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Nogimura A, Otani T, Noguchi T, Nakagawa-Senda H, Watanabe M, Yamada T, Suzuki S. Gender and age variations in the association between multigenerational cohabitation and self-rated health among middle-aged and older adults in Japan. NAGOYA JOURNAL OF MEDICAL SCIENCE 2024; 86:262-279. [PMID: 38962421 PMCID: PMC11219238 DOI: 10.18999/nagjms.86.2.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/28/2023] [Indexed: 07/05/2024]
Abstract
Despite encouraging multi-generational cohabitation, the population of Japanese people living alone has increased. However, little is known about the association between health and multigenerational cohabitation. This study examined the relationship between self-rated health and living arrangements among Japanese adults using data from the Japan Multi-Institutional Collaborative Cohort Study (2013-2017). The analysis employed multivariate logistic regression to examine the associations. Our results showed no association between living arrangements and self-rated health when stratified by gender. Living alone was found to be associated with poor self-rated health among women aged 65 and above. A similar association may exist among men in the same age group. Among women aged < 65 years, two-generation cohabitation was associated with a good self-rated health, similar to those living alone. Among men aged < 65 years, neither living alone nor two-generation cohabitation was significantly associated with good self-rated health. We found no association between three- or plus-generation cohabitation and self-rated health. Therefore, our findings indicate associations between multigenerational cohabitation and self-rated health, but they vary by gender and age. Invested stakeholders in the public health field should consider the potential impact of living arrangements on health based on gender and age.
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Affiliation(s)
- Akane Nogimura
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Division of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takahiro Otani
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Taiji Noguchi
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Department of Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hiroko Nakagawa-Senda
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Miki Watanabe
- Department of Educational Sciences, Lecture on Nursing Education, Faculty of Education, Aichi University of Education, Kariya, Japan
| | - Tamaki Yamada
- Okazaki Public Health Center, Okazaki Medical Association, Okazaki, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Morikawa K, Nomura K, Onozawa D, Sasaki H, Morikawa Y. Sociodemographic and environmental characteristics associated with thoughts of death and suicidal ideation in community-dwelling residents of a rural town in Japan: analyses from a perspective of accompanying problems. BMC Public Health 2024; 24:1130. [PMID: 38654210 DOI: 10.1186/s12889-024-18538-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 04/07/2024] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVE Suicide prevention has been focused on primary prevention as a group rather than individuals. However, we aimed to identify sociodemographic and environmental characteristics of individuals with suicidal thoughts among rural residents in Japan. METHODS In 2015, a cross-sectional home visit survey was conducted in a rural town in Akita Prefecture. A total of 1,844 residents aged ≥ 20 years (response rate, 65%) answered a self-administered questionnaire about suicidal thoughts in the past one month. Multivariate logistic regression analyses were used to investigate sociodemographic and environmental characteristics associated with suicidal thoughts in models with accompanying problems for human relations problems (HRP), health problems (HP), and financial problems (FP), or with no accompanying problems. RESULTS In total, 218 (men 9.4%, women 13.8%) had suicidal thoughts with accompanying problems for HRP (n = 104), HP (n = 112), and FP (n = 72). The risk characteristics were Kessler Psychological Distress Scale scores ≥ 9 in models with HRP, HP, and FP or with no accompanying problems; being a woman and current smoking with no accompanying problems; absence of a person for help in a model of FP; and absence of family member for help in a model of HRP or with no accompanying problems. The mitigating factor were being optimistic (a domain of resilience skills identified by factor analysis) in models of HRP, HP, and FP or with no accompanying problems; being aged 70-79 and being aged ≥ 80 in a model of HRP. CONCLUSIONS Suicidal thoughts among rural residents in Japan were associated with multifactorial sociodemographic and environmental characteristics.
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Affiliation(s)
- Kozue Morikawa
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
- Department of Judo Physical Therapy, Teikyo Heisei University Faculty of Health Care and Medical Sports, Chiba, Japan
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
| | - Daisuke Onozawa
- Department of Judo Physical Therapy, Teikyo Heisei University Faculty of Health Care and Medical Sports, Chiba, Japan
| | - Hisanaga Sasaki
- Department of Health Science and Nursing, Akita University Graduate School of Medicine, Akita, Japan
| | - Yoshiki Morikawa
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
- Department of Judo Physical Therapy, Teikyo Heisei University Faculty of Health Care and Medical Sports, Chiba, Japan
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Ren Z, Wang S, He M, Shi H, Zhao H, Cui L, Zhao J, Li W, Wei Y, Zhang W, Chen Z, Liu H, Zhang X. The effects of living arrangements and leisure activities on depressive symptoms of Chinese older adults: Evidence from panel data analysis. J Affect Disord 2024; 349:226-233. [PMID: 38211742 DOI: 10.1016/j.jad.2024.01.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/25/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Livable environment and ways, as the necessary conditions for the elderly to enjoy their old age, have a significant impact on their mental health and happiness. It's crucial to understand how living arrangements affect depressive symptoms in China. Studies on how various leisure activities modify this association are yet limited. METHODS This study relies on panel data derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), collected during waves spanning 2008/2009, 2011/2012, 2014, and 2018. The primary objective is to examine the relationship between living arrangements, leisure activities, and depressive symptoms of elderly individuals. Linear mixed-effects models were used to analyze the data. RESULTS A total of 26,342 observations aged 65 and over were included in this paper. Older adults living alone (β = 0.66, 95 % CI: 0.55, 0.76) or living in institutions (β = 0.69, 95 % CI: 0.40, 0.98) had more depressive symptoms than those living with family. Leisure activities were negatively associated with depressive symptoms (β = -0.16, 95 % CI: -0.18, -0.15). Moreover, there was significant interactions between living arrangements and leisure activities. No matter which kind of living arrangements, participating in physical, productive or social activity was associated with a lower risk of depressive symptoms. LIMITATIONS Study design might introduce bias, and it cannot establish causality between the tested variables. CONCLUSIONS Older adults living alone or in institutions have more possibility to develop depressive symptoms than those living with family, and such a relationship among Chinese older adults can be moderated by participating in leisure activities.
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Affiliation(s)
- Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China; School of Politics and Public Administration, Guangxi Normal University, Guilin 541006, Guangxi, China
| | - Shixun Wang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hong Shi
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hanfang Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Li Cui
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Jieyu Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Wenjun Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Yachen Wei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Wenjing Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Ziqiang Chen
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
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Tomioka K, Shima M, Saeki K. Smaller household size and higher prevalence of serious psychological distress in younger people and never-married people: a nationwide cross-sectional survey in Japan. Front Public Health 2024; 12:1292371. [PMID: 38528867 PMCID: PMC10962682 DOI: 10.3389/fpubh.2024.1292371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/28/2024] [Indexed: 03/27/2024] Open
Abstract
Background Small-member households are increasing worldwide. However, most previous studies have focused on older people and living alone. Using the latest national survey data, we investigated a dose-response relationship between household size and serious psychological distress (SPD). Methods We analyzed data from the 2019 Comprehensive Survey of Living Conditions in Japan. The study participants were 405,560 community-dwelling adults aged 20 or older. Household size was classified into 5 or more, 3 or 4, two, and one (i.e., living alone). SPD was defined as ≥13 points based on the Kessler 6-item Psychological Distress Scale. We used multivariable logistic regressions and included age, education, equivalent household expenditures, housing tenure, employment contract, smoking, and illness under treatment as covariates. Results After stratified analyses by age and gender, a dose-response relationship between smaller household size and more common SPD was significant for younger, but not for older people (p-trend was <0.001 in men aged 20-59 and women aged 20-39). After stratified analyses by gender and marital status, a dose-response relationship was significant only for the never-married group in both genders (p-trend was <0.001 in never-married men and women). Conclusion Smaller households were associated with higher prevalence of SPD in younger adults and in never-married individuals, regardless of gender. Our findings suggest a need to focus on younger people and never-married people to reduce the mental health risks due to small household sizes.
