Prevalence and factors associated with anxiety and depression among community-dwelling older adults in Hunan, China: a cross-sectional study

Depressive symptoms and all-cause mortality among middle-aged and older people in China and associations with chronic diseases

Introduction

It remains unclear whether depressive symptoms are associated with increased all-cause mortality and to what extent depressive symptoms are associated with chronic disease and all-cause mortality. The study aims to explore the relationship between depressive symptoms and all-cause mortality, and how depressive symptoms may, in turn, affect all-cause mortality among Chinese middle-aged and older people through chronic diseases.

Methods

Data were collected from the China Health and Retirement Longitudinal Study (CHARLS). This cohort study involved 13,855 individuals from Wave 1 (2011) to Wave 6 (2020) of the CHARLS, which is a nationally representative survey that collects information from Chinese residents ages 45 and older to explore intrinsic mechanisms between depressive symptoms and all-cause mortality. The Center for Epidemiological Studies Depression Scale (CES-D-10) was validated through the CHARLS. Covariates included socioeconomic variables, living habits, and self-reported history of chronic diseases. Kaplan-Meier curves depicted mortality rates by depressive symptom levels, with Cox proportional hazards regression models estimating the hazard ratios (HRs) of all-cause mortality.

Results

Out of the total 13,855 participants included, the median (Q1, Q3) age was 58.00 (51.00, 63.00) years. Adjusted for all covariates, middle-aged and older adults with depressive symptoms had a higher all-cause mortality rate (HR = 1.20 [95% CI, 1.09-1.33]). An increased rate was observed for 55-64 years old (HR = 1.23 [95% CI, 1.03-1.47]) and more than 65 years old (HR = 1.32 [95% CI, 1.18-1.49]), agricultural Hukou (HR = 1.44, [95% CI, 1.30-1.59]), and nonagricultural workload (HR = 1.81 [95% CI, 1.61-2.03]). Depressive symptoms increased the risks of all-cause mortality among patients with hypertension (HR = 1.19 [95% CI, 1.00-1.40]), diabetes (HR = 1.41[95% CI, 1.02-1.95]), and arthritis (HR = 1.29 [95% CI, 1.09-1.51]).

Conclusion

Depressive symptoms raise all-cause mortality risk, particularly in those aged 55 and above, rural household registration (agricultural Hukou), nonagricultural workers, and middle-aged and older people with hypertension, diabetes, and arthritis. Our findings through the longitudinal data collected in this study offer valuable insights for interventions targeting depression, such as early detection, integrated chronic disease care management, and healthy lifestyles; and community support for depressive symptoms may help to reduce mortality in middle-aged and older people.

Association between Oral Health and Depressive Symptoms in Chinese Older Adults: The Mediating Role of Dietary Diversity

Diet is a modifiable factor in healthy population aging. Additionally, oral health and diet are important factors affecting depressive symptoms. To assess the mediating role of dietary diversity (DD) in oral health and depressive symptoms in older adults, we selected 8442 participants aged ≥ 65 years from the 2018 Chinese Longitudinal Health Longevity Survey (CLHLS) for a cross-sectional study. Depressive symptoms were determined based on scores on the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Dietary diversity scores (DDS) were established based on the frequency of intake of food groups. Oral health was measured by denture use and toothbrushing frequency. Stepwise multiple linear regression and PROCESS macros were used for mediated effects analysis and testing. The sample had a positive detection rate of 44.1% for depressive symptoms, 40.8% for denture use, and 41.9% for once-a-day toothbrushing. Denture use (ρ = -0.077, p < 0.01) and toothbrushing frequency (ρ = -0.115, p < 0.01) were negative predictors of depressive symptoms in older adults. DD significantly mediated the association between denture use (indirect effect -0.047; 95%CI: -0.068-0.028; p < 0.001), toothbrushing frequency (indirect effect -0.041; 95%CI: -0.054-0.030; p < 0.001), and depressive symptoms. Denture use and toothbrushing frequency not only directly reduce the risk of depressive symptoms in older adults, but also indirectly affect depressive symptoms through DD.

The effect of spiritual reminiscence therapy on depression and hope among Iranian older adults: a quasi-experimental study

This quasi-experimental study aimed to evaluate the impact of spiritual reminiscence therapy (SRT) on depression and hope among older adults living in Shahroud, northeast of Iran. One hundred fifty-six older adults were selected through convenience sampling and assigned non-randomly to the intervention (n= 78) and control (n= 78) groups. The data collection tools included the Geriatric Depression Scale and Adult Hope Scale. For the intervention group, SRT was conducted in six weekly sessions, each lasting 60 to 90 min, over six weeks. The data were analyzed utilizing descriptive statistics and inferential tests (independent t-test, Chi-square test, and analysis of covariance). The two groups' post-intervention mean scores on depression (t= 11.63 and P< 0.001), and hope (t= 4.41 and P< 0.001) were statistically different, suggesting that SRT positively affected older adults by alleviating despair and boosting hope. The findings indicate that engaging in SRT can be beneficial in reducing depression and fostering hope among older adults.

