Association between social capital and depression among older people: evidence from Anhui Province, China

Association between social capital, mental health, and digital health literacy among the university students in China: a multigroup analysis based on major difference

BACKGROUND

This study aimed to clarify medical-nonmedical difference on the relationship between social capital, mental health and digital health literacy of university students in China, and furtherly provide evidence-based suggestions on the improvement of the digital health literacy for the university students.

METHODS

The snowball sampling method was used to collect data from the university students (including medical students and nonmedical students) through online questionnaires, and finally 1472 university students were included for the data analysis, of whom, 665 (45.18%) were medical students, 807 (54.82%) were nonmedical students; 462 (31.39%) were male, 1010 (68.61%) were female. Mean value of the age was 21.34 ± 2.33 for medical students vs. 20.96 ± 2.16 for nonmedical students. Descriptive analysis, chi-square test analysis, one-way Analysis of Variance (conducted by SPSS) and structural equation modeling (conducted by AMOS) were employed to explore the difference on the relationship between social capital, mental health and digital health literacy between the medical students and nonmedical students.

RESULTS

The mean value of the digital health literacy was 36.27 (37.33 for medical students vs. 35.39 for nonmedical students). The SEM analysis showed that there was a statistically positive correlation between social capital and digital health literacy (stronger among the nonmedical students (0.317) than medical students (0.184)). Mental health had a statistically positive impact on the digital health literacy among medical students (0.242), but statistically significant correlation was not observed in nonmedical students (0.017). Social capital was negatively correlated with the mental health for both medical students and NMS (stronger among the nonmedical students (0.366) than medical students (0.255)). And the fitness indices of SEM were same between medical students and nonmedical students (GFI = 0.911, AGFI = 0.859, CFI = 0.922, RMSEA = 0.074).

CONCLUSION

The digital health literacy of the university student was relatively high. Both social capital and mental health could exert a positive effect on digital health literacy, while social capital was found to be positively associated with mental health. Statistical difference was found between medical students and nonmedical students on the above correlations. Implications were given on the improvement of the digital health literacy among university students in China.

Anti-stigmatizing: a collaborative autoethnography on recovery from depression

Introduction

Despite extensive research on clinical treatments for depression, there remains a significant gap in understanding of the lived experiences and recovery journeys of those with depression. This study sought to explore the recovery process through an "anti-stigmatizing" lens, emphasizing the cultural-psychological mechanisms at play and the importance of personal narratives in shaping the recovery trajectory.

Methods

Using a collaborative autoethnographic approach, this report focuses on the first author's journey of depression recovery. This research methodology allows for an in-depth exploration of subjective experiences, with a specific emphasis on the interaction between societal stigma, personal identity, and mental-health challenges.

Results

It is found that the depression-recovery experience can be divided into four stages from an anti-stigma perspective: (1) encountering the public stigma of emotions; (2) internalizing the stigma to a self-stigma; (3) "decriminalizing" the expected stigma of a "depressed" identity through diagnosis; and (4) being able to cope with and understanding the public stigma relating to depression when facing it again. Key factors that were found to contribute to recovery were self-awareness, community empowerment, and recognition and acceptance by close friends and family.

Discussion

We propose a reconceptualization of depression that incorporates a societal perspective on internalized stigma. Recovery from depression is not merely a medical process; it also pertains to how the patient frees themselves from public stigma. The results strongly indicate the need for a paradigm shift toward a more inclusive and empathetic approach to mental-health care, and we emphasize the importance of personal narratives in depression recovery.

Personal dignity in people with early-stage dementia: A longitudinal study

BACKGROUND

A psychosocial problem faced by people with early-stage dementia (PwESD) is the perception of threats to personal dignity. Insights into its dynamics are important for understanding how it changes as dementia advances and to develop suitable interventions. However, longitudinal studies on this change in PwESD are lacking.

AIMS

To determine how perceptions of dignity and selected clinical and social factors change over 1 year in home-dwelling PwESD and the predictors associated with changes in perceptions of dignity over 1 year.

RESEARCH DESIGN AND METHODS

A longitudinal study was conducted. The sample included 258 home-dwelling Czech PwESD. Data were collected using the Patient Dignity Inventory (PDI-CZ), Mini-Mental State Examination, Bristol Activities of Daily Living Scale, Geriatric Depression Scale and items related to social involvement. Questionnaires were completed by the PwESD at baseline and after 1 year.

ETHICAL CONSIDERATIONS

The study was approved by the ethics committee and informed consent was provided by the participants.

RESULTS

People with Early-Stage Dementia rated the threat to dignity as mild and the ratings did not change significantly after 1 year. Cognitive function, self-sufficiency, vision, and hearing worsened, and more PwESD lived with others rather than with a partner after 1 year. Worsened depression was the only predictor of change in perceived personal dignity after 1 year, both overall and in each of the PDI-CZ domains. Predictors of self-sufficiency and pain affected only some PDI-CZ domains.

CONCLUSIONS

Perceptions of threat to dignity were mild in PwESD after 1 year, although worsened clinical factors represented a potential threat to dignity. Our findings lead us to hypothesise that perceived threats to personal dignity are not directly influenced by health condition, but rather by the social context.

Association between social capital and quality of life in older adults with subjective cognitive decline: A cross-sectional study

BACKGROUND

Subjective cognitive decline (SCD) is increasingly recognized as a clinical and medical risk factor for mild cognitive impairment (MCI) and dementia. Currently, there is little evidence regarding the quality of life (QoL) in older adults with SCD and the impact of social capital on their QoL.