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Affiliation(s)
- Kimiko Tomioka
- Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Japan
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Brasileiro LEE, Dantas AAG, Linhares DB, Vale HA, Terradas-Monllor M, Ochandorena-Acha M, Paiva ALDM, de Medeiros MYD, Jerez-Roig J, de Souza DLB. Incidence of depression among community-dwelling older adults: A systematic review. Psychogeriatrics 2024; 24:496-512. [PMID: 38263357 DOI: 10.1111/psyg.13081] [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: 06/22/2023] [Revised: 12/11/2023] [Accepted: 01/06/2024] [Indexed: 01/25/2024]
Abstract
We aimed to synthesise information related to the incidence of depression and depressive symptoms (DDS) in a community-dwelling older adult population at a global level. In this systematic review, we included articles with a cohort study design that evaluated the incidence of depression or depressive symptoms in older adults aged 60 years or more in a community-dwelling environment. Six databases were used: Web of Science, PubMed, Scopus, LILACS, SciELO, and Cochrane, and the entire selection process was independently performed by peers. We divided the included articles into subgroups according to the DDS assessment instrument: (i) Geriatric Depression Scale; (ii) Center for Epidemiologic Studies Depression Scale; (iii) miscellaneous scales; and (iv) diagnostic interviews. Each cumulative incidence value obtained per item was adjusted for a 1-year follow-up period, which generated an annual cumulative incidence (AcI). From 46 articles, 42 used scales to evaluate the depressive variable, with an AcI estimate of around 4.5%. The articles that assessed depression categorically observed a variation in AcI between 0.2% and 7.0%. Among all the materials included, the group that used the Geriatric Depression Scale observed the lowest and the highest AcI, 1.3% and 26.6% respectively. Most of the productions were from countries in the Asian continent (52.2%), followed by Europe (30.4%), the Americas (13%), and Oceania (4.4%). Despite the variation of AcI, we found a frequent occurrence of DDS in older adults in the community-dwelling environment, which highlights the need for preventive actions and better-targeted early care, especially in terms of primary health care.
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Affiliation(s)
- L E E Brasileiro
- Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
- Multicampi School of Medical Sciences, Federal University of Rio Grande do Norte (UFRN), Caicó, Brazil
| | - Amanda Almeida Gomes Dantas
- Department of Collective Health, Graduate Program in Collective Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Dorothy Bezerra Linhares
- Multicampi School of Medical Sciences, Federal University of Rio Grande do Norte (UFRN), Caicó, Brazil
| | - Heron Alves Vale
- Multicampi School of Medical Sciences, Federal University of Rio Grande do Norte (UFRN), Caicó, Brazil
| | - Marc Terradas-Monllor
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health, and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Vic, Spain
| | - Mirari Ochandorena-Acha
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health, and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Vic, Spain
| | | | | | - Javier Jerez-Roig
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health, and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Vic, Spain
| | - Dyego Leandro Bezerra de Souza
- Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
- Department of Collective Health, Graduate Program in Collective Health, Federal University of Rio Grande do Norte, Natal, Brazil
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Zheng G, Zhou B, Fang Z, Jing C, Zhu S, Liu M, Chen X, Zuo L, Chen H, Hao G. Living alone and the risk of depressive symptoms: a cross-sectional and cohort analysis based on the China Health and Retirement Longitudinal Study. BMC Psychiatry 2023; 23:853. [PMID: 37978367 PMCID: PMC10655346 DOI: 10.1186/s12888-023-05370-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND There were a few studies that examined the longitudinal association between living alone and depressive symptoms, and the vast majority of them were conducted in patients with certain diseases, such as heart failure, cancer, and glaucoma. This study aimed to examine the association between living alone and depressive symptoms in a large representative older Chinese population. METHODS The China Health and Retirement Longitudinal Study (CHARLS) data from 2015 to 2018 were used. Living alone was defined as participants who did not live with others ever or more than 11 months in the past year at baseline. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies-Depression Scale (CES-D10). The multivariate logistic regression was used to estimate the relationship between living alone and depressive symptoms. RESULTS There were 5,311 and 2,696 participants ≥ 60 years old included in the cross-sectional and cohort analysis, respectively. The risk of depressive symptoms in participants who lived alone was significantly higher than those who lived with others in both cross-sectional (OR:1.33; 95%CI:1.14,1.54) and cohort analysis (OR:1.23; 95%CI:0.97,1.55). There was a significant interaction between financial support and living alone (Pinteraction = 0.008) on the risk of depressive symptoms. Stratified analyses showed that, compared to those who lived with others, the risk of depressive symptoms in participants who lived alone increased by 83% (OR:1.83; 95%CI:1.26,2.65) in participants receiving lower financial support. However, we did not find statistically significant associations in participants with medium (OR:1.10; 95%CI: 0.74,1.63) and higher financial support (OR: 0.87; 95%CI: 0.53,1.41). CONCLUSION Living alone was associated with a higher risk of depressive symptoms in the Chinese older population, and this association was moderated by the receipt of financial support. Living alone may be an effective and easy predictor for early identification of high-risk populations of depression in the older population.
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Affiliation(s)
- Guangjun Zheng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Biying Zhou
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Zhenger Fang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Chunxia Jing
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, China
| | - Sui Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Mingliang Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xia Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Lei Zuo
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Haiyan Chen
- Department of Parasitic Disease and Endemic Disease Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Guang Hao
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Guangzhou, 510632, Guangdong, China.
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Huang M, Liu K, Liang C, Wang Y, Guo Z. The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety. BMC Geriatr 2023; 23:506. [PMID: 37608361 PMCID: PMC10463962 DOI: 10.1186/s12877-023-04161-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 07/10/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND With modernization and ageing in China, the population of older adults living alone is increasing. Living alone may be a potential risk factor for depressive symptoms. However, no parallel mediation model analysis has investigated the mediating factors for living alone or not (living arrangements) and depressive symptoms. METHODS This cross-sectional study included a total number of 10,980 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), 1699 of whom lived alone and 9281 of whom did not live alone. Binary logistic regression and parallel mediation effect model were used to explore the relationship between living alone or not and depressive symptoms and possible mediation effects. Bootstrap analysis was used to examine the mediation effect of living alone or not on depressive symptoms. RESULTS Compared to the participants who were not living alone, the living alone group had a higher rate of depressive symptoms. The binary logistic regression showed that after adjusting for other covariates, the risk of depressive symptoms was approximately 0.21 times higher for living alone compared to not living alone (OR = 1.21, 95% CI: 1.06, 1.37). Further, the results of the bootstrap analysis supported the partial mediating role of sleep quality and anxiety. Mediation analysis revealed that sleep quality and anxiety partially mediate the relationship between living alone and depressive symptoms (β = 0.008, 95% CI [0.003, 0.014]; β = 0.015, 95% CI [0.008, 0.024], respectively). CONCLUSIONS Sleep quality and anxiety were identified as partially parallel mediators between living alone or not and depressive symptoms. Older adults living alone with poorer sleep quality and more pronounced anxiety were positively associated with higher levels of depressive symptoms. Older adults living alone should be encouraged to engage in social activities that may improve sleep quality, relieve anxiety, and improve feelings of loneliness caused by living alone. Meanwhile, older adults living alone should receive attention and support to alleviate their depressive symptoms.
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Affiliation(s)
- Mina Huang
- Department of Nursing, The Jinzhou Medical University, Jinzhou, China
| | - Kun Liu
- Department of Medical College, The Jinzhou Medical University, Jinzhou, China
| | - Chunguang Liang
- Department of Nursing, The Jinzhou Medical University, Jinzhou, China
| | - Yongzhu Wang
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, No.2, Section 5, Renmin Street, Jinzhou, Liaoning, 121001, China
| | - Zhanpeng Guo
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, No.2, Section 5, Renmin Street, Jinzhou, Liaoning, 121001, China.
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McElroy E, Herrett E, Patel K, Piehlmaier DM, Gessa GD, Huggins C, Green MJ, Kwong ASF, Thompson EJ, Zhu J, Mansfield KE, Silverwood RJ, Mansfield R, Maddock J, Mathur R, Costello RE, Matthews A, Tazare J, Henderson A, Wing K, Bridges L, Bacon S, Mehrkar A, Shaw RJ, Wels J, Katikireddi SV, Chaturvedi N, Tomlinson LA, Patalay P. Living alone and mental health: parallel analyses in UK longitudinal population surveys and electronic health records prior to and during the COVID-19 pandemic. BMJ MENTAL HEALTH 2023; 26:e300842. [PMID: 37562853 PMCID: PMC10577768 DOI: 10.1136/bmjment-2023-300842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND People who live alone experience greater levels of mental illness; however, it is unclear whether the COVID-19 pandemic had a disproportionately negative impact on this demographic. OBJECTIVE To describe the mental health gap between those who live alone and with others in the UK prior to and during the COVID-19 pandemic. METHODS Self-reported psychological distress and life satisfaction in 10 prospective longitudinal population surveys (LPSs) assessed in the nearest pre-pandemic sweep and three periods during the pandemic. Recorded diagnosis of common and severe mental illnesses between March 2018 and January 2022 in electronic healthcare records (EHRs) within the OpenSAFELY-TPP. FINDINGS In 37 544 LPS participants, pooled models showed greater psychological distress (standardised mean difference (SMD): 0.09 (95% CI: 0.04; 0.14); relative risk: 1.25 (95% CI: 1.12; 1.39)) and lower life satisfaction (SMD: -0.22 (95% CI: -0.30; -0.15)) for those living alone pre-pandemic. This gap did not change during the pandemic. In the EHR analysis of c.16 million records, mental health conditions were more common in those who lived alone (eg, depression 26 (95% CI: 18 to 33) and severe mental illness 58 (95% CI: 54 to 62) more cases more per 100 000). For common mental health disorders, the gap in recorded cases in EHRs narrowed during the pandemic. CONCLUSIONS People living alone have poorer mental health and lower life satisfaction. During the pandemic, this gap in self-reported distress remained; however, there was a narrowing of the gap in service use. CLINICAL IMPLICATIONS Greater mental health need and potentially greater barriers to mental healthcare access for those who live alone need to be considered in healthcare planning.
