1
|
Glei DA, Weinstein M. Daily exposure to stressors, daily perceived severity of stress, and mortality risk among US adults. PLoS One 2024; 19:e0303266. [PMID: 38748692 PMCID: PMC11095670 DOI: 10.1371/journal.pone.0303266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/23/2024] [Indexed: 05/19/2024] Open
Abstract
Prior studies of perceived stress and mortality have yielded mixed results, but most are based on one-time measurements of perceived stress. We use daily diary data from the Midlife in the United States study to measure exposure to stressors and perceived severity of stress and investigate their associations with mortality. We also explore whether the associations vary by age and assess whether the associations are stronger for extrinsic than intrinsic mortality, which is more likely to be aging-related. The analysis included 4,756 observations for 2,915 respondents aged 21-95 who participated in at least one of three waves (1996-97, 2004-09, 2017-19) of the National Study of Daily Experiences. Participants reported daily stressors and perceived severity on 8 consecutive evenings at each wave. Mortality was followed through December 31, 2021. In fully-adjusted models, daily exposure to stressors was associated with mortality, but only at younger ages (HR = 1.20 per SD at age 50, 95% CI: 1.01‒1.42). The association was slightly stronger for extrinsic (HR = 1.31 per SD at age 50, 95% CI: 1.01‒1.69) than for intrinsic mortality, which was not significant (HR = 1.24 per SD at age 50, 95% CI: 0.98‒1.56). When we used an alternative measure of daily perceived severity of stress, the demographic-adjusted association appeared to be similar in magnitude, but after careful adjustment for potential confounding with health status, the association weakened and was no longer statistically significant (HR = 1.17 per SD at age 50, 95% CI: 0.99-1.37). Perceived severity was not significantly associated with either extrinsic or intrinsic mortality even at age 50. Most Americans die at older ages, where stress exposure does not appear to be significantly associated with mortality. Nonetheless, our results suggest that stress exposure is more strongly associated with midlife mortality, which has an undue influence on overall life expectancy.
Collapse
Affiliation(s)
- Dana A. Glei
- Center for Population and Health, Georgetown University, Washington, District of Columbia, United States of America
| | - Maxine Weinstein
- Center for Population and Health, Georgetown University, Washington, District of Columbia, United States of America
| |
Collapse
|
2
|
Cao YF, Shi GP, Zhang H, Sun MZ, Wang ZD, Chu XF, Guo JH, Wang XF. Association between Perceived Stress and Motoric Cognitive Risk Syndrome in an Elderly Population: Rugao Longevity and Aging Study. Dement Geriatr Cogn Disord 2024; 53:74-82. [PMID: 38408448 PMCID: PMC11098018 DOI: 10.1159/000537937] [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: 10/21/2023] [Accepted: 02/12/2024] [Indexed: 02/28/2024] Open
Abstract
INTRODUCTION Previous studies have indicated a correlation between perceived stress and cognitive decline. However, it remains unknown whether high levels of perceived stress can result in motoric cognitive risk (MCR) syndrome. This study investigated the relationship between perceived stress and MCR in a community-based population. METHODS The study cohort comprised 852 elderly individuals from the Rugao Longitudinal Aging Cohort. Perceived stress was assessed using the 10-item Perceived Stress Scale (PSS-10), while MCR was defined as the coexistence of subjective memory complaints (SMCs) and slow gait speed. RESULTS The average age of the study participants is 79.84 ± 4.34 years. The mean score of PSS-10 among participants is 10.32 (range = 0-33; [SD] = 5.71), with a median score of 10.00 (6.00, 14.00). The prevalence of MCR is 9.3%. In the logistic regression analysis, for each 1-SD (5.71) increase in the global PSS-10 score, the risk of MCR increased by 40% (95% CI 1.09-1.80). Additionally, in the aspect of two components of MCR, with a 1-SD increase (5.71) in the global PSS-10 score, there was a 50% (95% CI 1.29-1.75) increase in the risk of SMCs and a 27% (95% CI 1.04-1.55) increase in the risk of slow gait speed. In terms of specific walking speed, there was a reverse correlation between the global PSS-10 score and walking speed (r = -0.14, p < 0.001). CONCLUSIONS This study provided preliminary evidence that high levels of perceived stress were associated with the risk of MCR in a community-dwelling population.
Collapse
Affiliation(s)
- Yuan-Fei Cao
- MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, China
- Fudan University Rugao Research Institute of Longevity and Aging, Rugao, China
| | - Guo-Ping Shi
- Fudan University Rugao Research Institute of Longevity and Aging, Rugao, China
| | - Hui Zhang
- MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, China
- Fudan University Rugao Research Institute of Longevity and Aging, Rugao, China
- Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China
| | - Meng-Zhen Sun
- Fudan University Rugao Research Institute of Longevity and Aging, Rugao, China
- Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China
| | - Zheng-Dong Wang
- Fudan University Rugao Research Institute of Longevity and Aging, Rugao, China
| | - Xue-Feng Chu
- Fudan University Rugao Research Institute of Longevity and Aging, Rugao, China
| | - Jiang-Hong Guo
- Fudan University Rugao Research Institute of Longevity and Aging, Rugao, China
| | - Xiao-Feng Wang
- MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, China
- Fudan University Rugao Research Institute of Longevity and Aging, Rugao, China
- Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
3
|
Nilaweera D, Gurvich C, Freak-Poli R, Woods RL, Owen A, McNeil J, Nelson M, Stocks N, Ryan J. The association between adverse events in later life and mortality in older individuals. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2023; 16:100210. [PMID: 37753199 PMCID: PMC10518669 DOI: 10.1016/j.cpnec.2023.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023] Open
Abstract
Background Stress can have adverse impacts on health, particularly when it is chronic or resulting from major adverse events. Our study investigated whether relatively common adverse events in older individuals were associated with an increased risk of death, as well as cause-specific death and potential gender differences. Methods Participants were 12896 community-dwelling Australians aged ≥70 years at enrolment into the ASPREE (ASPirin in Reducing Events in the Elderly) study and without known life-limiting disease. A questionnaire administered in the year after enrolment, collected information on ten adverse events experienced in the past year. Mortality status was verified by multiple sources including health records and the National Death Index across a maximum of 10 years. Underlying causes of death were determined using clinical information by two adjudicators. Cox-proportional hazards regression models were used to estimate mortality risk. Results Two of the ten adverse events were associated with an increased risk of mortality in fully adjusted models. A 69% increased risk of mortality was observed in participants who reported their spouse/partner had recently died (95% CI: 1.19-2.39, P < 0.01). Cancer-related but not cardiovascular deaths also increased. Participants with a seriously ill spouse/partner also had a 23% increased risk of mortality (HR: 1.23, 95% CI: 1.02-1.48, P = 0.03). There was a tendency for these associations to be stronger among men than women. Limitations Perceived stress and cortisol were not measured, thus limiting our understanding of the psychological and physiological impacts of adverse events. Conclusions Experiencing adverse events in later-life, especially the death of a spouse/partner, may be a risk factor for earlier mortality. These findings may increase public health awareness and better inform initiatives for particular groups, including bereaved men.
