants3491 Chinese participants aged 60 and over.Primary and secondary outcome measuresThe 30-item Geriatric Depression Scale and WHO Disability Assessment Schedule 2.0 were used to evaluate depressive symptoms and functional disability, respectively. Data were analysed using SPSS statistics V.25.0 program with χ2 test, Mann-Whitney U test, binary logistic regression analysis and classification and regression tree (CART) model.ResultsThe prevalence of depressive symptoms in 3336 interviewed older people was 52.94%. After adjustment, subjects who had problems in mobility domain (adjusted OR (AOR) 1.842, 95% CI 1.503 to 2.258), getting along domain (AOR 1.616, 95% CI 1.299 to 2.010), life activities domain (AOR 1.683, 95% CI 1.370 to 2.066) and participation domain (AOR 3.499, 95% CI 2.385 to 4.987) had an increased depressive symptoms risk. However, cognition domain (AOR 0.785, 95% CI 0.647 to 0.953) negatively correlated with depressive symptoms. Additionally, the CART model showed that those who had problems in mobility domain, getting along domain and were unemployed, the possibility of having depressive symptoms was the highest.ConclusionsMore attention should be paid to unemployed older adults, and those with problems in participation, life activities, getting along and mobility and no problems in cognition to maintain a good psychological state.
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Affiliation(s)
- Jian Rong
- Department of Scientific Research, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xueqin Wang
- Department of Medical Engineering, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yanhong Ge
- Department of Health Service Management, Anhui Medical University, Hefei, Anhui, China
| | - Guimei Chen
- Department of Health Service Management, Anhui Medical University, Hefei, Anhui, China
| | - Hong Ding
- Department of Health Service Management, Anhui Medical University, Hefei, Anhui, China
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Yu J, Si H, Qiao X, Jin Y, Ji L, Liu Q, Bian Y, Wang W, Wang C. Predictive value of intrinsic capacity on adverse outcomes among community-dwelling older adults. Geriatr Nurs 2021; 42:1257-1263. [PMID: 34555568 DOI: 10.1016/j.gerinurse.2021.08.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To examine the predictive value of intrinsic capacity on one-year incident adverse outcomes among community-dwelling older adults. METHODS A total of 756 community-dwelling older adults aged ≥ 60 years were followed up after 1 year. Intrinsic capacity was assessed using the revised integrated care for older people screening tool. Adverse outcomes included incident disability, recurrent falls, hospitalization, emergency department visits, and poor quality of life. Multivariate logistic regression models were performed to evaluate the predictive value of intrinsic capacity domains on adverse outcomes. RESULTS Cognitive decline, limited mobility, visual impairment and depressive symptoms predicted incident disability. Visual impairment predicted recurrent falls. Cognitive decline and limited mobility predicted emergency department visits. Limited mobility predicted poor quality of life. DISCUSSION Intrinsic capacity could predict incident adverse outcomes among community-dwelling older adults. Assessing intrinsic capacity would facilitate early identification of older adults at high risk of adverse outcomes and prompt targeted interventions.
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Affiliation(s)
- Jiaqi Yu
- Peking University; No.38 Xueyuan Road, Beijing, 100191; P. R. China
| | - Huaxin Si
- Peking University; No.38 Xueyuan Road, Beijing, 100191; P. R. China
| | - Xiaoxia Qiao
- Peking University; No.38 Xueyuan Road, Beijing, 100191; P. R. China
| | - Yaru Jin
- Peking University; No.38 Xueyuan Road, Beijing, 100191; P. R. China
| | - Lili Ji
- Peking University; No.38 Xueyuan Road, Beijing, 100191; P. R. China
| | - Qinqin Liu
- Peking University; No.38 Xueyuan Road, Beijing, 100191; P. R. China
| | - Yanhui Bian
- Peking University; No.38 Xueyuan Road, Beijing, 100191; P. R. China
| | - Wenyu Wang
- Peking University; No.38 Xueyuan Road, Beijing, 100191; P. R. China
| | - Cuili Wang
- Peking University; No.38 Xueyuan Road, Beijing, 100191; P. R. China.