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Affiliation(s)
- Eoin McElroy
- School of Psychology, Ulster University, Coleraine, UK
| | - Emily Herrett
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Kishan Patel
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Dominik M Piehlmaier
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Strategy and Marketing, University of Sussex Business School, Brighton, UK
| | - Giorgio Di Gessa
- Epidemiology and Public Health, University College London, London, UK
| | - Charlotte Huggins
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - Michael J Green
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Alex S F Kwong
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Ellen J Thompson
- Department of Twin Research & Genetic Epidemiology, King's College London, London, UK
| | - Jingmin Zhu
- Epidemiology and Public Health, University College London, London, UK
| | - Kathryn E Mansfield
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Rosie Mansfield
- Centre for Longitudinal Studies, University College London, London, UK
| | - Jane Maddock
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Rohini Mathur
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Ruth E Costello
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Anthony Matthews
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - John Tazare
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Alasdair Henderson
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Kevin Wing
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Lucy Bridges
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sebastian Bacon
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Amir Mehrkar
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Richard John Shaw
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Jacques Wels
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | | | - Nish Chaturvedi
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Laurie A Tomlinson
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Praveetha Patalay
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
- Centre for Longitudinal Studies, University College London, London, UK
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Cedrone F, Berselli N, Stacchini L, De Nicolò V, Caminiti M, Ancona A, Minutolo G, Mazza C, Cosma C, Gallinoro V, Catalini A, Gianfredi V. Depressive Symptoms of Public Health Medical Residents during the COVID-19 Pandemic, a Nation-Wide Survey: The PHRASI Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095620. [PMID: 37174140 PMCID: PMC10178174 DOI: 10.3390/ijerph20095620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
Depression is a widespread condition, which increased during the COVID-19 pandemic among healthcare workers as well. The large workload of the pandemic response also affected Public Health Residents (PHRs) who played an important role in infection prevention and control activities. This work aims to assess depression in Italian PHRs, based on data collected through the PHRASI (Public Health Residents' Anonymous Survey in Italy) study. In 2022, 379 PHRs completed the self-administered questionnaire containing Patient Health Questionnaire-9 to evaluate clinically relevant depressive symptoms (PHQ-9 ≥ 10). Multivariate logistic regression shows that the intention (aOR = 3.925, 95% CI = (2.067-7.452)) and the uncertainty (aOR = 4.949, 95% CI = (1.872-13.086)) of repeating the test to enter another postgraduate school/general practitioner course and the simultaneous attendance of two traineeships (aOR = 1.832, 95% CI = (1.010-3.324)) are positively related with depressive symptoms. Conversely, the willingness to work in the current traineeship place (aOR = 0.456, 95% CI = (0.283-0.734)) emerged as a protective factor. Similar results were obtained considering mild-to-severe (PHQ-9 ≥ 5) depressive symptoms and/or stratifying by sex. The findings, suggesting the protective role of job satisfaction toward depression, might entail future interventions to improve the learning experience and promote work-life balance.
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Affiliation(s)
- Fabrizio Cedrone
- Hospital Management, Local Health Authority of Pescara, 65100 Pescara, Italy
| | - Nausicaa Berselli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| | - Lorenzo Stacchini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Valentina De Nicolò
- Department of Public Health and Infectious Disease, Sapienza University of Rome, 00185 Rome, Italy
| | - Marta Caminiti
- Department of Medicine and Surgery-Sector of Public Health, University of Perugia, 06100 Perugia, Italy
| | - Angela Ancona
- School of Hygiene and Preventive Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Giuseppa Minutolo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
| | - Clara Mazza
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Claudia Cosma
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Veronica Gallinoro
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Alessandro Catalini
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60100 Ancona, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy
- CAPHRI Care and Public Health Research Institute, Maastricht University, 6211 Maastricht, The Netherlands
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10
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Takahara M, Iida O, Ohura N, Soga Y, Yamaoka T, Azuma N. Social isolation in patients with chronic limb-threatening ischemia: a cross-sectional study. Sci Rep 2023; 13:1933. [PMID: 36732613 PMCID: PMC9894975 DOI: 10.1038/s41598-023-29197-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
Assistance by family members or friends plays important roles in the course of treating patients with chronic limb-threatening ischemia (CLTI), both during hospitalization and after discharge. The aim of this study was to reveal the prevalence of social isolation and to explore relevant clinical backgrounds in patients with CLTI presenting with tissue loss and requiring revascularization. We analyzed 413 patients registered in a multicenter study in whom revascularization were scheduled for CLTI with tissue loss. Social isolation was analyzed by assessing the residence status of the patients and the involvement of a trusted family member or friend in their daily lives and during hospitalization. Patients living alone accounted for 24.5% (95% confidence interval [CI] 20.1-28.8%) of the study population. Patients receiving welfare were more likely to live alone (P < 0.001). For patients living alone, 21.8% (95% CI 12.8-30.8%) met a trusted family member or friend in their daily lives less than once per year. Younger age and receiving welfare were independently associated with lower frequency of meeting the trusted person in their daily lives (both P < 0.05). The adjusted odds ratio of age and receiving welfare was 0.44 (95% CI 0.29-0.67) per 10-year increase and 3.47 (95% CI 1.43-8.44), respectively. During hospitalization, 9.9% (95% CI 6.8-13.0%) of the patients had no hospital visits by a trusted family member or friend on three key occasions: the patient's first hospital visit, the preoperative explanation regarding the planned operation, and the day of the operation. Younger age and receiving welfare were independently associated with lower frequency of hospital visits by a family member or friend (both P < 0.05). The adjusted odds ratio of age and receiving welfare for no visit versus ≥ 1 visit was 0.51 (0.36-0.74) per 10-year increase and 5.29 (2.46-11.4), respectively. In conclusion, social isolation is common among patients with CLTI, especially younger patients and those on welfare. Practical countermeasures against social isolation are warranted in the management of CLTI.
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Affiliation(s)
- Mitsuyoshi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Osamu Iida
- Cardiovascular Center, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan
| | - Norihiko Ohura
- Department of Plastic, Reconstructive Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-0004, Japan
| | - Yoshimitsu Soga
- Department of Cardiology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-Ku, Kitakyushu, Fukuoka, 802-0001, Japan
| | - Terutoshi Yamaoka
- Department of Vascular Surgery, Matsuyama Red Cross Hospital, 1 Bunkyo-Cho, Matsuyama, Ehime, 790-8524, Japan
| | - Nobuyoshi Azuma
- Department of Vascular Surgery, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, 078-8510, Japan
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11
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Decreasing patterns of depression in living alone across middle-aged and older men and women using a longitudinal mixed-effects model. Soc Sci Med 2023; 317:115513. [PMID: 36450172 DOI: 10.1016/j.socscimed.2022.115513] [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: 08/02/2022] [Revised: 10/23/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022]
Abstract
There is little evidence regarding the association between living arrangement and depression, and no studies have examined the age- and gender-specific differences in this association. The present study sought to examine the longitudinal changes in depression patterns between isolative living versus living in company among middle-aged and older men and women by obtaining data from waves 1-7 of the Korean Longitudinal Study of Aging (KloSA), which comprises a sample of persons at least 45 years of age in the Republic of Korea (2273 middle-aged and 1387 older men, 2805 middle aged and 1862 older women). Depression scores were based on the self-reported Center for Epidemiologic Studies Depression Scale (CES-D-10) short forms. Using mixed-effect linear regression models, we estimated depression patterns by living arrangement across age- and gender groups. Our findings from the mixed-effects model revealed that over a 14-year follow-up period, there were significant decreasing patterns of depression were among middle-aged men and women, and older men living alone compared to living with a spouse and living with others. However, living alone still had the highest depression compared to other living arrangement types. On the other hand, the depression of older women living alone changed to a level similar to those living with others during the follow-up period. In conclusion, these findings indicate that living alone significantly increases the risk of depression, but the risk decreases over time. Additionally, depression patterns by living arrangement proved to differ across age and gender groups.