Collapse
Affiliation(s)
- Dinuli Nilaweera
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Caroline Gurvich
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mark Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, University of Adelaide, South Australia, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
4
|
Méndez-Chacón E. Construct validity of the self-report instrument of perceived stress in the general Costa Rican population of retirement age. RESEARCH SQUARE 2023:rs.3.rs-2969356. [PMID: 37461613 PMCID: PMC10350197 DOI: 10.21203/rs.3.rs-2969356/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
Background It is known that the effects of stress on the body harm health and mortality outcomes. This phenomenon has been widely studied since its conceptualization. Applying self-report instruments to the general population can help identify degrees of stress and provide evidence on how stress affects social relationships, health, and even mortality. This research aims to explore the internal validity of questions of perceived stress in the general Costa Rican population close to pension or retirement age. Methods A nationally representative sample of 2743 individuals born between 1945-1955 in Costa Rica completed a series of questions related to perceived stress. Factor analysis, elements of classical test theory, and a Rasch model were used to generate evidence of scale validity. Results Adequate internal consistency was obtained by factor analysis, with one factor explaining 70% of the variability. The Omega Index value was 0.58. The fit values (INFIT) detected by the Rasch model range between 0.8 and 1.2. Conclusions the items form a scale that refers to the construct of perceived stress and has sufficient internal consistency.
Collapse
|
5
|
Amestoy ME, D'Amico D, Fiocco AJ. Neuroticism and Stress in Older Adults: The Buffering Role of Self-Esteem. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6102. [PMID: 37372689 DOI: 10.3390/ijerph20126102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 04/29/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Chronic stress is associated with accelerated aging and poor health outcomes in older adults. According to the Transactional Model of Stress (TMS), distress is experienced when one perceives the stressor, or threat, to outweigh the ability to cope. The experience of distress is correlated with trait neuroticism, which is associated with greater perceptions of stress and stress reactivity, as well as a tendency to engage in maladaptive coping strategies. However, as individual personality traits do not act in isolation, this study aimed to investigate the moderating role of self-esteem in the relationship between neuroticism and distress using a TMS framework. METHODS A total of 201 healthy older adults (Mage = 68.65 years) completed questionnaires measuring self-esteem, neuroticism, perceived stress, and positive coping. RESULTS Greater neuroticism was significantly associated with less positive coping at low (b = -0.02, p < 0.001) and mean self-esteem levels (b = -0.01, p < 0.001), but not at high self-esteem levels (b = -0.01, p = 0.06). No moderating effect was found for perceived stress or overall distress. CONCLUSION The results support the association between trait neuroticism and indices of stress and suggest a potential buffering effect of self-esteem in moderating the negative association between neuroticism and positive coping.
Collapse
Affiliation(s)
- Maya E Amestoy
- Department of Psychological Clinical Science, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON M1C 1A4, Canada
| | - Danielle D'Amico
- Department of Psychology, Toronto Metropolitan University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada
| | - Alexandra J Fiocco
- Department of Psychology, Toronto Metropolitan University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada
| |
Collapse
|
6
|
Wongpakaran N, Pooriwarangkakul P, Suwannachot N, Mirnics Z, Kövi Z, Wongpakaran T. Moderating role of observing the five precepts of Buddhism on neuroticism, perceived stress, and depressive symptoms. PLoS One 2022; 17:e0277351. [PMID: 36449445 PMCID: PMC9710746 DOI: 10.1371/journal.pone.0277351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 10/25/2022] [Indexed: 12/05/2022] Open
Abstract
PURPOSE Evidence has shown that the Five precepts significantly affect the relationship between attachment and resilience; however, little is known whether observing the Five Precepts would help reduce depressive symptoms among those who experience risks. The aim of this study was to examine the moderating role of the Five Precepts in the mediation model relationship among neuroticism, perceived stress, and depression. PATIENTS AND METHODS The study employed a cross-sectional survey design and data were collected from the end of 2019 to September 2022 in Thailand. In all, 644 general participants completed questionnaires on the Neuroticism Inventory (NI), the 10-item Perceived Stress Scale (PSS), Depression Subscale, and the Five-Precept Subscale of the Inner Strength-based Inventory (SBI-PP). Mediation and moderation analyses with 5000 bootstrapping methods were used. RESULTS Among all, 74.2% were female, and the mean age totalled 28.28 years (SD = 10.6). SBI-PP was shown to have a moderation effect on the relationship between NI, PSS and depressive symptoms. The moderating effect between SBI-PP and PSS was significant, whereas SBI-PP and NI was not. The index of moderated mediation from the Five Precepts was significant (b = -0.019 (95%CI -0.029, -0.009)). The moderated mediation model increased the percent variance explaining depressive symptoms to 47.6%, compared with 32.6% from the mediation model alone. CONCLUSION Observing the Five Precepts offers evidence that it buffers the effect of perceived stress on depression. People with high levels of observing the Five Precepts are less likely to develop depressive symptoms. Implications as well as possible future research are discussed.
