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Segel-Karpas D. Anger and anxiety in older adults: a cross-lagged examination. Aging Ment Health 2024; 28:1209-1215. [PMID: 38516943 DOI: 10.1080/13607863.2024.2320137] [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: 07/17/2023] [Accepted: 02/01/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES Both anger and anxiety are common in older adulthood, with aversive consequences for individuals' physical and mental health. Theory suggests that anger can be an emotional response to the experience of anxiety. Similarly, anger can induce anxiety symptoms. Despite studies documenting the co-occurrence of anger and anxiety and their strong theoretical links, little is known about their temporal relationship. The primary aim of this study was to investigate the longitudinal cross-lagged relationship between anger expression, anger suppression, and anxiety. METHODS A large and representative sample of older adults (N=6,852) was utilized, with data collected in two waves at an interval of four years. All variables were measured using validated self-report scales.Data were analyzed using Structural Equation Modeling. RESULTS Results indicate that both anger suppression and anger expression are significant predictors of anxiety symptoms. Similarly, anxiety is a significant predictor of both anger suppression and anger expression. CONCLUSIONS The effects did not differ in magnitude, suggesting a balanced reciprocity between anger and anxiety. An understanding of this reciprocal association can inform interventions and strategies aimed at promoting emotional well-being in older individuals. By addressing both anger and anxiety concurrently, interventions may have a more comprehensive impact on improving mental health outcomes in this population.
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Gyasi RM, Hajek A, Owusu R, James PB, Boampong MS, Accam BT, Abass K, Owusu-Dabo E, Phillips DR. Sleep and Happiness in Urban-Dwelling Older Adults in Ghana: A Serial Multiple Mediation Model of Generalized Anxiety and Depressive Symptoms. Am J Geriatr Psychiatry 2023; 31:953-964. [PMID: 37270306 DOI: 10.1016/j.jagp.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/04/2023] [Accepted: 05/06/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Sleep problems (SP) are highly prevalent and seriously affect health and well-being in old age. The aim of this study was to examine the association between SP and happiness in an urban-dwelling older sample. The authors further explore the effects of generalized anxiety and depressive symptoms in the SP-happiness link using serial mediating modeling. METHODS Data came from the 2016 to 2018 Aging, Health, Psychological Well-being, and Health-seeking Behavior Study in Ghana (n = 661). The authors measured happiness with the cross-culturally validated item on a five-point scale. The GAD-7 and the CESD-8, respectively, assessed generalized anxiety and depressive symptoms. Participants reported nighttime and daytime SP in the last 30 days. The SPSS-based Hayes' PROCESS macro program (Model 6) was constructed to quantify the hypothesized mediation effect. RESULTS The analysis included 661 adults aged greater than or equal to 50 years (mean age = 65.53 [SD] = 11.89 years; 65.20% women). After full adjustment, path models showed that SP was negatively associated with happiness (β = -0.1277, 95%CI = -0.15950 to -0.096). Bootstrapping estimates revealed that the SP-happiness link was serially mediated via generalized anxiety representing 8.77%, depressive symptoms yielding 18.95%, and anxiety symptoms→depressive symptoms accounting for 26.70% of the total effect. CONCLUSION Generalized anxiety and depressive symptoms may explain the negative association between SP and happiness in urban-dwelling older adults in the sub-Saharan African (SSA) context. Interventions, social and clinical, to improve happiness through sleep quality should include ways to improve mental health. Longitudinal and cross-cultural data are warranted to assess the bi-directionality of this relationship.
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Affiliation(s)
- Razak M Gyasi
- Aging and Development Unit, African Population and Health Research Center (RMG), Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University (RMG, PBJ), Lismore, NSW, Australia.