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12
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Xu R, Liu Y, Mu T, Ye Y, Xu C. Determining the association between different living arrangements and depressive symptoms among over-65-year-old people: The moderating role of outdoor activities. Front Public Health 2022; 10:954416. [PMID: 35991056 PMCID: PMC9386358 DOI: 10.3389/fpubh.2022.954416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/15/2022] [Indexed: 11/22/2022] Open
Abstract
Background China is presently facing the challenge of meeting enormous health demands because of its rapidly aging society. Enrolling older persons in eldercare institutions is a helpful alternative for relieving family caregivers and promoting healthy aging. However, changes in the living environment may negatively affect the mental health of the elderly. Objective To explore the association between different living arrangements and depressive symptoms among over-65-year-old people in China and the moderating role of outdoor activities. Method The 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) used a mixed sampling method to collect the health and demographic information of 15,874 older adults over 65 years from 23 provinces in China. After considering this study's inclusion and exclusion criteria, the final sample comprised 12,200 participants. The participants' risk of depressive symptoms was assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). The potential association between the two elements was tested using a regression model. Result This study's findings suggested a significant relationship between depressive symptoms and living arrangements (P < 0.001). Participants living alone and those living in eldercare institutions had 1.26-times (95%CI: 1.10–1.44) and 1.39-times (95%CI: 1.09–1.77) higher risks of depressive symptoms, respectively, than those living with household members. Outdoor activities play a moderating role between different living arrangements and depressive symptoms. Among participants who engaged in outdoor activities, no significant difference was observed in the risk of depressive symptoms between those living in eldercare institutions and those living with household members (adjusted odds ratio = 1.15, 95%CI = 0.81–1.64, P = 0.426). Conclusion The high risk of depressive symptoms among older Chinese people living alone or in eldercare institutions requires considerable attention. The evidence from this study suggests that older people living alone and those living in eldercare institutions should regularly engage in appropriate outdoor activities.
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Affiliation(s)
- Rixiang Xu
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yulian Liu
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
- Ningbo Municipal Hospital of TCM Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China
| | - Tingyu Mu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yaping Ye
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
| | - Caiming Xu
- School of Law, Zhejiang University City College, Hangzhou, China
- *Correspondence: Caiming Xu
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13
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The frequency of job participation and well-being of older people in Japan: Results from JAGES study. Arch Gerontol Geriatr 2022; 102:104720. [DOI: 10.1016/j.archger.2022.104720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/27/2022] [Accepted: 05/07/2022] [Indexed: 11/23/2022]
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14
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Ogawa K, Shirai K, Nozaki S, Shikimoto R, Sawada N, Mimura M, Iso H, Tsugane S. The association between midlife living arrangement and psychiatrist-diagnosed depression in later life: who among your family members reduces the risk of depression? Transl Psychiatry 2022; 12:156. [PMID: 35410408 PMCID: PMC9001692 DOI: 10.1038/s41398-022-01880-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/18/2022] [Accepted: 02/25/2022] [Indexed: 11/09/2022] Open
Abstract
This study investigates the longitudinal association between living arrangements and psychiatrists' diagnosis of depression in the general population. In 1990, 1254 Japanese men and women aged 40-59 years were enroled and completed questionnaires on the living arrangement in the Japan Public Health Center-based Prospective Study (JPHC Study) and participated in a mental health screening (2014-2015). The study diagnosed a major depressive disorder (MDD) assessed by well-trained certified psychiatrists through medical examinations. During the follow-up, a total of 105 participants (36 men and 69 women) aged 64-84 years were diagnosed with MDD by psychiatrists. Living with a child (ren) was associated with a reduced risk of MDD for men but not for women; the respective multivariable ORs (95% CIs) were 0.42 (0.19-0.96) and 0.59 (0.32-1.09). These associations remained unchanged after adjusting for living with spouse and parent(s). In conclusion, living with a child (ren) was associated with a reduced risk of MDD in men, suggesting the role of a child (ren) in the prevention of MDD.
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Affiliation(s)
- Kento Ogawa
- grid.136593.b0000 0004 0373 3971Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, Japan
| | - Kokoro Shirai
- grid.136593.b0000 0004 0373 3971Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, Japan
| | - Shoko Nozaki
- grid.26091.3c0000 0004 1936 9959Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Ryo Shikimoto
- grid.26091.3c0000 0004 1936 9959Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Norie Sawada
- grid.272242.30000 0001 2168 5385Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Masaru Mimura
- grid.26091.3c0000 0004 1936 9959Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, Japan.
| | - Shoichiro Tsugane
- grid.272242.30000 0001 2168 5385Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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15
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Wu D, Liu F, Huang S. Assessment of the relationship between living alone and the risk of depression based on longitudinal studies: A systematic review and meta-analysis. Front Psychiatry 2022; 13:954857. [PMID: 36111305 PMCID: PMC9468273 DOI: 10.3389/fpsyt.2022.954857] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/11/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Living alone is one of the most common psychosocial factors that may have an impact on lifestyle management and health status. Although many previous cross-sectional studies have found that living alone increases the risk of depression. However, this risk has rarely been assessed on the basis of longitudinal studies. Therefore, we will explore this relationship on the basis of longitudinal studies. METHODS We systematically searched Pubmed, Embase, and Cochrane databases up to May 2022. Adjusted odds ratios (ORs), and 95% confidence intervals (CIs) were pooled by a random-effects model using an inverse variance method. RESULTS Seven studies (six cohort studies and one case-control study) were included in our study. A total of 123,859 without a history of psychosis individuals were included, and the proportion of females was 65.3%. We applied a random-effects model to minimize the heterogeneity. Overall, the pooled data suggest that people living alone are associated with an increased risk of depression compared to those who do not live alone (OR 1.42, 95%CI 1.19-1.70). CONCLUSION Compared to people who live with others, living alone increases the risk of depression. Only cross-sectional studies and a few longitudinal studies currently support this association; more high-quality studies will be required in the future to confirm this causal association.
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Affiliation(s)
- Daolin Wu
- Department of Sleep Medicine, Ganzhou People's Hospital, Ganzhou, China
| | - Fuwei Liu
- Department of Cardiology, Ganzhou People's Hospital, Ganzhou, China
| | - Shan Huang
- Department of Psychiatry, The Third People's Hospital of Ganzhou, Ganzhou, China
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16
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Kikuchi H, Machida M, Nakamura I, Saito R, Odagiri Y, Fukushima N, Takamiya T, Amagasa S, Fukui K, Kojima T, Watanabe H, Inoue S. Persistence of mental health deterioration among people living alone during the COVID-19 pandemic: a periodically-repeated longitudinal study. J Epidemiol 2022; 32:345-353. [PMID: 35431299 PMCID: PMC9189317 DOI: 10.2188/jea.je20210397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background This longitudinal study aimed to investigate how psychological distress levels changed from early to middle phases of the new coronavirus (COVID-19) pandemic depending on the living arrangements of individuals. Methods An internet-based, longitudinal survey of 2,400 Japanese people was conducted every 5–6 weeks between February 2020 and January 2021. The presence of severe psychological distress (SPD) was measured using the Kessler’s psychological distress scale. Living arrangements were classified into two groups (ie, living alone or living with others). Mixed-effects logistic regression analysis was performed to assess whether changes in SPD status were different depending on living arrangements. Results Of 2,400 respondents, 446 (18.5%) lived alone. Although the proportion of SPD in both individuals living alone and those living with others increased to the same extent in the early phase of the pandemic, the distress levels decreased after the early phase of the pandemic in the group living with others, compared with the group living alone, for which SPD remained high. The odds ratio (OR) of developing SPD in interaction term with survey phases tended to be higher among those who lived alone than those who lived with others in Phase 6 (OR 1.89; 95% confidence interval [CI], 0.99–3.64) and Phase 7 (OR 1.88; 95% CI, 0.97–3.63). Conclusion During the COVID-19 pandemic, those living alone are persistently at a higher risk of SPD compared to those living with others. Effective countermeasures targeting those living alone, such as enhancing online communication or providing psychological therapies, are essential.
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Affiliation(s)
- Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Masaki Machida
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Itaru Nakamura
- Department of Infection Prevention and Control, Tokyo Medical University Hospital
| | - Reiko Saito
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University
| | - Yuko Odagiri
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Noritoshi Fukushima
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Tomoko Takamiya
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Shiho Amagasa
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Keisuke Fukui
- Graduate School of Advanced Science and Engineering, Hiroshima University
| | - Takako Kojima
- Department of International Medical Communications, Tokyo Medical University
| | - Hidehiro Watanabe
- Department of Infection Prevention and Control, Tokyo Medical University Hospital
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University
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17
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Naz S, Muhammad D, Ahmad A, Shabnam, Ali P. Pregnant women perceptions regarding their husbands and in-laws' support during pregnancy: a qualitative study. Pan Afr Med J 2021; 39:229. [PMID: 34630841 PMCID: PMC8486935 DOI: 10.11604/pamj.2021.39.229.25659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/07/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction pregnancy is a stressful condition during which women require family and in-laws´ support. This study was aimed to explore the women´s perceptions regarding their husband and in-law´s support during pregnancy. Methods by using qualitative exploratory design ten pregnant women in third trimester of pregnancy and living in joint family system were recruited through purposive sampling technique from a village of district Nowshehra, Khyber Pakhtunkhwa, Pakistan. Approval for conducting this study was obtained from Ethics Review Committee of Khyber Medical University. Data were collected from the recruited participants through face to face in-depth interviews. Data were analyzed through thematic analysis. One hundred open codes were generated from the data. Through axial coding, extra and unnecessary codes were omitted and then eleven categories were identified from open codes. Results the identified categories were kept under three salient themes of lack of comprehensive support mechanism, physical and mental strain, and barriers to antenatal services. Perceived support of husbands and in-laws, needs and barriers to maternal and child health were discussed by the participants. Conclusion the study findings suggest that family relationship quality might not be improved by taking interventions i.e. making policies only but the incorporation of health professionals´ support with family member´s behavior can improve maternal health.