AIMS

To examine the perceptions of social capital and QoL among older adults with SCD.

METHODS

A total of 325 participants (92.9 % response rate) with a self-reported diagnosis of SCD completed the Chinese version of the 36-item Short-Form Health Survey, the Chinese Shortened Social Capital Scale and the Generalized Anxiety Disorder Scale. A t-test was used to compare the QoL score of our sample with the Chinese norm. Pearson correlation analysis and multivariate linear regression analysis were used to assess the association of social capital with QoL.

RESULTS

Social capital were strongly correlated with the total QoL, as well as its physical component summary and mental component summary. The QoL score of older adults with SCD was significantly lower than the Chinese norm (P < 0.001). Multivariate analysis showed that social capital, physical activity, nutrition and anxiety symptoms were factors associated with QoL among older SCD population (P < 0.05).

CONCLUSION

The findings of the current study suggest that older adults with SCD may experience lower QoL. Social capital is associated with the QoL in older adults with SCD. These findings have implications for clinicians who work with older adults with SCD.

Complex association of self-rated health, depression, functional ability with loneliness in rural community-dwelling older people

BACKGROUND

This study aimed to explore whether and how self-rated health, depression and functional ability interactively associated with loneliness using a sample group of older adults residing in China rural communities.

METHODS

Data on socio-demographic information, self-rated health, depressive symptoms, functional ability and loneliness (quantified via a single question) were collected from 1009 participants. Cross-tabulations with chi-square test, bivariate correlations, and Classification and Regression Tree (CART) models were employed for analysis.

RESULTS

We found that 45.1% of the participants were classified as lonely. Our results gain insight into the hierarchical order of predictors for the presence of loneliness, suggesting that there was a significant interaction between functional ability and depressive symptoms while self-rated health was not a significant factor. The probability of loneliness increased with the combination of limited functional ability and depression, and varied with different interaction of functional ability, depressive symptoms, and marital status, respectively. Notably, while there were some differences, similar associations were observed among older male and female respondents.

CONCLUSION

To delay or reduce loneliness, early detection which focuses on older people who report limitations in functional ability, depression, and being female, offers opportunities to start early interventions. Our findings might be helpful not only in designing and implementing loneliness prevention programs but also in improving healthcare for older rural community-dwelling people.

Changes in Generalized and Particularized Trust and Their Link to Depressive Symptoms: Exploring the Roles of Changes in Self-Rated Health, Family Support and Life Satisfaction Among Chinese Older Adults

This study aimed to examine whether changes in generalized trust (GT) and particularized trust (PT) predict changes in depressive symptoms (CES-D 8), and whether changes in self-rated health (SRH), family support (FS), and life satisfaction (LS) mediate the relationship between changes in the two types of trust and depressive symptoms in Chinese older adults. Structural equation modeling was employed to analyze two-wave data on 3770 participants aged 65 and over. Our results showed that in a context where GT was low and PT was high, an increase in GT was associated with more depressive symptoms, while an increase in PT was associated with fewer depressive symptoms. As such, GT cannot be viewed as protective against depression in older adults in a given context. LS partially mediated the relationship between changes in PT and depressive symptoms. The findings support psychosocial processes rather than health-problem and support pathways.

Examining the use of decision trees in population health surveillance research: an application to youth mental health survey data in the COMPASS study

INTRODUCTION

In population health surveillance research, survey data are commonly analyzed using regression methods; however, these methods have limited ability to examine complex relationships. In contrast, decision tree models are ideally suited for segmenting populations and examining complex interactions among factors, and their use within health research is growing. This article provides a methodological overview of decision trees and their application to youth mental health survey data.

METHODS

The performance of two popular decision tree techniques, the classification and regression tree (CART) and conditional inference tree (CTREE) techniques, is compared to traditional linear and logistic regression models through an application to youth mental health outcomes in the COMPASS study. Data were collected from 74 501 students across 136 schools in Canada. Anxiety, depression and psychosocial well-being outcomes were measured along with 23 sociodemographic and health behaviour predictors. Model performance was assessed using measures of prediction accuracy, parsimony and relative variable importance.

RESULTS

Decision tree and regression models consistently identified the same sets of most important predictors for each outcome, indicating a general level of agreement between methods. Tree models had lower prediction accuracy but were more parsimonious and placed greater relative importance on key differentiating factors.

CONCLUSION

Decision trees provide a means of identifying high-risk subgroups to whom prevention and intervention efforts can be targeted, making them a useful tool to address research questions that cannot be answered by traditional regression methods.

Association between organophosphorus pesticide exposure and depression risk in adults: A cross-sectional study with NHANES data

Organophosphorus pesticides (OPPs) are widely used pesticides, and previous studies showed that OPPs can increase the risk of central nervous system disorders (e.g., Parkinson's and Alzheimer's disease). However, few studies have comprehensively explored their association with depression in general adults. We analyzed data from 5206 participants aged 20 years or more based on four National Health and Nutrition Examination Survey (NHANES) cycles. OPPs exposure was estimated using measures of urinary concentrations for six OPPs metabolites. Survey-weighted generalized linear regression model (SWGLM) was used to explore the association of OPPs metabolites with depression. Subgroup analyses were performed by age (≦60 years and >60 years) and gender. The weighted quantile sum (WQS) regression model was used to explore the overall association of six OPPs metabolites with depression. In addition, The Bayesian kernel machine regression (BKMR) model was applied to investigate the interaction and joint effects of multiple OPPs metabolites with depression. The SWGLM showed that dimethyl phosphate (DMP) and dimethyl thiophosphate (DMTP), whether taken as continuous or quartile variables, had a positive correlation with depression. Diethyl phosphate (DEP) and dimethyl dithiophosphate (DMDTP) in the highest quartile were positively associated with depression compared to the lowest quartile. In subgroup analysis, we found that the effects of the above chemicals on depression existed in the male and young middle-aged population, while DMP was present in the female. There was a significant combined overall effect of six OPPs metabolites with depression [OR = 1.232, 95%CI: (1.011, 1.504)] in WQS. Furthermore, the BKMR model also showed a positive trend in the overall effect of six OPPs metabolites with depression. In conclusion, our results suggest that exposure to OPPs may increase the risk of depression in US adults. Men and young and middle-aged populations are more vulnerable to OPPs and the mixture of OPPs metabolites may induce depression.