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics (AH), Hamburg, Germany
| | - Richmond Owusu
- Department of Health Policy, Planning, and Management, School of Public Health, University of Ghana (RO), Legon, Ghana
| | - Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University (RMG, PBJ), Lismore, NSW, Australia
| | - Mary Sefa Boampong
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology (MSB), Kumasi, Ghana
| | - Burnett Tetteh Accam
- Department of Mathematics, Kwame Nkrumah University of Science and Technology (BTA), Kumasi, Ghana
| | - Kabila Abass
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology (KA), Kumasi, Ghana
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology (EO-D), Kumasi, Ghana
| | - David R Phillips
- Department of Sociology and Social Policy, Lingnan University (DRP), Tuen Mun, New Territories, Hong Kong
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Tan M, Bhanu C, Frost R. The association between frailty and anxiety: A systematic review. Int J Geriatr Psychiatry 2023; 38:e5918. [PMID: 37157226 DOI: 10.1002/gps.5918] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/18/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVES Previous systematic reviews show a clear relationship between frailty and depression, however the association with anxiety is much less frequently explored. Previous single studies indicate evidence is mixed. We completed a systematic review and meta-analysis to identify the relationship between frailty and anxiety. METHODS We searched five electronic databases for observational studies in older people in community, care home and outpatient settings with any/no health conditions that measured the association between anxiety and frailty using validated measures. Studies were screened by one reviewer with 10% checked by a second reviewer. The Mixed Methods Appraisal Tool was used to assess study quality. We used meta-analysis to aggregate study findings, with subgroup analyses to explore heterogeneity. RESULTS Out of 1272 references, a total of 20 cross-sectional and 1 longitudinal studies were eligible. Older adults with frailty were substantially more likely to display anxiety symptoms than robust populations, across both dichotomous and continuous data sets (n = 10, OR = 3.48, 95% CI: 2.08, 5.81, p < 0.0001, I2 = 94%; N = 5, SMD = 3.13, 95% CI: 1.06, 5.21, I2 = 98%). Similarly, pre-frail older adults were more likely to have anxiety symptoms than robust older adults but to a lesser extent (N = 6, OR = 1.95, 95% CI: 1.41, 2.71, I2 = 63%; N = 3, SMD = 1.70, 95% CI: 0.01, 3.38, I2 = 98%). CONCLUSIONS There is a clear association between pre-frailty/frailty and anxiety in older adults. However, data are heterogeneous and primarily from cross-sectional studies so causality cannot be determined. Future research should evaluate the effectiveness of anxiety screening and treatments in frail older adults.
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Affiliation(s)
- Melissa Tan
- UCL Medical School, University College London, London, UK
| | - Cini Bhanu
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Rachael Frost
- Research Department of Primary Care and Population Health, University College London, London, UK
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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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Li J, Zhang Y, Siu Man Chan B, Tan SN, Lu J, Luo X, Shen Y, Zhang XY. Associations between anxiety, depression, and risk of suicidal behaviors in Chinese medical college students. Front Psychiatry 2022; 13:1012298. [PMID: 36532186 PMCID: PMC9757065 DOI: 10.3389/fpsyt.2022.1012298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/09/2022] [Indexed: 12/05/2022] Open
Abstract
Background Previous studies have established a strong association between depression and suicidal behaviors, yet the relationship between anxiety and suicidal behaviors remains unclear. This study examines whether anxiety and depression are independent risk factors for suicidal behaviors in medical college students, and further, whether anxiety may increase the greater risk of suicidal behaviors (SB) in participants with depression. Methods This cross-sectional study was conducted among 4,882 medical students. Demographic information, anxiety, and depression data were collected using online questionnaires or through a widely used social media app named WeChat. Results Anxiety and depression were independent risk factors for suicidal behaviors, and levels of risk correlated positively with the severity of both anxiety and depressive symptoms. A dose-response relationship was identified between the severity of anxiety and the risk of SB, as well as the severity of depression and SB. Furthermore, anxiety increased the risk of suicidal behaviors in participants with depression, with a dose-response relationship between the severity of anxiety symptoms and the risk of SB. Conclusion The findings highlight the importance of screening for anxiety and depressive symptoms in medical college students, as well as reducing anxiety in addition to depressive symptoms in treatment. This study provides valuable data as a reference for clinicians for suicide risk assessments.