Collapse
Affiliation(s)
- Nahathai Wongpakaran
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | | | | | | | - Zsuzsanna Kövi
- Károli Gáspár University of the Reformed Church, Budapest, Hungary
- * E-mail: (TW); (ZK)
| | - Tinakon Wongpakaran
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
- * E-mail: (TW); (ZK)
| |
Collapse
|
7
|
Rosas C, Oliveira HC, Neri AL, Ceolim MF. Stressful events, depressive symptoms, and frailty associated to older adults’ survival and mortality. Geriatr Nurs 2022; 46:62-68. [DOI: 10.1016/j.gerinurse.2022.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 11/29/2022]
|
8
|
Méndez-Chacón E. Gender Differences in Perceived Stress and Its Relationship to Telomere Length in Costa Rican Adults. Front Psychol 2022; 13:712660. [PMID: 35282254 PMCID: PMC8915848 DOI: 10.3389/fpsyg.2022.712660] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 01/25/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Stress is associated with disease and reduced leukocyte telomere length (LTL). The objective of this research is to determine if self-perceived stress is associated with telomere length in Costa Rican adults and the gender differences in this association. Findings may help explain how some populations in apparent socioeconomic disadvantage and with limited access to specialized medical services have a remarkably high life expectancy. Methodology Data come from the pre-retirement cohort of the Costa Rican Longevity and Healthy Aging Study (CRELES), a population based survey conducted in the households to 2,327 adults aged 53 to 66 years. The DNA to measure LTL was extracted from blood cells in laboratories of the University of Costa Rica whereas the Blackburn laboratory at the University of California performed the telomere length measurement applying the quantitative polymerase chain reaction (Q-PCR). The relationship between telomere length and perceived stress was measured using least-squares multiple regression. Perceived stress was measured by a set of questions about family, job, finances and, health reasons to be stressed. Models included the control variables: (1) age and sex of the participant, (2) whether he or she resides in the Nicoya area, a “blue zone” known for its high longevity, and (3) the aforementioned sociodemographic, health and lifestyles characteristics. Results Stress perception and LTL are significantly different by sex. Women perceived higher stress levels than men in almost all aspects studied, except work. Women have significantly longer telomeres. Shorter telomeres are significantly associated with caregiving stress in men and with parental health concerns in women. Counter-intuitive telomere lengthenings were observed among women who feel stressed about caring for family members; and among men who feel stressed due to their family relationships as well as concerns about their own health. Discussion Results confirm that people with self-perceived stress due to caregiving or health issues have shorter telomeres. The relationship between stress and telomere length differs between men and women. Gender relations exert a strong modifier effect on the relationship between stress and LTL: gender is related to perceived stress, telomere length, and apparently also to the way stress and LTL are related.
Collapse
|
9
|
Depressive symptoms and other negative psychological states relate to ex vivo inflammatory responses differently for men and women: Cross-sectional and longitudinal evidence. Physiol Behav 2022; 244:113656. [PMID: 34838823 PMCID: PMC8828045 DOI: 10.1016/j.physbeh.2021.113656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/09/2021] [Accepted: 11/23/2021] [Indexed: 02/03/2023]
Abstract
An array of negative psychological states - including depressive symptoms, perceived stress, rumination, and negative affect - have been linked to immune function and inflammatory responses. Herein we show evidence of gender-dependent associations between ex vivo lipopolysaccharide (LPS)-stimulated cytokine responses and such psychological states, in both cross-sectional and longitudinal analyses from three annual waves (N = 162 at baseline, 67.3% female). In cross-sectional analyses (at baseline), gender moderated the associations of depressive symptoms (previously reported), perceived stress (B = -0.043, 95%CI [-0.080, -0.015]), rumination (B = -0.500, [-1.015, -0.232]), negative affect (B = -0.020, [-0.020, -0.005]), and positive affect (B = 0.024, [0.008, 0.047]) with LPS-stimulated cytokine responses. In each analysis, negative psychological states were positively associated with LPS-stimulated cytokine responses among men but negatively among women (with associations for positive affect in the opposite direction). In longitudinal analyses (across three annual measurements), similar associations were seen for depressive symptoms (B = -0.024, [-0.059, -0.004]), perceived stress (B = -0.045, [-0.069, -0.024]), and rumination (B = -0.381, [-0.622, -0.120]). These results indicate that gender is a critical factor in associations between a broad array of negative psychological states and inflammatory responses and identify one pathway by which gender may influence psychosomatic health.
Collapse
|
10
|
Lin CH, Wang SH, Lane HY. Effects of Sodium Benzoate, a D-Amino Acid Oxidase Inhibitor, on Perceived Stress and Cognitive Function Among Patients With Late-Life Depression: A Randomized, Double-Blind, Sertraline- and Placebo-Controlled Trial. Int J Neuropsychopharmacol 2022; 25:545-555. [PMID: 35023557 PMCID: PMC9352177 DOI: 10.1093/ijnp/pyac006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/05/2022] [Accepted: 01/11/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Compared with adults with depression in the general population, elderly depressive patients are prone to poor treatment response, more side effects, and early withdrawal with current antidepressants (which principally modulate monoamines). Whether N-methyl-D-aspartate receptor enhancement can benefit treatment of late-life depression deserves study. This study aims to compare sodium benzoate (a D-amino acid oxidase inhibitor and an indirect N-methyl-D-aspartate receptor enhancer), sertraline (a selective serotonin reuptake inhibitor), and placebo in the treatment of late-life depression. METHODS In this randomized, double-blind trial, 117 patients with major depressive disorder aged 55 years or older received 8-week treatment of 250-1500 mg/d of sodium benzoate, 25-150 mg/d of sertraline, or placebo in 2 medical centers. The primary outcome measures were Hamilton Depression Rating Scale and Perceived Stress Scale scores. RESULTS Three treatments similarly decreased clinicians-rated Hamilton Depression Rating Scale scores. Compared with placebo, sodium benzoate but not sertraline substantially improved Perceived Stress Scale scores and cognitive function. Sertraline, but not benzoate, significantly reduced self-report Geriatric Depression Scale scores. Benzoate and placebo showed similar safety profiles, while sertraline was more likely to raise low-density lipoprotein than benzoate and placebo. Benzoate-treated patients were less likely to drop out than sertraline or placebo recipients. CONCLUSIONS Sertraline can reduce subjective depressive symptoms, while benzoate can decrease perceived stress, improve cognitive function, and enhance treatment adherence in late-life depression patients. The results show promise for D-amino acid oxidase inhibition as a novel approach for perceived stress and cognitive decline among patients with late-life depression. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03414931. Registered January 2016.
Collapse
Affiliation(s)
- Chieh-Hsin Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | | | - Hsien-Yuan Lane
- Correspondence: Hsien-Yuan Lane, MD, PhD, Department of Psychiatry, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taiwan ()
| |
Collapse
|
11
|
The Impact of Leisure Activities on the Mental Health of Older Adults: The Mediating Effect of Social Support and Perceived Stress. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6264447. [PMID: 34790344 PMCID: PMC8592769 DOI: 10.1155/2021/6264447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/14/2021] [Accepted: 10/27/2021] [Indexed: 01/18/2023]
Abstract
As the aging continues, China has become the country with the largest older population. In order to ensure the well-being of older adults in their later years, the whole society is increasingly concerned about the mental health of older adults. In 2019, we conduct a questionnaire survey in Shaanxi Province. Stratified random sampling is used to select three representative cities, and 677 samples are selected from the survey results for research. By using the structural equation model, we aim to reveal the mechanism of leisure activities' influence on mental health of the older adults and verify whether social support and perceived stress play a mediating role. The study finds that the older adults' leisure activities have no significant direct impact on mental health. Social support has a significant mediating effect between leisure activities and mental health of the older adults. Leisure activities indirectly affect the mental health of the older adults through social support, and participation in leisure activities can improve the social support of the older adults, thus improving the mental health level of the older adults. Perceived stress plays a significant mediating role between leisure activities and mental health of the older adults. By participating in leisure activities, the perceived stress of the older adults will be reduced, thus improving their mental health. Social support and perceived stress play a sufficient mediating role in the influence of leisure activities on mental health.