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Ma Y, Xiang Q, Yan C, Liao H, Wang J. Relationship between chronic diseases and depression: the mediating effect of pain. BMC Psychiatry 2021; 21:436. [PMID: 34488696 PMCID: PMC8419946 DOI: 10.1186/s12888-021-03428-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic diseases have a high incidence in China and may cause pain and depression. However, the association of chronic diseases with pain and the incidence of depression has not been comprehensively investigated. METHODS The study population was obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The cross-sectional data from15,213 persons were included. CHARLS provides nationally representative data from21,097 individuals aged 45 years and older in approximately 150 districts and 450 villages. The main outcome was the incidence of depression. The main independent variable was chronic disease (no chronic disease, one chronic disease, and two or more chronic diseases). The mediators were the degree of pain (no pain, mild pain, and moderate to severe pain) and whether measures were taken to relieve pain (measures taken and no measures taken). We performed chi-square and binary logistic regression analyses of the associations of chronic disease with pain and the incidence of depression. The mediation model was examined using the Sobel test. RESULTS Patients with more chronic diseases had more severe pain (OR = 3.697, P < 0.001, CI = 2.919-4.681) and were more likely to develop depression (OR = 2.777, P < 0.001, CI = 2.497-3.090). The degree of pain partially mediated the interaction between chronic disease and depression in this study (t = 7.989, P < 0.001). The incidence of depression was high in people who were female, less educated, unmarried, living in rural areas, and working. CONCLUSIONS The degree of pain had a partial mediating effect on chronic disease and depression. Pain relief measures should be considered when treating patients with depression.
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Affiliation(s)
- Ying Ma
- grid.33199.310000 0004 0368 7223Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 Hubei China
| | - Qin Xiang
- grid.33199.310000 0004 0368 7223Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 Hubei China
| | - Chaoyang Yan
- grid.33199.310000 0004 0368 7223Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 Hubei China
| | - Hui Liao
- grid.33199.310000 0004 0368 7223Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 Hubei China
| | - Jing Wang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. .,The Key Research Institute of Humanities and Social Science of Hubei Province, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. .,Institute for Poverty Reduction and Development, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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Lin S, Wu Y, Fang Y. Comparison of Regression and Machine Learning Methods in Depression Forecasting Among Home-Based Elderly Chinese: A Community Based Study. Front Psychiatry 2021; 12:764806. [PMID: 35111085 PMCID: PMC8801448 DOI: 10.3389/fpsyt.2021.764806] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/26/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Depression is highly prevalent and considered as the most common psychiatric disorder in home-based elderly, while study on forecasting depression risk in the elderly is still limited. In an endeavor to improve accuracy of depression forecasting, machine learning (ML) approaches have been recommended, in addition to the application of more traditional regression approaches. METHODS A prospective study was employed in home-based elderly Chinese, using baseline (2011) and follow-up (2013) data of the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative cohort study. We compared four algorithms, including the regression-based models (logistic regression, lasso, ridge) and ML method (random forest). Model performance was assessed using repeated nested 10-fold cross-validation. As the main measure of predictive performance, we used the area under the receiver operating characteristic curve (AUC). RESULTS The mean AUCs of the four predictive models, logistic regression, lasso, ridge, and random forest, were 0.795, 0.794, 0.794, and 0.769, respectively. The main determinants were life satisfaction, self-reported memory, cognitive ability, ADL (activities of daily living) impairment, CESD-10 score. Life satisfaction increased the odds ratio of a future depression by 128.6% (logistic), 13.8% (lasso), and 13.2% (ridge), and cognitive ability was the most important predictor in random forest. CONCLUSIONS The three regression-based models and one ML algorithm performed equally well in differentiating between a future depression case and a non-depression case in home-based elderly. When choosing a model, different considerations, however, such as easy operating, might in some instances lead to one model being prioritized over another.