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Affiliation(s)
- Jia Li
- Department of Applied Psychology, College of Preschool Education, Changsha Normal University, Changsha, Hunan, China
| | - Yaru Zhang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Bella Siu Man Chan
- Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, BC, Canada
| | - Sun Nee Tan
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine (Neuroscience), The University of British Columbia, Vancouver, BC, Canada
| | - Jianping Lu
- Department of Child Psychiatry of Shenzhen Kangning Hospital, Mental Health School, Shenzhen Mental Health Center, Shenzhen University, Shenzhen, China
| | - Xuerong Luo
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yanmei Shen
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Liu Y, Zhao W, Lu Y, Zhao Y, Zhang Y, Dai M, Hai S, Ge N, Zhang S, Huang M, Liu X, Li S, Yue J, Lei P, Dong B, Dai L, Dong B. Systematic metabolic characterization of mental disorders reveals age-related metabolic disturbances as potential risk factors for depression in older adults. MedComm (Beijing) 2022; 3:e165. [PMID: 36204590 PMCID: PMC9523679 DOI: 10.1002/mco2.165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/01/2022] [Accepted: 07/14/2022] [Indexed: 11/13/2022] Open
Abstract
Mental disorders are associated with dysregulated metabolism, but comprehensive investigations of their metabolic similarities and differences and their clinical relevance are few. Here, based on the plasma metabolome and lipidome of subcohort1, comprising 100 healthy participants, 55 cases with anxiety, 52 persons with depression, and 41 individuals with comorbidity, which are from WCHAT, a perspective cohort study of community-dwelling older adults aged over 50, multiple metabolites as potential risk factors of mental disorders were identified. Furthermore, participants with mental illnesses were classified into three subtypes (S1, S2, and S3) by unsupervised classification with lipidomic data. Among them, S1 showed higher triacylglycerol and lower sphingomyelin, while S2 displayed opposite features. The metabolic profile of S3 was like that of the normal group. Compared with S3, individuals in S1 and S2 had worse quality of life, and suffered more from sleep and cognitive disorders. Notably, an assessment of 6,467 individuals from the WCHAT showed an age-related increase in the incidence of depression. Seventeen depression-related metabolites were significantly correlated with age, which were validated in an independent subcohort2. Collectively, this work highlights the clinical relevance of metabolic perturbation in mental disorders, and age-related metabolic disturbances may be a bridge-linking aging and depressive.
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Affiliation(s)
- Yu Liu
- National Clinical Research Center for Geriatrics and Department of General PracticeState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduChina
| | - Wanyu Zhao
- National Clinical Research Center for Geriatrics and Department of General PracticeState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduChina
| | - Ying Lu
- National Clinical Research Center for Geriatrics and Department of General PracticeState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduChina
| | - Yunli Zhao
- Department of Health Research Methods, Evidence, and ImpactMcMaster UniversityHamiltonOntarioCanada
| | - Yan Zhang
- National Clinical Research Center for Geriatrics and Department of General PracticeState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduChina
| | - Miao Dai
- National Clinical Research Center for Geriatrics and Department of General PracticeState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduChina
| | - Shan Hai
- National Clinical Research Center for Geriatrics and Department of General PracticeState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduChina
| | - Ning Ge
- National Clinical Research Center for Geriatrics and Department of General PracticeState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduChina
| | - Shuting Zhang
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
| | - Mingjin Huang
- The Third Hospital of MianyangSichuan Mental Health CenterMianyangChina
| | - Xiaohui Liu
- School of Life SciencesTsinghua UniversityBeijingChina
| | - Shuangqing Li
- National Clinical Research Center for Geriatrics and Department of General PracticeState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduChina
| | - Jirong Yue
- National Clinical Research Center for Geriatrics and Department of General PracticeState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduChina
| | - Peng Lei
- National Clinical Research Center for Geriatrics and Department of General PracticeState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduChina
| | - Biao Dong
- National Clinical Research Center for Geriatrics and Department of General PracticeState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduChina
| | - Lunzhi Dai
- National Clinical Research Center for Geriatrics and Department of General PracticeState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduChina
| | - Birong Dong
- National Clinical Research Center for Geriatrics and Department of General PracticeState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduChina
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Fernandez-Rodrigues V, Sanchez-Carro Y, Lagunas LN, Rico-Uribe LA, Pemau A, Diaz-Carracedo P, Diaz-Marsa M, Hervas G, de la Torre-Luque A. Risk factors for suicidal behaviour in late-life depression: A systematic review. World J Psychiatry 2022; 12:187-203. [PMID: 35111588 PMCID: PMC8783161 DOI: 10.5498/wjp.v12.i1.187] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/17/2021] [Accepted: 11/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Suicide is a leading cause of preventable death worldwide, with its peak of maximum incidence in later life. Depression often puts an individual at higher risk for suicidal behaviour. In turn, depression deserves particular interest in old age due to its high prevalence and dramatic impact on health and wellbeing. AIM To gather integrated evidence on the potential risk factors for suicide behaviour development in depressive older adults, and to examine the effects of depression treatment to tackle suicide behaviour in this population. METHODS A systematic review of empirical studies, published from 2000 onwards, was conducted. Suicidal behaviour was addressed considering its varying forms (i.e., wish to die, ideation, attempt, and completed suicide). RESULTS Thirty-five papers were selected for review, comprising both clinical and epidemiological studies. Most of studies focused on suicidal ideation (60%). The studies consistently pointed out that the risk was related to depressive episode severity, psychiatric comorbidity (anxiety or substance use disorders), poorer health status, and loss of functionality. Reduced social support and loneliness were also associated with suicide behaviour in depressive older adults. Finally, the intervention studies showed that suicidal behaviour was a robust predictor of depression treatment response. Reductions in suicidal ideation were moderated by reductions in risk factors for suicide symptoms. CONCLUSION To sum up, common and age-specific risk factors seem to be involved in suicide development in depressive older adults. A major effort should be made to tackle this serious public health concern so as to promote older people to age healthily and well.