Collapse
|
12
|
Wongpakaran N, Wongpakaran T, Wedding D, Mirnics Z, Kövi Z. Role of Equanimity on the Mediation Model of Neuroticism, Perceived Stress and Depressive Symptoms. Healthcare (Basel) 2021; 9:healthcare9101300. [PMID: 34682980 PMCID: PMC8544574 DOI: 10.3390/healthcare9101300] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/20/2021] [Accepted: 09/28/2021] [Indexed: 01/11/2023] Open
Abstract
Background: Equanimity is widely and commonly practiced, but few have investigated the concept in clinical research. While the mediation model of neuroticism, perceived stress and depression have been demonstrated, it remains unclear whether equanimity mediates the relationship of these variables in parallel, serial or moderated mediation models. This study aimed to investigate the role of equanimity among those models. Methods: In all, 644 general participants (74.2% female, mean age = 28.28 (SD = 10.6)) provided data on the 10-item Perceived Stress Scale (PSS), the Neuroticism Inventory (NI), depression subscale of the Core Symptom Index, and the equanimity subscale of the inner Strength-based Inventory. Mediation and moderation analyses with the 5000 bootstrapping method were applied. Results: Equanimity was shown to moderate the relationship between NI/PSS and depressive symptom. Statistical evaluation supported all parallel, serial and moderated mediation models. Equanimity as a moderator provided a higher amount of percent variance explained by depressive symptoms than parallel and serial mediation models. Conclusions: Results suggest that the effect of perceived stress and neuroticism on depression can be mitigated by increasing levels of equanimity. The results demonstrated one potential benefit from practicing equanimity; enabling its extension to mental health problems could constitute an interesting focus for future research.
Collapse
Affiliation(s)
- Nahathai Wongpakaran
- Geriatric Psychiatry Unit and Psychotherapy Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mia University, Chiang Mai 50200, Thailand;
| | - Tinakon Wongpakaran
- Geriatric Psychiatry Unit and Psychotherapy Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mia University, Chiang Mai 50200, Thailand;
- Correspondence: (T.W.); (Z.K.); Tel.: +66-53-935422 (ext. 320) (T.W.); +36-7-038-42092 (Z.K.); Fax: +66-53-935426 (T.W.)
| | - Danny Wedding
- School of Humanistic and Clinical Psychology, Saybrook University, Oakland, CA 94611, USA;
| | - Zsuzsanna Mirnics
- Institute of Psychology, Head of Department of Personality and Health Psychology, Károli Gáspár University of the Reformed Church in Hungary, Bécsi Street 324, H-1037 Budapest, Hungary;
| | - Zsuzsanna Kövi
- Institute of Psychology, Head of Department of Personality and Health Psychology, Károli Gáspár University of the Reformed Church in Hungary, Bécsi Street 324, H-1037 Budapest, Hungary;
- Correspondence: (T.W.); (Z.K.); Tel.: +66-53-935422 (ext. 320) (T.W.); +36-7-038-42092 (Z.K.); Fax: +66-53-935426 (T.W.)
| |
Collapse
|
13
|
McLoughlin S, Kenny RA, McCrory C. Does the choice of Allostatic Load scoring algorithm matter for predicting age-related health outcomes? Psychoneuroendocrinology 2020; 120:104789. [PMID: 32739647 DOI: 10.1016/j.psyneuen.2020.104789] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 12/27/2022]
Abstract
Allostatic Load (AL) is posited to provide a measure of cumulative physiological dysregulation across multiple biological systems and demonstrates promise as a sub-clinical marker of overall health. Despite the large heterogeneity of measures employed in the literature to represent AL, few studies have investigated the impact of different AL scoring systems in predicting health. This study uses data for 4477 participants aged 50+ years participating in the Irish Longitudinal Study on Ageing (TILDA) to compare the utility of 14 different scoring algorithms that have been used to operationalise AL (i.e. count-based high-risk quartiles, deciles, two-tailed cut-points, z-scores, system-weighted indices, clinical cut-points, sex-specific scores, and incorporating medication usage). Model fit was assessed using R2, Bayesian Information Criterion (BIC), and the area under the Receiver Operating Characteristic curve (AUC). The measure incorporating medications predicted walking speed and SRH marginally better than others. In general, AL was not predictive of grip strength. Overall, the results suggest that the choice of AL scoring algorithm exerts a relatively modest influence in predicting a number of important health outcomes.
Collapse
Affiliation(s)
- Sinead McLoughlin
- The Irish Longitudinal Study on Ageing (TILDA), Trinity Central, Trinity College Dublin, 152-160 Pearse Street, Dublin 2, Ireland.
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity Central, Trinity College Dublin, 152-160 Pearse Street, Dublin 2, Ireland; Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Cathal McCrory
- The Irish Longitudinal Study on Ageing (TILDA), Trinity Central, Trinity College Dublin, 152-160 Pearse Street, Dublin 2, Ireland
| |
Collapse
|
14
|
Belo P, Navarro-Pardo E, Pocinho R, Carrana P, Margarido C. Relationship Between Mental Health and the Education Level in Elderly People: Mediation of Leisure Attitude. Front Psychol 2020; 11:573. [PMID: 32296375 PMCID: PMC7141236 DOI: 10.3389/fpsyg.2020.00573] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 03/11/2020] [Indexed: 12/01/2022] Open
Abstract
Purpose The present study intends to explore the influence of education on the mental health of retired people and the mediating role of a leisure attitude in this relationship. Design/Methodology The sample was simple random, and a confidentiality agreement was established. The sample was composed of 403 Portuguese participants (37.2% male; 62.8% female). The participants completed the MHI and the LAS. Findings The hypothesized mediation model showed that a leisure attitude mediated the association between education and well-being. In addition, higher levels of distress were found in participants with higher levels of education. Scientific Contribution Our results suggest that old-aged people with high education and a more positive leisure attitude have a better psychological adjustment concerning well-being. Also, a higher level of education can lead to a better perception of aging changes (physical, life, profession).
