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Jalali A, Ziapour A, Karimi Z, Rezaei M, Emami B, Kalhori RP, Khosravi F, Sameni JS, Kazeminia M. Global prevalence of depression, anxiety, and stress in the elderly population: a systematic review and meta-analysis. BMC Geriatr 2024; 24:809. [PMID: 39367305 PMCID: PMC11451041 DOI: 10.1186/s12877-024-05311-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 08/16/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND Several preliminary studies have been conducted in the field of the prevalence of depression, anxiety, and stress in the elderly population. These studies have examined the prevalence in limited geographic areas with small sample sizes. Also, there are many limitations in the meta-analysis studies. The objective of the present study was to synthesize the global prevalence statistics of depression, anxiety, and stress in the elderly population through a systematic review and meta-analysis. METHODS The present systematic review included retrieval of primary studies from the oldest relevant study up to 2023. To find the relevant studies, international databases such as Scopus, Embase, PubMed, and Web of Science (WoS) were systematically searched. Also, a manual search was performed through the Google Scholar search engine and a review of the sources of related articles. The qualitative assessment of the studies was conducted using the Joanna Briggs Institute (JBI) checklist. Due to a high heterogeneity among the study results, a Random Effects model was chosen. RESULTS A total of 42 articles on depression, 47 articles on anxiety and 13 articles on stress were included in the meta-analysis. The overall estimates for prevalence based on a random-effects model were as follows: depression, 19.2% (95% CI: 13.0 - 27.5%); anxiety, 16.5% (95% CI: 11.1 - 22.8%); and stress, 13.9% (95% CI: 5.5 - 30.9%). The highest prevalence of depression and anxiety was recorded in Africa. The prevalence of depression was higher in nursing homes, and stress was more prevalent in individuals with COVID-19 compared to other populations. CONCLUSION The findings revealed a high prevalence of depression, anxiety, and stress in the elderly population. Therefore, it is recommended that healthcare professionals and policymakers pay more attention to the prevention and management of these disorders in the elderly population.
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Affiliation(s)
- Amir Jalali
- Department of Medical Education, Virtue University of Medical Sciences, Tehran, Iran
| | - Arash Ziapour
- Cardiovascular Research Center, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Zohreh Karimi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Rezaei
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Bashir Emami
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Pourmirza Kalhori
- Department of Emergency Medicine, Paramedical School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fataneh Khosravi
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jelveh Sadat Sameni
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Kazeminia
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Shafiee A, Teymouri Athar MM, Seighali N, Amini MJ, Hajishah H, Arabazadeh Bahri R, Akhoundi A, Beiky M, Sarvipour N, Maleki S, Zandifar A, Bakhtiyari M. The prevalence of depression, anxiety, and sleep disturbances among medical students and resident physicians in Iran: A systematic review and meta-analysis. PLoS One 2024; 19:e0307117. [PMID: 39178292 PMCID: PMC11343466 DOI: 10.1371/journal.pone.0307117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 06/29/2024] [Indexed: 08/25/2024] Open
Abstract
BACKGROUND We sought to conduct this comprehensive systematic review and meta-analysis to assess the prevalence of depression, anxiety, and sleep disturbance in Iranian medical students and resident physicians. METHODS A systematic search was conducted on 23 December 2023 in PubMed/MEDLINE, Web of Science, Scopus, and Iranian national databases. We pooled the prevalence of individual studies using the random effect model. RESULTS Our systematic search showed 36 articles that meet the eligibility criteria. Most included studies were cross-sectional. The most used questionnaire to assess depression, anxiety, and sleep disturbance were Beck Depression Inventory (BDI), The Depression, Anxiety and Stress Scale-21 Items (DASS-21), and The Pittsburgh Sleep Quality Index (PSQI), respectively. The overall prevalence of depression, anxiety, and sleep disturbance among Iranian medical students were 43% (95%CI: 33%-53%%, I2 = 98%), 44% (95%CI: 31%-58%%, I2 = 99%), 48% (95%CI: 39%-56%%, I2 = 97%), respectively. The results of subgroup and meta-regression analyses showed questionnaires used and the place of the medical school were significantly associated with the prevalence of aforementioned outcomes. Funnel plot and Begg's regression test did not show a significant source of funnel plot asymmetry for depression, anxiety, and sleep disturbance. CONCLUSION In conclusion, our study showed that nearly half of the medical students had some type of depression, anxiety, and sleep disturbance problems. To address this serious national public health issue, efficient preventive measures, routine screenings, and prompt interventions are required.
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Affiliation(s)
- Arman Shafiee
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Niloofar Seighali
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Javad Amini
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Hamed Hajishah
- Student Research Committee, School of Medicine, Islamic Azad University of Medical Sciences, Tehran, Iran
| | | | - Amirhossein Akhoundi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Maryam Beiky
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Nastaran Sarvipour
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Saba Maleki
- School of Medicine, Guilan University of Medical Sciences (GUMS), Rasht, Guilan Province, Iran
| | - Atefeh Zandifar
- Department of Psychiatry, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahmood Bakhtiyari
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Gibian JT, Bartosiak KA, Riegler V, King J, Lucey BP, Barrack RL. The CCJR® Gerard A. Engh Excellence in Knee Research Award: Remote Monitoring of Sleep Disturbance Following Total Knee Arthroplasty: A Cautionary Note. J Arthroplasty 2024; 39:S22-S26. [PMID: 38599526 DOI: 10.1016/j.arth.2024.03.065] [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: 01/15/2024] [Revised: 03/24/2024] [Accepted: 03/28/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Sleep disturbances are common after total knee arthroplasty (TKA). Despite the rising popularity of wearables to track sleep, little evidence exists in the arthroplasty literature regarding their efficacy. We aimed to correlate validated wearable sleep metrics with patient-reported sleep quality following TKA. METHODS Patients undergoing primary TKA were consecutively enrolled. Patients used a wearable device preoperatively and 90 days postoperatively to track five previously-validated measures of sleep. Each month, they rated their sleep quality. Wearable sleep data was correlated with patient-reported sleep quality using a point biserial correlation test. Categorical data were compared using Chi-square tests. A total of 110 patients were included. RESULTS Preoperatively, 20.8% of patients reported "fairly bad" or "very bad" sleep; this increased to 44.4% 30 days postoperatively, then decreased to 26.5% 60 days postoperatively, and to 20.2% 90 days postoperatively. At 30 days postoperatively, time in bed, time asleep, and minutes of rapid eye movement sleep weakly correlated with patient-reported sleep quality (correlations 0.356, 0.345, and 0.345, respectively; P < .001). Sleep quality did not correlate with any wearable metric collected 60 or 90 days postoperatively. CONCLUSIONS Patient-reported sleep quality following TKA initially worsened postoperatively, then improved to preoperative levels by 90 days. Time in bed, time asleep, and rapid eye movement sleep minutes only weakly correlated with patient-reported sleep quality at 30 days; no other correlations were detected. Surgeons that utilize remote monitoring following TKA should be aware that surrogate measures generated from these devices may correlate weakly, if at all, with the patient-reported outcome of the parameter being studied.
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Affiliation(s)
- Joseph T Gibian
- Department of Orthopaedics, Washington University School of Medicine, St. Louis, Missouri
| | - Kimberly A Bartosiak
- Department of Orthopaedics, Washington University School of Medicine, St. Louis, Missouri
| | - Venessa Riegler
- Department of Orthopaedics, Washington University School of Medicine, St. Louis, Missouri
| | - Jackie King
- Department of Orthopaedics, Washington University School of Medicine, St. Louis, Missouri
| | - Brendan P Lucey
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Robert L Barrack
- Department of Orthopaedics, Washington University School of Medicine, St. Louis, Missouri
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Xu L, Gao Y, Shi D, Wang Y, Li R, Cai Y. Social support moderates the relationship between sleep quality and mental health: A Chinese Fangcang shelter hospital-based study in asymptomatic COVID-19 carriers. Heliyon 2024; 10:e31782. [PMID: 38841459 PMCID: PMC11152662 DOI: 10.1016/j.heliyon.2024.e31782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 05/12/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024] Open
Abstract
This study aimed to determine the association between sleep quality and mental health in COVID-19 carriers in China and evaluate the moderating effects of perceived social support. 1283 asymptomatic COVID-19 carriers were enrolled from March 2022 to April 2022 among Ruijin Jiahe Fangcang shelter hospital in Shanghai, China. They were assessed using the Pittsburgh Sleep Quality Index (PSQI), the General Health Questionnaire (GHQ), and the Perceived Social Support Scale (PSSS) respectively. Participants had an average age of 39.64 years and 59.6 % of whom were male. In total, 34.3 % of participants presented with poor sleep quality; 41.1 % showed bad mental health. Sleep quality was positively related to mental health (r = 0.321, P < 0.001, 95 %CI = 0.267, 0.369) and social support was negatively related to mental health (r = -0.414, P < 0.001, 95 %CI = -0.457, -0.367). Meanwhile, social support played a moderating role between sleep quality and mental health (β = 0.066, P < 0.05, 95 %CI = 0.016, 0.117). These findings indicate that mental health resulting from the COVID-19 pandemic are increasingly apparent in China and provide a focus on sleep quality for the early prevention of mental health in asymptomatic carriers. And social support may be beneficial to the improvement of mental health, especially for people in crisis (e.g., COVID-19 pandemic).
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Affiliation(s)
- Lulu Xu
- Department of Public Health, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
- Center for Community Health Care, Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Ying Gao
- Department of Public Health, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
- Center for Community Health Care, Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Dake Shi
- Department of Infection Control, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Ying Wang
- Department of Public Health, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
- Center for Community Health Care, Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Rui Li
- Department of Nursing, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yong Cai
- Department of Public Health, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
- Center for Community Health Care, Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, 200025, China
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Li Y, Deng Y, Zhang Y, Xu D, Zhang X, Li Y, Li Y, Chen M, Wang Y, Zhang J, Wang L, Cang Y, Cao P, Bi L, Xu H. Distinct glutamatergic projections of the posteroventral medial amygdala play different roles in arousal and anxiety. JCI Insight 2024; 9:e176329. [PMID: 38842948 PMCID: PMC11383360 DOI: 10.1172/jci.insight.176329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 06/05/2024] [Indexed: 08/13/2024] Open
Abstract
Sleep disturbance usually accompanies anxiety disorders and exacerbates their incidence rates. The precise circuit mechanisms remain poorly understood. Here, we found that glutamatergic neurons in the posteroventral medial amygdala (MePVGlu neurons) are involved in arousal and anxiety-like behaviors. Excitation of MePVGlu neurons not only promoted wakefulness but also increased anxiety-like behaviors. Different projections of MePVGlu neurons played various roles in regulating anxiety-like behaviors and sleep-wakefulness. MePVGlu neurons promoted wakefulness through the MePVGlu/posteromedial cortical amygdaloid area (PMCo) pathway and the MePVGlu/bed nucleus of the stria terminals (BNST) pathway. In contrast, MePVGlu neurons increased anxiety-like behaviors through the MePVGlu/ventromedial hypothalamus (VMH) pathway. Chronic sleep disturbance increased anxiety levels and reduced reparative sleep, accompanied by the enhanced excitability of MePVGlu/PMCo and MePVGlu/VMH circuits but suppressed responses of glutamatergic neurons in the BNST. Inhibition of the MePVGlu neurons could rescue chronic sleep deprivation-induced phenotypes. Our findings provide important circuit mechanisms for chronic sleep disturbance-induced hyperarousal response and obsessive anxiety-like behavior and are expected to provide a promising strategy for treating sleep-related psychiatric disorders and insomnia.
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Affiliation(s)
- Ying Li
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Yuchen Deng
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Yifei Zhang
- Department of Pathology, Taikang Medical School (School of Basic Medical Sciences), Wuhan University, Wuhan, China
- Center for Pathology and Molecular Diagnostics
| | - Dan Xu
- Department of Nuclear Medicine, and
| | - Xuefen Zhang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Yue Li
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Yidan Li
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Ming Chen
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Yuxin Wang
- Department of Pathology, Taikang Medical School (School of Basic Medical Sciences), Wuhan University, Wuhan, China
- Center for Pathology and Molecular Diagnostics
| | - Jiyan Zhang
- Department of Pathology, Taikang Medical School (School of Basic Medical Sciences), Wuhan University, Wuhan, China
- Center for Pathology and Molecular Diagnostics
| | - Like Wang
- Department of Pathology, Taikang Medical School (School of Basic Medical Sciences), Wuhan University, Wuhan, China
- Center for Pathology and Molecular Diagnostics
| | - Yufeng Cang
- Department of Pathology, Taikang Medical School (School of Basic Medical Sciences), Wuhan University, Wuhan, China
- Center for Pathology and Molecular Diagnostics
| | - Peng Cao
- National Institute of Biological Sciences, Beijing, China
- Tsinghua Institute of Multidisciplinary Biomedical Research, Tsinghua University, Beijing, China
| | - Linlin Bi
- Department of Pathology, Taikang Medical School (School of Basic Medical Sciences), Wuhan University, Wuhan, China
- Center for Pathology and Molecular Diagnostics
- Guangdong Province Key Laboratory of Psychiatric Disorders, Southern Medical University, Guangzhou, China
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
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Zhang Y, Lin C, Li H, Li L, Zhou X, Xiong Y, Yan J, Xie M, Zhang X, Zhou C, Yang L. The relationship between childhood adversity and sleep quality among rural older adults in China: the mediating role of anxiety and negative coping. BMC Psychiatry 2024; 24:346. [PMID: 38720293 PMCID: PMC11077779 DOI: 10.1186/s12888-024-05792-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Studies have revealed the effects of childhood adversity, anxiety, and negative coping on sleep quality in older adults, but few studies have focused on the association between childhood adversity and sleep quality in rural older adults and the potential mechanisms of this influence. In this study, we aim to evaluate sleep quality in rural older adults, analyze the impact of adverse early experiences on their sleep quality, and explore whether anxiety and negative coping mediate this relationship. METHODS Data were derived from a large cross-sectional study conducted in Deyang City, China, which recruited 6,318 people aged 65 years and older. After excluding non-agricultural household registration and lack of key information, a total of 3,873 rural older adults were included in the analysis. Structural equation modelling (SEM) was used to analyze the relationship between childhood adversity and sleep quality, and the mediating role of anxiety and negative coping. RESULTS Approximately 48.15% of rural older adults had poor sleep quality, and older adults who were women, less educated, widowed, or living alone or had chronic illnesses had poorer sleep quality. Through structural equation model fitting, the total effect value of childhood adversity on sleep quality was 0.208 (95% CI: 0.146, 0.270), with a direct effect value of 0.066 (95% CI: 0.006, 0.130), accounting for 31.73% of the total effect; the total indirect effect value was 0.142 (95% CI: 0.119, 0.170), accounting for 68.27% of the total effect. The mediating effects of childhood adversity on sleep quality through anxiety and negative coping were significant, with effect values of 0.096 (95% CI: 0.078, 0.119) and 0.024 (95% CI: 0.014, 0.037), respectively. The chain mediating effect of anxiety and negative coping between childhood adversity and sleep quality was also significant, with an effect value of 0.022 (95% CI: 0.017, 0.028). CONCLUSIONS Anxiety and negative coping were important mediating factors for rural older adult's childhood adversity and sleep quality. This suggests that managing anxiety and negative coping in older adults may mitigate the negative effects of childhood adversity on sleep quality.
