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Hathaway CA, Townsend MK, Conejo-Garcia JR, Fridley BL, Moran Segura C, Nguyen JV, Armaiz-Pena GN, Sasamoto N, Saeed-Vafa D, Terry KL, Kubzansky LD, Tworoger SS. The relationship of lifetime history of depression on the ovarian tumor immune microenvironment. Brain Behav Immun 2023; 114:52-60. [PMID: 37557966 PMCID: PMC10592154 DOI: 10.1016/j.bbi.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/04/2023] [Accepted: 08/06/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Depression is associated with a higher ovarian cancer risk. Prior work suggests that depression can lead to systemic immune suppression, which could potentially alter the anti-tumor immune response. METHODS We evaluated the association of pre-diagnosis depression with features of the anti-tumor immune response, including T and B cells and immunoglobulins, among women with ovarian tumor tissue collected in three studies, the Nurses' Health Study (NHS; n = 237), NHSII (n = 137) and New England Case-Control Study (NECC; n = 215). Women reporting depressive symptoms above a clinically relevant cut-point, antidepressant use, or physician diagnosis of depression at any time prior to diagnosis of ovarian cancer were considered to have pre-diagnosis depression. Multiplex immunofluorescence was performed on tumor tissue microarrays to measure immune cell infiltration. In pooled analyses, we estimated odds ratios (OR) and 95% confidence intervals (CI) for the positivity of tumor immune cells using a beta-binomial model comparing those with and without depression. We used Bonferroni corrections to adjust for multiple comparisons. RESULTS We observed no statistically significant association between depression status and any immune markers at the Bonferroni corrected p-value of 0.0045; however, several immune markers were significant at a nominal p-value of 0.05. Specifically, there were increased odds of having recently activated cytotoxic (CD3+CD8+CD69+) and exhausted-like T cells (CD3+Lag3+) in tumors of women with vs. without depression (OR = 1.36, 95 %CI = 1.09-1.69 and OR = 1.24, 95 %CI = 1.01-1.53, respectively). Associations were comparable when considering high grade serous tumors only (comparable ORs = 1.33, 95 %CI = 1.05-1.69 and OR = 1.25, 95 %CI = 0.99-1.58, respectively). There were decreased odds of having tumor infiltrating plasma cells (CD138+) in women with vs. without depression (OR = 0.54, 95 %CI = 0.33-0.90), which was similar among high grade serous carcinomas, although not statistically significant. Depression was also related to decreased odds of having naïve and memory B cells (CD20+: OR = 0.54, 95 %CI = 0.30-0.98) and increased odds of IgG (OR = 1.22, 95 %CI = 0.97-1.53) in high grade serous carcinomas. CONCLUSION Our results provide suggestive evidence that depression may influence ovarian cancer outcomes through changes in the tumor immune microenvironment, including increasing T cell activation and exhaustion and reducing antibody-producing B cells. Further studies with clinical measures of depression and larger samples are needed to confirm these results.
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Affiliation(s)
| | - Mary K Townsend
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Brooke L Fridley
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Carlos Moran Segura
- Advanced Analytical and Digital Laboratory, Moffitt Cancer Center, Tampa, FL, USA
| | - Jonathan V Nguyen
- Advanced Analytical and Digital Laboratory, Moffitt Cancer Center, Tampa, FL, USA
| | - Guillermo N Armaiz-Pena
- Department of Basic Sciences, Division of Pharmacology, School of Medicine, Ponce Health Sciences University, Ponce, PR, USA
| | - Naoko Sasamoto
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Daryoush Saeed-Vafa
- Advanced Analytical and Digital Laboratory, Moffitt Cancer Center, Tampa, FL, USA; Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, FL, USA
| | - Kathryn L Terry
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA.
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Jung FUCE, Gerhards S, Luppa M, Löbner M, Riedel-Heller SG. The impact of BMI on psychological health in oldest old individuals-Are there differences between women and men? PLoS One 2023; 18:e0283089. [PMID: 36989264 PMCID: PMC10058076 DOI: 10.1371/journal.pone.0283089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/02/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVE The aim of this study was to determine the association of mental health issues associated with BMI and gender in the oldest old population (secondary data analyses). METHOD The data were taken from the second follow-up of a long-term study investigating the impact of the COVID-19 pandemic on health in oldest old individuals (range: 77-96 years). The response rate was 80.0%. Apart from sociodemographic characteristics (age, gender, weight and height); anxiety, depression, somatic complaints and social support were assessed in this survey. RESULTS Analyses revealed gender-specific differences, indicating that male participants with excess weight show more complaints compared to their counterparts without excess weight. According to regression results, BMI was associated with somatization, but not depression or anxiety. CONCLUSION High BMI contributed to more somatic complaints and men may be affected differently by BMI regarding their mental well-being. Longitudinal results are needed in order to confirm these findings and develop suitable interventions based on individual needs of the oldest old.