Association of social capital with self-perceived eHealth literacy among community-dwelling older people: Age and gender differences

Background

Studies have confirmed that social factors, including social capital and eHealth literacy, are important in later life. Currently, few studies are available for determining the relationship between social capital and eHealth literacy, and whether such a relationship exists among older people and there are age and gender differences in the relationship remain unclear. Consequently, this study aimed to investigate the association between social capital and eHealth literacy, specifically examing its variations in age and gender.

Methods

A cross-sectional study of 4,257 residents aged ≥ 60 years and dwelling in the community was conducted across four cities in China. A structured questionnaire was used to collect data on general characteristics, socioeconomic status, social capital, and eHealth literacy. Generalized linear models were employed to assess these associations.

Results

There were 4,218 respondents (age 71.9 ± 7.2 years; 64.8% women). Overall, social participation, social connection, trust, cohesion, and reciprocity were all statistically associated with eHealth literacy (p < 0.05), while such an association was not observed for social support (p > 0.05). Specifically, a higher level of social participation was associated with better eHealth literacy scores among participants aged 70-79 years (p < 0.001), and a higher level of social connection was associated with better eHealth literacy scores for those aged 60-69 and 70-79 years (p < 0.001). Meanwhile, no gender differences in the associations were found.

Conclusion

There is an association between social capital and eHealth literacy in older men and women. The association varis with age. The findings provide a reference for developing targeted measures to improve self-perceived eHealth literacy among older people. It is essential for achieving active and healthy aging and developing the knowledge and understanding of relevant theories, concepts, and evidence within the field of health and social capital.

Individual-level social capital is associated with depressive symptoms among middle-aged community dwellers in rural Vietnam: a cross-sectional study

OBJECTIVES

There has been comparatively little research on the association between social capital and depressive symptoms in low- and middle-income countries. To address this deficit this study examined the association among middle-aged adults in rural Vietnam.

DESIGN

A cross-sectional study.

SETTING

Data came from the baseline survey of the Khánh Hòa Cardiovascular Study, which is an ongoing prospective cohort study aiming to elucidate the determinants of cardiovascular diseases.

PARTICIPANTS

A total of 3000 people aged 40-60 years old residing in rural communes in Khánh Hòa province, Vietnam.

EXPOSURE OF INTEREST

Cognitive social capital (ie, low, middle and high) and structural social capital (in terms of social participation; yes or no) were assessed via a questionnaire.

PRIMARY OUTCOME MEASURE

Depressive symptoms were assessed with the 11-item Center for Epidemiologic Studies Depression Scale.

RESULTS

A robust Poisson regression model revealed that adults in the highest versus lowest cognitive social capital tertile had a 61% lower prevalence of depressive symptoms (prevalence ratio (PR)=0.39, 95% CI=0.31 to 0.49). Individuals with higher structural social capital were also significantly less likely to experience depressive symptoms (PR=0.74, 95% CI=0.61 to 0.90).

CONCLUSION

In a cohort of 3000 middle-aged rural residents in Vietnam, both cognitive and structural social capital assessed at the individual level were inversely associated with the prevalence of depressive symptoms.

Associations between trajectories of social participation and functional ability among older adults: Results from the China Health and Retirement Longitudinal Study

Introduction

Functional ability (FA) and social participation (SP) are important indicators of healthy aging, both their trajectories are heterogeneous. It is little known about how the SP trajectories affects FA trajectories.

Methods

FA was assessed by 20 items covering the ability of meeting basic needs and mobility. SP was assessed by frequency of participating in 10 social activities. Group-based trajectory modeling (GBTM) was used to identify the trajectories of FA and SP of the participants.

Results

Two FA trajectories were identified: low baseline-decline tendency (16.1%) and high baseline-stable tendency (83.9%) trajectories. Two SP trajectories were also identified: low baseline-stable tendency (58.5%) and high baseline-increase tendency (41.5%) trajectories. After controlling for the potential covariates, participants among the high baseline-increase tendency SP trajectory group also had significantly higher odds ratios to be belonged in high baseline-stable tendency FA trajectory group (ORs = 2.64, 95%CI = 1.98-3.05).

Conclusions

High-increasing social participation had a protective effect to maintain high baseline-stable tendency functional ability among older adults. These findings suggest social participation appears to have great benefits on promoting healthy aging in China.

Factors Associated with Medication Adherence among Community-Dwelling Older People with Frailty and Pre-Frailty in China

BACKGROUND

Frail and pre-frail older people often need to take medications. However, factors related to medication adherence among this population remain unclear, warranting further research. This study aims to identify correlates of medication adherence among frail and pre-frail older adults.