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Affiliation(s)
- Yuqin Zhang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Chengwei Lin
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Hongwei Li
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Lei Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Deyang Integrated Traditional Chinese and Western Medicine Hospital, Deyang, 618000, China
| | - Xueyan Zhou
- Centre for Aging Health Service of Deyang City, Deyang, 618000, China
| | - Ying Xiong
- Health Commission of Deyang City, Deyang, 618000, China
| | - Jin Yan
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Mengxue Xie
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Xueli Zhang
- Sichuan Provincial Health Information Center, Chengdu, 610015, Sichuan, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research,School of Public Health, Cheeloo College of Medicine,Shandong University, NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
| | - Lian Yang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China.
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Sun M, Zhang Q, Han Y, Liu J. Sleep Quality and Subjective Cognitive Decline among Older Adults: The Mediating Role of Anxiety/Depression and Worries. J Aging Res 2024; 2024:4946303. [PMID: 38746043 PMCID: PMC11093690 DOI: 10.1155/2024/4946303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/22/2024] [Indexed: 05/16/2024] Open
Abstract
Background Subjective cognitive decline (SCD) in older individuals has been implicated as a possible precursor to Alzheimer's disease. Poor sleep quality and anxiety/depressive symptoms have been linked to the progression of SCD, but these associations and older adults' worries have yet to be fully established in the Chinese older adult population, which is one of the largest in the world. The aim of this study was to explore the relationship between sleep quality, anxiety/depression symptoms, and worries, and SCD prevalence among Chinese community-dwelling older individuals. Methods A total of 707 adults aged between 60 and 99 from Shanghai, China, completed self-report questionnaires that covered their cognitive and mental well-being, as well as demographic information. Subjective cognitive decline (SCD) was evaluated using the memory/cognition syndromes of the old adult self-report (OASR). Sleep quality, anxiety/depression, and worries were measured from their respective sections of the OASR. Results The general linear regression models showed that poorer sleep quality was associated with an increased prevalence of anxiety/depression symptoms, worries, and SCD among older adults. As suggested by the mediation analysis, anxiety/depression and worries were significant mediators in the relationship between sleep quality and SCD prevalence, and these two factors also have a serial mediation effect between sleep quality and SCD prevalence. Conclusions Poorer sleep quality is associated with a higher rate of SCD among older adults, and a higher prevalence of anxiety/depression and worries mediate this relationship, suggesting possible mechanism pathways that lead to SCD. These factors may provide the basis for early, targeted interventions for older adults' mental health preservation and improved quality of life.
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Affiliation(s)
- McKenna Sun
- University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | - Yifei Han
- Northeastern University, Boston, MA 02115, USA
| | - Jianghong Liu
- University of Pennsylvania, Philadelphia, PA 19104, USA
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Liu J, Zhu Y, Tan JK, Ismail AH, Ibrahim R, Hassan NH. Factors Associated with Frailty in Older Adults in Community and Nursing Home Settings: A Systematic Review with a Meta-Analysis. J Clin Med 2024; 13:2382. [PMID: 38673654 PMCID: PMC11050860 DOI: 10.3390/jcm13082382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Frailty is a globally recognized issue. However, there is a lack of evidence exploring factors associated with frailty among older residents in community and nursing-home settings. Methods: To explore the prevalence and factors associated with frailty among older adults in community and nursing-home settings, we conducted a systematic search following the PRISMA guidelines across Web of Science, MEDLINE, EMBASE, PubMed, and Cochrane databases up until January 2024, selecting 38 studies which encompassed 150,642 participants. Results: Our findings showed higher frailty prevalence in nursing homes compared to communities. Frailty was significantly associated with sociodemographic (living alone, poor self-reported health), physiological (poor sleep, low activity of daily living), behavioral (physical inactivity) and disease (chronic conditions, depression) factors in both community and nursing-home settings. Conclusions: There are numerous factors associated with frailty in older adults in nursing-home and community settings. These factors underscore the significance of promptly identifying high-risk individuals and devising appropriate interventions to mitigate frailty among them.
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Affiliation(s)
- Jia Liu
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| | - Yuezhi Zhu
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (Y.Z.); (J.K.T.)
| | - Jen Kit Tan
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (Y.Z.); (J.K.T.)
| | - Azera Hasra Ismail
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| | - Roszita Ibrahim
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Nor Haty Hassan
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
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Tanwar T, Aldabbas M, Iram I, Veqar Z. Sleep quality and its association with anxiety, stress, sleep-related beliefs and attitudes and postural control in young adults: a cross-sectional study. Int J Adolesc Med Health 2024; 36:169-176. [PMID: 38413222 DOI: 10.1515/ijamh-2023-0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/09/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVES Adequate sleep is essential for young adults, as this age group primarily consists of students, job seekers, and working people constantly managing a hectic lifestyle. Poor quality of sleep, which is essential for physical and mental well-being in the short and long term, can result in impaired overall health. However, there exists a gap in the literature regarding the factors affecting sleep among young adults. Hence, the objective of this study was to find the prevalence of sleep-related parameters (sleep health, hygiene, and sleep-related beliefs and attitudes) and potential risk factors for sleep quality and to investigate the association between sleep and postural control in young adults. METHODS This prospective, cross-sectional, analytical study included 181 young adults, 113 (62.43 %) females, and 68 (37.57 %) males, with a mean age of 23.82 ± 2.88 years. Sleep quality, health, beliefs, hygiene, stress, anxiety, and depression were assessed using questionnaires. Postural control was assessed using center of pressure (COP) indices. RESULTS The overall prevalence of poor sleep quality was 79.01 % among young adults. Multiple linear regression showed that predictors explained 44 % of sleep quality variance (adjusted R square=0.44, f (12,168) = 20.91, p<0.05). Poor sleep-related beliefs and attitudes (95 % CI [0.037, 0.679], p=0.029), higher perceived stress (95 % CI [0.005, 0.219], p=0.039), higher anxiety severity (95 % CI [0.108, 0.526], p=0.003), and poor COP stability index A/P (95 % CI [4.986, 11.248], p=0.00) were found to be significant predictors of poor sleep quality. CONCLUSIONS High anxiety and stress, and poor dysfunctional beliefs and attitudes about sleep are predictors of poor sleep quality in young adults. These factors may significantly affect sleep quality and the experience of restful sleep among young adults. Also, poor sleep quality is associated with reduced postural control (decreased stability in the A/P direction). These findings are crucial for improving young adults' overall health and well-being, as poor sleep is highly prevalent among this age group.
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Affiliation(s)
- Tarushi Tanwar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, Delhi, India
| | - Mosab Aldabbas
- Faculty of Applied Medical Sciences, Department of Physical Therapy, Al-Azhar University, Gaza, Palestine
| | - Iram Iram
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, Delhi, India
| | - Zubia Veqar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, Delhi, India
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Zhou K, Zhu X, Yang L, Gao Z, Wei X, Kuang J, Xu M. Latent class analysis of symptoms of depression and anxiety among older women. J Women Aging 2024; 36:93-106. [PMID: 37556738 DOI: 10.1080/08952841.2023.2243799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/07/2023] [Accepted: 07/14/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVES This cross-sectional study aims to consider the potential classification of depression and anxiety symptoms among older women, and identify the influencing factors of this classification. METHODS This study examines Chinese women aged 65 years and older. Latent class analysis was used to explore the mental health subgroups of older women, and multivariate logistic regression was employed to examine the influencing factors based on the health ecological model among these subgroups. RESULTS The results helped classify this population under three subgroups: the coexistence of depression and anxiety group, dominated depression group, and the low symptoms group. Moreover, class differences in terms of age, residence, education, income, assessment of current life and health status, sleep duration, and health behaviors, such as alcohol use and exercise were noted. CONCLUSIONS These findings explain the heterogeneity among older women, and help illuminate their unique aspects of mental health. Accordingly, they are significant for scholars and policymakers to understand depression and anxiety among older women.
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Affiliation(s)
- Kexin Zhou
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Xuemei Zhu
- Department of Nursing, The Second Affiliated hospital of Harbin Medical University, Harbin, China
| | - Li Yang
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Zihan Gao
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Xiao Wei
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Jinke Kuang
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Mengfan Xu
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
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11
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Peixoto VGMNP, Facci LA, Barbalho TCS, Souza RN, Duarte AM, Almondes KM. The context of COVID-19 affected the long-term sleep quality of older adults more than SARS-CoV-2 infection. Front Psychiatry 2024; 15:1305945. [PMID: 38380125 PMCID: PMC10877719 DOI: 10.3389/fpsyt.2024.1305945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/18/2024] [Indexed: 02/22/2024] Open
Abstract
Introduction Sleep problems are one of the most persistent symptoms of post-COVID syndrome in adults. However, most recent research on sleep quality has relied on the impact of the pandemic, with scarcely any data for older adults on the long-term consequences of COVID infection. This study aims to understand whether older individuals present persistently impaired sleep quality after COVID-19 infection and possible moderators for this outcome. Methods This is a cross-sectional analysis of a longitudinal cohort study with 70 elders with 6-month-previous SARS-CoV-2 infection and 153 controls. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality; Geriatric Depression Scale and Geriatric Anxiety Inventory for screening depression and anxiety. Demographics and comorbid conditions were collected. Results The mean age of participants was 66,97 ± 4,64 years. There were no statistical differences in depression and anxiety between groups. Poor sleep quality was found in 52,9% and 43,8% of the COVID and control groups (p=.208). After controlling for multiple variables, all the following factors resulted in greater chances of poor sleep quality: female gender (OR, 2.12; p=.027), memory complaints (OR, 2.49; p=.074), insomnia (OR, 3.66; p=.032), anxiety (OR, 5.46; p<.001), depression (OR, 7.26; p=.001), joint disease (OR, 1.80; p=.050), glucose intolerance (OR, 2.20; p=.045), psychoactive drugs (OR, 8.36; p<.001), diuretics (OR, 2.46; p=.034), and polypharmacy (OR, 2.84; p=.016). Conclusion Psychosocial burden in the context of the COVID-19 pandemic and pre-existing conditions seems to influence the sleep quality of older adults more than SARS-CoV-2 infection.
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Affiliation(s)
- Vanessa Giffoni M. N. P. Peixoto
- Post-graduation Program in Psychobiology, Universidade Federal do Rio Grande do Norte, Natal, Brazil
- Department of Clinical Medicine, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Lucas Alves Facci
- Department of Clinical Medicine Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Thiago C. S. Barbalho
- Department of Clinical Medicine Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | | | - Alice Mendes Duarte
- Department of Clinical Medicine Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Katie Moraes Almondes
- Post-graduation Program in Psychobiology, Universidade Federal do Rio Grande do Norte, Natal, Brazil
- Department of Psychology, Universidade Federal do Rio Grande do Norte, Natal, Brazil
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12
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Liu J, Chen Q. Sequential link in depression, sleep and cognition: Longitudinal evidence from a serial multiple mediation analysis of older adults in China. Arch Gerontol Geriatr 2024; 117:105249. [PMID: 37952418 DOI: 10.1016/j.archger.2023.105249] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND A growing body of literature examines the link between depression, sleep and cognition, but little is known regarding the extent to which this relationship holds among older adults over time. OBJECTIVE This study examines how sleep duration mediates the relationship between depressive symptoms and cognitive performance, by utilizing partial least squares structural equation modelling (PLS-SEM) estimation. METHODS This study utilizes the 2013-18 China Health and Retirement Longitudinal Study (CHARLS) dataset, of which 3557 participants over the age of 50 satisfied inclusion criteria. Depressive symptoms and cognitive performance are measured by the Center for Epidemiological Studies Depression Scale (CESD) and the Mini-Mental State Examination (MMSE); sleep duration is assessed using the adapted Pittsburgh Sleep Quality Index (PSQI). A serial multiple mediation model was built to assess how depressive symptoms in 2013 and in 2018 are related, in addition to assessing their links with sleep duration and cognitive performance. FINDINGS Results indicate that early depression positively predicts depression progression (std.β = 0.564, 95 % Confidence Interval: 0.534, 0.594), but negatively predicts sleep duration (std.β = -0.081, 95 % CI: -0.128, -0.034) and cognitive performance (std.β = -0.118, 95 % CI: -0.165, -0.072). The sequential indirect effect of early depression operating via depression progression and sleep duration is evaluated to be -0.083 (95 % CI: -0.110, -0.056), representing as much as 41.29 % of the total effect. CONCLUSIONS Early depressive symptoms are directly associated with increased depressive symptoms and shortened sleep, which are identified as key channels through which early depression is linked with worsened cognition. CLINICAL IMPLICATIONS Many older adults may underestimate the adverse costs of early depression, since its net effects on cognition could be channeled indirectly and discretely via depression progression and sleep, which is worth highlighting in health guidelines and clinical recommendations.
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Affiliation(s)
- Ji Liu
- Faculty of Education, Shaanxi Normal University, Xian, Shaanxi, China
| | - Qiaoyi Chen
- School of Basic Medical Sciences, Xian Jiaotong University, Xian, Shaanxi, China.
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13
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Wang X, Luo H. Effects of traditional Chinese exercise therapy on pain scores, sleep quality, and anxiety-depression symptoms in fibromyalgia patients: a systematic review and meta-analysis. BMC Musculoskelet Disord 2024; 25:99. [PMID: 38281020 PMCID: PMC10821260 DOI: 10.1186/s12891-024-07194-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/10/2024] [Indexed: 01/29/2024] Open
Abstract
OBJECTIVE This study aims to assess the effectiveness of traditional Chinese exercise therapy in alleviating pain, improving sleep quality, and reducing symptoms of anxiety and depression among fibromyalgia patients. METHODS We conducted a comprehensive search across various databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge, VIP database, and Wanfang, to identify randomized controlled trials (RCTs) examining the impact of Traditional Chinese Exercise (TCE) interventions on fibromyalgia. Two independent authors extracted data from the selected studies based on predefined inclusion and exclusion criteria. Meta-analyses were performed using RevMan 5.3. RESULTS The analysis encompassed 15 RCTs, comprising 936 participants. The meta-analysis revealed that TCE significantly surpassed the control group in reducing pain scores for fibromyalgia patients, as evidenced by improvements in FIQ [MD = -3.30, 95% CI (- 5.37, - 0.69), z = 2.53, p = 0.01] and VAS [MD = -1.87, 95% CI (- 2.12, - 1.61), z = 6.98, p < 0.00001]. Additionally, TCE demonstrated notable enhancements in sleep quality (PSQI) [MD = -2.23, 95% CI (- 2.86, - 1.61), z = 6.98, p < 0.0001], as well as in alleviating symptoms of anxiety and depression [MD = - 0.59, 95% CI (- 0.80, - 0.39), z = 5.63, p < 0.0001]. CONCLUSION Traditional Chinese Exercise (TCE) exhibits significant efficacy in ameliorating pain, enhancing sleep quality, and alleviating symptoms of anxiety and depression in fibromyalgia patients.
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Affiliation(s)
- Xinzheng Wang
- Department of Physical Education, Zhejiang Chinese Medical University, Province, Zhejiang, 310053, Hangzhou, China
| | - Hongbin Luo
- Department of Physical Education, Zhejiang Chinese Medical University, Province, Zhejiang, 310053, Hangzhou, China.