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Affiliation(s)
- Franziska U C E Jung
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, Leipzig University, Leipzig, D-Germany
| | - Sina Gerhards
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, Leipzig University, Leipzig, D-Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, Leipzig University, Leipzig, D-Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, Leipzig University, Leipzig, D-Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, Leipzig University, Leipzig, D-Germany
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Lin WY, Chang CK, Tung FI, Lin TY, Lin YK. Interpreting the Evidence of Body Mass Index in Relation to Mental Health Status in Community-Dwelling Older Adults. Gerontology 2022; 68:1311-1320. [PMID: 35500556 DOI: 10.1159/000524450] [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: 09/13/2021] [Accepted: 04/01/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Maintaining a better physical and mental health status is an important issue for older adults in their later life. Thus, the study's purpose was to evaluate the association between body mass index (BMI) and mental health status in older adults aged 65 years old or above residing in communities of Taipei City, Taiwan. METHODS We carried out secondary data analysis with data from a volunteer-based health examination project for older adults >65 years old residing in Taipei City from 2006 to 2010 with a retrospective study design. BMI, calculated by standardized measuring procedures for height and weight, and mental health status, evaluated by 5-item Brief Symptom Rating Scale (BSRS-5), were collected at their first visits of health examination. A BSRS-5 score ≥6 was considered an inferior mental health status for the outcome. In statistical analysis, univariable and multivariable logistic regressions were adopted to estimate the relative risk of inferior mental health status, treating BMI as the major exposure of interest. RESULTS A total of 90,576 subjects were involved, with a mean age of 73.38 years old (SD = 6.64 years) and 49.21% females. With confounders controlled, compared to normal or overweight (23 ≤ BMI <30), an adjusted OR of 1.23 (95% CI: 1.18, 1.29) on inferior mental health status was detected for the underweight group (BMI <23) significantly. Adjusted OR for those obese (BMI ≧30) was 0.87 (95% CI: 0.79, 0.96). Significantly elevated ORs of underweight were found for both genders, but the significantly protective effect of obese was only detected for females. CONCLUSION Keeping an appropriate weight or even being overweighted might be beneficial for older adults dwelling in the community, especially for males.
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Affiliation(s)
- Wan-Yu Lin
- Department of Health and Welfare, College of City Management, University of Taipei, Taipei, Taiwan.,Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chin-Kuo Chang
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,King's College London (Institute of Psychiatry, Psychology & Neurosciences), London, United Kingdom.,South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Fu-I Tung
- Department of Orthopedics, Taipei City Hospital, Taipei, Taiwan
| | - Tung-Yi Lin
- Department of Health and Welfare, College of City Management, University of Taipei, Taipei, Taiwan
| | - Yu-Kai Lin
- Department of Health and Welfare, College of City Management, University of Taipei, Taipei, Taiwan
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Xu J, Tang M, Wu X, Kong X, Liu Y, Xu X. Lactobacillus rhamnosus zz-1 exerts preventive effects on chronic unpredictable mild stress-induced depression in mice via regulating the intestinal microenvironment. Food Funct 2022; 13:4331-4343. [PMID: 35302147 DOI: 10.1039/d1fo03804d] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Depression remains one of the most prevalent psychiatric disorders, and it has been confirmed that it is related to the dysfunction of the microbiota-gut-brain axis. Manipulation of the gut microenvironment by probiotics might improve mental health and prevent stress-related psychiatric disorders. The present study aimed to determine whether Lactobacillus rhamnosus (L. rhamnosus) zz-1 could prevent the occurrence of depression and its potential mechanisms using a mouse model with chronic unpredictable mild stress (CUMS). The results indicated that L. rhamnosus zz-1 intervention ameliorated CUMS-induced depression-like behaviors of mice with reduced body growth rate, lowered sucrose preference, increased immobility time, as well as decreased curiosity and mobility. Moreover, L. rhamnosus zz-1 significantly inhibited hormones released due to hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis, alleviated CUMS-induced deficits of monoamine neurotransmitters, and increased the expression of brain-derived neurotrophic factor (BDNF) and tyrosine kinase receptor B (TrkB). These benefits were partially linked to the regulation of the intestinal microenvironment. L. rhamnosus zz-1 alleviated intestinal damage and reduced intestinal inflammation of the depressed mice. Meanwhile, L. rhamnosus zz-1 effectively adjusted the dysbiosis of mouse gut microbiota induced by CUMS, such as changes in the abundance of the Lachnospiraceae NK4A136 group, Bacteroides, and Muribaculum. Taken together, these results demonstrated that L. rhamnosus zz-1 was effective in preventing depression from chronic stress, adding new evidence to support the mental benefits of probiotics.