Collapse
Affiliation(s)
- Pedro Belo
- R&D Unit, Polytechnic Institute of Setúbal, Setúbal, Portugal
| | - Esperanza Navarro-Pardo
- Department of Developmental and Educational Psychology, Universitat de València, Valencia, Spain
| | - Ricardo Pocinho
- Department of Social Sciences, School of Education and Social Sciences, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Pedro Carrana
- Department of Engineering and Industrial Management, Coimbra Institute of Engineering, Polytechnic Institute of Coimbra, Coimbra, Portugal
| | - Cristovao Margarido
- Department of Social Sciences, School of Education and Social Sciences, Polytechnic Institute of Leiria, Leiria, Portugal
| |
Collapse
|
15
|
Banjongrewadee M, Wongpakaran N, Wongpakaran T, Pipanmekaporn T, Punjasawadwong Y, Mueankwan S. The role of perceived stress and cognitive function on the relationship between neuroticism and depression among the elderly: a structural equation model approach. BMC Psychiatry 2020; 20:25. [PMID: 31959135 PMCID: PMC6971914 DOI: 10.1186/s12888-020-2440-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 01/10/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Depression comprises common psychological problems, and has been strongly related to neuroticism and perceived stress. While neuroticism has been shown to have a direct effect on depression, it also has an indirect effect via perceived stress. Among the elderly, cognitive function produces influences that should not be overlooked when investigating depression. This study aimed to determine the role of mediating effects of perceived stress as well as cognitive function on neuroticism and depression among elderly patients. METHODS This research constituted a secondary analysis, with data collected during the pre-operative period of 429 elderly individuals undergoing elective, noncardiac surgery. The evaluation included the Perceived Stress Scale, the Neuroticism Inventory, the Montreal Cognitive Assessment, and the Geriatric Depression Scale. Structural equation modeling was used to investigate the hypothesized model. RESULTS Neuroticism exhibited a significant indirect effect on perceived stress via depression and cognition (β = 0.162, 95% CI 0.026, 0.322, p = .002). Neuroticism initially had a direct effect on depression (β = 0.766, 95% CI 0.675, 0.843 p = 0.003); thereafter, it was reduced after covariates were added (β = 0.557, 95% CI 0.432, 0.668 p = 0.002). Based on this model, the total variance explained by this model was 67%, and the model showed an acceptable fit with the data. CONCLUSIONS Both perceived stress and cognitive function partially mediated the effect of neuroticism on depression, with perceived stress exhibiting a greater effect. TRIAL REGISTRATION The study protocol has been registered at Clinicaltrials.gov under registered number: NCT02131181.
Collapse
Affiliation(s)
- Mukda Banjongrewadee
- 0000 0000 9039 7662grid.7132.7Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200 Thailand
| | - Nahathai Wongpakaran
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand.
| | - Tinakon Wongpakaran
- 0000 0000 9039 7662grid.7132.7Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200 Thailand
| | - Tanyong Pipanmekaporn
- 0000 0000 9039 7662grid.7132.7Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Yodying Punjasawadwong
- 0000 0000 9039 7662grid.7132.7Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sirirat Mueankwan
- 0000 0004 0640 1251grid.470093.9Division of Surgical Critical Care and Trauma, Department of Surgery, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand
| |
Collapse
|
16
|
Banjongrewadee M, Wongpakaran N, Wongpakaran T, Pipanmekaporn T, Punjasawadwong Y, Mueankwan S. Role of perceived stress in postoperative delirium: an investigation among elderly patients. Aging Ment Health 2020; 24:148-154. [PMID: 30518247 DOI: 10.1080/13607863.2018.1523881] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objectives: This study examined levels of perceived stress (PS), postoperative delirium (POD) and associated factors among Thai elderly patients undergoing elective noncardiac surgery.Background and aims: Preoperative PS and change after operation have not been widely studied. Moreover, psychological factors associated with PS and POD has been poorly investigated.Materials and Methods: In total, 429 elderly patients were recruited at a university hospital. The preoperative evaluation included sociodemographic data, health behaviors at risk, Perceived Stress Scale (PSS-10), Neuroticism Inventory (NI), Mental State Examination T10 (MSET10), Montreal Cognitive Assessment (MoCA) and Geriatric Depression Scale (GDS-15). Three-day postoperative evaluation included PSS-10 and Confusion Assessment Method Algorithm (CAM) or CAM-ICU for Delirium. Multiple regression and logistic regression analysis were performed to determine potential predictors.Results: Females were 58.97%, and the mean age was 69.93 ± 6.87 years. Mean pre- and postoperative PS were 12.77 ± 5.41 and 13.39 ± 5.26, respectively (P < 0.05). Multiple regression revealed that neuroticism, depression, and BMI predicted PS significantly. None of the independent variables was found to predict postoperative PS except for preoperative PS (p <.001). POD at the recovery room was predicted by preoperative PS (odds ratio = 1.181, 95% CI = 1.019-1.369), whereas overall POD was predicted by MoCA (odds ratio = .864, 95% CI = .771 -.968).Conclusion: Preoperative PS was significant in that it was associated with postoperative PS and POD. A careful assessment of preoperative PS as well as providing brief interventions for patients with high levels of this condition may reduce the risk of POD.
Collapse
Affiliation(s)
- Mukda Banjongrewadee
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tanyong Pipanmekaporn
- Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Yodying Punjasawadwong
- Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sirirat Mueankwan
- Division of Surgical Critical Care and Trauma, Department of Surgery, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand
| |
Collapse
|
17
|
Kruk J, Aboul-Enein BH, Bernstein J, Gronostaj M. Psychological Stress and Cellular Aging in Cancer: A Meta-Analysis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:1270397. [PMID: 31814865 PMCID: PMC6877941 DOI: 10.1155/2019/1270397] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/17/2019] [Accepted: 09/28/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Epidemiological evidence continues to accumulate on the effect of psychosocial and behavioral factors in relation to cancer risk, progression, and mortality. MATERIAL AND METHODS This article presents the current evidence on the relationship between psychological stress and the risk of cancer and cellular aging process. Ten databases were searched to identify publications up to September 2019. References from retrieved articles were also reviewed. We included nine review papers and 26 cohort or case-control studies based on inclusion/exclusion criteria. RESULTS Results of previously published review articles did not show consistent evidence for the association between cancer risk and psychological stress, while previous evidence is stronger regarding the role of chronic psychological stress on cancer growth and metastasis and aging. In seven observational studies, severe life events, anxiety, depression, insufficient social support perception, or avoiding coping strategy were significantly associated with breast cancer risk. For other specific types of cancer, 11 studies reported increased risk factors for stressful life events, and two others found increased mortality or a decline in treatment adherence. CONCLUSIONS Recent epidemiological evidence generally suggests psychosocial factors may be considered risk factors for specific types of cancer and play a key role in the cellular aging process. Understanding molecular mechanisms of the stress interaction is important in cancer management and prevention. The psychological stressors should be considered when developing or evaluating change in psychosocial practice.