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14
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Yuan D, Meng Y, Ai Z, Zhou S. Research trend of epigenetics and depression: adolescents' research needs to strengthen. Front Neurosci 2024; 17:1289019. [PMID: 38249586 PMCID: PMC10799345 DOI: 10.3389/fnins.2023.1289019] [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: 09/05/2023] [Accepted: 11/30/2023] [Indexed: 01/23/2024] Open
Abstract
Objective With its high prevalence, depression's pathogenesis remains unclear. Recent attention has turned to the interplay between depression and epigenetic modifications. However, quantitative bibliometric analyses are lacking. This study aims to visually analyze depression epigenetics trends, utilizing bibliometric tools, while comprehensively reviewing its epigenetic mechanisms. Methods Utilizing the Web of Science core dataset, we collected depression and epigenetics-related studies. Employing VOSViewer software, we visualized data on authors, countries, journals, and keywords. A ranking table highlighted field leaders. Results Analysis encompassed 3,469 depression epigenetics studies published from January 2002 to June 2023. Key findings include: (1) Gradual publication growth, peaking in 2021; (2) The United States and its research institutions leading contributions; (3) Need for enhanced collaborations, spanning international and interdisciplinary efforts; (4) Keyword clustering revealed five main themes-early-life stress, microRNA, genetics, DNA methylation, and histone acetylation-highlighting research hotspots; (5) Limited focus on adolescent depression epigenetics, warranting increased attention. Conclusion Taken together, this study revealed trends and hotspots in depression epigenetics research, underscoring global collaboration, interdisciplinary fusion, and multi-omics data's importance. It discussed in detail the potential of epigenetic mechanisms in depression diagnosis and treatment, advocating increased focus on adolescent research in this field. Insights aid researchers in shaping their investigative paths toward understanding depression's epigenetic mechanisms and antidepressant interventions.
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Affiliation(s)
- Dongfeng Yuan
- Faculty of Pharmacy, Hubei University of Chinese Medicine, Wuhan, China
| | - Yitong Meng
- Faculty of Pharmacy, Hubei University of Chinese Medicine, Wuhan, China
| | - Zhongzhu Ai
- Faculty of Pharmacy, Hubei University of Chinese Medicine, Wuhan, China
- Hubei Shizhen Laboratory, Wuhan, China
- Modern Engineering Research Center of Traditional Chinese Medicine and Ethnic Medicine of Hubei Province, Wuhan, China
| | - Shiquan Zhou
- Faculty of Pharmacy, Hubei University of Chinese Medicine, Wuhan, China
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15
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Kuo PY, Chen PH, Tsai SF, Lin WL, Hung CT, Huang SM. Psychometric evaluation of an adult post-COVID-19 symptom tool: a development and validation study. Sci Rep 2024; 14:664. [PMID: 38182859 PMCID: PMC10770111 DOI: 10.1038/s41598-024-51287-1] [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: 01/03/2024] [Indexed: 01/07/2024] Open
Abstract
The objective of this study was aimed to develop and validate an instrument for post-COVID-19 symptoms in adults. Data were collected from adults with a previous COVID-19 diagnosis in Taiwan. We developed the initial instrument through systematic review and expert feedback. Its validity was tested using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and criterion-related validity, while its reliability was tested using Cronbach's alpha. In total, 310 adults participated in this study. Examination of the EFA clearly classified a five-factor model with 24 items (Kaiser-Meyer-Olkin = 0.903; Bartlett's test of sphericity: X2 = 5242.956, df = 276, p < 0.01). The goodness of fit indices of the CFA were as follows: chi-square = 635.172 (p < 0.01), normed chi-square = 2.669, standardized root mean square residual = 0.077, root mean square error of approximation = 0.073, comparative fit index = 0.922, and Tuker and Lewis index = 0.910. The value of Cronbach's alpha coefficient for the total items was 0.941, and the values for the subscales ranged from 0.813 to 0.924. The instrument exhibited acceptable psychometric properties, proving it to be a valuable tool for evaluating post-COVID-19 symptoms in patients at hospitals.
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Affiliation(s)
- Po-Yuan Kuo
- Taipei Medical University Hospital, Taipei, Taiwan
| | - Ping-Ho Chen
- Taipei Medical University Hospital, Taipei, Taiwan
| | - Shu-Feng Tsai
- Department of Nursing, MacKay Medical College, No. 46, Section 3, Zhongzheng Road, Sanzhi District, New Taipei City, 252, Taiwan
| | - Wan-Ling Lin
- Taipei Medical University Hospital, Taipei, Taiwan
| | - Chia-Tai Hung
- Department of Nursing, MacKay Medical College, No. 46, Section 3, Zhongzheng Road, Sanzhi District, New Taipei City, 252, Taiwan
| | - Sheng-Miauh Huang
- Department of Nursing, MacKay Medical College, No. 46, Section 3, Zhongzheng Road, Sanzhi District, New Taipei City, 252, Taiwan.
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Wang J, Pang M, Jiang X, Li H, Xu J, Liu G, Li S, Kong F. The chain mediation model of social support and life satisfaction among migrant older adults with children: The role of mental health and sleep quality. Arch Gerontol Geriatr 2023; 115:105122. [PMID: 37441894 DOI: 10.1016/j.archger.2023.105122] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/15/2023]
Abstract
INTRODUCTION Few studies have examined the life satisfaction of migrant older adults with children (MOAC), who emerged due to rapid urbanization and population aging in China. This study aimed to explore the chain mediating effect of mental health and sleep quality on the association between social support and life satisfaction among MOAC in Weifang, China. METHODS A cross-sectional study was conducted using multi-stage cluster random sampling, and 613 participants were included. The Social Support Rating Scale, Depression Anxiety Stress Scale, Pittsburgh Sleep Quality Index, and Scale with Life Satisfaction were used to measure the social support, mental health, sleep quality, and life satisfaction of MOAC, respectively. Descriptive statistics, t-tests, and ANOVA were used to explore the relationship between sociodemographic variables and life satisfaction. Pearson's correlation analysis and structural equation modeling (SEM) were conducted to investigate the association between social support, mental health, sleep quality, and life satisfaction. RESULTS The mean total SWLS score was 27.87±5.58. SEM analysis demonstrated that social support had a positive effect on life satisfaction (β= 0.197). Mental health and sleep quality partially mediated the association between social support and life satisfaction (95% CI: 0.083-0.193), and the mediating effect accounted for 39.198% of the total effect. CONCLUSION Life satisfaction was relatively high, and mental health and sleep quality partially mediated the association between social support and life satisfaction. Policy suggestions were provided based on these results.
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Affiliation(s)
- Jieru Wang
- 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, Jinan 250012, China; Institute of Health and Elderly Care, Shandong University
| | - Mingli Pang
- 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, Jinan 250012, China; Institute of Health and Elderly Care, Shandong University
| | - Xiaoxu Jiang
- 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, Jinan 250012, China; Institute of Health and Elderly Care, Shandong University
| | - Hexian Li
- 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, Jinan 250012, China; Institute of Health and Elderly Care, Shandong University
| | - Jing Xu
- 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, Jinan 250012, China; Institute of Health and Elderly Care, Shandong University
| | - Guangwen Liu
- 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, Jinan 250012, China; Institute of Health and Elderly Care, Shandong University
| | - Shixue Li
- 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, Jinan 250012, China; Institute of Health and Elderly Care, Shandong University
| | - Fanlei Kong
- 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, Jinan 250012, China; Institute of Health and Elderly Care, Shandong University.
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Zhu L, Zheng D, Li R, Shen CJ, Cai R, Lyu C, Tang B, Sun H, Wang X, Ding Y, Xu B, Jia G, Li X, Gao L, Li XM. Induction of Anxiety-Like Phenotypes by Knockdown of Cannabinoid Type-1 Receptors in the Amygdala of Marmosets. Neurosci Bull 2023; 39:1669-1682. [PMID: 37368194 PMCID: PMC10603018 DOI: 10.1007/s12264-023-01081-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 03/08/2023] [Indexed: 06/28/2023] Open
Abstract
The amygdala is an important hub for regulating emotions and is involved in the pathophysiology of many mental diseases, such as depression and anxiety. Meanwhile, the endocannabinoid system plays a crucial role in regulating emotions and mainly functions through the cannabinoid type-1 receptor (CB1R), which is strongly expressed in the amygdala of non-human primates (NHPs). However, it remains largely unknown how the CB1Rs in the amygdala of NHPs regulate mental diseases. Here, we investigated the role of CB1R by knocking down the cannabinoid receptor 1 (CNR1) gene encoding CB1R in the amygdala of adult marmosets through regional delivery of AAV-SaCas9-gRNA. We found that CB1R knockdown in the amygdala induced anxiety-like behaviors, including disrupted night sleep, agitated psychomotor activity in new environments, and reduced social desire. Moreover, marmosets with CB1R-knockdown had up-regulated plasma cortisol levels. These results indicate that the knockdown of CB1Rs in the amygdala induces anxiety-like behaviors in marmosets, and this may be the mechanism underlying the regulation of anxiety by CB1Rs in the amygdala of NHPs.
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Affiliation(s)
- Lin Zhu
- Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brian Medicine, Zhejiang University, Hangzhou, 310058, China
- Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Hangzhou, 310029, China
| | - Di Zheng
- Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brian Medicine, Zhejiang University, Hangzhou, 310058, China
| | - Rui Li
- Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brian Medicine, Zhejiang University, Hangzhou, 310058, China
- Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Hangzhou, 310029, China
| | - Chen-Jie Shen
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brian Medicine, Zhejiang University, Hangzhou, 310058, China
| | - Ruolan Cai
- Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brian Medicine, Zhejiang University, Hangzhou, 310058, China
- Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Hangzhou, 310029, China
| | - Chenfei Lyu
- Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brian Medicine, Zhejiang University, Hangzhou, 310058, China
- Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Hangzhou, 310029, China
| | - Binliang Tang
- Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Hangzhou, 310029, China
- Rehabilitation Medicine Center, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 311399, China
| | - Hao Sun
- Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brian Medicine, Zhejiang University, Hangzhou, 310058, China
- Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Hangzhou, 310029, China
| | - Xiaohui Wang
- Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brian Medicine, Zhejiang University, Hangzhou, 310058, China
- Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Hangzhou, 310029, China
| | - Yu Ding
- Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brian Medicine, Zhejiang University, Hangzhou, 310058, China
| | - Bin Xu
- Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Hangzhou, 310029, China
| | - Guoqiang Jia
- Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brian Medicine, Zhejiang University, Hangzhou, 310058, China
- Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Hangzhou, 310029, China
| | - Xinjian Li
- Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brian Medicine, Zhejiang University, Hangzhou, 310058, China
- Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Hangzhou, 310029, China
| | - Lixia Gao
- Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brian Medicine, Zhejiang University, Hangzhou, 310058, China.
- Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Hangzhou, 310029, China.
| | - Xiao-Ming Li
- Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brian Medicine, Zhejiang University, Hangzhou, 310058, China.
- Center for Brain Science and Brain-Inspired Intelligence, Research Units for Emotion and Emotion Disorders, Chinese Academy of Medical Sciences, China/Guangdong-Hong Kong-Macao Greater Bay Area, Joint Institute for Genetics and Genome Medicine Between Zhejiang University and University of Toronto, Hangzhou, 310058, China.
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18
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Sheffler JL, Saliga H, Pickett S. The Role of Physical Activity on the Relationships Between Pain, Anxiety, and Sleep Quality in Older Age. J Gerontol A Biol Sci Med Sci 2023; 78:1881-1886. [PMID: 36161473 DOI: 10.1093/gerona/glac205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sleep quality is associated with a range of negative outcomes in older adults, including a higher risk for cognitive decline, greater disability, and poorer quality of life. Pain and anxiety are both important factors associated with poor sleep quality. Physical activity (PA) is frequently recommended to enhance sleep quality and may have additional benefits for pain and anxiety symptoms. However, current models have not examined the interplay among these factors in relation to sleep quality in older adults. METHODS We examined survey data from a community sample of 281 older adults (aged 55-98 years). Bootstrapped mediation and moderated mediation models using the PROCESS macro in SPSS were used to analyze indirect pathways from pain and anxiety to sleep quality and the conditional effects of exercise. RESULTS Higher levels of pain and anxiety were significantly and independently associated with poorer sleep quality in older adults. The effect of pain on sleep quality was partially mediated by anxiety symptoms. PA significantly moderated the effects of anxiety on sleep quality, while it did not significantly impact the relationship between pain and sleep quality. The overall indirect effect was not moderated by PA. CONCLUSION Pain and anxiety are both significant predictors of sleep quality in older adults, and pain influences sleep quality in older adults partially through its influence on anxiety symptoms. PA may be beneficial for sleep quality for individuals with high anxiety, but patients may see fewer benefits from PA if sleep problems are primarily related to pain.
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Affiliation(s)
- Julia L Sheffler
- Florida State University College of Medicine, Center for Translational Behavioral Science, Tallahassee, Florida, USA
| | - Hollyn Saliga
- Florida State University College of Medicine, Center for Translational Behavioral Science, Tallahassee, Florida, USA
| | - Scott Pickett
- Florida State University College of Medicine, Center for Translational Behavioral Science, Tallahassee, Florida, USA
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Li W, Sun L, Yue L, Xiao S. The left temporal transverse cortex is affected by poor sleep quality, which in turn contributes to depressive symptoms in older adults. Heliyon 2023; 9:e20751. [PMID: 37860546 PMCID: PMC10582376 DOI: 10.1016/j.heliyon.2023.e20751] [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: 03/13/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023] Open
Abstract
Sleep quality is critical for improving mental health among older adults. Despite this, there is a dearth of studies examining the correlation between sleep quality and emotional symptoms in the elderly population of China. This study included 496 community elders aged 55 years and older. The participants were divided into two groups based on their scores on the Pittsburgh Sleep Quality Index (PSQI), with 249 being classified as poor sleepers and 247 as good sleepers. All participants were asked to fill out a uniform survey which included details about their demographics, daily habits, and any illnesses they were dealing with. The Self-rating anxiety scale (SAS) and Geriatric Depression Scale (GDS) were employed to measure their levels of anxiety and depression, respectively. In addition, 50 healthy individuals also agreed to brain MR imaging. The finding of our study indicated that those with inadequate sleep had higher levels of depression and anxiety, and the overall anxiety and depression score was linked to the total PSQI score in a positive manner; The MRI subgroup analysis revealed that those with inadequate sleep quality had a greater thickness of the left transverse temporal gyrus (p < 0.05). In addition, a Linear regression analysis of the mediation model showed that poor sleep quality would result in higher scores on the GDS, and cortical thickness in the left transverse temporal gyrus played a fully mediated role in this process. Our research indicates that elderly people in community who have difficulty sleeping may be more likely to suffer from anxiety and depression, and this lack of sleep can result in depressive symptoms due to its impact on the thickness of the left transverse temporal cortex.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Lin Sun
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
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Torrente A, Alonge P, Pilati L, Gagliardo A, Vassallo L, Di Stefano V, Lupica A, Quartana I, Viticchi G, Silvestrini M, Bartolini M, Camarda C, Brighina F. Effects of a Single Session of OnabotulinumtoxinA Therapy on Sleep Quality and Psychological Measures: Preliminary Findings in a Population of Chronic Migraineurs. Toxins (Basel) 2023; 15:527. [PMID: 37755953 PMCID: PMC10537449 DOI: 10.3390/toxins15090527] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/09/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
Chronic migraine is a burdensome condition, and onabotulinumtoxinA is revealed to be an effective therapy. Migraine shows a bidirectional relationship with sleep, but the effects of preventive therapies on sleep quality are poorly studied. This study aims to evaluate the effects of a single session of onabotulinumtoxinA on patients' sleep quality and correlates the results with measures of comorbid anxiety/depression. Patients completed self-administrable questionnaires about sleep quality (Pittsburgh Sleep Quality Index-PSQI) and psychological symptoms (Beck Depression Inventory, 2nd edition-BDI-II-and Hospital Anxiety and Depression Scale-HADS-subscales "a" and "d" for anxiety and depression, respectively), and reported migraine frequency at baseline and after 12 weeks. The 42 included patients showed a significant reduction in migraine days (from 20.6 ± 6.0 to 13.6 ± 6.2, p < 0.001), while no changes were observed in sleep quality (PSQI score from 11.0 ± 5.0 to 9.8 ± 4.6, p = 0.277) or psychological measures (BDI-II from 16.7 ± 10.2 to 15.7 ± 10.3, p = 0.678; HADS-a from 10.3 ± 4.8 to 9.3 ± 5.5, p = 0.492; and HADS-d from 7.2 ± 3.9 to 7.1 ± 5.0, p = 0.901). On the other hand, a strong correlation among PSQI, BDI-II, HADS-a, and HADS-d scores (p < 0.001, rho > 0.7) was found. Despite its efficacy in migraine prevention, a single session of onabotulinumtoxinA was not able to affect patients' sleep quality or their psychological symptoms.