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Affiliation(s)
- Sehrish Naz
- Institute of Nursing Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Dildar Muhammad
- Institute of Nursing Sciences, Khyber Medical University, Peshawar, Pakistan
| | | | - Shabnam
- Institute of Nursing Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Parveen Ali
- The School of Nursing and Midwifery, University of Sheffield, United Kingdom
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18
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Nakagomi A, Shiba K, Kondo K, Kawachi I. Can social capital moderate the impact of widowhood on depressive symptoms? A fixed-effects longitudinal analysis. Aging Ment Health 2021; 25:1811-1820. [PMID: 32687396 DOI: 10.1080/13607863.2020.1793296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Widowhood is associated with increased risks of depression in the surviving spouse. We examined whether an increase in individual-level social capital mitigates the adverse impact of widowhood on depressive symptoms. METHODS We used data from the 2013/2016 waves of the Japan Gerontological Evaluation Study of functionally independent adults aged 65 years or older (men: n = 20,853; women: n =16,858). Fixed-effects regression was applied to examine the potential buffering effects of changes in social capital on changes in depressive symptoms following widowhood among married people living with their spouse and/or others at baseline. RESULTS Widowhood had a deleterious impact on depressive symptoms particularly among men who ended up living alone following their spouse's death. Fixed-effects models revealed that an increase in informal socializing and social participation might buffer the effects of spousal bereavement on depressive symptoms among men who became widowed during the first two years of follow-up and ended up living alone. DISCUSSION An increase in structural social capital may mitigate the impact of spousal bereavement on depressive symptoms. However, the associations vary by gender, living arrangement, and time since widowhood. Intensive efforts should be directed toward connecting the vulnerable group, widowed men living alone, to sources of social capital.
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Affiliation(s)
- Atsushi Nakagomi
- Takemi Program in International Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Koichiro Shiba
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.,Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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19
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Jeon SH, Hong GRS, Jang HY. Life Experiences of Older Men Living Alone With Depression. J Psychosoc Nurs Ment Health Serv 2021; 60:33-40. [PMID: 34432587 DOI: 10.3928/02793695-20210819-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
As the percentage of older adults living alone increases, social interest has been drawn to this physically, financially, and socially vulnerable group. The purpose of the current study was to gain a deeper understanding of the life experiences of older men with depression who live alone. Eight community-dwelling men aged ≥65 years who lived alone in Korea and had depression were enrolled in this study. Data were collected via individual in-depth interviews and analyzed using thematic analysis. Four themes emerged from analysis: Life Trapped in the Traditional Masculine Ideology, Weakening Mind and Body, Lost and Helpless, and Beginning of Communication With the World. Results of this study will be helpful in developing more effective depression intervention programs for older men living alone by increasing community health care professionals' understanding and sensitivity. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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Costantini H, Nihei M, Ueno T. 'Care literacy' in super aging Japan. OPEN RESEARCH EUROPE 2021; 1:85. [PMID: 37645109 PMCID: PMC10446049 DOI: 10.12688/openreseurope.13853.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 08/31/2023]
Abstract
Accentuated by the ongoing coronavirus disease (COVID-19) pandemic, the change in Japan to community-based health and care services for older adults indicates an urgent need to enhance and spread citizens' understanding of care. This is a broader notion of care that incorporates conditions within the community to support the inclusion of older adults, involving not only those older adults receiving care and their direct providers of care, but also others in the community who are involved in the daily lives of these older adults. To underpin such a broader notion of care across citizens, this paper proposes 'care literacy' as a novel analytical concept, defined as the knowledge and capabilities that enable people in need of care to live their daily lives in the community and facilitate potential health and care solutions. Reflecting the interconnection of health and care and rooted in the local context, care literacy underpins aging by enabling this involvement of the broader community, and is disseminated through media and grassroot activities.
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Affiliation(s)
- Hiroko Costantini
- Observatoire sociologique du changement (OSC), SciencesPo, Paris, 75337, France
- Institute of Population Ageing, University of Oxford, Oxford, OX2 6PR, UK
| | - Misato Nihei
- Department of Human and Engineered Environmental Studies, Graduate School of Frontier Sciences, University of Tokyo, Kashiwa City, Chiba prefecture, 277-8563, Japan
- Institute of Gerontology, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Tomoyuki Ueno
- Department of Rehabilitation, Koga/Bando Clinical Education and Training Center, Faculty of Medicine, University of Tsukuba, Tsukuba City, 305-8577, Japan
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21
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Fukita S, Kawasaki H, Yamasaki S. Comprehensive analysis of depression-related factors among middle-aged residents in Japan, an Eastern culture: A cross-sectional study. Medicine (Baltimore) 2021; 100:e25735. [PMID: 34106600 PMCID: PMC8133093 DOI: 10.1097/md.0000000000025735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/06/2021] [Indexed: 11/26/2022] Open
Abstract
There is a need to comprehensively identify depression-related factors, including individual and socioeconomic factors, in each country or cultural area, to consider effective measures to address depression within communities. However, there are not enough studies on middle-aged residents in Japan or other Eastern countries to currently achieve this. Thus, the aim of this study was to comprehensively identify factors related to depression in middle-aged residents in Japan, an Eastern country.The study design was cross-sectional. A questionnaire survey was conducted among all community residents aged 40 to 59 in a rural municipality in Western Japan. The questionnaire contained items on demographic characteristics, psychological factors, health-related behaviors, and socioeconomic factors. A Chi-Squared test or Fisher exact test was used to analyze the relationships between depression and each assessed factor. Next, a logistic regression analysis was performed to identify comprehensive relationships between depression and its related factors.Data from 362 participants were analyzed. The average age was 51.5 years; 148 were male. A Chi-Squared test or Fisher exact test demonstrated that many psychological factors, health-related behaviors, and socioeconomic factors ware significantly related to depression. A logistic regression analysis showed that depression was significantly associated with male gender, low sense of coherence, high cognitive stress levels, low help-seeking behavior, poor quality sleep, and a lack of hobbies. Nagelkerke R2 was 51%.This study revealed through multivariate analysis that depression was primarily associated with personal behavioral and psychological factors in Japan, an Eastern country with a holistic cultural background. This result is consistent with findings from Western countries. This study can contribute the promotion and evaluation of preventive measures for depression in Eastern culture that focus on individual behavioral and psychological factors.
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Affiliation(s)
- Susumu Fukita
- Faculty of Nursing & Medical Care, Keio University, Kanagawa
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiromi Kawasaki
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Satoko Yamasaki
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Suicide and Health Crisis in Extremadura: Impact of Confinement during COVID-19. TRAUMA CARE 2021. [DOI: 10.3390/traumacare1010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Because of its impact on social well-being, mental health, and financial security, the COVID-19 health crisis may increase the risk of suicide. This study’s objective was to determine what impact the period of confinement might have had on the incidence of deaths by suicide (DBS) in the Extremadura region (Spain). Cases registered in the Institutes of Legal Medicine and Forensic Science (IMLyCFs) from January 2015 to December 2020 were collected. Intra- and interannual comparisons were made of the suicide rates in the periods of confinement (March–June) and postconfinement (July–October) of 2020 with those of the preceding 5 years. After seasonally adjusting the data by means of a time series analysis, rate ratios (RRs) were calculated together with their 95% confidence intervals (CI). There were no significant differences between the suicide rates of 2020 and the mean of the preceding 5 years (RR = 0.94; CI: 0.56–1.55), and neither did any differences seen in the intra-annual analysis from the period of confinement to postconfinement reach statistical significance (RR = 0.74; CI: 0.45–1.20). It is necessary to strengthen vigilance during and after the crisis and ensure that assistance mechanisms are in place to prevent an increase in suicides.