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Affiliation(s)
- Jinzhao Xu
- Key Laboratory of Dairy Science, Ministry of Education, Northeast Agricultural University, Harbin 150030, P. R. China.,College of Food Science, Northeast Agricultural University, Harbin 150030, P. R. China.
| | - Mengqi Tang
- Key Laboratory of Dairy Science, Ministry of Education, Northeast Agricultural University, Harbin 150030, P. R. China.,College of Food Science, Northeast Agricultural University, Harbin 150030, P. R. China.
| | - Xinyu Wu
- Key Laboratory of Dairy Science, Ministry of Education, Northeast Agricultural University, Harbin 150030, P. R. China.,College of Food Science, Northeast Agricultural University, Harbin 150030, P. R. China.
| | - Xiangli Kong
- Key Laboratory of Dairy Science, Ministry of Education, Northeast Agricultural University, Harbin 150030, P. R. China.,College of Food Science, Northeast Agricultural University, Harbin 150030, P. R. China.
| | - Yini Liu
- College of Food Science, Northeast Agricultural University, Harbin 150030, P. R. China. .,College of Food Science and Technology, Jiangnan University, Wuxi 214122, P. R. China
| | - Xiaoxi Xu
- Key Laboratory of Dairy Science, Ministry of Education, Northeast Agricultural University, Harbin 150030, P. R. China.,College of Food Science, Northeast Agricultural University, Harbin 150030, P. R. China.
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5
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Badillo N, Khatib M, Kahar P, Khanna D. Correlation Between Body Mass Index and Depression/Depression-Like Symptoms Among Different Genders and Races. Cureus 2022; 14:e21841. [PMID: 35291524 PMCID: PMC8896404 DOI: 10.7759/cureus.21841] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 02/02/2022] [Indexed: 11/08/2022] Open
Abstract
Background While being overweight is a risk factor for hyperlipidemia, type 2 diabetes, cancer, and heart disease, it can also be a risk factor for depression and vice versa. In this study, we aimed to evaluate the relationship between body mass index (BMI) and the prevalence of depression symptoms between genders and races. Methodology A nationally representative sample was utilized to explore the relationship between depression-related symptoms and BMI status by comparing different genders and racial identities. The National Health and Nutrition Examination Survey (NHANES) data, managed by the Centers for Disease Control and Prevention, was used in this study. Data from 2013 to 2016 were included in the analysis. The Patient Health Questionnaire was used to collect information regarding responses to eight primary questions based on gender, race, and BMI status. Statistical analysis was conducted using descriptive analysis and the chi-square test. Results Data were presented as percentages. A majority of both men and women who admitted to having depression or depression-like symptoms more than half the days or nearly every day were overweight or obese. However, men had a higher prevalence compared to women for most questions. Statistical analysis showed that among men and women who felt down, depressed, or hopeless nearly every day, 61.5% (χ2 = 5.045, p = 0.992) and 50.9% (χ2 = 17.186, p = 0.308) were overweight, respectively. Among the races, those who felt down, depressed, or hopeless nearly every day, non-Hispanic Asian individuals had the lowest percentage of being overweight at 47.7% (χ2 = 7.099, p = 0.955), while Hispanic individuals other than Mexican Americans had the highest percentage of being overweight at 67.4% (χ2 = 8.792, p = 0.721). Conclusions Being overweight or obese appears to have a positive relationship with depression and depression-like symptoms for each gender and race. Similarly, individuals who report having depression-like symptoms are likely to be overweight or obese. Further research is needed to determine other differences in etiologies between genders and races, along with determining whether more individuals become depressed due to being overweight or obese or whether more individuals become overweight or obese due to being depressed. The results of this study are limited to the data obtained through NHANES.