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Affiliation(s)
| | - Yolanda Sanchez-Carro
- Department of Psychiatry, Universidad Autonoma de Madrid, Madrid 28046, Spain
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid 28029, Spain
| | - Luisa Natalia Lagunas
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid 28046, Spain
| | - Laura Alejandra Rico-Uribe
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid 28029, Spain
- Department of Psychology, La Rioja International University, Logrono 26006, Spain
| | - Andres Pemau
- Department of Psychology, Universidad Complutense de Madrid, Madrid 28223, Spain
| | | | - Marina Diaz-Marsa
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid 28029, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid 28046, Spain
- Institute of Psychiatry and Mental Health, San Carlos Clinical Hospital, Madrid 28040, Spain
| | - Gonzalo Hervas
- Department of Psychology, Universidad Complutense de Madrid, Madrid 28223, Spain
| | - Alejandro de la Torre-Luque
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid 28029, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid 28046, Spain
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Foroughan M, Rostami M, Jalal Younesi S. Determinants of Suicidal Ideation among Older Adults. GEROPSYCH 2021. [DOI: 10.1024/1662-9647/a000250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. This study examined the relationship of depression and life satisfaction with suicidal ideation among older Iranian adults. In this cross-sectional study, a total of 159 older adults in Tehran (73% community-residing, 60 years or older) participated. The data were gathered using the Beck Scale for Suicidal Ideation (BSSI), the Geriatric Depression Scale (GDS), and the Life Satisfaction Index-Z (LSIZ). According to the results, depression and life satisfaction are significantly related to suicidal ideation; the two variables predict 0.39% of the variance of suicidal ideation in older adults ( p < .01). The interaction between depression and life satisfaction is a stronger predictor of suicidal ideation in older adults than each of the variables alone.
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Affiliation(s)
- Mahshid Foroughan
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Rostami
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Jalal Younesi
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Kułak-Bejda A, Bejda G, Waszkiewicz N. Mental Disorders, Cognitive Impairment and the Risk of Suicide in Older Adults. Front Psychiatry 2021; 12:695286. [PMID: 34512415 PMCID: PMC8423910 DOI: 10.3389/fpsyt.2021.695286] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/29/2021] [Indexed: 12/02/2022] Open
Abstract
More than 600 million people are aged 60 years and over are living in the world. The World Health Organization estimates that this number will double by 2025 to 2 billion older people. Suicide among people over the age of 60 is one of the most acute problems. The factors strongly associated with suicide are mentioned: physical illnesses, such as cancer, neurologic disorder, pain, liver disease, genital disorders, or rheumatoid disorders. Moreover, neurologic conditions, especially stroke, may affect decision-making processes, cognitive capacity, and language deficit. In addition to dementia, the most common mental disorders are mood and anxiety disorders. A common symptom of these disorders in the elderly is cognitive impairment. This study aimed to present the relationship between cognitive impairment due to dementia, mood disorders and anxiety, and an increased risk of suicide among older people. Dementia is a disease where the risk of suicide is significant. Many studies demonstrated that older adults with dementia had an increased risk of suicide death than those without dementia. Similar conclusions apply to prodromal dementia Depression is also a disease with a high risk of suicide. Many researchers found that a higher level of depression was associated with suicide attempts and suicide ideation. Bipolar disorder is the second entity in mood disorders with an increased risk of suicide among the elderly. Apart from suicidal thoughts, bipolar disorder is characterized by high mortality. In the group of anxiety disorders, the most significant risk of suicide occurs when depression is present. In turn, suicide thoughts are more common in social phobia than in other anxiety disorders. Suicide among the elderly is a serious public health problem. There is a positive correlation between mental disorders such as dementia, depression, bipolar disorder, or anxiety and the prevalence of suicide in the elderly. Therefore, the elderly should be comprehensively provided with psychiatric and psychological support.