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Affiliation(s)
- Angelo Torrente
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (A.T.); (P.A.); (L.P.); (A.G.); (L.V.); (V.D.S.); (A.L.); (I.Q.); (C.C.)
| | - Paolo Alonge
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (A.T.); (P.A.); (L.P.); (A.G.); (L.V.); (V.D.S.); (A.L.); (I.Q.); (C.C.)
| | - Laura Pilati
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (A.T.); (P.A.); (L.P.); (A.G.); (L.V.); (V.D.S.); (A.L.); (I.Q.); (C.C.)
| | - Andrea Gagliardo
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (A.T.); (P.A.); (L.P.); (A.G.); (L.V.); (V.D.S.); (A.L.); (I.Q.); (C.C.)
- Clinical Neurophysiology Unit, Sleep Lab, “Clinical Course”, 90143 Palermo, Italy
| | - Lavinia Vassallo
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (A.T.); (P.A.); (L.P.); (A.G.); (L.V.); (V.D.S.); (A.L.); (I.Q.); (C.C.)
| | - Vincenzo Di Stefano
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (A.T.); (P.A.); (L.P.); (A.G.); (L.V.); (V.D.S.); (A.L.); (I.Q.); (C.C.)
| | - Antonino Lupica
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (A.T.); (P.A.); (L.P.); (A.G.); (L.V.); (V.D.S.); (A.L.); (I.Q.); (C.C.)
| | - Irene Quartana
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (A.T.); (P.A.); (L.P.); (A.G.); (L.V.); (V.D.S.); (A.L.); (I.Q.); (C.C.)
| | - Giovanna Viticchi
- Neurological Clinic, Marche Polytechnic University, 60020 Ancona, Italy; (G.V.); (M.S.); (M.B.)
| | - Mauro Silvestrini
- Neurological Clinic, Marche Polytechnic University, 60020 Ancona, Italy; (G.V.); (M.S.); (M.B.)
| | - Marco Bartolini
- Neurological Clinic, Marche Polytechnic University, 60020 Ancona, Italy; (G.V.); (M.S.); (M.B.)
| | - Cecilia Camarda
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (A.T.); (P.A.); (L.P.); (A.G.); (L.V.); (V.D.S.); (A.L.); (I.Q.); (C.C.)
| | - Filippo Brighina
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (A.T.); (P.A.); (L.P.); (A.G.); (L.V.); (V.D.S.); (A.L.); (I.Q.); (C.C.)
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Huang M, Liu K, Liang C, Wang Y, Guo Z. The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety. BMC Geriatr 2023; 23:506. [PMID: 37608361 PMCID: PMC10463962 DOI: 10.1186/s12877-023-04161-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 07/10/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND With modernization and ageing in China, the population of older adults living alone is increasing. Living alone may be a potential risk factor for depressive symptoms. However, no parallel mediation model analysis has investigated the mediating factors for living alone or not (living arrangements) and depressive symptoms. METHODS This cross-sectional study included a total number of 10,980 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), 1699 of whom lived alone and 9281 of whom did not live alone. Binary logistic regression and parallel mediation effect model were used to explore the relationship between living alone or not and depressive symptoms and possible mediation effects. Bootstrap analysis was used to examine the mediation effect of living alone or not on depressive symptoms. RESULTS Compared to the participants who were not living alone, the living alone group had a higher rate of depressive symptoms. The binary logistic regression showed that after adjusting for other covariates, the risk of depressive symptoms was approximately 0.21 times higher for living alone compared to not living alone (OR = 1.21, 95% CI: 1.06, 1.37). Further, the results of the bootstrap analysis supported the partial mediating role of sleep quality and anxiety. Mediation analysis revealed that sleep quality and anxiety partially mediate the relationship between living alone and depressive symptoms (β = 0.008, 95% CI [0.003, 0.014]; β = 0.015, 95% CI [0.008, 0.024], respectively). CONCLUSIONS Sleep quality and anxiety were identified as partially parallel mediators between living alone or not and depressive symptoms. Older adults living alone with poorer sleep quality and more pronounced anxiety were positively associated with higher levels of depressive symptoms. Older adults living alone should be encouraged to engage in social activities that may improve sleep quality, relieve anxiety, and improve feelings of loneliness caused by living alone. Meanwhile, older adults living alone should receive attention and support to alleviate their depressive symptoms.
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Affiliation(s)
- Mina Huang
- Department of Nursing, The Jinzhou Medical University, Jinzhou, China
| | - Kun Liu
- Department of Medical College, The Jinzhou Medical University, Jinzhou, China
| | - Chunguang Liang
- Department of Nursing, The Jinzhou Medical University, Jinzhou, China
| | - Yongzhu Wang
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, No.2, Section 5, Renmin Street, Jinzhou, Liaoning, 121001, China
| | - Zhanpeng Guo
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, No.2, Section 5, Renmin Street, Jinzhou, Liaoning, 121001, China.
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Haldar P, Prasad K, Kant S, Dwivedi SN, Vibha D, Pandit AK, Srivastava AK, Kumar A, Ikram MA, Henning T. Metabolic risk factors and psychosocial problems independently explain poor sleep quality and obstructive sleep apnea symptoms among adults in urban India. Sleep Breath 2023; 27:1541-1555. [PMID: 36280653 DOI: 10.1007/s11325-022-02725-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
STUDY OBJECTIVES To determine if metabolic risk factors are associated with poor sleep quality and obstructive sleep apnea-like symptoms (OSA symptoms) independent of psychosocial problems and demographic and lifestyle factors in older Indian adults. METHODOLOGY We analyzed baseline data from adults (≥ 50 years) from a population-based cohort, the LoCARPoN study, in India. Variables were grouped as (a) demographic and lifestyle factors such as smoking, alcohol use, and physical activity; (b) psychosocial problems including symptoms of depression, anxiety, and perceived stress; and (c) metabolic risk factors including glycated hemoglobin, high-density lipoprotein, low-density lipoprotein, total cholesterol, body mass index, and hypertension. Variables were examined as predictors of poor sleep quality and OSA symptoms. Groups of variables were added stepwise to a logistic regression. Variance explained by nested models was quantified using McFadden's pseudo R2, and change was formally tested with the log-likelihood ratio test. RESULTS Among 7505 adults, the prevalence of poor sleep quality was 16.9% (95% CI: 16.0, 17.7), and OSA symptoms were present in 7.0% (95% CI: 6.4, 7.6). Psychosocial problems had a strong independent association with both poor sleep quality (pseudo R2 increased from 0.10 to 0.15, p < 0.001) and more OSA symptoms (pseudo R2 increased from 0.08 to 0.10, p < 0.001). Metabolic risk factors had a modest independent association with sleep quality (pseudo R2 increased from 0.14 to 0.15, p < 0.01), but a strong association with OSA symptoms (pseudo R2 increased from 0.08 to 0.10, p < 0.001). CONCLUSION Psychosocial and metabolic risk factors were independently associated with sleep quality and OSA symptoms. This fact implied that OSA symptoms may affect both mental health and physical health. Our findings have public health implications because the number and proportion of the elderly in India is increasing, while the prevalence of metabolic risk factors and psychosocial problems is high already. These facts have the potential to exacerbate not only the burden of sleep disorders and OSA symptoms but also associated cardiovascular and neurologic sequelae, further stretching the Indian health-care system.
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Affiliation(s)
- Partha Haldar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kameshwar Prasad
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India.
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sada Nand Dwivedi
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Awadh Kishor Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Amit Kumar
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Tiemeier Henning
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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23
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Genario R, Gil S, Oliveira-Júnior G, Leitão AE, Franco T, Dos Santos Sales RC, Ferriolli E, Busse AL, Filho WJ, Gualano B, Roschel H. Sleep quality is a predictor of muscle mass, strength, quality of life, anxiety and depression in older adults with obesity. Sci Rep 2023; 13:11256. [PMID: 37438429 DOI: 10.1038/s41598-023-37921-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/29/2023] [Indexed: 07/14/2023] Open
Abstract
We aimed to investigate associations between sleep quality with selected quantitative and qualitative parameters of health in older individuals with obesity. Cross-sectional assessment (n = 95 men/women; ≥ 65 years; BMI ≥ 30 kg/m2) of sleep quality, body composition, handgrip strength, quality-of-life, anxiety/depression. Mean PSQI score was 6.3. Poor sleepers (n = 49) presented lower appendicular lean mass (ALM) (16.2 vs 17.8 kg; p = 0.0273), ALM/BMI (0.47 vs 0.53 kg/BMI; p = 0.0085), fat mass (48.6 vs 46.6%; p = 0.0464), handgrip strength (19.7 vs 22.0 kgf; p = 0.0542) and handgrip/BMI (0.57 vs 0.66 kgf/BMI; p = 0.0242) than good sleepers. They also had higher anxiety (8.6 vs 5.6; p = 0.0100) and depression (4.8 vs 3.2; p = 0.0197) scores, worse health-related quality-of-life and lower scores in mental (62.8 vs 73.0; p = 0.0223) and physical (52.9 vs 67.3; p = 0.0015) domains. Adjusted models showed that PSQI was negatively associated with ALM (β = - 0.13, 95% CI - 0.25; - 0.01) and health-related quality of life on physical (β = - 2.76, 95% CI - 3.82; - 1.70) and mental (β = - 2.25, 95% CI - 3.38; - 1.12) domains, and positively associated with anxiety (β = 0.57; 95% CI 0.26; 0.87) and depression (β = 0.31; 95% CI 0.13; 0.49). Poor sleep quality associates with impaired selected quantitative and qualitative parameters of health. Additionally, sleep quality was shown as an independent predictor of ALM, health-related quality-of-life, anxiety and depression in older individuals with obesity.
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Affiliation(s)
- Rafael Genario
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Saulo Gil
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Gersiel Oliveira-Júnior
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Alice Erwig Leitão
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Tathiane Franco
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Ruan Célio Dos Santos Sales
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Eduardo Ferriolli
- Division of Internal and Geriatric Medicine, Department of Internal Medicine-Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Alexandre Leopold Busse
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Wilson Jacob Filho
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil.
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
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Sánchez-Narváez F, Velasco-Orozco JJ, Pérez-Archundia E. Burnout Syndrome and Sleep Quality in Basic Education Teachers in Mexico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6276. [PMID: 37444122 PMCID: PMC10341465 DOI: 10.3390/ijerph20136276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
Burnout syndrome (BS) is the result of chronic stress in the workplace. Moreover, chronic stress can affect sleep. A unidirectional relationship has been established between burnout and sleep, and it is known that white-collar workers with burnout syndrome have sleep fragmentation and marked daytime sleepiness. OBJECTIVE The aim of this study was to assess the relationships between burnout and sleep quality in elementary school teachers in Mexico. METHODS We collected data from more than 400 teachers who completed tests. Correlation analyses controlled for anxiety and depression, and Poisson logistic regression analyses were performed to examine the relationships of burnout with sleep quality, depression, and anxiety. RESULTS There was a significant correlation between burnout syndrome (mainly in the dimension of emotional exhaustion) and sleep disturbances; significant correlations were also observed with other burnout, depression, and anxiety dimensions. The strength of the correlations decreased after controlling for depression and anxiety. CONCLUSIONS The symptoms of burnout syndrome in teachers can overlap with sleep disorders, so it is necessary to make a differential diagnosis to differentiate burnout syndrome from depression and anxiety, among others.
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Affiliation(s)
- Francisco Sánchez-Narváez
- Faculty of Humanities-Enterprise, Universidad Estatal del Valle de Ecatepec, Valle de Anahuac, Ecatepec 55210, Mexico
- Mexican Institute of Integral Sleep Medicine, del Valle, Benito Juárez 03100, Mexico
| | - Juan Jesús Velasco-Orozco
- Faculty of Anthropology, Universidad Autónoma del Estado de México, Universidad, St. Toluca 50130, Mexico
- Instituto Superior de Ciencias de la Educación del Estado de México, Santa Cruz, Toluca 50030, Mexico
| | - Eduardo Pérez-Archundia
- Instituto Superior de Ciencias de la Educación del Estado de México, Santa Cruz, Toluca 50030, Mexico
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Ji S, Li B, Zhu C, Jiang G, Tang Y, Chen L. Risk assessment model for sleep disturbance based on gastrointestinal myoelectrical activity in middle-aged and elderly people. Front Psychiatry 2023; 14:1183108. [PMID: 37426096 PMCID: PMC10327604 DOI: 10.3389/fpsyt.2023.1183108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Background Sleep disturbance has become a considerable factor affecting the quality of life for middle-aged and elderly people; however, there are still many obstacles to screening sleep disturbance for those people. Given the growing awareness of the association between gastrointestinal function and sleep disturbance, our study aims to predict the risk of sleep disturbance using gastrointestinal electrophysiological signals. Methods The Pittsburgh Sleep Quality Index and gastrointestinal electrophysiological signals of 914 participants in western China were used to establish the model. Demographic characteristics and routine blood test were collected as covariates. Participants were randomly assigned into two sets with a 7:3 ratio for training and validation. In the training set, the least absolute shrinkage and selection operator (LASSO) regression and stepwise logistic regression were used, respectively for variables selection and optimization. To assess the model performance, receiver operator characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were utilized. Then, validation was performed. Results Thirteen predictors were chosen from 46 variables by LASSO regression. Then, age, gender, percentage of normal slow wave and electrical spreading rate on the pre-meal gastric channel, dominant power ratio on the post-meal gastric channel, coupling percent and dominant frequency on the post-meal intestinal channel were the seven predictors reserved by logistic regression. The area under ROC curve was 0.65 in the training set and 0.63 in the validation set, both exhibited moderate predictive ability. Furthermore, by overlapping the DCA results of two data-sets, there might be clinical net benefit if 0.35 was used as reference threshold for high risk of sleep disturbance. Conclusion The model performs a worthy predictive potency for sleep disturbance, which not only provides clinical evidence for the association of gastrointestinal function with sleep disturbance, but also can be considered as an auxiliary assessment for screening sleep disturbance.