METHODS

From November 2020 to December 2020; a total of 4218 community-dwelling residents aged ≥ 60 years were interviewed by a cross-sectional survey in China. Data on subjects' general information; medication adherence; and frailty status was obtained via the face-to-face structured questionnaire. Logistic regression models were fitted; separately; to examine these factors linked to medication adherence.

RESULTS

We found that 36.2% (n = 1527) and 18.8% (n = 792) of respondents were classified as pre-frail and frail. According to the Morisky scale scores, 66.74% (n = 2815) were found to have adequate medication adherence, and 33.26% (n = 1403) were found to have inadequate medication adherence. Among the pre-frail respondents, age (adjusted odds ratio (AOR) = 1.64; 95% confidence interval (CI): 1.18-2.29, P = 0.003), marital status (AOR = 1.52; 95% CI: 1.04-2.21, P = 0.030), smoking status (AOR = 0.61; 95% CI: 0.37-0.99, P = 0.044), and functional ability (AOR = 0.72; 95% CI: 0.58-0.91, P = 0.006) were significantly related to medication adherence. Among them, advanced age and single were risk factors, which were positively related to the medication adherence of subjects in pre-frailty, while quitting smoking and limited functional ability contributed to improving their medication adherence. In contrast, only age (AOR = 1.77; 95% CI: 1.16-2.69, P = 0.008) was significantly associated with medication adherence among frail subjects.

CONCLUSION

Influencing factors to medication adherence of old people in pre-frailty and frailty have been enriched, which provides a certain reference for promoting medication adherence in this population. Future adherence intervention methods should be designed based on these factors.

Association of social capital with obesity among older adults in China: a cross-sectional analysis

Background

Under the global aging trend, health issues of the elderly have received more and more attention. Among them, older adults’ obesity is one of the common health problems of the elderly. The association between social capital and obesity in the older adults has been analysed and discussed in previous studies but remains controversial. There are few studies on the association between social capital and obesity in the older adults in China. We examined whether social capital was associated with obesity in Chinese older adults.

Methods

The data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) —wave 8 (2017–2018) was used in this study. Totally, 10,164 respondents were included in the final analysis. Generalized trust, social participation (informal social interaction and participation of organized social activities), and social support was used as measures of social capital. Obesity status was defined by body mass index (BMI). Logistic regression analyses were used to assess associations between the social capital and obesity, adjusting for confounders.

Results

We found that the older adults who did not trust people around had greater odds of being overweighted/obese compared to those who trust [Adjusted Odds Ratio (AOR) 1.155, 95% CI 1.045 to 1.265]. The older adults having formal participation (participating in organized social activities) registered considerably higher BMI (AOR 1.155, 95% CI 1.041 to 1.269). The older adults who did not trust people around them had greater odds of being overweighted/obese both in males (AOR 1.172, 95% CI 1.012–1.333) and in females (AOR 1.155, 95% CI 1.004–1.306). Males having formal social participation were more likely to be overweighted/obese (AOR 1.181, 95% CI 1.024 to 1.337), but not in females.

Conclusions

Generalized trust and formal social participation was associated with overweight/obesity among older adults in China. Targeted obesity interventions for older adults are needed by developing public health policies for social capital optimization.

Association between social capital and self-rated health among community-dwelling older adults

Background

It is less known about whether the association of social capital with self-rated health (SRH) varies by the presence of health conditions and how social capital, together with other variables, is linked to self-rated health in later life.

Objectives

This article aimed to explore the association of social capital with self-rated health and to examine whether the association varies among older people with and without health conditions, with a special focus on how social capital and relevant factors have an effect on self-rated health among community-dwelling older adults.

Methods

Cross-sectional data were obtained from a survey that commenced from July to September 2017 in Anhui Province. Data on socio-demographic information, social capital (six dimensions), and self-rated health were analyzed. Binary logistic regression and classification and regression tree (CART) models were used to estimate the association.

Results

Based on the findings, we found that social capital regarding less social support (adjusted odds ratio (AOR) = 1.57, 95% CI: 1.21-2.04), and less reciprocity (AOR = 1.73, 95% CI: 1.29-2.31) were associated with self-rated health among general older adults. Social capital as measured by less social participation (AOR = 1.55, 95% CI: 1.06-2.27), less cohesion (AOR = 0.63, 95% CI: 0.42-0.94), and less reciprocity (AOR =1.77, 95% CI: 1.17-2.68) were linked to self-rated health among older people with health conditions. While social capital regarding less social support (AOR = 2.15, 95% CI: 1.39-3.33) was related to self-rated health among older people without health conditions. We observed the interacting effect of social capital in the CART model, an implication that much focus should be geared toward vulnerable subgroups, especially depressed and lonely older people, as they have low reciprocity and little cohesion.

Conclusion

This work demonstrates that social capital may be relevant in devising programs and measures to improve self-rated health among community-dwelling older adults with comorbidity.

Using Decision Trees to Examine Environmental and Behavioural Factors Associated with Youth Anxiety, Depression, and Flourishing

Modifiable environmental and behavioural factors influence youth mental health; however, past studies have primarily used regression models that quantify population average effects. Decision trees are an analytic technique that examine complex relationships between factors and identify high-risk subgroups to whom intervention measures can be targeted. This study used decision trees to examine associations of various risk factors with youth anxiety, depression, and flourishing. Data were collected from 74,501 students across Canadian high schools participating in the 2018-2019 COMPASS Study. Students completed a questionnaire including validated mental health scales and 23 covariates. Decision trees were grown to identify key factors and subgroups for anxiety, depression, and flourishing outcomes. Females lacking both happy home life and sense of connection to school were at greatest risk for higher anxiety and depression levels. In contrast with previous literature, behavioural factors such as diet, movement and substance use did not emerge as differentiators. This study highlights the influence of home and school environments on youth mental health using a novel decision tree analysis. While having a happy home life is most important in protecting against youth anxiety and depression, a sense of connection to school may mitigate the negative influence of a poor home environment.