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Affiliation(s)
| | - Grzegorz Bejda
- The School of Medical Science in Bialystok, Bialystok, Poland
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10
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Comorbid depressive and anxiety symptoms and frailty among older adults: Findings from the West China health and aging trend study. J Affect Disord 2020; 277:970-976. [PMID: 33065841 DOI: 10.1016/j.jad.2020.08.070] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 07/07/2020] [Accepted: 08/24/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Depression and anxiety are two common mental disorders in older people. Studies have reported that depression is strongly associate with frailty, but few studies focus on anxiety disorder and comorbid two mental disorders. In this study, we aimed to identify associations between comorbid depressive and anxiety symptoms with frailty in older adults. METHODS 4,103 community-dwellings adults aged 60 and older from the baseline of the West China Health and Aging Trend (WCHAT) study were included. Frailty was measured by the Fried frailty phenotype criteria. The 15-item Geriatric Depression Scale (GDS-15) and 7-item Generalized Anxiety Disorder Scale (GAD-7) assessed for depressive and anxiety symptoms with a cut-off value of 5. Multinomial logistic regression was used to explore the association between different depressive and anxiety status and frailty. RESULTS 8.7% of old adults suffered comorbid depressive and anxiety symptoms in the present study. The prevalence of pre-frailty and frailty was 47.0% and 6.7%, respectively. After adjusting for covariates, individuals with comorbid depressive and anxiety symptoms had higher odds of being pre-frail (OR=1.86, 95% CI=1.41, 2.45) and frail (OR=7.03, 95% CI=4.48, 11.05) compared to those without depressive and anxiety symptoms. In the comorbidity group, those with severe comorbid symptoms also had higher prevalence of pre-frailty and frailty. LIMITATIONS Depressive and anxiety symptom assessments were based on screening tools. CONCLUSIONS This study suggested comorbid depressive and anxiety symptoms were associated with frailty among Chinese older adults. Further efforts to screen and target depression and anxiety comorbidity may be warranted.
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Lim S, Oh Y, Cho K, Kim MH, Moon S, Ki S. The question of preoperative anxiety and depression in older patients and family protectors. Anesth Pain Med (Seoul) 2020; 15:217-225. [PMID: 33329817 PMCID: PMC7713824 DOI: 10.17085/apm.2020.15.2.217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/23/2019] [Accepted: 10/23/2019] [Indexed: 11/17/2022] Open
Abstract
Background Higher levels of anxiety increase the risks of surgery, including morbidity and mortality. The objectives of this study were to measure anxiety and depression during the preoperative period and to identify the degree of knowledge and concerns of older patients and their family protectors regarding anesthesia, and the causes of these concerns. Methods We administered a questionnaire to older patients scheduled to undergo surgery and their family protectors one day prior to the surgery. The questionnaire included tools for quantifying anxiety and depression (Anxiety-Visual Analogue Scale, the Amsterdam Preoperative Anxiety and Information Scale, State-Trait Anxiety Inventory Korean YZ Form, and Short Form Geriatric Depression Scale). We also asked about the concrete causes of anxiety using pre-created forms. Results There were 140 older patients and family protectors who participated in the study. The majority of older patients (n = 114, 81.4%) undergoing surgery and their family protectors (n = 114, 81.4%) indicated that they were anxious. Most of the older patients and their family protectors responded that they had insufficient knowledge about anesthesia, and they were mostly worried about failure to awaken following surgery, and postoperative pain. Older patients with higher anxiety scores showed higher depression scores. There were significant differences in depression scores depending on the presence of cohabitating family members. Conclusions It is important to remember that older patients with higher depression scores have higher anxiety during the preoperative period.