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Posel D. Living alone and depression in a developing country context: Longitudinal evidence from South Africa. SSM Popul Health 2021; 14:100800. [PMID: 34013016 PMCID: PMC8114168 DOI: 10.1016/j.ssmph.2021.100800] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/07/2021] [Accepted: 04/11/2021] [Indexed: 11/05/2022] Open
Abstract
In South Africa, single-person households were a household type enforced by apartheid legislation, designed to restrict the “influx” of Africans into “white” and typically urban areas of the country. Yet the increase in living alone has been one of the most marked demographic trends of the post-apartheid period. The trend, which has occurred alongside the persistence in individual labor migration patterns and a decline in rates of union formation, has been driven by changes among working-age adults, rather than among older adults. This is the first empirical study to investigate the mental health implications of living alone among all adults in South Africa using national longitudinal data. The data come from five waves of the panel household survey, the National Income Dynamics Study (NIDS), conducted from 2008 to 2017. Information on depressive symptoms was collected from all adults (15 years and older), who were asked the ten questions which make up the Center for Epidemiologic Studies Short Depression Scale (CES-D 10). Adults who lived alone reported significantly higher depression scores than other adults, in the pooled ordinary least squares models, and in the fixed effects model, which controlled for any unobservable, time-invariant differences between the two groups of adults. Vulnerability to depression was moderated by adults’ preferences to continue living in their area of residence (as a measure of their social integration), but the positive relationship remained sizeable and significant across all models. The findings shed light on a further dimension of the migrant labor system in South Africa, which has not received adequate attention in the empirical literature, viz. the mental health implications for adults of solo migration, and they provide further motivation for the provision of affordable and safe family housing in local areas of employment. The rise in solo living is a marked demographic trend in post-apartheid South Africa. Working-age adults are more likely than older adults to live alone. Solo-dwellers recorded significantly higher depression scores than other adults. Social integration moderated but did not eliminate this relationship.
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Affiliation(s)
- Dorrit Posel
- University of the Witwatersrand, Johannesburg, South Africa
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Yamada K, Kimura T, Cui M, Kubota Y, Ikehara S, Iso H. Social support, social cohesion and pain during pregnancy: The Japan Environment and Children's Study. Eur J Pain 2021; 25:872-885. [PMID: 33341980 PMCID: PMC8048612 DOI: 10.1002/ejp.1717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 12/16/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Persistent pain during pregnancy is a significant health issue, which could be correlated with psychological distress resulting from inadequate social support. This study aims to investigate whether the relationship between poor social support and antenatal pain is mediated by psychological distress. We also aimed to examine whether social cohesion moderates the influence of psychological distress on the relationship between social support and antenatal pain. METHODS We analysed 94,517 pregnancies of women from a Japanese national birth cohort completed questionnaires assessing pain, psychological distress, social support and social cohesion. Psychological distress was assessed using the Kessler Psychological Distress Scale. Two types of models were used: the mediation model to examine whether the association between social support and pain was mediated by psychological distress; the moderated mediation model to analyse whether social cohesion buffered the negative effect of inadequate social support on pain. Demographic, socioeconomic and psychological factors were controlled for in all analyses. RESULTS Psychological distress was fully mediated the association between social support and pain. Social cohesion had a focal moderation effect on the inverse association between social support and psychological distress (unstandardized regression coefficient [β] = 0.09; 95% CI, 0.07-0.11) and functioned as moderator for the indirect effect of social support on antenatal pain (index of moderated mediation = 0.006; 95% CI, 0.004-0.007). CONCLUSIONS Poor social support was related to antenatal pain through psychological distress, possibly buffered by social cohesion. During the antenatal period, social support and cohesion are important for women. SIGNIFICANCE In this study, poor social support was found to be associated with pain intensity during pregnancy, which was mediated by psychological distress and might be buffered by desirable social cohesion. This finding could potentially help healthcare providers and policy makers to understand the importance of desirable social cohesion in preventing pain among pregnant women.
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Affiliation(s)
- Keiko Yamada
- Public Health, Department of Social MedicineOsaka University Graduate School of MedicineSuitaOsakaJapan
- Department of PsychologyMcGill UniversityMontrealQCCanada
- Department of Anesthesiology and Pain ManagementJuntendo University Faculty of MedicineTokyoJapan
| | - Takashi Kimura
- Department of Public HealthHokkaido University Graduate School of MedicineSapporoHokkaidoJapan
| | - Meishan Cui
- Public Health, Department of Social MedicineOsaka University Graduate School of MedicineSuitaOsakaJapan
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Diseases PreventionOsakaJapan
| | - Satoyo Ikehara
- Public Health, Department of Social MedicineOsaka University Graduate School of MedicineSuitaOsakaJapan
| | - Hiroyasu Iso
- Public Health, Department of Social MedicineOsaka University Graduate School of MedicineSuitaOsakaJapan
- Department of Public Health MedicineFaculty of Medicine, University of TsukubaTsukubaIbarakiJapan
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25
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Yoshida Y, Iwasa H, Ishioka Y, Suzukamo Y. Leisure activity moderates the relationship between living alone and mental health among Japanese older adults. Geriatr Gerontol Int 2021; 21:421-425. [PMID: 33780130 DOI: 10.1111/ggi.14151] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/01/2021] [Accepted: 03/07/2021] [Indexed: 11/30/2022]
Abstract
AIM As living alone is associated with poor mental health, seeking a moderating factor in this relationship may help enhance quality of life of older people living alone. Therefore, this study examined the moderating effect of leisure activity on the relationship between living alone and mental health in older people. METHODS This study employed a cross-sectional analysis of questionnaire data. Research was conducted in a metropolitan Tokyo ward from September to October 2017. Participants were 314 community-dwelling Japanese individuals (158 women, 156 men) aged 70-84 years (mean ± SD, 77.7 ± 4.4). We analyzed mental health using the Japanese version of the World Health Organization-Five Well-Being Index as the outcome variable, and the 11 items of the Leisure Activity Scale and living arrangements as explanatory variables. Multivariate analyses were used to examine effects of leisure activity on living arrangements and mental health. RESULTS The proportion of people living alone was 22.9% (N = 72), and the mental health score was mean ± SD, 14.2 ± 7.2. Multiple regression analysis showed that subjective economic status (β = -0.177), instrumental activities of daily living (β = 0.167), living arrangements (β = -0.142) and leisure activity (β = 0.481) were associated with mental health. The interaction effect between living arrangements and leisure activity on mental health was significant (β = 0.112). CONCLUSIONS Our findings show that leisure activity moderates poor mental health in older adults living alone. Accordingly, interventions should encourage older adults living alone to engage in leisure activity to improve their mental health. Geriatr Gerontol Int 2021; 21: 421-425.
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Affiliation(s)
- Yuko Yoshida
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hajime Iwasa
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshiko Ishioka
- Graduate School of Science and Technology, Keio University, Yokohama, Japan
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Effect of the Information Support Robot on the Daily Activity of Older People Living Alone in Actual Living Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052498. [PMID: 33802506 PMCID: PMC7967636 DOI: 10.3390/ijerph18052498] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/20/2021] [Accepted: 02/26/2021] [Indexed: 11/16/2022]
Abstract
Information support robots (ISRs) have the potential to assist older people living alone to have an independent life. However, the effects of ISRs on the daily activity, especially the sleep patterns, of older people have not been clarified; moreover, it is unclear whether the effects of ISRs depend on the levels of cognitive function. To investigate these effects, we introduced an ISR into the actual living environment and then quantified induced changes according to the levels of cognitive function. Older people who maintained their cognitive function demonstrated the following behavioral changes after using the ISR: faster wake-up times, reduced sleep duration, and increased amount of activity in the daytime (p < 0.05, r = 0.77; p < 0.05, r = 0.89, and p < 0.1, r = 0.70, respectively). The results suggest that the ISR is beneficial in supporting the independence of older people living alone since living alone is associated with disturbed sleep patterns and low physical activity. The impact of the ISR on daily activity was more remarkable in the subjects with high cognitive function than in those with low cognitive function. These findings suggest that cognitive function is useful information in the ISR adaptation process. The present study has more solid external validity than that of a controlled environment study since it was done in a personal residential space.
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Nakagomi A, Shiba K, Kondo K, Kawachi I. Can Online Communication Prevent Depression Among Older People? A Longitudinal Analysis. J Appl Gerontol 2020; 41:167-175. [PMID: 33356760 DOI: 10.1177/0733464820982147] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Evidence on the association between internet usage and incidence of depression remains mixed. We examined the associations between different categories of internet usage and developing clinical depression. We used data from the 2013 and 2016 waves of the Japan Gerontological Evaluation Study (JAGES) comprising 12,333 physically and cognitively independent adults aged ≥65 years. Participants were engaged in seven categories of internet usage: communication with friends/family, social media, information collection about health/medicine, searching for medical facilities, purchase of drugs and vitamins, shopping, and banking. We found that internet use for communication had a protective influence on the probability of developing clinical depression defined as the Geriatric Depression Scale scores ≥5 or self-reported diagnosed depression. Our findings support the role of online communication with friends/family in preventing clinical depression among older people. Online communication could be particularly useful in the COVID-19 crisis because many families are geographically dispersed and/or socially distanced.