Effectiveness of Social Support for Community-Dwelling Elderly with Depression: A Systematic Review and Meta-Analysis

Depression in the elderly is an important health factor that requires intervention in the form of social support resources. The purpose of this study was to conduct a systematic review, while synthesizing available evidence on what kind of social support, such as social participation and social connection/network, is effective for depression in the elderly. We performed a quality assessment of the included studies using the revised Risk of Bias for Non-randomized Studies tool and a meta-analysis of studies published up to 14 May 2021. Of the 3449 studies, 52 were relevant to this study. The various types of social resource applications reported in these were classified into three types: social support, social participation, and social connection/network. The social support group had significantly lower depression compared to the control group (0.72 [0.65, 0.81], p < 0.00001, I2 = 92%). There was a significant decrease in depression in the social participation group compared to the control group (0.67 [0.56, 0.80], p < 0.00001, I2 = 93%) (2.77 [1.30, 5.91], p = 0.008, I2 = 97%) (0.67 [0.56, 0.80], p < 0.00001, I2 = 93%). Finally, the social connection/network group showed decreased depression compared to the control group (2.40 [1.89, 3.05], p < 0.00001, I2 = 24%) (0.83 [0.76, 0.90], p < 0.00001, I2 = 94%). The results of this systematic review confirmed the effects of various social support interventions in reducing depression among the elderly living in the community.

Association between social capital and depression among older adults of different genders: Evidence from Hangzhou, China

In China, it is critical to help older adults cope with depression due to the emerging impacts of factors such as increased life expectancy and the "one-child" family planning policy. Meanwhile, differences in retirement age have different effects on health in older adults of different gender. The relationship of gender differences in social capital and depression across the elderly population was unclear. Focusing on this demographic, this study conducted a telephone survey to explore the relationship between social capital and depression. Referring to electronic medical records, we randomly selected 1,042 elderly respondents (426 men, 616 women) from four areas in Hangzhou. We used social capital measurements and the Geriatric Depression Scale (GDS-15) to assess social capital and depression, respectively, then employed a multivariate logistic regression and structural equation modeling to examine the associations between factors, along with a consideration of gender. This study was discovered that differences in both income and morbidity contributed to differences in social capital and depression. In our sample of elderly respondents, we also found gender-based differences in cognitive and structural social capital. Compared to men, women were more likely to attain higher social capital and less likely to develop depression. At the same time, social networking and social engagement had negative impacts on depression in women, which was not the case for men. We found that lower reciprocity (men and women), social work (men), and trust (women) indicated higher risks of depression. Reciprocity and social networks were significantly and negatively correlated with depression among male respondents; in the male model, factors of trust, reciprocity, and social participation had positive effects on reducing the risk of depression, while social networks had a negative effect. For elderly persons, these findings suggest that mental health is affected by differences in social capital caused by policy differences and cultural differences caused by gender differences.

Social capital and health information seeking in China

Background

People’s potentials to seek health information can be affected by their social context, such as their social networks and the resources provided through those social networks. In the past decades, the concept of social capital has been widely used in the health realm to indicate people’s social context. However, not many such studies were conducted in China. Chinese society has its special quality that many Western societies lack: people traditionally render strong value to family relations and rely heavily on strong social ties in their social life. Therefore, the purpose of this study was to examine the association between different types of social capital and health information-seeking behavior (HISB) in the Chinese context. The different types of social capital were primarily bonding and bridging, as well as cognitive and structural ones.

Methods

Our analysis is based on a total of 3090 cases taken from the Health Information National Trends Survey (HINTS) – China, 2017. Dataset was weighted due to the overrepresentation of female respondents and hierarchical multiple regression analyses as well as binary logistic regression tests were operated to examine the associations between people’s social capital and their HISB.

Results

Some aspects of social capital emerged as positive predictors of HISB: information support (standing in for the cognitive component of social capital) promoted health information seeking, organization memberships (standing in for the structural component) encouraged cancer information seeking, and both the use of the internet and of traditional media for gaining health information were positively linked with bridging networks and organization memberships. Bonding networks (structural component) were not correlated with any other of the key variables and emotional support (cognitive social capital) was consistently associated with all health information-seeking indicators negatively.

Conclusions

Social capital demonstrated significant and complex relationships with HISB in China. Structural social capital generally encouraged HISB in China, especially the bridging aspects including bridging networks and organization memberships. On the other hand, emotional support as cognitive social capital damaged people’s initiatives in seeking health-related information.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13895-2.

[Relationship between social support and depression among older people from elderly care social organizations in Anhui Province, China]

OBJECTIVE

To examine the relationship between absent social support and depression among older adults from elderly care social organizations in Anhui Province, China.

METHODS

A cross-sectional study using a multi-stage stratified random sampling method was conducted in six selected cities of Anhui Province, China. A linear regression model was employed to estimate the association between absent social support and depression.

RESULTS

All in all, 1167 older people were included. Social support and the three dimensions studied were all negatively correlated with depression. These findings suggest that older people from elderly care organizations, who reported higher social support, were less likely to develop depression. This association also existed after stratified analysis in different areas: household (urban/rural), age and gender.