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Affiliation(s)
- Shaowu Lin
- The State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.,National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China.,Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Yafei Wu
- The State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.,National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China.,Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- The State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.,National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China.,Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
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Zhao D, Li J, Hao W, Yuan Y, Yu C, Jing Z, Wang Y, Fu P, Zhou C. The relationship between activities of daily living and suicidal ideation among Chinese rural older adults: a multiple mediation model through sleep quality and psychological distress. Aging (Albany NY) 2020; 12:22614-22625. [PMID: 33202378 PMCID: PMC7746386 DOI: 10.18632/aging.103857] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/21/2020] [Indexed: 11/26/2022]
Abstract
Few studies clarified the mechanisms underlying the relationship between activities of daily living and suicidal ideation among older adults. This study aimed to explore the multiple mediating roles of sleep quality and psychological distress between this relationship. A total of 3,243 rural older adults were included. Multiple mediation analysis was performed using Mplus 8.3. Activities of daily living was found to directly affect suicidal ideation (β=0.092, 95% CI=0.043−0.140) and through three significantly mediation pathways: (1) the path through sleep quality (β=0.019, 95% CI=0.007−0.031), which accounted for 9.79 % of the total effect; (2) the path through psychological distress (β=0.049, 95% CI=0.036−0.063), which accounted for 25.26 % of the total effect; (3) the path through sleep quality and psychological distress (β=0.034, 95% CI=0.026−0.042), which accounted for 17.53 % of the total effect. The total mediating effect was 52.58%. Attention should be paid to sleep quality and mental health among the Chinese rural older adults with activities of daily living limitation. For early detection and prevention of suicidal ideation, it is necessary to take sleep-based and positive psychological interventions for older adults with activities of daily living limitation.
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Affiliation(s)
- Dan Zhao
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Jie Li
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Wenting Hao
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Yemin Yuan
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Caiting Yu
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Zhengyue Jing
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Yi Wang
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Peipei Fu
- School of Health Care Management, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Chengchao Zhou
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.,NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
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35
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Al Madhani A, Al Harthi L, Balkhair A, Chan MF, Albusaidi BSR, Al Sibani N, Al-Adawi S. Prevalence and correlates of depressive symptoms among people living with HIV attending tertiary care hospitals in Oman. Pan Afr Med J 2020; 37:90. [PMID: 33244353 PMCID: PMC7680222 DOI: 10.11604/pamj.2020.37.90.23294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/16/2020] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION depressive symptoms have been widely reported among people living with HIV (PLHIV) around the world. The extent of this on PLHIV in the Arabian Peninsula is unclear. This study aims to examine the prevalence of depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9) in adult Omani patients with HIV attending a tertiary care hospital. It also aims to investigate the relationship between clinical and socio-demographic variables and depressive symptoms. METHODS LHIV, age >18 (n=101), participated in the study who were followed up at a teaching hospital in Muscat, Oman. Participants were identified by a convenient and consecutive sampling of eligible patients who came for consultation on the days that the investigator conducted recruitment. The presence of depressive symptoms was quantified by the Patient Healthcare Questionnaire-9 (PHQ-9). Various socio-demographic backgrounds and risk factors will be also sought as well as activities of daily living (ADL). Chi-square test, Fisher´s exact test, t-test and logistic regression were used to explore which variables were associated with patients having depressive symptoms. RESULTS the prevalence rate of depressive symptoms in this cohort was 41.6%. Depression among PLHIV was found to be significantly associated with age (p <0.001), HIV disease duration (p <0.001), total dependency for ADL (p <0.001) and comorbid hypertension (p <0.001). CONCLUSION depressive symptoms are common in Omani patients living with HIV. HIV care providers are urged to be vigilant to recognize depressive symptoms in these mood-vulnerable populations and to call for a multidisciplinary team with mental health professionals, for the prevention and treatment of depressive symptoms among PLHIV in Oman.
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Affiliation(s)
| | - Lara Al Harthi
- Department of Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Abdullah Balkhair
- Infectious Diseases Unit, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - Moon Fai Chan
- Department of Family Medicine and Public Health, Sultan Qaboos University, Muscat, Oman
| | - Badar SR Albusaidi
- Department of Nursing/Infectious Diseases Unit, Sultan Qaboos University Hospital, Muscat, Oman
| | - Nasser Al Sibani
- Department of Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Samir Al-Adawi
- Department of Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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Dong X. Advancing Asian Health Equity: Multimodal Approach to Translate Research into Practice and Policy. J Am Geriatr Soc 2020; 67:S476-S478. [PMID: 31403206 DOI: 10.1111/jgs.16110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 07/15/2019] [Indexed: 11/30/2022]
Affiliation(s)
- XinQi Dong
- Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey
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37
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Yin Z, Yang J, Huang C, Sun H, Wu Y. Eating and communication difficulties as mediators of the relationship between tooth loss and functional disability in middle-aged and older adults. J Dent 2020; 96:103331. [DOI: 10.1016/j.jdent.2020.103331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/20/2020] [Accepted: 03/26/2020] [Indexed: 10/24/2022] Open
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