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Affiliation(s)
| | - Koichiro Shiba
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Katsunori Kondo
- Chiba University, Japan.,National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Parvin E, Mohammadian F, Amani-Shalamzari S, Bayati M, Tazesh B. Dual-Task Training Affect Cognitive and Physical Performances and Brain Oscillation Ratio of Patients With Alzheimer's Disease: A Randomized Controlled Trial. Front Aging Neurosci 2020; 12:605317. [PMID: 33424581 PMCID: PMC7787183 DOI: 10.3389/fnagi.2020.605317] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/20/2020] [Indexed: 01/31/2023] Open
Abstract
This study aimed to investigate the effect of 12 weeks of dual-task training on cognitive status, physical performance, and brain oscillation of patients with Alzheimer's disease (AD). Twenty-six AD patients were randomly assigned to two groups, the training group (TG) and control group (CG). TG executed progressive combined exercises with visual stimulation twice a week for 12 weeks. Training included muscle endurance, balance, flexibility, and aerobic exercises with eyes closed and opened. Brain oscillation on electroencephalography (EEG) and a series of physical, cognitive, and mental tests were taken before and post-intervention. There was a significant improvement after training protocol in cognitive function, particularly in short-term and working memory, attention, and executive function (p < 0.01). Besides, there were substantial improvements in depression status (GDS scale), aerobic fitness (6 min walking), flexibility (chair sit and reach) functional ability (chair stand, timed up and go test), strength (knee extensions, preacher biceps curl, handgrip) in TG compared to CG. These signs of progress were associated with a significant increase (p < 0.05) in the frequency of brain oscillation and a decrease in the theta/alpha ratio. In addition to physical performance, the regular combined training with visual stimulation improves brain health as indicated by improving cognitive function and reducing the theta/alpha ratio. Clinical Trial Registration: Iranian Registry of Clinical Trials (IRCT) https://www.irct.ir/, identifier IRCT20190504043468N1-August 5, 2020.
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Affiliation(s)
- Elnaz Parvin
- Department of Exercise Physiology, Faculty of Physical Education and Sports Science, Kharazmi University, Tehran, Iran
| | - Fatemeh Mohammadian
- Department of Neurology, Roozbeh Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Sadegh Amani-Shalamzari
- Department of Exercise Physiology, Faculty of Physical Education and Sports Science, Kharazmi University, Tehran, Iran
| | - Mahdi Bayati
- Department of Exercise Physiology, Sports Medicine Research Center, Sport Sciences Research Institute, Tehran, Iran
| | - Behnaz Tazesh
- Sports and Exercise Medicine Specialist, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Nakagomi A, Shiba K, Hanazato M, Kondo K, Kawachi I. Does community-level social capital mitigate the impact of widowhood & living alone on depressive symptoms?: A prospective, multi-level study. Soc Sci Med 2020; 259:113140. [PMID: 32645611 DOI: 10.1016/j.socscimed.2020.113140] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/22/2020] [Accepted: 06/08/2020] [Indexed: 11/28/2022]
Abstract
Widowhood and living alone are linked to increased risk of depression. We examined prospectively whether community-level social capital can mitigate the adverse impact of widowhood and living alone on depressive symptoms. We used data of the Japan Gerontological Evaluation Study of functionally independent adults aged 65 years or older. Three waves of surveys were collected in 2010, 2013 and 2016. We conducted gender-stratified multilevel linear regression to examine the moderating effects of community-level social capital on depressive symptoms (as assessed by the 15-point Geriatric Depression Scale) associated with widowhood and living alone. Widowhood in the past 12 months in combination with living alone was associated with a marked worsening in depressive symptoms among men (beta coefficient = 1.67; 95% confidence interval: 1.38, 1.95). Community-level civic participation, but not social cohesion or reciprocity, was associated with lower depressive symptoms in men and women. In addition, community-level civic participation moderated the association between depressive symptoms and recent widowhood/living alone among men (coefficient per 1 standard deviation = -0.30; 95% confidence interval: -0.59, -0.02). We found no significant effect modification of community-level social capital on depressive symptoms associated with widowhood and living alone among women. Communities with greater civic participation appear to mitigate the onset of depressive symptoms among recently widowed men living alone. Promotion of community activities might be an effective community-level intervention to promote mental health in this vulnerable group.
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Affiliation(s)
- Atsushi Nakagomi
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
| | - Koichiro Shiba
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan; Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA
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Raony Í, de Figueiredo CS, Pandolfo P, Giestal-de-Araujo E, Oliveira-Silva Bomfim P, Savino W. Psycho-Neuroendocrine-Immune Interactions in COVID-19: Potential Impacts on Mental Health. Front Immunol 2020; 11:1170. [PMID: 32574266 PMCID: PMC7267025 DOI: 10.3389/fimmu.2020.01170] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/12/2020] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The impacts of the disease may be beyond the respiratory system, also affecting mental health. Several factors may be involved in the association between COVID-19 and psychiatric outcomes, such as fear inherent in the pandemic, adverse effects of treatments, as well as financial stress, and social isolation. Herein we discuss the growing evidence suggesting that the relationship between SARS-CoV-2 and host may also trigger changes in brain and behavior. Based on the similarity of SARS-CoV-2 with other coronaviruses, it is conceivable that changes in endocrine and immune response in the periphery or in the central nervous system may be involved in the association between SARS-CoV-2 infection and impaired mental health. This is likely to be further enhanced, since millions of people worldwide are isolated in quarantine to minimize the transmission of SARS-CoV-2 and social isolation can also lead to neuroendocrine-immune changes. Accordingly, we highlight here the hypothesis that neuroendocrine-immune interactions may be involved in negative impacts of SARS-CoV-2 infection and social isolation on psychiatric issues.
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Affiliation(s)
- Ícaro Raony
- School of Medicine, Federal Fluminense University, Niterói, Brazil.,Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
| | - Camila Saggioro de Figueiredo
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
| | - Pablo Pandolfo
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
| | - Elizabeth Giestal-de-Araujo
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil.,National Institute of Science and Technology on Neuroimmunomodulation - INCT-NIM, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Priscilla Oliveira-Silva Bomfim
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil.,National Institute of Science and Technology on Neuroimmunomodulation - INCT-NIM, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Rio de Janeiro Research Network on Neuroinflammation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Wilson Savino
- National Institute of Science and Technology on Neuroimmunomodulation - INCT-NIM, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Rio de Janeiro Research Network on Neuroinflammation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Imamura H, Uchiyama E, Akiyama M, Kaneko I, Takebayashi T, Nishiwaki Y. Relationship of living arrangement with the decline in functional capacity in elderly people by gender: a longitudinal observational study. Environ Health Prev Med 2020; 25:15. [PMID: 32434465 PMCID: PMC7240989 DOI: 10.1186/s12199-020-00853-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/01/2020] [Indexed: 11/30/2022] Open
Abstract
Background The living arrangement has been suggested as an important factor affecting health. Recent studies have also suggested that there was a risk among elderly persons who were not alone. This study examined whether the detailed living arrangement was associated with a future decline in functional capacity in the elderly, by gender, in a Japanese suburban city. Methods A 3-year longitudinal questionnaire survey (baseline: 2011; follow-up: 2014) for aged 65 years or older was conducted in Kurihara city, Japan. Of the respondents in the baseline survey, we analyzed those who scored 13 points (a perfect score which indicates the highest functional capacity; n = 2627) on the Tokyo Metropolitan Institute of Gerontology Index of Competence at the baseline. The exposure was living arrangement at baseline, divided into five categories: “with spouse only,” “living alone,” “with child and his/her spouse,” “with child without his/her spouse,” and “with other family/person.” The outcome was the decline in functional capacity at the follow-up survey (score decreased to 10 points or less from 13 points). Results Of the 2627 analyzed population, 1199 (45.6%) were men. The incidence of the decline was 5.8% in men and 5.9% in women. Multivariable logistic regression analyses adjusted for age, educational attainment, and health behavior and condition revealed that in women, the odds ratio of the decline was higher in living with child and his/her spouse (2.41, 95% confidence interval; 1.10–5.28) referring to living with spouse only. When adjusting activities inside and outside the home such as housework additionally, the association was attenuated to marginal significance (2.25, 0.98–5.18). No statistical significance was observed in men. Conclusions These results suggested that living with child and spouse of a child was associated with the future decline in women’s functional capacity.