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Affiliation(s)
- Shuming Ji
- Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, China
| | - Baichuan Li
- Department of Neurology, Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu, China
| | - Chenxing Zhu
- Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, China
| | - Guohui Jiang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Yusha Tang
- Department of Neurology, Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Chen
- Department of Neurology, Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu, China
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26
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Ma R, Yin Z, Chen Y, Yuan T, An Q, Gan Y, Xu Y, Jiang Y, Du T, Yang A, Meng F, Zhu G, Zhang J. Sleep outcomes and related factors in Parkinson's disease after subthalamic deep brain electrode implantation: a retrospective cohort study. Ther Adv Neurol Disord 2023; 16:17562864231161163. [PMID: 37200769 PMCID: PMC10185976 DOI: 10.1177/17562864231161163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/15/2023] [Indexed: 05/20/2023] Open
Abstract
Background Subthalamic nucleus deep brain stimulation (STN-DBS) improves sleep qualities in Parkinson's disease (PD) patients; however, it remains elusive whether STN-DBS improves sleep by directly influencing the sleep circuit or alleviates other cardinal symptoms such as motor functions, other confounding factors including stimulation intensity may also involve. Studying the effect of microlesion effect (MLE) on sleep after STN-DBS electrode implantation may address this issue. Objective To examine the influence of MLE on sleep quality and related factors in PD, as well as the effects of regional and lateral specific correlations with sleep outcomes after STN-DBS electrode implantation. Study Design Case-control study; Level of evidence, 3. Data Sources and Methods In 78 PD patients who underwent bilateral STN-DBS surgery in our center, we compared the sleep qualities, motor performances, anti-Parkinsonian drug dosage, and emotional conditions at preoperative baseline and postoperative 1-month follow-up. We determined the related factors of sleep outcomes and visualized the electrodes position, simulated the MLE-engendered volume of tissue lesioned (VTL), and investigated sleep-related sweet/sour spots and laterality in STN. Results MLE improves sleep quality with Pittsburgh Sleep Quality Index (PSQI) by 13.36% and Parkinson's Disease Sleep Scale-2 (PDSS-2) by 17.95%. Motor (P = 0.014) and emotional (P = 0.001) improvements were both positively correlated with sleep improvements. However, MLE in STN associative subregions, as an independent factor, may cause sleep deterioration (r = 0.348, P = 0.002), and only the left STN showed significance (r = 0.327, P = 0.004). Sweet spot analysis also indicated part of the left STN associative subregion is the sour spot indicative of sleep deterioration. Conclusion The MLE of STN-DBS can overall improve sleep quality in PD patients, with a positive correlation between motor and emotional improvements. However, independent of all other factors, the MLE in the STN associative subregion, particularly the left side, may cause sleep deterioration.
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Affiliation(s)
- Ruoyu Ma
- Department of Neurosurgery, Beijing Tiantan
Hospital, Capital Medical University, Beijing, China
| | - Zixiao Yin
- Department of Neurosurgery, Beijing Tiantan
Hospital, Capital Medical University, Beijing, China
| | - Yingchuan Chen
- Department of Neurosurgery, Beijing Tiantan
Hospital, Capital Medical University, Beijing, China
| | - Tianshuo Yuan
- Department of Neurosurgery, Beijing Tiantan
Hospital, Capital Medical University, Beijing, China
| | - Qi An
- Department of Neurosurgery, Beijing Tiantan
Hospital, Capital Medical University, Beijing, China
| | - Yifei Gan
- Department of Neurosurgery, Beijing Tiantan
Hospital, Capital Medical University, Beijing, China
| | - Yichen Xu
- Department of Neurosurgery, Beijing Tiantan
Hospital, Capital Medical University, Beijing, China
| | - Yin Jiang
- Department of Functional Neurosurgery, Beijing
Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Tingting Du
- Department of Functional Neurosurgery, Beijing
Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Anchao Yang
- Department of Neurosurgery, Beijing Tiantan
Hospital, Capital Medical University, Beijing, China
| | - Fangang Meng
- Department of Functional Neurosurgery, Beijing
Neurosurgical Institute, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation,
Beijing, China
| | - Guanyu Zhu
- Department of Neurosurgery, Beijing Tiantan
Hospital, Capital Medical University, No. 119 South 4th Ring West Road,
Fengtai District, Beijing 100070, China
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan
Hospital, Capital Medical University, No. 119 South 4th Ring West Road,
Fengtai District, Beijing 100070, China
- Department of Functional Neurosurgery, Beijing
Neurosurgical Institute, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation,
Beijing, China
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Xue D, Guo X, Li Y, Sheng Z, Wang L, Liu L, Cao J, Liu Y, Lou J, Li H, Hao X, Zhou Z, Fu Q. Risk Factor Analysis and a Predictive Model of Postoperative Depressive Symptoms in Elderly Patients Undergoing Video-Assisted Thoracoscopic Surgery. Brain Sci 2023; 13:brainsci13040646. [PMID: 37190611 DOI: 10.3390/brainsci13040646] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/30/2023] [Accepted: 04/09/2023] [Indexed: 05/17/2023] Open
Abstract
Among the elderly, depression is one of the most common mental disorders, which seriously affects their physical and mental health and quality of life, and their suicide rate is particularly high. Depression in the elderly is strongly associated with surgery. In this study, we aimed to explore the risk factors and establish a predictive model of depressive symptoms 1 month after video-assisted thoracoscopic surgery (VATS) in elderly patients. The study participants included 272 elderly patients (age > 65 years) undergoing VATS from April 2020 to May 2021 at 1 of 18 medical centers in China. The patients were divided into a depression group and a nondepression group according to the Chinese version of the nine-item Patient Health Questionnaire (PHQ-9). The patients' pre- and postoperative characteristics and questionnaires were collected and compared. Then, binary logistic regression was used to determine the risk factors that affect postoperative depressive symptoms, and the predictive model was constructed. The prediction efficiency of the model was evaluated by drawing the receiver operating characteristic curve (ROC), and the area under the curve (AUC) was calculated to evaluate the value of the predictive model. Among all of the included patients, 16.54% (45/272) suffered from depressive symptoms after VATS. The results of the univariate analysis showed that body mass index (BMI), chronic pain, leukocyte count, fibrinogen levels, prothrombin time, ASA physical status, infusion volume, anxiety, sleep quality, and postoperative pain were related to postoperative depressive symptoms (all p < 0.05). The results of multivariate logistic regression analysis showed that a high fibrinogen level (OR = 2.42), postoperative anxiety (OR = 12.05), poor sleep quality (OR = 0.61), and pain (OR = 2.85) were risk factors of postoperative depressive symptoms. A predictive model was constructed according to the regression coefficient of each variable, the ROC curve was drawn, and the AUC value was calculated to be 0.889. The prediction model may help medical personnel identify older patients at risk of developing depressive disorders associated with VATS and may be useful for clinical purposes.
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Affiliation(s)
- Dinghao Xue
- Medical School of Chinese PLA, Beijing 100853, China
- Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Xu Guo
- Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Yanxiang Li
- Medical School of Chinese PLA, Beijing 100853, China
- Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhuoqi Sheng
- Medical School of Chinese PLA, Beijing 100853, China
| | - Long Wang
- Department of Pain Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Luyu Liu
- Medical School of Chinese PLA, Beijing 100853, China
- Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Jiangbei Cao
- Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Yanhong Liu
- Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Jingsheng Lou
- Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Hao Li
- Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Xinyu Hao
- Medical School of Chinese PLA, Beijing 100853, China
- Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhikang Zhou
- Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Qiang Fu
- Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
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Ganidagli S, Ozturk E, Ozturk ZA. Risk factors of poor sleep quality in older adults: an analysis based on comprehensive geriatric assessment. Curr Med Res Opin 2023; 39:701-706. [PMID: 36927301 DOI: 10.1080/03007995.2023.2192124] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVES Sleep quality is associated with many diseases and conditions that affect individuals' health in various ways. We aimed to investigate the association between sleep quality and common geriatric conditions in older adults. METHODS The study included 237 older adults admitted to the geriatric outpatient clinic of a university hospital. All patients underwent comprehensive geriatric assessment (CGA). The Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), European Quality of Life (EQ-5D), Pittsburgh Sleep Quality Index (PSQI), Katz Index of Independence in Activities of Daily Living (ADL) and Lawton and Brody Instrumental Activities of Daily Living (IADL) questionnaires, Tinetti Balance and Gait Assessment (TBGA), and Mini Nutritional Assessment (MNA) were performed on the participants. RESULTS Participants had a mean age of 72.2 ± 6.3 years, and 146 (61.6%) of them had poor sleep quality. Of the participants, 61.2% were female. In the poor sleep quality group, GDS and BAI scores were higher while ADL, IADL, MNA, and EQ-5D index scores were lower. PSQI score had a negative correlation with ADL (r = -.207, p = .01), EQ-5D index (r = -.372, p = .00), MNA (r = -.277, p = .00), and TBGA (r = -.263, p = .41) scores and a positive correlation with GDS (r = .426, p = .00) and BAI (r = .450, p = .00) scores according to the results of correlation analysis. Multivariate logistic regression analysis showed that the presence of diabetes mellitus (DM) and higher GDS and BAI scores were independent variables for poor sleep quality [(p = .48, OR = 1.92; p = .20, OR = 1.11; and p <.01, OR = 1.11, respectively)]. CONCLUSIONS We found that DM and depressive and anxiety symptoms were the risks of poor sleep quality. In addition, participants with poor sleep quality had a worse quality-of-life and nutritional status. Improving sleep quality may be helpful in the management of geriatric syndromes and that sleep quality assessment should be part of CGA.
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Affiliation(s)
- Sencer Ganidagli
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, Sahinbey, Turkey
| | - Ercument Ozturk
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, Sahinbey, Turkey
| | - Zeynel Abidin Ozturk
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, Sahinbey, Turkey
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Wang TT, Liu YL, Hou Y, Li JP, Qiao C. The risk factors of progestational anxiety, depression, and sleep disturbance in women with recurrent pregnancy loss: A cross-sectional study in China. Front Psychol 2023; 14:1116331. [PMID: 37063554 PMCID: PMC10102375 DOI: 10.3389/fpsyg.2023.1116331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/10/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundThe risk factors of progestational anxiety, depression, and sleep disturbance in women with a history of recurrent pregnancy loss (RPL) remain controversial, additional study is needed to investigate the incidence and risk factors of progestational anxiety, depression, and sleep quality in RPL women.MethodsA cross-sectional study was conducted among 663 non-pregnant RPL women in Northeast China from October 2019 to July 2022. We assessed the state of anxiety, depression, and sleep quality before pregnancy using structured questionnaires, including sociodemographic characteristics, state-trait anxiety scale (STAI), center for epidemiological survey, depression scale (CES-D), Pittsburgh sleep quality index (PSQI), and symptom self-rating scale (SCL-90). Logistic regression was used to evaluate the association between sleep quality and anxiety, depression. Pearson’s correlation was used to evaluate the correlation between anxiety and depression. Multivariate logistic regression analysis was used to find the risk factors of depression symptoms. The receiver operating characteristic curve (ROC) was used to evaluate the predictive value of the model.ResultsThe incidence of state anxiety, trait anxiety, depression, and sleep disturbance in RPL women were 60.3, 51.7, 33.9, and 31.2%, respectively. The level of anxiety and depression in RPL women varied at different stages of treatment. In a longitudinal study (25 pairs), we found the level of state anxiety and trait anxiety were significantly lower after the cause was identified. Sleep disturbance is positively correlated with anxiety and depression. Logistic regression showed that the number of miscarriages ≥4 (Odds ratio (OR) = 2.268, 95%CI 1.300–3.956), Low household family income (OR = 1.613, 95%CI 1.036–2.513/OR = 2.361, 95%CI 1.095–5.092), interval since last miscarriage <6 months (OR = 2.154, 95%CI 1.246–3.726) and sleep disturbance (OR = 5.523, 95%CI 3.542–8.614) were associated with the occurrence of depressive symptoms. At the same time, anxiety can be used as a predictor of depression.ConclusionRecurrent pregnancy loss women have a certain degree of anxiety, depression, and sleep disturbance. Education level, interval since the last miscarriage <6 months, and sleep disturbance are risk factors for anxiety and depression. A history of pregnancy loss after 14 weeks and no living birth are also closely related to anxiety. Therefore, it is necessary to pay close attention to the psychological state of RPL women and provide appropriate psychosocial support to reduce the occurrence of negative emotions.
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Affiliation(s)
- Ting-ting Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Obstetrics and Gynecology of Higher Education of Liaoning Province, Shenyang, China
| | - Yi-lin Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Obstetrics and Gynecology of Higher Education of Liaoning Province, Shenyang, China
| | - Yue Hou
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Obstetrics and Gynecology of Higher Education of Liaoning Province, Shenyang, China
| | - Jia-po Li
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Obstetrics and Gynecology of Higher Education of Liaoning Province, Shenyang, China
| | - Chong Qiao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Obstetrics and Gynecology of Higher Education of Liaoning Province, Shenyang, China
- *Correspondence: Chong Qiao,
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Xiao S, Shi L, Zhang J, Li X, Lin H, Xue Y, Xue B, Chen Y, Zhou G, Zhang C. The role of anxiety and depressive symptoms in mediating the relationship between subjective sleep quality and cognitive function among older adults in China. J Affect Disord 2023; 325:640-646. [PMID: 36657496 DOI: 10.1016/j.jad.2023.01.048] [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: 06/02/2022] [Revised: 12/28/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND Deterioration of cognitive function has a significant impact on the unavoidable burden on individuals, families, and society. This study aimed to examine the serial multiple mediating effects of anxiety and depressive symptoms on the relationship between subjective sleep quality and cognitive function among older adults in China. METHODS We selected 6442 Chinese older adults aged 65 years and older from the 2018 Chinese Longitudinal Healthy Longevity Survey. The SPSS PROCESS macro was employed to perform simple and serial multiple mediation analyses. RESULTS Subjective sleep quality, depressive symptoms, anxiety symptoms, and cognitive function were significantly related (P < 0.01). Poor sleep quality can have a direct negative influence on cognitive function among older adults (effect = -0.110; 95 % CI = [-0.166, -0.053]), but it can also have an indirect negative impact via three pathways: the independent mediation of anxiety symptoms (effect = -0.028; 95 % CI = [-0.048, -0.011]), the independent mediation of depressive symptoms (effect = -0.014; 95 % CI = [-0.026, -0.002]), and the serial mediation of anxiety and depressive symptoms (effect = -0.009; 95 % CI = [-0.017, -0.001]). LIMITATIONS This study used a cross-sectional design, which restricts the ability to infer causal relationships. CONCLUSIONS The effect of subjective sleep quality on cognitive function was serially mediated by anxiety and depressive symptoms among older adults. Diverse therapies targeted at improving sleep quality in older adults may improve mood and cognitive functioning.
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Affiliation(s)
- Shujuan Xiao
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Xinru Li
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Huang Lin
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Yiming Chen
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Guangqing Zhou
- Health Management Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Chichen Zhang
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; School of Health Management, Southern Medical University, Guangzhou, Guangdong, China; Health Management Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Institute of Health Management, Southern Medical University, Guangzhou, Guangdong, China.