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Scarpato BS, Swardfager W, Eid M, Ploubidis GB, MacIntosh BJ, Wu CY, Launer LJ, Cogo-Moreira H. Dynamics between psychological distress and body mass index throughout adult life; evidence from 3 large cohort studies. J Psychiatr Res 2021; 144:378-388. [PMID: 34737123 DOI: 10.1016/j.jpsychires.2021.10.030] [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: 04/07/2021] [Revised: 08/25/2021] [Accepted: 10/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Associations between body mass index (BMI) and psychological distress (PD) have been reported; however, few longitudinal studies have accounted for likely life-course differences in BMI and PD stability, consistency, and their interplay across time. METHODS Via random intercepts cross-lagged panel models, we assessed the predictive effects (from BMI to PD or vice-versa) across the last two centuries in the Coronary Artery Risk Development in Young Adults [CARDIA, beginning in 1985-6] study using the Center for Epidemiological Studies-Depression Scale [CES-D], and in the National Child Development Study [NCDS, beginning in 1958] and British Cohort Study [BCS, beginning in 1970] using the Malaise Inventory [MI]), assessed at least 4 times in adult life. FINDINGS In CARDIA (n = 4724), NCDS58 (n = 7149) and BCS70 (n = 5967), autoregressive effects were stronger for BMI than for PD, meaning that carry-over effects from one occasion to the next were larger for BMI than for PD. Small interindividual correlations between traits of higher BMI and higher PD were identified among females (rfemale<|0·2|) but not males (rmale<|0·03|) in CARDIA and NCDS. Cross-lagged effects were very weak or close to zero (standardized effects η<|0·1|). INTERPRETATION In the United States, depressive symptoms and BMI were positively correlated at the trait level among females. In the United Kingdom, relationships between PD and BMI were inconsistent between generations, with effect sizes of unlikely clinical importance, indicating negligible dominance of an intraindividual effect of BMI on PD or vice versa.
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Affiliation(s)
- B S Scarpato
- Department of Psychiatry, Federal University of Sao Paulo UNIFESP, Sao Paulo, Brazil
| | - W Swardfager
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
| | - M Eid
- Department of Educational Science and Psychology, Freie Universität Berlin, Germany
| | - G B Ploubidis
- Centre for Longitudinal Studies, UCL Institute of Education, University College London, UK
| | - B J MacIntosh
- Department of Medical Biophysics, University of Toronto, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
| | - C Y Wu
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
| | - L J Launer
- Laboratory of Epidemiology and Population Science, National Institutes of Health, USA
| | - H Cogo-Moreira
- Department of Psychiatry, Federal University of Sao Paulo UNIFESP, Sao Paulo, Brazil; Department of Education, ICT and Learning, Østfold University College, Norway.
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Hajek A, Kretzler B, König HH. The Association Between Obesity and Social Isolation as Well as Loneliness in the Adult Population: A Systematic Review. Diabetes Metab Syndr Obes 2021; 14:2765-2773. [PMID: 34168476 PMCID: PMC8216698 DOI: 10.2147/dmso.s313873] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 05/27/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Obesity is associated with adverse health outcomes and can result in feelings of loneliness or social isolation, for example due to stigmatization. These factors are in turn associated with morbidity and mortality. Thus far, a systematic review is lacking with regard to the association between obesity, social isolation and loneliness. Therefore, our aim was to fill this gap in knowledge. MATERIALS AND METHODS Three established electronic databases (PubMed, PsycInfo, as well as CINAHL) were searched. Observational studies examining the link between obesity and loneliness or social isolation were included. Disease-specific samples were excluded. RESULTS In sum, six studies have been included. While some studies point to an association between obesity and increased loneliness levels, it should be acknowledged that findings are mixed. Study quality was quite high. CONCLUSION This systematic review showed that the literature is inconclusive and incomplete. Further research is required to shed further light on these associations. Moreover, studies from countries outside Europe, based on longitudinal data and using objective assessments of obesity, are urgently required. Gender differences should be further explored.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
- Correspondence: André Hajek Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, GermanyTel +49 40 7410 52877Fax +49 40 7410-40261 Email
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