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Affiliation(s)
- Haruhiko Imamura
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omori-Nishi, Ota-ku, Tokyo, 143-8540, Japan.
| | - Eiko Uchiyama
- Graduate School of Media and Governance, Keio University, Kanagawa, Japan
| | - Miki Akiyama
- Faculty of Environment and Information Studies, Keio University, Kanagawa, Japan
| | | | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Yuji Nishiwaki
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omori-Nishi, Ota-ku, Tokyo, 143-8540, Japan
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Imaiso J. Consideration of Social Aspects and Mental Health of Community-Dwelling Elderly People: A Literature Review. Health (London) 2020. [DOI: 10.4236/health.2020.125038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Noguchi T, Kondo K, Saito M, Nakagawa-Senda H, Suzuki S. Community social capital and the onset of functional disability among older adults in Japan: a multilevel longitudinal study using Japan Gerontological Evaluation Study (JAGES) data. BMJ Open 2019; 9:e029279. [PMID: 31597648 PMCID: PMC6797418 DOI: 10.1136/bmjopen-2019-029279] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The present study examined the association between community social capital and the onset of functional disability among older Japanese people by using validated indicators of social capital and a prospective multilevel design. DESIGN Prospective cohort study SETTING: We used data from the Japan Gerontological Evaluation Study, established from August 2010 to January 2012 in 323 districts. PARTICIPANTS The target population was restricted to non-institutionalised people aged 65 years or older who were independent in activities of daily living. Participants included 73 021 people (34 051 men and 38 970 women) who were followed up over a 3-year period. PRIMARY OUTCOME MEASURE The primary outcome measure was the onset of functional disability, defined as a new registration in public long-term care insurance system records with a care-needs level of two or above, analysed with multilevel Cox proportional hazards regression models by community social capital (civic participation, social cohesion and reciprocity). RESULTS The mean age of participants was 73.3 years (SD=6.0) for men and 73.8 years (SD=6.2) for women. During the study period, the onset of functional disability occurred in 1465 (4.3%) men and 1519 (3.9%) women. Of three community social capital variables, social cohesion significantly reduced the risk of onset of functional disability (HR 0.910; 95% CI 0.830 to 0.998) among men, after adjusting for individual social and behavioural variables. There was no significant effect among women. CONCLUSIONS Living in a community with rich social cohesion is associated with a lower incidence of onset of functional disability among older Japanese men.
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Affiliation(s)
- Taiji Noguchi
- Department of Public Health, Nagoya City University, Nagoya, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Katsunori Kondo
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Center for Preventive Medical Science, Chiba University, Chiba, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
| | | | - Sadao Suzuki
- Department of Public Health, Nagoya City University, Nagoya, Japan
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Oshio T, Kan M. Which is riskier for mental health, living alone or not participating in any social activity? Evidence from a population-based eleven-year survey in Japan. Soc Sci Med 2019; 233:57-63. [PMID: 31176058 DOI: 10.1016/j.socscimed.2019.05.049] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 05/21/2019] [Accepted: 05/29/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Takashi Oshio
- Institute of Economic Research, Hitotsubashi University, 2-1 Naka, Kunitachi-shi, Tokyo, 186-8603, Japan.
| | - Mari Kan
- School of Economics, University of Hyogo, 8-2-1 Gakuen-Nishi-machi, Nishi-ku, Kobe, Hyogo, 651-2197, Japan.
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Suzuki H, Kadota A, Okuda N, Hayakawa T, Nishi N, Nakamura Y, Arima H, Miyagawa N, Satoh A, Miyamatsu N, Yanagita M, Yatsuya H, Yamagata Z, Ohkubo T, Okamura T, Ueshima H, Okayama A, Miura K. Socioeconomic and lifestyle factors associated with depressive tendencies in general Japanese men and women: NIPPON DATA2010. Environ Health Prev Med 2019; 24:37. [PMID: 31138144 PMCID: PMC6540356 DOI: 10.1186/s12199-019-0788-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 04/17/2019] [Indexed: 11/25/2022] Open
Abstract
Background The gender-specific characteristics of individuals at an increased risk of developing depression currently remain unclear despite a higher prevalence of depression in women than in men. This study clarified socioeconomic and lifestyle factors associated with an increased risk of subclinical depression in general Japanese men and women. Methods Study participants were residents not receiving psychiatric treatments in 300 sites throughout Japan in 2010 (1152 men, 1529 women). Multivariable-adjusted odds ratios (OR) and 95% confidence intervals (95%CIs) for socioeconomic factors and lifestyle factors were calculated using a logistic regression analysis. Results Risk of depressive tendencies was significantly higher in men who were single and living alone (OR, 3.27; 95% CI, 1.56–6.88) than those married. The risk was significantly lower in women who were not working and aged ≥ 60 years (OR, 0.39; 95% CI, 0.22–0.68) and higher in men who were not working and aged < 60 years (OR, 3.57; 95%CI, 1.31–9.72) compared with those who were working. Current smoking was also associated with a significantly increased risk of depressive tendencies in women (OR, 2.96; 95% CI, 1.68–5.22) but not in men. Conclusions Socioeconomic and lifestyle factors were associated with an increased risk of depressive tendencies in general Japanese. Related factors were different by sex. Electronic supplementary material The online version of this article (10.1186/s12199-019-0788-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Harumitsu Suzuki
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan.,Department of Hygiene, Wakayama Medical University, Wakayama, Japan
| | - Aya Kadota
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan.,Department of Public Health, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Takehito Hayakawa
- The Kinugasa Research Organization, Ritsumeikan University, Kyoto, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Yasuyuki Nakamura
- Department of Food Sciences and Human Nutrition, Ryukoku University, Otsu, Japan
| | - Hisatomi Arima
- Faculty of Medicine, School of Medicine, Fukuoka University, Fukuoka, Japan
| | - Naoko Miyagawa
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Atsushi Satoh
- Faculty of Medicine, School of Medicine, Fukuoka University, Fukuoka, Japan
| | - Naomi Miyamatsu
- Department of Clinical Nursing, Shiga University of Medical Science, Otsu, Japan
| | - Masahiko Yanagita
- Department of Health and Sports Science, Doshisha University, Kyotanabe, Japan
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Japan
| | - Zentaro Yamagata
- Department of Health Sciences, Yamanashi University, Kofu, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University, Tokyo, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan
| | - Hirotsugu Ueshima
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan.,Department of Public Health, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan. .,Department of Public Health, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan.
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Jacob L, Haro JM, Koyanagi A. Relationship between living alone and common mental disorders in the 1993, 2000 and 2007 National Psychiatric Morbidity Surveys. PLoS One 2019; 14:e0215182. [PMID: 31042720 PMCID: PMC6493731 DOI: 10.1371/journal.pone.0215182] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 03/27/2019] [Indexed: 12/27/2022] Open
Abstract
Given the high prevalence of common mental disorders (CMDs) and individuals living alone in the United Kingdom, the goal of this study using English nationally representative data was to examine the association between living alone and CMDs, and to identify potential mediating factors of this association. The data were drawn from the 1993, 2000 and 2007 National Psychiatric Morbidity Surveys. CMDs were assessed using the Clinical Interview Schedule-Revised (CIS-R), a questionnaire focusing on past week neurotic symptoms. The presence of CMDs was defined as a CIS-R total score of 12 and above. Multivariable logistic regression and mediation analyses were conducted to analyze the association between living alone and CMDs, and to identify mediators in this association. The prevalence of CMDs was higher in individuals living alone than in those not living alone in all survey years. Multivariable analysis showed a positive association between living alone and CMDs in all survey years (1993: odds ratio [OR] = 1.69; 2000: OR = 1.63; and 2007: OR = 1.88). Overall, loneliness explained 84% of the living alone-CMD association. Living alone was positively associated with CMDs. Interventions addressing loneliness among individuals living alone may be particularly important for the mental wellbeing of this vulnerable population.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
- * E-mail:
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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Honjo K, Kimura T, Baba S, Ikehara S, Kitano N, Sato T, Iso H, Kishi R, Yaegashi N, Hashimoto K, Mori C, Ito S, Yamagata Z, Inadera H, Kamijima M, Heike T, Iso H, Shima M, Kawai Y, Suganuma N, Kusuhara K, Katoh T. Association between family members and risk of postpartum depression in Japan: Does “who they live with” matter? -The Japan environment and Children's study. Soc Sci Med 2018; 217:65-72. [DOI: 10.1016/j.socscimed.2018.09.043] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 09/20/2018] [Accepted: 09/22/2018] [Indexed: 02/04/2023]
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Haseda M, Kondo N, Takagi D, Kondo K. Community social capital and inequality in depressive symptoms among older Japanese adults: A multilevel study. Health Place 2018; 52:8-17. [PMID: 29775833 PMCID: PMC6075939 DOI: 10.1016/j.healthplace.2018.04.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 04/13/2018] [Accepted: 04/30/2018] [Indexed: 11/23/2022]
Abstract
Although studies have suggested that community social capital contributes to narrow income-based inequality in depression, the impacts may depend on its components. Our multilevel cross-sectional analysis of data from 42,208 men and 45,448 women aged 65 years or older living in 565 school districts in Japan found that higher community-level civic participation (i.e., average levels of group participation in the community) was positively associated with the prevalence of depressive symptoms among the low-income groups, independent of individual levels of group participation. Two other social capital components (cohesion and reciprocity) did not significantly alter the association between income and depressive symptoms.
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Affiliation(s)
- Maho Haseda
- Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, Japan.
| | - Naoki Kondo
- Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, Japan; Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, Japan.
| | - Daisuke Takagi
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, Japan.
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Inohana 1-8-1, Chuou-ku, Chiba City, Chiba, Japan; Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Morioka Town 7-430, Obu City, Aichi, Japan.
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