Collapse
Affiliation(s)
- Joanna Kruk
- Faculty of Physical Culture and Health, University of Szczecin, Piastów 40b/6, 71-004 Szczecin, Poland
| | - Basil Hassan Aboul-Enein
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - Joshua Bernstein
- College of Graduate Health Studies, A.T. Still University of Health Sciences, 800 W. Jefferson St., Kirksville, MO 63501, USA
| | - Magdalena Gronostaj
- Faculty of Medicine, Biotechnology and Laboratory Medicine, Pomeranian Medical University, Rybacka 1, 70-204 Szczecin, Poland
| |
Collapse
|
18
|
Seangpraw K, Auttama N, Kumar R, Somrongthong R, Tonchoy P, Panta P. Stress and associated risk factors among the elderly: a cross-sectional study from rural area of Thailand. F1000Res 2019; 8:655. [PMID: 32269755 PMCID: PMC7122445 DOI: 10.12688/f1000research.17903.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/26/2020] [Indexed: 11/25/2022] Open
Abstract
Background. Stress is a common mental health problem of the elderly population that affects their quality of life. The objective of this study was to determine the level of stress and associated factors among the elderly living in rural areas of Thailand. Methods. This was a cross-sectional study conducted in two sub-districts of rural Thailand and interviewed 403 elderly persons. We used simple random sampling technique from a list of registered elderly individuals and conducted face-to-face interviews using a questionnaire. The questionnaire were piloted, validated and pretested beforehand. Multiple linear regression was applied for data analysis. This study was approved by the Ethical Review Committee of the University of Phayao, Thailand. Results. The mean age of the participants was 68 and two thirds (67%) were female. Less than 43% of the participants had moderate, and one third (34%) had high levels of stress. More than half of participants had low level stress management. Stress was significantly associated with alcohol and illness with a predictive power of 3.0% [(R = 0.173, R Square = 0.030) (p<0.05)]. Conclusion. We conclude that risk factors such as alcohol and illness affect elderly population living in rural areas of Thailand to a major extent in terms of stress.
Collapse
Affiliation(s)
- Katekaew Seangpraw
- Public Health, School of Medicine, University of Phayao, Phayao, Thailand
| | | | - Ramesh Kumar
- Health System and Policy, Health Services Academy, Islamabad, Pakistan
| | - Ratana Somrongthong
- College of Public Health,, Chulalongkorn University, Thailand, Bangkok, Thailand
| | | | | |
Collapse
|
19
|
Seangpraw K, Auttama N, Kumar R, Somrongthong R, Tonchoy P, Panta P. Stress and associated risk factors among the elderly: a cross-sectional study from rural Thailand. F1000Res 2019; 8:655. [PMID: 32269755 PMCID: PMC7122445 DOI: 10.12688/f1000research.17903.1] [Citation(s) in RCA: 5] [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] [Accepted: 04/26/2019] [Indexed: 08/17/2023] Open
Abstract
Background. Stress is a common mental health problem of the elderly population that affects their quality of life. The objective of this study was to determine the level of stress and associated factors among the elderly living in rural areas of Thailand. Methods. This was a cross-sectional study conducted in two sub-districts of rural Thailand and interviewed 403 elderly persons. We used simple random sampling technique from a list of registered elderly individuals and conducted face-to-face interviews using a questionnaire. The questionnaire were piloted, validated and pretested beforehand. Multiple linear regression was applied for data analysis. This study was approved by the Ethical Review Committee of the University of Phayao, Thailand. Results. The mean age of the participants was 68 and two thirds (67%) were female. Less than 43% of the participants had moderate, and one third (34%) had high levels of stress. More than half of participants had low level stress management. Stress was significantly associated with alcohol and illness with a predictive power of 3.0% [(R = 0.173, R Square = 0.030) (p<0.05)]. Conclusion. We conclude that risk factors such as alcohol and illness affect elderly population living in rural areas of Thailand to a major extent in terms of stress.
Collapse
Affiliation(s)
- Katekaew Seangpraw
- Public Health, School of Medicine, University of Phayao, Phayao, Thailand
| | | | - Ramesh Kumar
- Health System and Policy, Health Services Academy, Islamabad, Pakistan
| | - Ratana Somrongthong
- College of Public Health,, Chulalongkorn University, Thailand, Bangkok, Thailand
| | | | | |
Collapse
|
20
|
History of Non-Fatal Physical Assault Is Associated with Premature Mortality for Whites but Not Blacks. J 2018. [DOI: 10.3390/j1010009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Exposure to trauma increases the long-term risk of mortality, and experiencing non-fatal physical assault is not an exception. To better understand population heterogeneity in this link, the current study explored Black–White differences in the association between history of non-fatal physical assault and risk of all-cause mortality over a 25-year period in the United States. Data came from the Americans’ Changing Lives (ACL) study that followed 3617 non-institutionalized respondents for up to 25 years. History of non-fatal physical assault at baseline was the predictor. Outcome was time to death due to all-cause mortality during follow-up from baseline (1986) to follow-up (2011). Confounders included gender, age, and baseline socio-economic status (education and income), health behaviors (smoking and drinking), and health status (chronic medical conditions, self-rated health, and body mass index). Race was the moderator. Cox regressions were used for multi-variable analysis. History of non-fatal physical assault at baseline was associated with an increased risk of mortality, above and beyond baseline socioeconomic status, health behaviors, and health status. Race interacted with history of non-fatal physical assault on mortality, suggesting a stronger effect for Whites compared to Blacks. In race-specific models, history of non-fatal physical assault was associated with risk of mortality for Whites but not Blacks. The current study showed that experiencing non-fatal physical assault increases the risk of premature death above and beyond demographics, socioeconomic status, health behaviors, and health status. Experiencing non-fatal physical assault may have a larger effect on premature mortality among Whites than Blacks. Future research is needed on how Blacks and Whites differ in the health consequences of social adversities.
Collapse
|
21
|
Chang LC. Is Social Support Always Related to Stress Reduction in Nursing Home Residents? A Study in Leisure Contexts. Res Gerontol Nurs 2018; 11:174-180. [PMID: 29767805 DOI: 10.3928/19404921-20180502-02] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/02/2018] [Indexed: 11/20/2022]
Abstract
The current study examined the main and interaction effects of leisure self-determination and two leisure social support types (emotional and instrumental) on stress in nursing home residents. A total of 139 nursing home residents (mean age = 79.4 years) in Taichung City, Taiwan, were recruited. Data were collected using face-to-face surveys, which included measures of leisure self-determination, leisure emotional support, leisure instrumental support, and stress. Data were analyzed using a hierarchical regression analysis. Results indicated that leisure self-determination and leisure emotional support were significantly and negatively correlated with stress, whereas leisure instrumental support was not. Moreover, higher levels of leisure instrumental support decreased the relationship between leisure self-determination and stress reduction. Therefore, enhancing levels of leisure self-determination and leisure emotional support appears to be an effective means of reducing stress in nursing home residents. However, providing excessive leisure instrumental support to nursing home residents should be avoided. [Res Gerontol Nurs. 2018; 11(4):174-180.].