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Wang L, He S, Yan N, Pan R, Niu Y, Li J. Mediating role of depressive symptoms on the relationship between sleep duration and cognitive function. Sci Rep 2023; 13:4067. [PMID: 36906644 PMCID: PMC10008529 DOI: 10.1038/s41598-023-31357-6] [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: 06/05/2022] [Accepted: 03/10/2023] [Indexed: 03/13/2023] Open
Abstract
Although some studies have shown the association between sleep duration and cognitive impairment is positive, the mechanism explaining how sleep duration is linked to cognition remains poor understood. The current study aims to explore it among Chinese population. A cross-sectional study of 12,589 participants aged 45 or over was conducted, cognition was assessed by three measures to capture mental intactness, episodic memory, and visuospatial abilities. The Center for Epidemiologic Studies Depression Scale 10 (CES-D10) was administered during the face-to-face survey to assess depressive status. Sleep duration was reported by the participants themselves. Partial correlation and linear regression were used to explore the association between sleep duration, cognition, and depression. The Bootstrap methods PROCESS program was used to detect the mediation effect of depression. Sleep duration was positively correlated with cognition and negatively with depression (p < 0.01). The CES-D10 score (r = - 0.13, p < 0.01) was negatively correlated with cognitive function. Linear regression analysis showed sleep duration was positively associated with cognition (p = 0.001). When depressive symptoms were considered, the association between sleep duration and cognition lost significance (p = 0.468). Depressive symptoms have mediated the relationship between sleep duration and cognitive function. The findings revealed that the relationship between sleep duration and cognition is mainly explained by depressive symptoms and may provide new ideas for interventions for cognitive dysfunction.
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Affiliation(s)
- Liqun Wang
- Department of Epidemiology and Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, 750004, China
| | - Shulan He
- Department of Epidemiology and Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, 750004, China
| | - Ning Yan
- Heart Centre &, Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Ruiping Pan
- Department of Chinese Medicine, The Second People's Hospital of Shizuishan, Shizuishan, 753000, China
| | - Yang Niu
- Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, 750004, China.
| | - Jiangping Li
- Department of Epidemiology and Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, China.
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, 750004, China.
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Papi S, Barmala A, Amiri Z, Vakili-Basir A, Cheraghi M, Nejadsadeghi E. Mediating Roles of Stress, Anxiety, and Depression in the Relationship between Constipation and Sleep Quality among the Elderly: Structural Equation Modeling (SEM). Sleep Sci 2023; 16:1-6. [PMID: 37151776 PMCID: PMC10157831 DOI: 10.1055/s-0043-1767750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/05/2022] [Indexed: 05/09/2023] Open
Abstract
Introduction Sleep quality is an important health index in the elderly. As age increases, changes occur in sleep quality leading to sleep disorders and recurrent complaints. Sleep quality management of the elderly requires identification of its determinants. The present study aimed to determine the mediating roles of stress, anxiety, and depression in the relationship between constipation and sleep quality among the elderly using structural equation modeling (SEM). Materials and Methods A correlational design was used in the present study through structural equation modeling. In this work, 363 elderlies were examined by multi-stage random sampling. Data collection tools included four questionnaires, namely a demographic information questionnaire, the constipation questionnaire (ROME III), the Depression, Anxiety, and Stress Scale-short form, and the Pittsburgh Sleep Quality Index (PSQI), which were completed by interview and the self-report method. The SPSS Statistics for Windows, version 22.0, and SPSS AMOS (IBM Corp., Armonk, NY, USA) were used to analyze the data. Results The results indicated that the proposed model had an acceptable fit ( p < 0.000, root mean square error of approximation [RMSEA] = 0.062, comparative fit index [CFI] = 0.83, goodness-of-fit index [GFI] = 0.87, and Χ 2 /df = 1.94). The fitted model could explain 60% of the sleep quality variance. According to the proposed model, constipation could significantly predict sleep quality due to the mediation of stress, anxiety, and depression ( p < 0.05). Conclusion The constructs of this model (constipation, stress, anxiety, and depression) can be used as a reference framework to design effective interventions and improve sleep quality in old people.
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Affiliation(s)
- Shahab Papi
- Mazandaran University of Medical Sciences, School of Health, Department of Geriatric Health, Sari, Iran
| | - Azin Barmala
- Academic Center for Education, Culture and Research (ACECR), Health Education Research Group, Khuzestan, Ahvaz, Iran
| | - Zeynab Amiri
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation, Tehran, Tehran, Iran
| | - Ahmad Vakili-Basir
- Department of Epidemiology & Biostatics, School of Public Health, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Maria Cheraghi
- Mazandaran University of Medical Sciences, School of Health, Department of Geriatric Health, Sari, Iran
| | - Elham Nejadsadeghi
- Behbahan Faculty of Medical Sciences, Behbahan, Iran
- Address for correspondence Elham Nejadsadeghi
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Determining the correlation between old age adaptation, aging in place and depression in older adults: A descriptive correlational study. Arch Psychiatr Nurs 2023; 43:153-161. [PMID: 37032010 DOI: 10.1016/j.apnu.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 01/15/2023] [Accepted: 02/20/2023] [Indexed: 03/08/2023]
Abstract
We conducted this study to determine the correlation between old age adaptation, aging in place, and depression in older adults. We carried out the descriptive correlational study with older adults (n:319) Ağrı Provincial Directorate of Health between October 2021 and April 2022. "SPSS 25 and Amos 23 programs" were used in the analysis of the data. Python 3.11.1, Microsoft Power BI programs were used for machine learning and graphical visualizations. In the study, it was determined that the model for the relationship between aging at a place level, adaptation difficulty in older adults level, and geriatric depression level was significant (F(2,316) = 37.002, p = 0.001). The aging in place level and the adaptation difficulty in older adults level explain 18.5% of the total variance of the level of geriatric depression. In the regression model, it was determined that the increase in the level of aging in place (t = -6.081, p < 0.001) and the decrease in the level of adaptation difficulty in older adults (t = 4.107, p < 0.001) of the participants caused a statistical decrease in the level of "Geriatric Depression." It has been determined that adaptation difficulty in older adults has a moderator role in the relationship between geriatric depression level and aging in place level. In our data set, while the estimate of the presence of depression was 40 % with logistic regression analysis, it was 97 % with Random Forest. The study determined that as the level of aging in -place increased and the adaptation difficulty in older adults decreased, and depression decreased.
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Wang R, Ye C, Huang X, Halimulati M, Sun M, Ma Y, Fan R, Zhang Z. cMIND Diet, Indoor Air Pollution, and Depression: A Cohort Study Based on the CLHLS from 2011 to 2018. Nutrients 2023; 15:1203. [PMID: 36904202 PMCID: PMC10005708 DOI: 10.3390/nu15051203] [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: 01/29/2023] [Revised: 02/26/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023] Open
Abstract
This study aims to explore the interaction between a Chinese version of the Mediterranean-DASH intervention for neurodegenerative delay (cMIND) diet and indoor air pollution and its effect on depression among older adults. This cohort study used 2011-2018 data from the Chinese Longitudinal Healthy Longevity Survey. Participants included 2724 adults aged 65 and older without depression. The Chinese version of the Mediterranean-DASH intervention for neurodegenerative delay (cMIND) diet scores ranged from 0 to 12 based on validated food frequency questionnaire responses. Depression was measured using the Phenotypes and eXposures Toolkit. Cox proportional hazards regression models were used to explore the associations, and the analysis was stratified using the cMIND diet scores. A total of 2724 participants (54.3% males and 45.9% 80 years and older) at baseline were included. Living with severe indoor pollution was associated with a 40% increase in the risk of depression (HR: 1.40, 95% CI: 1.07, 1.82) compared to living without indoor pollution. Indoor air pollution exposure was significantly associated with cMIND diet scores. Participants with a lower cMIND diet score (HR: 1.72, 95% CI: 1.24, 2.38) had a greater association with severe pollution than those with a higher cMIND diet score. The cMIND diet may alleviate depression caused by indoor pollution among older adults.
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Affiliation(s)
- Ruoyu Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Haidian District, Beijing 100191, China
| | - Chen Ye
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Xicheng District, Beijing 100050, China
| | - Xiaojie Huang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Haidian District, Beijing 100191, China
| | - Mairepaiti Halimulati
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Haidian District, Beijing 100191, China
| | - Meng Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Haidian District, Beijing 100191, China
| | - Yuxin Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Haidian District, Beijing 100191, China
| | - Rui Fan
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Haidian District, Beijing 100191, China
- Beijing’s Key Laboratory of Food Safety Toxicology Research and Evaluation, Haidian District, Beijing 100191, China
| | - Zhaofeng Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Haidian District, Beijing 100191, China
- Beijing’s Key Laboratory of Food Safety Toxicology Research and Evaluation, Haidian District, Beijing 100191, China
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Mobile Phone Addiction and Sleep Quality among Older People: The Mediating Roles of Depression and Loneliness. Behav Sci (Basel) 2023; 13:bs13020153. [PMID: 36829382 PMCID: PMC9952244 DOI: 10.3390/bs13020153] [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: 01/04/2023] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
Rapid social development has made the elderly increasingly dependent on mobile phones, and mobile phone addiction has a negative effect on sleep quality. The underlying mechanism between the two is unclear. This study examined the mediating role of depression and loneliness in the relationship between phone addiction and sleep quality in older adults. Mobile Phone Addiction Scale Short Version, Pittsburgh Sleep Quality Index scale, UCLA (University of California, Los Angeles)-8 Loneliness Scale, and Short Geriatric Depression Scale (GDS-15) were used to investigate 459 older adults in China. The results showed that there was a positive correlation between mobile phone addiction and sleep quality in the elderly. In addition, depression and loneliness partially mediated the relationship between mobile phone addiction and sleep quality in older adults. The current study provides new insights into the impact of mobile phone addiction on sleep quality and the importance of depression and loneliness in older adults. The limitations and significance of this study are discussed.
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Ding JY, Wu WT, Liang Z, Yu C, Xiao XH. Depression and activities of daily living in elderly people applying for admission to public nursing facilities. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-6. [PMID: 36757805 DOI: 10.1080/23279095.2023.2169828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVE The present study aims to (1) investigate the prevalence of positive screening for depression among elderly people applying for admission to public nursing facilities in Shenzhen and (2) to explore the correlation between depression and activities of daily living (ADL) among the elderly. METHODS Visual and hearing acuity, ADL (obtained using the Barthel index), cognition and depression levels, and communication and social interaction skills were assessed in all elderly adults aged ≥60 years who applied for admission to public nursing facilities in Shenzhen between April 1, 2018, and December 31, 2019. RESULTS A total of 1,113 elderly adults, 34.95% of whom were assessed as being depressed, were evaluated. Regarding dependence on the care of others, the ADL assessment results showed that 11.86% of the study subjects were fully dependent, 10.51% were severely dependent, 12.58% were moderately dependent, 42.86% were mildly dependent, and only 22.19% were fully capable of self-care. The univariate analysis suggested that gender, cognition level, visual and hearing acuity, and communication and social interaction skills were all correlated with the occurrence of depression. The prevalence of positive screening for depression was relatively high among subjects with an ADL score of ≤65; With an ADL score of ≤65, the prevalence of depression increased by 6% with every 1-point ADL score decrease. CONCLUSION The prevalence of depression among elderly adults applying for admission to public nursing facilities in Shenzhen was high. For this reason, nursing facility caregivers should focus on screening elderly adults (especially subjects with impaired ADL function) for depression in order to improve their quality of life.
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Affiliation(s)
- Jing-Yun Ding
- Department of Geriatrics, First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Wei-Tao Wu
- Department of Geriatrics, First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Zhen- Liang
- Department of Endocrinology, The 2nd Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Cong Yu
- Department of Nursing, First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Xiao-Hua Xiao
- Department of Geriatrics, First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
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Gibian JT, Bartosiak KA, Lucey BP, Riegler V, King J, Barrack RL. Sleep Disturbances Following Total Knee Arthroplasty. J Arthroplasty 2023; 38:S120-S124. [PMID: 36773659 DOI: 10.1016/j.arth.2023.01.066] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/29/2023] [Accepted: 01/31/2023] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND Sleep disturbances are common after total knee arthroplasty (TKA), yet literature examining sleep and postoperative pain remains sparse. With the use of wearable devices, convenient objective remote sleep monitoring is now possible. We aimed to measure patient sleep following TKA using validated questionnaires and wearable devices to compare sleep patterns to pain scores 90 days postoperatively. METHODS Adult patients with body mass index < 45 undergoing unilateral primary TKA were enrolled. Patients wore a monitor, which tracked sleep duration and disturbances (getting up at least once during the night). They completed weekly Pittsburgh Sleep Quality Index (PSQI) questionnaires and visual analog scale (VAS) pain scores. Sleep patterns were compared with pain scores and sleep duration was compared with PSQI responses. RESULTS There were 110 patients included with 54.5% women; average age was 64 years (range, 43-80). VAS scores decreased postoperatively. PSQI overall sleep scores, sleep quantity, and sleep quality worsened for the first 30 days then improved past baseline levels by 90 days. Recorded sleep duration did not change, and recordings did not correlate at any point with VAS scores. PSQI overall score and sleep quantity did not correlate with VAS. At 30 days postoperatively, patients reporting "very bad" sleep had significantly worse VAS scores than those reporting "bad" sleep. CONCLUSION Patient-reported sleep quality (very bad sleep) correlated well with VAS pain score at 30 days, while sleep duration (monitored or patient-reported) did not correlate with any clinical measure and does not seem to be a useful metric in assessing TKA outcome.
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Affiliation(s)
- Joseph T Gibian
- Washington University School of Medicine Department of Orthopaedics, St. Louis, Missouri
| | - Kimberly A Bartosiak
- Washington University School of Medicine Department of Orthopaedics, St. Louis, Missouri
| | - Brendan P Lucey
- Washington University School of Medicine Department of Neurology, St. Louis, Missouri
| | - Venessa Riegler
- Washington University School of Medicine Department of Orthopaedics, St. Louis, Missouri
| | - Jackie King
- Washington University School of Medicine Department of Orthopaedics, St. Louis, Missouri
| | - Robert L Barrack
- Washington University School of Medicine Department of Orthopaedics, St. Louis, Missouri
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Dong L, Sun T, Tong P, Guo J, Ke X. Prevalence and Correlates of Depression and Anxiety in Patients with Functional Anorectal Pain. J Pain Res 2023; 16:225-232. [PMID: 36726856 PMCID: PMC9885881 DOI: 10.2147/jpr.s400085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
Purpose Patients with functional anorectal pain (FAP) often experience psychological distress, impaired quality of life, increased healthcare utilisation, and even suicidal tendencies. However, limited data exists on the psychological correlates of FAP in Chinese patients. Therefore, this study aimed to examine the prevalence of depression, anxiety, and related psychosocial factors in Chinese patients with FAP. Methods We used a cross-sectional research design and recruited 100 patients with FAP from SuBei Hospital's multidisciplinary clinic for pelvic floor disorders between January and December 2021. Information on patients' demographic and disease characteristics was also collected. Depressive and anxiety symptoms were assessed using the Patient Health Questionnaire Depression (PHQ-9) and the Generalised Anxiety Disorder Questionnaire (GAD-7). Multiple logistic regression analysis was used to examine factors associated with depression and anxiety. Results The prevalence of depressive and anxiety symptoms among patients with FAP was 55% and 46%, respectively. Being a woman, specific marital status (single, divorced, separated, or widowed), longer FAP duration, and sleep disturbance were significantly associated with an increased risk of depressive symptoms. Additionally, specific marital status (single, divorced, separated, or widowed), sleep disturbance, and high Visual Analogue Scale scores were associated with anxiety symptoms. Conclusion Depressive and anxiety symptoms are prevalent in patients with FAP. Several socio-demographic and clinical predictors have been identified. There is a need for psychologists to be involved in the treatment of patients with FAP. Thus, multidisciplinary treatment may be the optimal treatment strategy.