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Huang C, Kogure M, Tomata Y, Sugawara Y, Hozawa A, Momma H, Tsuji I, Nagatomi R. Association of serum adiponectin levels and body mass index with worsening depressive symptoms in elderly individuals: a 10-year longitudinal study. Aging Ment Health 2020; 24:725-731. [PMID: 30884953 DOI: 10.1080/13607863.2019.1584877] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Data regarding the association between adiponectin levels and body mass index (BMI) and long-term changes in depressive symptoms are limited and inconsistent. Thus, we investigated whether circulating adiponectin levels and BMI were independently and combinedly correlated to longitudinal changes in depressive symptoms.Methods: This prospective cohort study evaluated 269 elderly Japanese individuals aged ≥70 years who participated in the Tsurugaya Project conducted between 2002 and 2012. A short form of the Geriatric Depression Scale (GDS) was used to assess depressive status. Serum adiponectin levels were measured using an enzyme-linked immunosorbent assay or a latex particle-enhanced turbidimetric immunoassay. BMI was calculated as body weight (kg)/height (m2).Results: Multiple linear regression analysis revealed that baseline serum adiponectin levels were positively associated with changes in GDS scores (β = 0.14, P = 0.035). However, no association was observed after adjusting for BMI (β = 0.09, P = 0.185). Low BMI was associated with increased GDS scores at the 10-year follow-up (β = -0.14, P = 0.033). Participants with a combination of high adiponectin levels and low BMI had a 3.3-fold higher risk of worsening depressive symptoms than those with low adiponectin levels and high BMI (odds ratio: 3.35, 95% confidence interval: 1.60-7.00; P = 0.001).Conclusions: This longitudinal study indicated that high serum adiponectin levels and low BMI were both associated with worsening depressive symptoms among older Japanese individuals. Furthermore, the combination of high adiponectin levels and low BMI was associated with worsening depressive symptoms.
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Affiliation(s)
- Cong Huang
- Department of Sports and Exercise Science, College of Education, Zhejiang University, 148 Tianmushan Road, Hangzhou, China.,Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mana Kogure
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku Universit, Sendai, Japan
| | - Yasutake Tomata
- Department of Health Informatics and Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yumi Sugawara
- Department of Health Informatics and Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku Universit, Sendai, Japan
| | - Haruki Momma
- Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | - Ichiro Tsuji
- Department of Health Informatics and Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryoichi Nagatomi
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan.,Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
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Hajek A, Brettschneider C, van der Leeden C, Lühmann D, Oey A, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, Röhr S, Löbner M, Mösch E, Bickel H, Heser K, Wagner M, Scherer M, Maier W, Riedel-Heller SG, König HH. Prevalence and factors associated with obesity among the oldest old. Arch Gerontol Geriatr 2020; 89:104069. [PMID: 32413689 DOI: 10.1016/j.archger.2020.104069] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/30/2020] [Accepted: 04/03/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE To determine the prevalence of overweight and obesity, and to identify factors associated with obesity, among the oldest old. METHODS For this study, data from follow-up (FU) wave 7 and FU wave 8 of the "Study on Needs, Health Service Use, Costs and Health-Related Quality of Life in a Large Sample of Oldest-Old Primary Care Patients (85+)" (AgeQualiDe) were used. At FU wave 7, the mean age was 88.9 years (SD: 2.9; 85-100 years). Body-mass-index (BMI) categories were defined according to the World Health Organization (WHO) thresholds: underweight (BMI < 18.5 kg/m²), normal weight (18.5 kg/m² ≤ BMI < 25 kg/m²), overweight (25 kg/m² ≤ BMI < 30 kg/m²), and obesity (BMI ≥ 30 kg/m²). Longitudinal regression analysis was used to determine factors associated with obesity. RESULTS At FU wave 7, 3.0 % were underweight, 48.9 % were normal weight, 37.9 % were overweight, and 10.2 % were obese. Regressions showed that the probability of obesity decreased with age (OR: 0.77 [95 % CI: .593-.999]) and less chronic conditions (OR: 1.32 [95 % CI: 1.11-1.57]). The probability of obesity was not associated with sex, educational level, marital status, social isolation, visual impairment, hearing impairment, depression, and dementia. CONCLUSION Nearly half of the individuals in very late life had excess weight. Thus, excess weight remains a major challenge, even in very old age. Given the demographic ageing in upcoming decades, this is an issue which we should be aware of.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany.
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany
| | - Carolin van der Leeden
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg-Eppendorf, Germany
| | - Dagmar Lühmann
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg-Eppendorf, Germany
| | - Anke Oey
- Institute of General Practice, Hannover Medical School, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, Leipzig, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University of Munich, Germany
| | - Kathrin Heser
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg-Eppendorf, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany
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