Collapse
|
22
|
Okely JA, Weiss A, Gale CR. The interaction between stress and positive affect in predicting mortality. J Psychosom Res 2017; 100:53-60. [PMID: 28789793 PMCID: PMC5555349 DOI: 10.1016/j.jpsychores.2017.07.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/30/2017] [Accepted: 07/07/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Positive affect is associated with longevity; according to the stress-buffering hypothesis, this is because positive affect reduces the health harming effects of psychological stress. If this mechanism plays a role, then the association between positive affect and mortality risk should be most apparent among individuals who report higher stress. Here, we test this hypothesis. METHODS The sample consisted of 8542 participants aged 32-86 from the National Health and Nutrition Examination Survey (NHANES I) Epidemiological Follow-up Study (NHEFS). We used Cox's proportional hazards regression to test for the main effects of and the interaction between positive affect and perceived stress in predicting mortality risk over a 10year follow up period. RESULTS Greater positive affect was associated with lower mortality risk. We found a significant interaction between positive affect and perceived stress such that the association between positive affect and mortality risk was stronger in people reporting higher stress. In the fully adjusted model, a standard deviation increase in positive affect was associated with a 16% (HR=0.84; 95% CI=0.75, 0.95) reduction in mortality risk among participants who reported high levels of stress. The association between positive affect and mortality risk was weaker and not significant among participants who reported low levels of stress (HR=0.98; 95% CI=0.89, 1.08). CONCLUSION Our results support the stress-buffering model and illustrate that the association between positive affect and reduced risk may be strongest under challenging circumstances.
Collapse
Affiliation(s)
- Judith A. Okely
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK,Corresponding author at: Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh EH8 9JZ, UKDepartment of PsychologyUniversity of Edinburgh7 George SquareEdinburghEH8 9JZUK
| | - Alexander Weiss
- Department of Psychology, University of Edinburgh, Edinburgh, UK.
| | - Catharine R. Gale
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| |
Collapse
|
23
|
Tsai HJ, Chang FK. Associations of various perceived-stress situations with depressive symptoms in ≥50-year old Taiwanese men and women: Results from the Taiwan Longitudinal Study on Aging. Arch Gerontol Geriatr 2016; 67:113-9. [DOI: 10.1016/j.archger.2016.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 07/16/2016] [Accepted: 07/17/2016] [Indexed: 11/24/2022]
|
24
|
Chang LC, Yu P, Chang SY. Longitudinal relationships between two self-efficacy types and stress in active older adults in Taichung City, Taiwan. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2016. [DOI: 10.1080/14623730.2016.1159596] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
25
|
Association between Social Integration and Health among Internal Migrants in ZhongShan, China. PLoS One 2016; 11:e0148397. [PMID: 26863008 PMCID: PMC4749174 DOI: 10.1371/journal.pone.0148397] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 01/18/2016] [Indexed: 12/27/2022] Open
Abstract
Internal migrants are the individuals who migrate between regions in one country. The number of internal migrants were estimated at 245 million in China in 2013. Results were inconsistent in the literature about the relationship between their health statuses and social integration. The main difference exists on how to measure the social integration and whether health statuses of internal migrants improve with years of residence. To complement the existing literature, this study measured social integration more comprehensively and estimated the internal migrants’ health statuses with varying years of residence, and explored the associations between the migrants’ social integration and health. We used the data from 2014 Internal Migrant Dynamic Monitoring Survey of Health and Family Planning in ZhongShan, China. Health status was measured from four aspects: self-reported health, subjective well-being, perception of stress, mental health. We measured social integration through four dimensions: economy, social communication, acculturation, and self-identity. The analyses used multiple linear regressions to examine the associations between self-reported health, subjective well-being, and perception of stress, mental health and social integration. The analytical sample included 1,999 households of the internal migrants and 1,997 local registered households, who were permanent residents in ZhongShan. Among the internal migrants, Adults in the labor force, who were aged 25 to 44 years old, accounted for 91.2% of the internal migrant population, while 74.6% of the registered population were in that age group. Median residential time among migrants was 2.8 (1.3–6.2) years, and 20.2% of them were migrating in the same Guangdong province. Except for mental health, other health statuses among migrants had significant differences compared with local registered population, e.g. self-reported health was better, but subjective well-being was worse. However, these health measurements were improved with more years of residence. Moreover, our results show that two aspects of social integration, economic integration and self-identity, were significantly associated with health status. Subjective feeling of relative social status levels were more associated with health, which prompted the attention to social fairness and the creation of a fair and respectful culture. More interventions could be experimented, such as encouraging internal migrants to participate in community activities more actively, educating local registered residents to treat internal migrants more equally, and developing self-identity among internal migrants. Better social, economic, and cultural environment can benefit internal migrants’ health statuses.
Collapse
|
26
|
Different perceptions of stress, coping styles, and general well-being among pregnant Chinese women: a structural equation modeling approach. Arch Womens Ment Health 2016; 19:71-8. [PMID: 25822710 DOI: 10.1007/s00737-015-0523-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 03/17/2015] [Indexed: 02/05/2023]
Abstract
Few studies have examined different perceptions of stress or explored the positive aspects of well-being among pregnant Chinese women, so there is a need to explore these phenomena in order to fill the research gap. The aim of this study was to examine the relationships among the different perceptions of stress, coping styles, and general well-being using a structural equation modeling approach. We examined a hypothetical model among 755 pregnant Chinese women based on the integration of theoretical models. The Perceived Stress Scale (PSS), the Trait Coping Styles Questionnaire (TCSQ), and the General Well-Being Schedule (GWB) were used to measure perceived stress, coping styles, and general well-being, respectively. A structural equation model showed that positive and negative perceptions of stress significantly influenced positive and negative coping styles, respectively. Different perceptions of stress were significantly associated with general well-being, but different coping styles had no significant effects on general well-being. The model had a good fit to the data (IFI = 0.910, TLI = 0.904, CFI = 0.910, and RMSEA = 0.038). Different perception of stress was able to predict significant differences in coping styles and general well-being.