DISCUSSION

A higher level of social support was correlated with lower chances of experiencing depression. These findings are consistent with the majority of previous literature having reported on social support among elderly populations. However, some of our findings differ from those of other studies.

CONCLUSIONS

Our study suggests that improved social support could help to prevent depression among older adults.

Less Social Participation Is Associated With a Higher Risk of Depressive Symptoms Among Chinese Older Adults: A Community-Based Longitudinal Prospective Cohort Study

OBJECTIVE

We aimed to examine the association between social participation and depressive symptoms among Chinese older people aged 65 years or above to supplement limited studies in China on this topic.

METHODS

This community-based longitudinal prospective cohort study used the data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, baseline in 2014 and a follow-up in 2018). Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale. Social participation was assessed using a composite index by considering the frequency for the two types of social activity: organized social activities and informal activities. Pearson's χ² test was used to correlate the characteristics of participants with social participation or depressive symptoms. Log-binomial regression models were used to assess the association between social participation and the risk of depressive symptoms.

RESULTS

The incidence of depressive symptoms was 28.8% among 2,200 participants in 2018 after a 4-year follow-up. Participants with no social participation (32.6%), organized social activities (30.6%), or informal social activities (31.2%) were more likely to have depressive symptoms. After the adjustment of demographic factors, socioeconomic status, lifestyle habits, and health status, in comparison with older people who often engaged in social participation, organized social activities, and informal social activities, the risk of depressive symptoms was 45% [adjusted risk ratio (aRR): 1.45, 95% CI: 1.16-1.82], 42% (aRR: 1.45, 95% CI: 1.02-2.00), and 29% (aRR: 1.29, 95% CI: 1.02-1.99) higher among older people with no social participation and who never engaged in organized social activities and informal social activities, respectively.

CONCLUSIONS

This study showed that the lack of social participation, including organized social activities and informal social activities, was associated with a higher risk of depressive symptoms after 4 years among older adults in China. Our findings shed lights into the feasibility of promoting social participation to reduce the risk of depressive symptoms and promote longevity and healthy aging among older adults.

Associations between education levels and prevalence of depressive symptoms: NHANES (2005-2018)

PURPOSE

Our study investigated the relationships between the prevalence of depressive symptoms and education levels in those aged ≥20 years.

METHODS

A total of 34,102 participants from the National Health and Nutrition Examination Surveys 2005-2018 were involved in our cross-sectional study. The relations of depressive symptoms (as outcome variable) and education levels (as an independent variable) were analyzed using multivariable logistic regression models in the main analyzes. Sensitivity analyzes, including a multiple sensitivity analysis, were also performed.

RESULT

The education levels were negatively associated with depressive symptoms after adjusting related covariates. Compared with the reference group of individuals with less than 9th grade, people with college graduate or above had an adjusted odds ratio (OR) of 0.464 (95% CI 0.361, 0.595, P < 0.0001). On the other hand, the statistically significant negative association disappeared among Mexican Americans, other races, separated, and high family poverty income ratio group. These results remained stable under a wide range of sensitivity analyzes.

CONCLUSION

Our study indicated the elevated education levels correlated with the decreased prevalence of depressive symptoms, and race, marital status, and family economic factors played a critical role in the relationship. This report reminds us to pay close attention to the further study of factors that affected the association between depressive symptoms and education levels.

LIMITATIONS

The cross-sectional study leaves problems about the direction of causality unclear.

Association between social capital and frailty and the mediating effect of health-promoting lifestyles in Chinese older adults: a cross-sectional study

BACKGROUND

To explore the association between social capital and frailty and the mediating effect of health-promoting lifestyles among Chinese older adults, while providing scientific evidence for frailty intervention.

METHODS

In May 2021, a cross-sectional study was conducted among 674 Chinese older adults in Changsha city. Data was collected using the Chinese Shortened Social Capital Scale (comprising structural social capital and cognitive social capital as two subscales), a simplified version of the Health-Promoting Lifestyle Profile and the Tilburg Frailty Indicator. Linear regression analysis was used to examine the association between social capital and frailty. Structural equation modeling was used to test the mediating effect of health-promoting lifestyles.

RESULTS

Cognitive social capital was significantly negatively associated with frailty and its three dimensions (physical, psychological, and social frailty), but structural social capital was not. Health-promoting lifestyles played a mediating role in the associations of cognitive social capital with frailty, physical and psychological frailty, but not with social frailty.

CONCLUSIONS

Higher cognitive social capital was associated with a reduced likelihood of frailty. The health-promoting lifestyles partially mediated the association between cognitive social capital and frailty. The use of health-promoting lifestyles or appropriate cognitive social capital interventions may reduce frailty among older adults.

Relationship between social capital and quality of life among adult stroke patients: a cross-sectional study in Anhui Province, China

Objectives

Few studies have investigated the association between social capital and quality of life (QoL) among stroke patients. To address this research gap, we aimed to explore the association between social capital and QoL among stroke patients in Anhui Province, China.

Study design

Cross-sectional study.

Methods

This cross-sectional study was conducted using a multi-stage stratified random sampling method. The following data including demographic characteristics, health-related conditions, five dimensions of social capital status, and quality of life (QoL) were collected using a questionnaire. Generalized linear models were then used to determine the relationship between social capital and QoL after adjusting for confounding factors.

Results

A total of 390 participants were included for the final analysis in this study. Our results indicated that subjects with higher social capital including social connection (coefficient: 28.28, 95% CI: 19.39–37.16), social support (coefficient: 21.17, 95% CI: 10.63–31.71), trust (coefficient: 13.46, 95% CI: 2.73–24.19), reciprocity (coefficient: 25.56, 95% CI: 15.97–35.15), and cohesion (coefficient: 19.30, 95% CI: 9.90–28.70) had increased odds of reporting poor QoL when compared with lower social capital group. We also observed that the association between social capital and QoL varied across cities.