Association of habitual physical activity with depression and anxiety: a multicentre cross-sectional study

OBJECTIVE

Despite the known benefits of physical activity, the effect of habitual physical activity (HPA) on depression and anxiety remains unclear. This study aimed to investigate the association of HPA with the risk of depression and anxiety among Chinese adults, with the consideration of disease severity.

METHODS

The participants in this multicentre cross-sectional study were from the nationwide survey of the psychology and behaviour of Chinese residents. Depression and anxiety were measured using the nine-item Patient Health Questionnaire and seven-item Generalised Anxiety Disorder scale. HPA was assessed by the short form of the International Physical Activity Questionnaire. Crude and adjusted ORs with their 95% CIs were estimated by using ordinal logistic regression.

RESULTS

Of the 19 798 participants, 3901 (19.7%) had anxiety and 8914 (45.02%) had depression. Compared with inactive participants, depression risk in individuals reporting low, median and high volume HPA was reduced by 23% (OR 0.77, 95% CI 0.66 to 0.89), 21% (OR 0.79, 95% CI 0.68 to 0.90) and 13% (OR 0.87, 95% CI 0.78 to 0.98), respectively, after adjustment for confounder. No significant association of HPA with anxiety risk was observed.

CONCLUSION

Participation in HPA, whether low, median or high volume, was associated with a lower risk of depression compared with inactive participation, while no significant association was observed between HPA and anxiety.

Prevalence of depression and anxiety among elderly primary care patients in Palestine

Background and objectives

Depression and anxiety are common mental health disorders among the elderly worldwide. In this study, we estimated the prevalence of depression and anxiety and related risk factor among elderly attending Primary Health care (PHC) centers in Palestine.

Methods

A cross-sectional study was conducted from February to July 2021 with a sample size of 380 participants aged ≥60 attending PHC centers in West Bank, using an interviewer-administered questionnaire. We used the Geriatric Depression Scale-15 and the Geriatric anxiety Scale to screen for depression and anxiety, respectively. Logistic regression models were used to identify predictors of depression and anxiety.

Results

The prevalence of depression and anxiety was 41.1 and 39.2%, respectively. Elderly people living in rural areas (aOR = 2.63; 95% CI: 1.72-4.20), uneducated (aOR = 2.92; 95% CI: 1.41-6.13), and without monthly income (aOR = 3.42; 95% CI: 1.52-7.61) were more likely to have depression. On the other hand, anxiety was independently associated with living in rural areas (aOR = 1.93, 95% CI: 1.23-3.04) and having non-communicable diseases (aOR = 2.01; 95% CI: 1.13-3.49).

Conclusion

Depression and anxiety are common in Palestine, a developing country with a lack of elderly related services. This should be emphasized at the national and regional levels where geriatric health care services are scarce. Such information is required by policymakers and external funding agencies in order to develop future agendas.

Prevalence of COVID-19 anxiety, geriatric anxiety, and related factors among the elderly in Quchan, Iran during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

Anxiety is a prevalent mental disorder among the elderly, leading to discomfort, disability, increased expenses, reduced quality of life, and dysfunction. Consequently, this study was conducted to determine the prevalence of COVID-19 anxiety and geriatric anxiety, along with the factors influencing anxiety, in the elderly population served by urban healthcare centres in Quchan.

METHODS

This cross-sectional study involved 650 elderly individuals aged 60-95 years. The participants were selected using a two-stage cluster sampling method. Data were collected through three questionnaires: the Geriatric Anxiety Inventory (GAI), the Corona Disease Anxiety Scale (CDAS), and a questionnaire on factors contributing to anxiety. Data analysis was performed using simple and multiple regression with IBM SPSS 24.

RESULTS

The prevalence of geriatric anxiety among the elderly was 40.3%, while the prevalence of COVID-19 anxiety (moderate and severe) was 22.8%. Significant relationships were observed between geriatric anxiety and substance abuse, stressful life events, comorbidities, COVID-19 anxiety, financial support, loneliness, walking habits, and sleep patterns (P < 0.05).

CONCLUSION

COVID-19 anxiety and geriatric anxiety are prevalent concerns among the elderly. Factors like substance abuse, stressful life events, COVID-19-related anxiety, comorbidity, living alone, lack of financial support, and poor walking and sleeping habits, which affect anxiety in the elderly, it is essential to address these factors in life planning and provide services through relevant organisations, healthcare teams, and initiatives by the elderly themselves.

Sleep and Depression in Older Adults: A Narrative Review

PURPOSE OF REVIEW

The sleep-depression association has been recognized for decades. Efforts to clarify this association continue at an increasing pace. This review summarizes recent research on the sleep-depression association in older adults.