Collapse
|
27
|
Roepke-Buehler SK, Dong X. Perceived Stress and Elder Abuse: A Population-Based Study of Adult Protective Services Cases in Chicago. J Am Geriatr Soc 2015; 63:1820-8. [PMID: 26280151 PMCID: PMC9943550 DOI: 10.1111/jgs.13613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To characterize the relationship between perceived stress and Adult Protective Services (APS) elder abuse cases in a population-based sample. DESIGN Cross-sectional. SETTING Chicago. PARTICIPANTS community-dwelling, older adults (N = 8,558; mean age 74 ± 7, 62% female, 64% African American). MEASUREMENTS Perceived Stress Scale (PSS), APS database linkage. RESULTS Bivariate and adjusted analyses showed that perceived stress was significantly higher in APS clients than in participants without any APS interaction for various subtypes of abuse (e.g., abuse from a perpetrator and self-neglect). This relationship was strongest for those with a confirmed history of abuse from a perpetrator, with a medium-large effect size (t = -5.8, P < .001, Cohen D = -0.6). Those in the highest stress tertile had a likelihood of having confirmed history of abuse from a perpetrator that was nearly three times as great as that of those in lower stress tertiles (odds ratio = 2.7, 95% confidence interval = 1.2-6.2). Analyses of individual PSS items revealed a robust relationship between distress items and APS involvement. Items reflecting coping were inconsistently associated with elder abuse. CONCLUSION Clients of APS have higher levels of perceived stress, and abuse from a perpetrator strengthens this relationship. Therefore, victims of abuse from a perpetrator may be at the highest risk of stress-related consequences and should be targeted for intervention efforts that enhance empowerment and effective coping strategies.
Collapse
Affiliation(s)
- Susan K. Roepke-Buehler
- Department of Behavioral Sciences, Rush University, Chicago, Illinois,Department of Medicine, Rush University, Chicago, Illinois
| | - XinQi Dong
- Department of Behavioral Sciences, Rush University, Chicago, Illinois,Department of Medicine, Rush University, Chicago, Illinois,Department of Nursing, Rush University, Chicago, Illinois
| |
Collapse
|
28
|
Alhurani AS, Dekker R, Tovar E, Bailey A, Lennie TA, Randall DC, Moser DK. Examination of the potential association of stress with morbidity and mortality outcomes in patient with heart failure. SAGE Open Med 2014; 2. [PMID: 26246898 PMCID: PMC4523379 DOI: 10.1177/2050312114552093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objectives: The high mortality and morbidity rates associated with heart failure are still not well explained. A few psychosocial factors have been studied and explain some of this risk, but other factors, like stress, remain largely unexplored in heart failure. This study aimed to (1) examine the association of stress with 6-month cardiac event-free survival, (2) examine the relationship of stress with salivary cortisol, and (3) examine the association of salivary cortisol level with 6-month cardiac event-free survival. Method: A total of 81 heart failure patients participated. Stress was measured using the brief Perceived Stress Scale. Cortisol was measured from unstimulated whole expectorated saliva. Cox regression analyses were used to determine whether stress predicted event-free survival, and if salivary cortisol predicted event-free survival. Linear and multiple regressions were used to determine the association of stress with salivary cortisol. Results: Stress was not a significant predictor of event-free survival in heart failure (heart rate = 1.06; 95% confidence interval = 0.95–1.81; p = 0.32). Salivary cortisol was a significant predictor of event-free survival in the unadjusted model (heart rate = 2.30; 95% confidence interval = 0.99–5.927; p = 0.05), but not in the adjusted model. Stress (β 1.06; 95% confidence interval = 0.95–1.18; p = 0.32) was not a significant predictor of salivary cortisol level. Conclusion: Stress is a complex phenomenon, and our measure of stress may not have captured it well. Alternatively, the physical stressors acting in heart failure produce levels of neurohormonal activation that mask the effects of psychosocial stressors or an indirect association of stress with outcomes that is mediated through another construct. Future studies are needed to investigate stress in patients with heart failure to provide definitive answers.
Collapse
Affiliation(s)
- Abdullah S Alhurani
- College of Nursing, University of Kentucky, Lexington, KY, USA
- The University of Jordan, Amman, Jordan
| | - Rebecca Dekker
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Elizabeth Tovar
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Alison Bailey
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Terry A Lennie
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - David C Randall
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Debra K Moser
- College of Nursing, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
29
|
Vasunilashorn S, Lynch SM, Glei DA, Weinstein M, Goldman N. Exposure to stressors and trajectories of perceived stress among older adults. J Gerontol B Psychol Sci Soc Sci 2014; 70:329-37. [PMID: 24906395 DOI: 10.1093/geronb/gbu065] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Models of stress incorporate both the environmental demands experienced by individuals (stressors) and the appraisal of these life events (perceptions). Because little is known about the extent to which experience and perceptions are related, we examine this relationship in a nationally representative population of older Taiwanese adults. METHOD Using growth models applied to data from 3 waves (1999, 2003, and 2007) of the Taiwan Longitudinal Study of Aging, we (a) investigate patterns of change in perceived stress in later adulthood and (b) examine how experienced stressors influence perceived stress. Participants were asked to report the presence of, and in some cases the degree of, exposure to stressors including total number of medical conditions, difficulty with activities of daily living, difficulty with mobility functions, being financially worse off compared with the prior wave, experiencing the death of a child, and experiencing a marital disruption. Items reflecting perceived stress included concerns about various domains pertaining to the respondent and his/her family member. RESULTS Our results indicate that exposure to stressors increases, whereas perceived stress decreases, over time. Change in exposure to stressors is not generally associated with change in perceptions of stress, with the exception of a summary measure of health-related exposure to stressors. An increase in poor health over time is related to an increase in perceived stress in all domains. DISCUSSION The results underscore the importance of distinguishing between perceptions of stress and exposure to stressors when studying the links between stress and health among older adults. Furthermore, the diminishing linkage between experienced stressors and perceptions of stress suggests that older adults' appraisal may be an adaptive coping strategy that emerges to buffer some of the difficulties that are inevitable in later life.
Collapse
Affiliation(s)
- Sarinnapha Vasunilashorn
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
| | - Scott M Lynch
- Department of Sociology, Duke University, Durham, North Carolina
| | - Dana A Glei
- Center for Population and Health, Georgetown University, Washington, District of Columbia
| | - Maxine Weinstein
- Center for Population and Health, Georgetown University, Washington, District of Columbia
| | - Noreen Goldman
- Office of Population Research, Princeton University , New Jersey
| |
Collapse
|
30
|
Tsai AC, Chi SH, Wang JY. Association of perceived stress with depressive symptoms in older Taiwanese: Results of a population-based study. Geriatr Gerontol Int 2014; 15:535-43. [DOI: 10.1111/ggi.12307] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Alan C Tsai
- Department of Healthcare Administration; Asia University; Taichung Taiwan
- Department of Health Services Management; School of Public Health; China Medical University; Taichung Taiwan
| | - Shu-Huang Chi
- Department of Healthcare Administration; Asia University; Taichung Taiwan
| | - Jiun-Yi Wang
- Department of Healthcare Administration; Asia University; Taichung Taiwan
- Center for Health Policy and Management Research; Asia University; Taichung Taiwan
| |
Collapse
|