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Affiliation(s)
- Liping Dong
- Affifiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, People’s Republic of China,Department of Clinical Psychology, Yangzhou University Affiliated Northern Jiangsu People’s Hospital, Yangzhou, People’s Republic of China
| | - Ting Sun
- Department of Clinical Psychology, Yangzhou University Affiliated Northern Jiangsu People’s Hospital, Yangzhou, People’s Republic of China
| | - Ping Tong
- Department of Clinical Psychology, Yangzhou University Affiliated Northern Jiangsu People’s Hospital, Yangzhou, People’s Republic of China
| | - Jia Guo
- Department of Proctology of Traditional Chinese Medicine, Yangzhou University Affiliated Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu, People’s Republic of China
| | - Xiaoyan Ke
- Affifiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, People’s Republic of China,Correspondence: Xiaoyan Ke, Child Mental Health Research Center, the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, People’s Republic of China, Tel +8613305176562, Fax +8602982296194, Email
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Deng M, Qian M, Lv J, Guo C, Yu M. The association between loneliness and sleep quality among older adults: A systematic review and meta-analysis. Geriatr Nurs 2023; 49:94-100. [PMID: 36470104 DOI: 10.1016/j.gerinurse.2022.11.013] [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: 09/19/2022] [Revised: 11/18/2022] [Accepted: 11/18/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE To systematically review studies and explore the association between loneliness and sleep quality among older adults. METHODS A comprehensive literature search was conducted in 8 databases from their inception to February 28, 2022. Studies that investigated the association between loneliness and sleep quality among older people were obtained. Comprehensive Meta-analysis was used to meta-analyze data in the included studies. RESULTS In total, 16 studies with 23,485 participants were included in this review, and 6 of these studies were included in the meta-analysis. The meta-analysis showed that older adults who were lonely were significantly more likely to suffer from low sleep quality than their counterparts without loneliness (pooled OR = 1.750, 95% CI: 1.511-2.026, p < 0.01). CONCLUSIONS Loneliness is associated with poor sleep quality among older adults. Loneliness reduction measures should be considered as one of the essential elements in sleep management programs for older people with low sleep quality.
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Affiliation(s)
- Mengying Deng
- School of Nursing, Peking University, 38 Xueyuan Rd., Haidian District, Beijing, China
| | - Min Qian
- Department of Nursing, Beijing Ji Shui Tan Hospital and the 4th Medical College of Peking University, Beijing, China
| | - Jinghong Lv
- School of Nursing, Peking University, 38 Xueyuan Rd., Haidian District, Beijing, China
| | - Chenming Guo
- School of Nursing, Peking University, 38 Xueyuan Rd., Haidian District, Beijing, China
| | - Mingming Yu
- School of Nursing, Peking University, 38 Xueyuan Rd., Haidian District, Beijing, China.
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40
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Zhang H, Zhang Y, Sheng S, Xing Y, Mou Z, Zhang Y, Shi Z, Yu Z, Gao Q, Cai W, Jing Q. Relationship Between Physical Exercise and Cognitive Impairment Among Older Adults with Type 2 Diabetes: Chain Mediating Roles of Sleep Quality and Depression. Psychol Res Behav Manag 2023; 16:817-828. [PMID: 36960417 PMCID: PMC10030003 DOI: 10.2147/prbm.s403788] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/10/2023] [Indexed: 03/19/2023] Open
Abstract
Objective Although physical exercise has been shown to boost physical, psychological, and psychiatric conditions in older adults, there is a relative lack of research on the mechanisms involved in this process for older adults with type 2 diabetes mellitus (T2DM). We thus evaluated whether sleep quality and depression mediated the relationship between physical exercise and cognitive impairment in older adults with T2DM by focusing on the exercise-physiology-psychology and psychiatry connection. Methods Self-reported data were collected from 2646 older adults with T2DM in Weifang, Shandong, China. Regression and bootstrap analyses were conducted to explore the chain mediator model including physical exercise, cognitive impairment, sleep quality, and depression. Results Engaging in physical exercise (coefficient = -0.6858, p < 0.001), high levels of sleep quality (coefficient = -0.3397, p = 0.015), and low levels of depression (coefficient = 0.3866, p < 0.001) were significantly associated with a low level of cognitive impairment. Sleep quality and depression mediated the chain effect between physical exercise and cognitive impairment (total effect = -1.0732, 95% CI [-1.3652, -0.7862]; direct effect = -0.6858, 95% CI [-0.9702, -0.3974]; indirect effect = -0.3875, 95% CI [-0.5369, -0.2521]). Conclusion Physical exercise may improve sleep quality in older adults with T2DM, alleviating depression and delaying the development of cognitive impairment. Physical exercise can enhance patients' ability to resist depression and cognitive impairment, and creating comfortable sleep environments can also reinforce the effects of this process. These findings have important implications for promoting healthy aging in older adults with T2DM.
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Affiliation(s)
- Han Zhang
- School of Management, Weifang Medical University, Weifang, Shandong, People’s Republic of China
- “Health Shandong” Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People’s Republic of China
- China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People’s Republic of China
| | - Yefan Zhang
- School of Management, Weifang Medical University, Weifang, Shandong, People’s Republic of China
- “Health Shandong” Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People’s Republic of China
- China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People’s Republic of China
| | - Sen Sheng
- School of Management, Weifang Medical University, Weifang, Shandong, People’s Republic of China
- “Health Shandong” Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People’s Republic of China
| | - Yang Xing
- Weifang People’s Hospital, Weifang, People’s Republic of China
| | - Zhongchen Mou
- School of Psychology, Weifang Medical University, Weifang, People’s Republic of China
| | - Yanqiu Zhang
- School of Management, Weifang Medical University, Weifang, Shandong, People’s Republic of China
- “Health Shandong” Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People’s Republic of China
- China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People’s Republic of China
| | - Zhixue Shi
- School of Management, Weifang Medical University, Weifang, Shandong, People’s Republic of China
- “Health Shandong” Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People’s Republic of China
- China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People’s Republic of China
| | - Zhenjie Yu
- School of Management, Weifang Medical University, Weifang, Shandong, People’s Republic of China
- “Health Shandong” Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People’s Republic of China
| | - Qianqian Gao
- School of Management, Weifang Medical University, Weifang, Shandong, People’s Republic of China
- “Health Shandong” Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People’s Republic of China
- China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People’s Republic of China
| | - Weiqin Cai
- School of Management, Weifang Medical University, Weifang, Shandong, People’s Republic of China
- “Health Shandong” Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People’s Republic of China
- China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People’s Republic of China
- Correspondence: Weiqin Cai; Qi Jing, School of Management, Weifang Medical University, No. 7166 Baotongxi Street, Weifang, 261053, People’s Republic of China, Tel +8618106369128, Email ;
| | - Qi Jing
- School of Management, Weifang Medical University, Weifang, Shandong, People’s Republic of China
- “Health Shandong” Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People’s Republic of China
- China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People’s Republic of China
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Liu H, Zhou Z, Fan X, Shen C, Ma Y, Sun H, Xu Z. Association Between Multiple Chronic Conditions and Depressive Symptoms Among Older Adults in China: Evidence From the China Health and Retirement Longitudinal Study (CHARLS). Int J Public Health 2023; 68:1605572. [PMID: 36938299 PMCID: PMC10020227 DOI: 10.3389/ijph.2023.1605572] [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: 11/10/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Objectives: The purpose of this study was to explore the association between multiple chronic conditions (MCCs) and depressive symptoms among older adults in China. Methods: We used the fourth round of data from the China Health and Retirement Longitudinal Study, and included 9789 older adults aged 60 years old and above. Results: Compared with the older adults without chronic disease, older adults with MCCs and those with one chronic disease had a high risk of depression (MCCs: OR-adjusted: 1.55, 95% CI: 1.37 to 1.75; one chronic disease: OR-adjusted: 1.20, 95% CI: 1.05-1.37). In urban areas, the prevalence among older adults with MCCs was 2.01 times higher than that among older adults without chronic disease (OR-adjusted: 2.01, 95% CI: 1.56-2.60), while it was 1.44 times higher in rural areas (OR-adjusted:1.44, 95% CI: 1.25-1.65). Self-reported health, duration of sleep, social activities, and type of medical insurance were the influencing factors of depressive symptoms in older adults. Conclusion: This study contributed to enriching the research on the relationship between MCCs and depressive symptoms in older adults in China.
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Affiliation(s)
- Haixia Liu
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
- *Correspondence: Haixia Liu,
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Xiaojing Fan
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Chi Shen
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Yang Ma
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Hongwei Sun
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Zhaoyang Xu
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
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Abstract
Qualitative evidences have shown that having the habit of reading might be beneficial for mental health. The present study aims to examine the relationship between reading and depression. National cross-sectional survey data of adults aged >40 years in mainland China were used. The Center for Epidemiological Studies Depression Scale questionnaire was utilized to detect depression status. Multilevel binary logistic and linear regression models were employed to reveal the association, and restricted cubic spline with 4 knots was adopted to describe the non-linear association of reading quantity and depression. The prevalence of depression was 13.02% in the target population. It was found that the habit of reading was negatively associated with depression, the odds ratio was 0.809 (95% confidence interval: 0.657-0.997). Diverse association between reading and depression was observed in different age groups, and a significant association was identified among the elderly, but not in the middle-aged population. Restricted cubic spline showed several books read per year might lower the risk of depression and 20-items Center for Epidemiological Studies Depression Scale score. A lower prevalence of depression was observed in the target population. The habit of reading was negatively associated with depression. Age-specific association was observed. It is worth paying attention to the reading habit that could be beneficial in the elderly for mental health intervention, but it needs to be confirmed by experimental study.
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Affiliation(s)
- Degong Pan
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - Zhiqin Hai
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - Xiao Yang
- Neuroscience Center, General Hospital of Ningxia Medical University, Key Laboratory of Craniocerebral Diseases of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Shulan He
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - Xiaojun Li
- Yijinhuoluo Disease Control and Prevention Center, Erdos, Inner Mongolia, China
| | - Jiangping Li
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
- Research Center of Health Big Data, Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, Ningxia Hui Autonomous Region, China
- * Correspondence: Jiangping Li, Shengli South Street 1160#, Yinchuan, Ningxia 750004, China (e-mail: )
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Li L, Zhang Q, Zhu L, Zeng G, Huang H, Zhuge J, Kuang X, Yang S, Yang D, Chen Z, Gan Y, Lu Z, Wu C. Daytime naps and depression risk: A meta-analysis of observational studies. Front Psychol 2022; 13:1051128. [PMID: 36591028 PMCID: PMC9798209 DOI: 10.3389/fpsyg.2022.1051128] [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: 09/22/2022] [Accepted: 11/18/2022] [Indexed: 12/23/2022] Open
Abstract
Background The relationship between daytime napping and depression remains debatable. Thus, a meta-analysis in this study was conducted to evaluate the relationship between daytime napping and depression. Methods The PubMed, Embase, Web of Science, and China National Knowledge Infrastructure databases were searched up to February 2022, and the reference lists of the included studies were also retrieved. A random-effects model was used to estimate the combined effect size. Results Nine studies with 649,111 participants were included in the final analysis. The pooled odds ratio (OR) was 1.15 (95% confidence interval: 1.01-1.31) with a significant heterogeneity (I 2 = 91.3%, P for heterogeneity <0.001), and the results demonstrated an increased risk of depressive symptoms among daytime nappers. Visual inspection of the funnel plot and Egger's and Begg's tests identified no obvious evidence of publication bias. Conclusion This meta-analysis indicates that daytime naps are a predictor of depression. The effects of daytime napping on depression may vary depending on the characteristics of people, the pattern of naps, and the individual's sleep experience. The findings may have significant implications for future research on depression.
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Affiliation(s)
- Liqing Li
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China,School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qi Zhang
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Liyong Zhu
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Guohua Zeng
- School of Economics and Management, Jiangxi University of Science and Technology, Ganzhou, Jiangxi, China
| | - Hongwei Huang
- Department of Health Management Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jian Zhuge
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Xiaorui Kuang
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Sule Yang
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Di Yang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Zhensheng Chen
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Yong Gan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zuxun Lu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chunmei Wu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China,*Correspondence: Chunmei Wu
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Kim K, Hwang G, Cho YH, Kim EJ, Woang JW, Hong CH, Son SJ, Roh HW. Relationships of Physical Activity, Depression, and Sleep with Cognitive Function in Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15655. [PMID: 36497729 PMCID: PMC9737085 DOI: 10.3390/ijerph192315655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/21/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
This cross-sectional, observational study aimed to integrate the analyses of relationships of physical activity, depression, and sleep with cognitive function in community-dwelling older adults using a single model. To this end, physical activity, sleep, depression, and cognitive function in 864 community-dwelling older adults from the Suwon Geriatric Mental Health Center were assessed using the International Physical Activity Questionnaire, Montgomery-Asberg Depression Rating Scale, Pittsburgh Sleep Quality Index, and Mini-Mental State Examination for Dementia Screening, respectively. Their sociodemographic characteristics were also recorded. After adjusting for confounders, multiple linear regression analysis was performed to investigate the effects of physical activity, sleep, and depression on cognitive function. Models 4, 5, 7, and 14 of PROCESS were applied to verify the mediating and moderating effects of all variables. Physical activity had a direct effect on cognitive function (effect = 0.97, p < 0.01) and indirect effect (effect = 0.36; confidence interval: 0.18, 0.57) through depression. Moreover, mediated moderation effects of sleep were confirmed in the pathways where physical activity affects cognitive function through depression (F-coeff = 13.37, p < 0.001). Furthermore, these relationships differed with age. Thus, the associations among physical activity, depression, and sleep are important in interventions for the cognitive function of community-dwelling older adults. Such interventions should focus on different factors depending on age.