RECENT FINDINGS

Research over the past 4 years has utilized cross-sectional, longitudinal, cohort, and intervention designs to examine these associations. Short (< 7 h) and long (> 8-9 h) sleep durations and insomnia symptoms are risk factors for depression in older adults. Similarly, short sleep, long sleep, insomnia symptoms, and depression are all risk factors for poorer health in late life, including increased risk of cognitive decline, falls, and poorer quality-of-life. Intervention studies have produced mixed findings, with some studies suggesting that sleep interventions may be potentially effective in improving both insomnia and mood symptoms. Intervention studies incorporating both behavioral and physiological measures of sleep, and larger and diverse samples may enhance the field's understanding of the complex interplay between sleep and mood in older adults.

Longitudinal Association Between Perceived Availability of Home- and Community-Based Services and All-Cause Mortality Among Chinese Older Adults: A National Cohort Study

Home- and community-based services (HCBS) may contribute to lowering mortality and enhancing quality of life among older adults. Limited research, however, has examined this relationship in the Chinese context. This study explored the longitudinal association between perceived availability of HCBS and all-cause mortality among Chinese older adults. This cohort study included 8,102 individuals aged 65 years and older from the 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. HCBS included daily life assistance, medical care services, emotional support and social services, and reconciliation and legal aid services. The association between perceived availability of HCBS and all-cause mortality was investigated using Cox proportional hazards models. Emotional support and social services were negatively associated with all-cause mortality (HR = 0.86, 95% CI: 0.78 ~ 0.95, P = .004). Daily life assistance, medical care services, and reconciliation and legal aid services were not significantly associated with all-cause mortality. Providing community-level emotional support and social services may reduce the risk of death. Focusing on the mental health and social well-being of older adults is just as important as caring for their physical health.

Prevalence and factors associated with anxiety and depression among Chinese prison officers during the prolonged COVID-19 pandemic

Objective

This study examined the prevalence of anxiety and depression-along with the potential risk and protective factors-among Chinese prison officers during the prolonged COVID-19 pandemic.

Method

A cross-sectional survey of 1,268 officers from five prisons in western and southern China was administered between June and July 2022. The questionnaires comprised two sections. In the first section, the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate the prevalence of anxiety and depression, respectively, among prison officers. In the second section, the potential influencing factors were examined. Categorical data were compared using χ2 tests and t-tests; binary logistic regression analysis was performed to identify factors associated with anxiety and depression.

Results

The prevalence rates of anxiety and depression among the prison officers were 72.6% and 69.8%, respectively. Risk factors for anxiety were older age, being unmarried, work-family conflicts, job demands, and COVID-19 burnout; protective factors were exercise, positive family relationships, and group cohesion. Work-family conflicts, job demands, intolerance of uncertainty regarding COVID-19, and COVID-19 burnout were risk factors for depression, whereas annual income >150,000 RMB, exercise, positive family relationships, group cohesion, and job autonomy were protective factors against depression.

Conclusion

The prevalence of anxiety and depression among Chinese prison officers was relatively high during the prolonged COVID-19 pandemic, and more targeted measures should be implemented to improve their mental health. This study offers a reference for improving prison officers' mental health in response to similar public health emergencies in the future.

Association between depression and oxidative balance score: National Health and Nutrition Examination Survey (NHANES) 2005-2018

BACKGROUND

Few studies have investigated the relationship between systemic oxidative stress status and depression. The oxidative balance score (OBS) was used to assess systemic oxidative stress status, with higher OBS scores implying exposure to more antioxidants. This study aimed to explore whether OBS is associated with depression.

METHODS

18,761 subjects from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 were selected. Depression was diagnosed by the Patient Health Questionnaire (PHQ-9, score ≥ 10). OBS was scored by 20 dietary and lifestyle factors. Weighted logistic regression and restricted cubic splines (RCS) were used to assess the association between OBS and depression.

RESULTS

The prevalence of depression was 8.42 %. There was a significant negative nonlinear relationship between OBS, dietary OBS, lifestyle OBS and depression (p for nonlinear < 0.05). Compared to the lowest quartile of OBS, the adjusted ORs for the highest quartile of OBS, dietary OBS, and lifestyle OBS and depression were 0.290 (95 % CI: 0.193-0.434), 0.500(95 % CI: 0.380-0.658), 0.403(95 % CI: 0.299-0.545) respectively, and all P for trend < 0.001. In stratified analyses, three OBS were negatively associated with the odds of depression across sex groups (all P for trend < 0.05), and the OR was smaller in the female group than in the male group.

LIMITATIONS

Cross-sectional data and absence of drug considerations.

CONCLUSIONS

OBS was strongly negatively associated with depression, especially in females. The findings underline the significance of adhering to an antioxidant diet and lifestyle, which helps prevent depression and appears to be of greater benefit to women.