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Affiliation(s)
- Sehun Lim
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Younmi Oh
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Kwangrae Cho
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Myoung-Hun Kim
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sungho Moon
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Seunghee Ki
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
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The effect of anxiety on cognition in older adult inpatients with depression: results from a multicenter observational study. Heliyon 2019; 5:e02235. [PMID: 31497664 PMCID: PMC6722253 DOI: 10.1016/j.heliyon.2019.e02235] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/06/2019] [Accepted: 08/01/2019] [Indexed: 11/23/2022] Open
Abstract
Late-life depression is associated with reduced cognitive function beyond normal age-related cognitive deficits. As comorbid anxiety frequently occur in late-life depression, this study aimed to examine the association between anxiety symptoms and cognitive function among older inpatients treated for depression. We hypothesized that there would be an overall additive effect of comorbid anxiety symptoms on dysfunction across cognitive domains. The study included 142 patients treated for late-life depression in hospital, enrolled in the Prognosis of Depression in the Elderly study. Anxiety symptoms were measured at admission using the anxiety subscale of the Hospital Anxiety and Depression Scale. Patients completed cognitive tasks at admission and discharge. Linear mixed and generalized linear mixed models were estimated to investigate the effect of anxiety, on continuous and categorical cognitive scores, respectively, while controlling for depression. Anxiety severity at admission was not associated with performance in any of the cognitive domains. Patients with more symptoms of anxiety at admission demonstrated a significant improvement in immediate recall during the hospital stay. Patients with a score above cutoff indicating clinically significant symptoms on the anxiety subscale performed better on general cognitive function, as measured by the Mini Mental Status Examination at admission, than those below cutoff for anxiety. In conclusion, comorbid anxiety symptoms had no additive effect on cognitive dysfunction in late-life depression in our sample of inpatients.
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Bakkane Bendixen A, Engedal K, Selbaek G, Benth JŠ, Hartberg CB. Anxiety symptom levels are persistent in older adults with a mental disorder: A 33-month follow-up study. Int J Geriatr Psychiatry 2019; 34:601-608. [PMID: 30609143 DOI: 10.1002/gps.5058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/20/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Anxiety symptoms are common in old age and have been suggested as risk factors for development of cognitive impairment and mortality. The objective of the present study was to investigate whether anxiety symptoms among older adults with a mental health diagnosis are persistent, and severity of anxiety predicts cognitive decline and mortality. METHODS We collected data from 201 patients referred to specialist mental health service in a department of geriatric psychiatry. Of these, 150 were reexamined after 33 months, while 51 patients died before follow-up. Mean age (SD) at baseline among the patients that were reexamined was 73.4 (7.3) years, and 67% were women. The Geriatric Anxiety Inventory (GAI) was used to measure anxiety symptoms at baseline and follow-up. We investigated whether higher GAI scores at baseline were associated with persistence of anxiety. Associations with cognitive decline or mortality were also explored. The associations were estimated by use of trajectory analysis and regression models. RESULTS Seventy-four percentages had the same level of anxiety symptoms, and 29% had a high level of anxiety at baseline and follow-up. GAI score at baseline was not associated with cognitive decline or mortality at 33-month follow-up. CONCLUSION In a longitudinal study of anxiety symptoms among older adults in specialist mental health services, we demonstrate persistent high or low levels of anxiety symptoms. Anxiety trajectories over time were not predicted by patient characteristics. Also the level of anxiety cannot be used as predictor for future cognitive decline or mortality in a clinical population.
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Affiliation(s)
- Anette Bakkane Bendixen
- Department of Geriatric Psychiatry, Diakonhjemmet Hospital, Oslo, Norway.,Vestfold Hospital Trust, Norwegian National Advisory Unit on Aging and Health, Toensberg, Norway.,Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Knut Engedal
- Vestfold Hospital Trust, Norwegian National Advisory Unit on Aging and Health, Toensberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Geir Selbaek
- Vestfold Hospital Trust, Norwegian National Advisory Unit on Aging and Health, Toensberg, Norway.,Institute of Health and Society, University of Oslo, Oslo, Norway.,Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
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