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Affiliation(s)
- Kahee Kim
- Department of Psychiatry, Ajou University School of Medicine, Suwon 16499, Republic of Korea
| | - Gyubeom Hwang
- Department of Psychiatry, Ajou University School of Medicine, Suwon 16499, Republic of Korea
| | - Yong Hyuk Cho
- Department of Psychiatry, Ajou University School of Medicine, Suwon 16499, Republic of Korea
| | - Eun Jwoo Kim
- Suwon Geriatric Mental Health Center, Suwon 16499, Republic of Korea
| | - Ji Won Woang
- Suwon Geriatric Mental Health Center, Suwon 16499, Republic of Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon 16499, Republic of Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon 16499, Republic of Korea
- Suwon Geriatric Mental Health Center, Suwon 16499, Republic of Korea
| | - Hyun Woong Roh
- Department of Psychiatry, Ajou University School of Medicine, Suwon 16499, Republic of Korea
- Suwon Geriatric Mental Health Center, Suwon 16499, Republic of Korea
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Jiang Y, Wang Y, Wang R, Zhang X, Wang X. Differences in pain, disability, and psychological function in low back pain patients with and without anxiety. Front Physiol 2022; 13:906461. [DOI: 10.3389/fphys.2022.906461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives: Non-specific low back pain affects people of all ages and is a leading contributor to disease burden worldwide. Chronic low back pain (LBP) reduces working hours, increases comorbidities, and increases rehabilitation needs. The aim of this study was to evaluate whether there were differences in pain, dysfunction, and psychological factors between two groups. The supplementary demonstrated the relationship between these influencing factors and anxiety.Methods: A cross-sectional study was designed to analyze the differences in pain, disability, and psychological function in non-specific LBP patients with and without anxiety. In total, 60 subjects were divided into two groups based on self-rated anxiety scores: 30 patients with SAS score ≥50 were in the low back pain with anxiety group, and 30 for the LBP without anxiety group with SAS score <50. The pain intensity was assessed using the Visual Analog Scale; psychological function, using the Pain Anxiety Symptoms Scale, the Tampa Scale for Kinesiophobia, and the Fear Avoidance Beliefs Questionnaire; functional disability, using the Oswestry Disability Index and the Roland–Morris Disability Questionnaire; quality of life using 36-Item Short-Form Health Survey questionnaire; and the quality of sleep using Pittsburgh Sleep Quality Index, and the relationships between variables and anxiety scores were estimated using Spearman correlation analysis.Results: A total of 60 participants were enrolled after self-rated anxiety was assessed and the full investigation was finished. The analyses showed significant differences of pain intensity (p = 0.034, disability (ODI, p = 0.007; RMDQ, p = 0.012) and psychological function (TSK, p = 0.000; PASS, p = 0.009; FABQ, p = 0.000; SF-36, p = 0.000; and PSQI, p = 0.000) between the two groups. Spearman correlation analysis showed that the anxiety score had significant positive correlations with functional disability (ODI, p = 0.004 and 95% CI = 0.112–0.573; RMDQ, p = 0.003, 95% CI = 0.135–0.586) and psychological function (TSK, p = 0.001, 95% CI = 0.174–0.612), excellent positive correlation with quality of sleep (PASS, p = 0.025, 95% CI = 0.031–0.512), and strongly negative correlations with the quality of life (SF-36, p = 0.000, 95% CI = 0.761–0.433).Conclusion: We recognized that anxiety in low back pain patients was mainly due to interaction with the intensity of pain, disability level, and a mass of psychological function. The future research direction could be to alleviate the anxiety on the comprehensive efficacy of patients with low back pain.
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Bartosiak K, Schwabe M, Lucey B, Lawrie C, Barrack R. Sleep Disturbances and Disorders in Patients with Knee Osteoarthritis and Total Knee Arthroplasty. J Bone Joint Surg Am 2022; 104:1946-1955. [PMID: 35926180 DOI: 10.2106/jbjs.21.01448] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
➤ There is increasing evidence that patient-reported outcomes following total knee arthroplasty (TKA) are associated with psychosocial factors and pain catastrophizing. Sleep disturbance, pain, and mental health have a complex interaction, which, if unrecognized, can be associated with impaired patient-reported outcomes and dissatisfaction following TKA. ➤ The gold standard of objective sleep assessment is polysomnography, which is not feasible to use routinely for TKA patients. Wearable devices are a validated and less costly alternative. ➤ Subjective sleep measures, such as the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, or Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive test sleep domains, are simple to administer and provide additional insight into sleep disturbance. Although objective and subjective measures do not correlate precisely, they can be informative together. ➤ Sleep disturbances in the elderly population are common and multifactorial in etiology, stemming from the interplay of sleep disorders, medication side effects, and pain. Commonly prescribed medications following TKA as well as postoperative pain can exacerbate underlying sleep disturbances. ➤ Obstructive sleep apnea (OSA) is prevalent in patients seeking TKA. In the setting of OSA, postoperative opioids can cause respiratory depression, resulting in consequences as severe as death. A standardized multimodal pain protocol including anti-inflammatories and gamma-aminobutyric acid (GABA) analogues may allow for decreased reliance on opioids for pain control. ➤ Surgeons should reassure patients that postoperative sleep disturbance is common and transient, collaborate with the patient's primary care doctor to address sleep disturbance, and avoid prescription of pharmaceutical sleep aids.
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Affiliation(s)
- Kimberly Bartosiak
- Department of Orthopaedics, Washington University in St. Louis, St. Louis, Missouri
| | - Maria Schwabe
- Department of Orthopaedics, Washington University in St. Louis, St. Louis, Missouri
| | - Brendan Lucey
- Department of Orthopaedics, Washington University in St. Louis, St. Louis, Missouri
| | - Charles Lawrie
- Miami Orthopedics & Sports Medicine Institute, Baptist Health South Florida, Miami, Florida
| | - Robert Barrack
- Department of Orthopaedics, Washington University in St. Louis, St. Louis, Missouri
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Wang J, Qin W, Pang M, Zhao B, Xu J, Li S, Kong F. The Effect of Chronic Disease and Mental Health on Sleep Quality among Migrant Elderly Following Children in Weifang City, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12734. [PMID: 36232032 PMCID: PMC9564950 DOI: 10.3390/ijerph191912734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/23/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
Few studies have focused on the sleep quality among migrant elderly following children (MEFC). This study aimed to investigate the effects of chronic disease and mental health on the sleep quality of MEFC in Weifang, China. A cross-sectional study was conducted by multi-stage cluster random sampling, and in total 613 participants were enrolled. Sleep quality and mental health were assessed by the Pittsburgh Sleep Quality Index (PSQI) and the Depression, Anxiety, and Stress Scale (DASS-21), respectively. Chronic disease was assessed by the question "how many chronic diseases do you have?" A descriptive analysis and chi-square test were used to describe participants' sociodemographic variables, chronic disease, mental health, and sleep quality. The relationship between chronic disease, mental health, and sleep quality was explored by establishing binary logistic regression models. The results showed that 18.3% of MEFC's sleep quality was poor. MEFCs who were male were more likely to report good sleep quality. MEFCs who have similar monthly family income compared with others around, with multimorbidity, depression, and anxiety were more likely to report poor sleep quality. Nearly 1/5 of MEFCs were having poor sleep quality in this study. Results indicated that chronic diseases, depression, and anxiety were risk factors for the sleep quality of MEFC. Implications for the government, communities, and families of MEFC were given for improving their sleep quality.
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Affiliation(s)
- Jieru Wang
- 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, Jinan 250012, China
| | - Wen Qin
- Shandong University Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Mingli Pang
- 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, Jinan 250012, China
| | - Bo Zhao
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju 26493, Korea
| | - Jing Xu
- 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, Jinan 250012, China
| | - Shixue Li
- 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, Jinan 250012, China
| | - Fanlei Kong
- 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, Jinan 250012, China
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Lee S, Oh H, Kim S, Park W, Kwon S, Lim MJ, Jung KH, Seo W. Factors That Influence Sleep Disturbance and the Mediating Effects of Depression on Sleep Disturbance in Patients With Rheumatoid Arthritis. Orthop Nurs 2022; 41:335-344. [PMID: 36166609 DOI: 10.1097/nor.0000000000000880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Little is known about the nature of relationships between sleep disturbance and influencing factors in rheumatoid arthritis. The purpose of this study was to identify factors that influence sleep disturbance and to evaluate mediating effects of depression on sleep disturbance. A nonexperimental, descriptive, correlational study design was adopted. One hundred patients with rheumatoid arthritis were recruited. Inflammatory status and levels of pain, fatigue, functional disability, depression, and sleep disturbance were measured. The factors that directly influenced sleep disturbance were gender, rheumatoid arthritis duration, serum C-reactive protein level, fatigue, and depression. Depression was found to have mediating effects on the relationships between sleep disturbance and arthritis symptoms. Pain, fatigue, and depression were found to have significant direct or indirect impacts on sleep disturbance. Our findings may improve understanding of sleep disturbance and aid the development of effective nursing management strategies for patients with rheumatoid arthritis suffering from sleep disturbance.
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Affiliation(s)
- SiWon Lee
- SiWon Lee, BSN, RN , Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HyunSoo Oh, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- SooHyun Kim, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- Won Park, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- SeongRyul Kwon, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Mie Jin Lim, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Kyong-Hee Jung, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - HyunSoo Oh
- SiWon Lee, BSN, RN , Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HyunSoo Oh, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- SooHyun Kim, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- Won Park, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- SeongRyul Kwon, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Mie Jin Lim, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Kyong-Hee Jung, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - SooHyun Kim
- SiWon Lee, BSN, RN , Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HyunSoo Oh, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- SooHyun Kim, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- Won Park, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- SeongRyul Kwon, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Mie Jin Lim, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Kyong-Hee Jung, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - Won Park
- SiWon Lee, BSN, RN , Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HyunSoo Oh, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- SooHyun Kim, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- Won Park, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- SeongRyul Kwon, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Mie Jin Lim, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Kyong-Hee Jung, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - SeongRyul Kwon
- SiWon Lee, BSN, RN , Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HyunSoo Oh, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- SooHyun Kim, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- Won Park, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- SeongRyul Kwon, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Mie Jin Lim, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Kyong-Hee Jung, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - Mie Jin Lim
- SiWon Lee, BSN, RN , Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HyunSoo Oh, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- SooHyun Kim, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- Won Park, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- SeongRyul Kwon, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Mie Jin Lim, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Kyong-Hee Jung, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - Kyong-Hee Jung
- SiWon Lee, BSN, RN , Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HyunSoo Oh, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- SooHyun Kim, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- Won Park, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- SeongRyul Kwon, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Mie Jin Lim, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Kyong-Hee Jung, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
| | - WhaSook Seo
- SiWon Lee, BSN, RN , Graduate student, Department of Nursing, Inha University, Incheon, Republic of Korea
- HyunSoo Oh, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- SooHyun Kim, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
- Won Park, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- SeongRyul Kwon, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Mie Jin Lim, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- Kyong-Hee Jung, PhD, MD , Professor, School of Medicine, Inha University, Incheon, Republic of Korea
- WhaSook Seo, PhD, RN , Professor, Department of Nursing, Inha University, Incheon, Republic of Korea
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Cai G, Lu Y, Chen J, Yang D, Yan R, Ren M, He S, Wu S, Zhao Y. Brain-wide mapping of c-Fos expression with fluorescence micro-optical sectioning tomography in a chronic sleep deprivation mouse model. Neurobiol Stress 2022; 20:100478. [PMID: 35991686 PMCID: PMC9389418 DOI: 10.1016/j.ynstr.2022.100478] [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: 03/08/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 11/23/2022] Open
Abstract
Chronic sleep deprivation (SD) is a common problem for humans and can lead to many deleterious effects, including depression, anxiety, stroke, permanent cognitive deficits, stress, and other physiological diseases. It is vital to acquire information about the relevant neural activities at the whole-brain level to systematically explore the mechanisms of brain dysfunction related to SD. Expression of the immediate-early gene (IEG) Fos in the mouse brain has been widely used as a functional marker of brain activity in the field of neuroscience. However, most previous studies only analyzed the change of c-Fos in several specific brain regions using traditional research methods or in short-term SD model. Here, we applied c-Fos mapping through the fluorescence micro-optical sectioning tomography (fMOST) technique and AAV-PHP.eB to comprehensive analysis the state of cumulative activation across the whole brain in a mouse model of chronic SD. The chronic rapid eyes movement (REM) SD model was induced by moving mice to a separate holding area filled with water. The experimental period lasted for 6 h per day. The results showed that after 14 days of SD, the mice displayed anxiety-like behaviors in open field test and elevated plus maze test, and displayed depression-like behaviors in tail suspension test and the sucrose preference test. The c-Fos + cells were detected in a maximum of 230 brain regions. SD-induced stress model evoked c-Fos expression in several brain regions compared to the control group. In particular, the isocortex-cerebral cortex plate area, including the retrosplenial, anterior cingulate, agranular insular, gustatory, and parasubiculum, appear to be the most sensitive regions after chronic REM SD.
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Affiliation(s)
- Guohong Cai
- Department of Gastroenterology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710065, China
- Department of Neurobiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Yifan Lu
- Department of Neurobiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
- College of Life Sciences & Research Center for Resource Peptide Drugs, Shaanxi Engineering & Technological Research Center for Conversation & Utilization of Regional Biological Resources, Yanan University, Yanan, 716000, China
| | - Jing Chen
- Department of Anatomy, Histology and Embryology and K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Dingding Yang
- Department of Neurobiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Ruixuan Yan
- Department of Neurobiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Mudan Ren
- Department of Gastroenterology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710065, China
| | - Shuixiang He
- Department of Gastroenterology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710065, China
| | - Shengxi Wu
- Department of Neurobiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Yan Zhao
- Department of Gastroenterology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710065, China
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50
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Yu X, Shi Z, Wang D, Niu Y, Xu C, Ma Y, Liu H, Guo H, Li M, Zhang Y. Prevalence and associated factors of frailty among community dwelling older adults in Northwest China: a cross-sectional study. BMJ Open 2022; 12:e060089. [PMID: 35914908 PMCID: PMC9345078 DOI: 10.1136/bmjopen-2021-060089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To investigate the prevalence of the comprehensive frailty and its associated factors among community dwelling older adults. DESIGN A cross-sectional study. SETTING Six community healthcare centres in Xi'an City, Northwest China. PARTICIPANTS A total of 2647 community dwelling older adults completed the study between March and August 2021. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the prevalence of frailty, measured with the Comprehensive Frailty Assessment Instrument. The secondary outcomes were potential factors associated with frailty, measured with a social-demographic and health-related information sheet, the Short-Form Mini-Nutritional Assessment and the Pittsburgh Sleep Quality Index. RESULTS The participants averaged 27.77±10.13 in the total score of the Comprehensive Frailty Assessment Instrument. According to the cut-off points defining the classification of frailty, the majority of the participants were with mild (n=1478, 55.8%) or high (n=390, 14.8%) frailty. Multivariate stepwise linear regression analysis demonstrated that older age, lower educational level, empty nesters, higher level of self-perceived medical burden, abnormal body weight, physical inactivity, medication taking, increased number of clinic visit, undernutrition and poor sleep quality are associated with higher total score in the Comprehensive Frailty Assessment Instrument, indicating higher level of frailty. Multivariate multinomial logistic regression analysis exhibited similar findings but further captured female gender as a risk factor for the presence of mild and high frailty compared with no-low frailty. CONCLUSION The prevalence of the comprehensive frailty and frailty in the physiological, psychological, social and environmental domains is high. A variety of social-demographic, health-related and behavioural factors were associated with the comprehensive frailty. Further investigations on frailty prevalence and its associated factors based on comprehensive assessments are desirable.
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Affiliation(s)
- Xingfeng Yu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Zhengyan Shi
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Dan Wang
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yaqi Niu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Cuixiang Xu
- Shaanxi Provincial Key Laboratory of Infection and Immune Diseases, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Yunmiao Ma
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Hongmei Liu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Hua Guo
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Minjie Li
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Yulian Zhang
- The Director's Office, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
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