Conclusions

Our findings show that social capital is associated with QoL in adult stroke patients, suggesting that social capital may be significant for enhancing QoL among adults with stroke.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-022-01925-x.

Socio-economic and technological aspects of mental health of older persons: the role of strong and weak ties in Ghana

Research indicates that social capital can influence the extent to which socio-economic status (SES) and information and communications technology (ICT) affect mental health. This study uses empirical data to examine the veracity of this claim by examining the effect of SES and ICT use on the mental health of older persons in Ghana, as well as the moderating role of bonding (i.e. strong ties) and bridging (i.e. weak ties) social capital in these associations. Data were drawn from 409 older persons from four regions in Ghana as part of a broader cross-sectional survey. Ordinal logistic regression analyses showed that SES and ICT use had positive associations with mental health after adjusting for other socio-demographic factors. Bridging social capital modified the association between SES and mental health positively. Bonding social capital also moderated the relations between ICT use on mental health positively. We argue that the prevalent nature of resources embedded in strong ties and the diversity of support that emerge from weak ties account for the difference in their influence observed in this study. Thus, while advances in socio-economic and technological conditions can enhance older persons’ mental health, equal attention must be paid to the characteristics of their strong and weak ties as they possess the resources to make socio-technological policies even more meaningful.

Mediating Role of Depressive Symptoms on the Association Between Neighborhood Social Cohesion and Quality of Life in Individuals with Type 2 Diabetes Mellitus

PURPOSE

Few studies have explored the association between neighborhood social cohesion (NSC), a type of social capital, and the quality of life of patients with type 2 diabetes mellitus (T2DM). In addition, the potential mechanism for this association remains unclear. The current study examined the mediation effect of depressive symptoms on the relationship between NSC and quality of life among diabetes patients in China.

PATIENTS AND METHODS

A cross-sectional study of 1747 T2DM patients was conducted. The specific quality of life (DSQL), Center for Epidemiological Survey Depression (CES-D), and social capital scales were administered using a face-to-face survey. Partial correlation analysis and a linear regression model were employed to explore the relationship between NSC, depressive symptoms, and quality of life. Bootstrap analysis using PROCESS was used to test the mediation model.

RESULTS

After controlling for covariates, NSC was negatively correlated with depressive symptoms (r=-0.24, P<0.01) and DSQL score (r=-0.20, P<0.01) while depressive symptoms were positively correlated with DSQL score (r=0.46, P<0.01). Linear regression analysis also found that NSC was negatively associated with the DSQL score, while depressive symptoms were positively associated with the DSQL score. Depressive symptoms mediated the relationship between NSC and quality of life in T2DM patients (explaining 50.7% of the total variance).

CONCLUSION

NSC was positively associated with improved quality of life among Chinese T2DM patients in this study, and depressive symptoms were likely to partially explain this relationship. These findings may be used to help maintain a good quality of life among at-risk individuals. Additional prospective studies are needed to confirm these findings.

Methodological challenges in harmonisation of the variables used as indicators of social capital in epidemiological studies of ageing – results of the ATHLOS project

The present article aims to highlight methodological aspects related to understanding and conceptualising social capital for the purposes of population research as well as describing the key challenges in the harmonisation process of indicators of social capital. The study was conducted in the frame of the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project. After a review of social capital theories developed in social science and a subsequent review of the documentation of 18 international cohorts, decision trees of the harmonisation of social variables were developed. The known-group validity was verified. The results focused on generalised trust, civic engagement and social participation are presented. The summary of the availability of any indicators of these concepts is classified in seven domains (generalised trust, political participation, religious participation, senior-specific participation, participation in sport groups, participation in volunteer/charity group activities, any participation) across surveys. The results of the analysis for known-group validity support the construct validity of the harmonised variables.

Elderly care in Nepal: Are existing health and community support systems enough

In Nepal, a few governmental and community-based programmes for elderly care are in place; however, information about successful implementation and overall effectiveness of these programmes is not well understood. In this article, we introduced these programmes and discussed existing programmes’ gaps and implementation problems in light of existing grey and peer-reviewed evidence. A few notable governmental programmes, such as providing monthly allowances, pensions and free health care, have targeted specifically the elderly individuals. Yet, most health care institutions and providers are privately owned and profit-oriented, and there is a general lack of proper governmental health as well as social security systems for the elderly in the country. Generally, Nepalese communities consist of neighbourhood-based and religious-based groups that provide emotional and spiritual support to elderly individuals as well as provide support for health care access when needed. However, the influence that these groups can have on health and social well-being of elderly remains not well understood. Traditional family-based support systems may be feasible only for some families, while for others it could impose financial and psychological burdens. The role of the state is important in the effective implementation of existing programmes as well as in the development and implementation of additional programmes to ensure health and social well-being of elderly individuals. Furthermore, there is a need to establish partnerships with existing community structures and to mobilize them in the implementation of community-based programmes.

Association between socioeconomic welfare and depression among older adults: Evidence from the China health and Retirement Longitudinal Study

This study aims to examine the association between province-level socioeconomic welfare factors and depression symptoms among older adults in China. Province-level socioeconomic characteristics were merged with microdata for respondents over 65 years from the 2018 China Health and Retirement Longitudinal Study (CHARLS) Wave 4 (N = 6657). Principal component analysis (PCA) was used to extract three socioeconomic welfare factors constructed from 14 province-level variables. A Bayesian mixed-effects logistic model was applied to measure the association between the three socioeconomic welfare factors and depression symptoms while controlling for socio-demographic variables. The PCA showed that economic welfare, medical resource welfare, and social service welfare together explained 72.2 percent of the total variance of the 14 province-level variables. It was found that increasing economic welfare was significantly associated with a lower probability of depression symptoms (OR = 0.806, 95%CI: [0.674, 0.967]), while medical facilities were associated with a higher probability of depression symptoms (OR = 1.181, 95%CI: [1.029, 1.354]) among Chinese older adults. Uncertainty existed as to whether having access to social welfare (OR = 0.941, 95%CI: [0.835, 1.060]) was associated with prevalence of depression. Thus, improved socioeconomic welfare systems for older adults (which possibly require an increase in spending) are necessary to contribute further to reduced depression risk in China. Policymakers should also improve the utilization of medical resources to mitigate the incidence of depression among the elderly in China.

Association between social capital and loneliness among older adults: a cross-sectional study in Anhui Province, China

BACKGROUND

We aimed to examine the association between social capital and loneliness in Anhui Province, China.

METHODS

Data were collected from a cross-sectional study using a multi-stage stratified cluster sampling strategy. Data on demographic characteristics, socioeconomic factors, social capital, and loneliness in 1810 older adults (aged 60 years and older) were used for analysis. Binary logistic regression models and a classification and regression tree model were performed to assess the association of social capital and loneliness.

RESULTS

Our results indicated that social capital in terms of lower level of social participation (AOR = 1.38; 95% CI: 1.10-1.74), social connection (AOR = 1.51; 95% CI: 1.18-1.93), and reciprocity (AOR = 1.47; 95% CI: 1.13-1.90) were associated with higher odds of developing loneliness. We noted the interactive effect of different social capital dimensions on loneliness, suggesting that the risk for suffering loneliness was greatest in older people limited in functional ability, with less trust, less social connection, and less social participation.

CONCLUSIONS

Our findings show that social capital is associated with loneliness in older adults. This implies that social capital, especially in terms of trust, social connection, and social participation may be significant for alleviating loneliness in later life.

The relationship among social capital, eHealth literacy and health behaviours in Chinese elderly people: a cross-sectional study

Background

Social capital has been linked to health behaviours, but the underlying mechanism is unclear. Previous studies have found that health literacy played the role of a mediator in the relationships among social capital, individual physical activity and nutrition. But it is not clear whether eHealth literacy mediates the impact of social capital on health behaviours. Therefore, our research aimed to explore the relationships among social capital (structural and cognitive social capital), eHealth literacy, and the health behaviours of elderly people, and to analyse the mediating effect of eHealth literacy, while providing a theoretical basis for a health behaviour intervention for elderly people.

Methods

From January to February 2019, we conducted a cross-sectional survey of 1201 Chinese people aged over 60 years using the Chinese Shortened Social Capital Scale (contains two subscales of structural social capital and cognitive social capital), eHealth Literacy Scale, and Health-Promoting Lifestyle Profile. We used structural equation modelling to test a hypothetical mediation model.

Results

The mean scores of social capital was 72.07 (SD = 13.03), 17.24 (SD = 9.34) for eHealth literacy, and 112.23 (SD = 23.25) for health behaviours. Social capital and eHealth literacy were significantly correlated with health behaviours, and social capital and structural social capital were significantly correlated with eHealth literacy. Lastly, eHealth literacy mediated the relationship between structural social capital and health behaviours.

Conclusions

eHealth literacy was an important mediating factor for elderly people’s structural social capital and health behaviours. Therefore, social capital and eHealth literacy must be considered when designing and implementing health behaviour intervention programmes for elderly people.

Relationship Between Social Capital and Depressive Symptoms Among Type 2 Diabetes Mellitus Patients in Northwest China: A Mediating Role of Sleep Quality

Objective: There are few studies about the relationship between social capital (SC) and depression among type 2 diabetes mellitus (T2DM) patients, and the mechanism explaining how SC leads to decreased depression is unclear. The current study aims to explore the relationship between SC and depressive symptoms among the T2DM patients in northwest China, with a particular focus on the mediating role of sleep quality. Methods: A cross-sectional study of 1,761 T2DM patients from Ningxia Province was conducted. The Center for Epidemiological Survey Depression Scale (CES-D) and self-report sleep quality questionnaire coupled with the SC scales were administered during the face-to-face survey. The Bootstrap methods PROCESS program is employed to test the mediation model. Results: The prevalence of depressive symptoms among T2DM patients was 24.8%. After controlling for covariates, the SC (r = -0.23, p < 0.001) was negatively correlated with CES-D score; the sleep quality was also negatively correlated with CES-D score (r = -0.31, p < 0.001); and the SC was positively correlated with sleep quality (r = 0.10, p < 0.001). Logistic regression analysis showed that SC was inversely related to the risk of depressive symptoms. Meanwhile, sleep quality was negatively associated with depressive symptoms. Sleep quality has mediated the relationship between SC and depressive symptoms among T2DM patients (explaining 12.6% of the total variance). Conclusions: We elucidated how SC interacted with depressive symptoms through the mediation pathway of sleep quality using a representative sample of the Chinese diabetes patients. The findings indicate that the improvement of SC and sleep quality may help in maintaining mental health among T2DM patients. Hence, clinicians can suggest that patients communicate more with others to improve the SC and, in turn, maintain their health.