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Reiner A, Steinhoff P. The association of social networks and depression in community-dwelling older adults: a systematic review. Syst Rev 2024; 13:161. [PMID: 38902787 PMCID: PMC11188217 DOI: 10.1186/s13643-024-02581-6] [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: 03/13/2024] [Accepted: 06/10/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Depression is a globally prevalent mental condition, particularly among older adults. Previous research has identified that social networks have a buffering effect on depression. Existing systematic reviews have either limited their research to specific geographic areas or provided evidence from over a decade ago. The vast body of recent literature particularly from the last decade emphasizes the need for a comprehensive review. This systematic review aims to analyze the association of structural aspects of social networks and depression in older adults. METHODS The electronic databases APA PsycINFO, ProQuest, PSYINDEX, PubMed, Scopus, SocINDEX, and Web of Science were searched from date of data base inception until 11 July 2023. Studies were eligible for inclusion if they reported on community-dwelling older adults (defined as a mean age of at least 60 years old), had an acceptable definition for depression, referred to the term social network in the abstract, and were published in English. Quality was appraised using the Newcastle Ottawa Scale for cross-sectional and longitudinal studies. Outcome data were extracted independently from each study and analyzed by direction of the relationship, social network domain and cross-sectional or longitudinal study design. RESULTS In total, 127 studies were included. The study categorizes structural network aspects into seven domains and finds that larger and more diverse networks, along with closer social ties, help mitigate depression. The literature on the relationships between depression and network density, homogeneity, and geographical proximity is scarce and inconclusive. DISCUSSION AND IMPLICATIONS: Despite inconsistent findings, this review highlights the importance of quantifying complex social relations of older adults. Limitations of this review include publication and language bias as well as the exclusion of qualitative research. Further research should use longitudinal approaches to further investigate the reciprocal relationship between social networks and depression. Following this review, interventions should promote the integration of older adults in larger and more diverse social settings. Other: This work was supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Grant [454899704]. This systematic review was pre-registered. The review-protocol can be accessed at https://doi.org/10.17605/OSF.IO/6QDPK .
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Affiliation(s)
- Amelie Reiner
- Institute of Sociology and Social Psychology, University of Cologne, Albertus-Magnus-Platz, 50923, Cologne, Germany.
| | - Paula Steinhoff
- Institute of Sociology and Social Psychology, University of Cologne, Albertus-Magnus-Platz, 50923, Cologne, Germany
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Ma D, Cao J, Wei J, Jiang J. Immature defense mechanisms mediate the relationship between negative life events and depressive symptoms. Front Psychiatry 2024; 14:1341288. [PMID: 38274424 PMCID: PMC10808586 DOI: 10.3389/fpsyt.2023.1341288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
Objective This study aimed to analyze the patterns of life events (LEs) and defense mechanisms in outpatients with depression and investigate the mediating role of defense mechanisms in the association between LEs and depressive symptoms in a psychosomatic outpatient sample in China. Materials and methods All of 2,747 outpatients (aged 18-65) from psychosomatic department were investigated in this study. LEs, depressive symptoms, and defense mechanisms were assessed by the Life Events Scale (LES), Patient-Health-Questionnaire-9 (PHQ-9), and the Defense Style Questionnaire (DSQ), respectively. Results Based on the optimal cut-off point of PHQ-9, 1840 (67.0%) patients had a PHQ-9 score of 10 or higher (depression group), and 907 (33.0%) had a score below 10 (non-depression group). The scores of Negative Life Events (NLEs), immature and intermediate defense mechanisms in the depression group were significantly higher than those in the non-depression group, while the scores of mature defense mechanisms were the opposite (p < 0.001). NLEs was directly related to depressive symptoms (b = 0.010, p < 0.001), and significant indirect effect via immature defense mechanisms (b = 0.008, p < 0.001) was observed. Conclusion Immature defense mechanisms play an important mediating role in the relationship between NLEs and depressive symptoms. Helping patients improving defense mechanisms and dealing with NLEs may be of great help in the treatment of relevant patients.
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Affiliation(s)
| | - Jinya Cao
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Rosenblum S, Cohen Elimelech O. Daily Functional Characteristics and Health Among Older Adults During COVID-19: A Structural Equation Modeling Approach. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241233430. [PMID: 38385207 PMCID: PMC10885779 DOI: 10.1177/00469580241233430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Within a few years, 1 in 6 people will be aged 60 years or older. Extreme situations, such as the COVID-19 crisis, constitute a challenge to older adults. However, the literature on the daily functional characteristics of older adults in the past and during the COVID-19 crisis and their relationships to their physical and mental health is scarce. This study aimed to examine the past and present daily functional factors associated with physical and mental health in older adults. Using an online platform, 204 Israelis aged 60 years and older reported their physical health symptoms and anxiety levels. They completed questionnaires about past (negative life events and childhood daily functional self-actualization) and present (adulthood daily functional self-actualization, functional cognition and sleep quality) factors. Structural equation modeling revealed correlations between functional cognition and childhood daily functional self-actualization (β = -.18) and anxiety (β = .15); adulthood daily functional self-actualization and past negative life events (β = -.18), anxiety (β = -.50), and physical symptoms (β = -16); and sleep quality and past childhood daily functional self-actualization (β = -.19), negative life events (β = .22), anxiety (β = .18), and physical symptoms (β = .40). These findings shed light on potential functional factors for older adults' health, indicating that these functional factors play a vital role in reducing health problems in later life.
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Qiu Y, Cong Z, Wang X, Li S. Potential factors associated with resilience among older adults in rural China: a multilevel analysis. BMC Geriatr 2023; 23:844. [PMID: 38087241 PMCID: PMC10717782 DOI: 10.1186/s12877-023-04575-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Resilience is crucial for older adults who experience adversities, but research on the issue in rural China remains limited. This study aims to examine factors associated with resilience among older adults in rural China, as related to different types of resilience, and under different levels of adversity. METHODS Data were taken from the eight-wave (2001-2021) Longitudinal Study of Older Adults in Anhui Province, China. We used data from the eighth wave (2021) for the outcome variables and lagged predictors (2018) to avoid reverse causal effects. The study sample included individuals 60 years and above, excluding new participants from 2021, those without any adverse events, and any respondents with incomplete analytic data. Resilience was operationalized as residuals of the regressions of life satisfaction (Life Satisfaction Scale) and depressive symptoms (CES-D) on adversity, referred to as Type-1 and Type-2 resilience respectively. These two types of resilience were then treated as the outcome variables in subsequent multilevel regressions, with the predictors focusing on individual, social, and environmental characteristics and resources. This study adheres to STROBE guidelines. RESULTS 43% of rural older adults exhibited both Type-1 and Type-2 resilience, whereas 18% exhibited only Type-1 resilience and 7% exhibited only Type-2 resilience. Common factors associated with both types of resilience included self-rated health, satisfaction with one's own financial situation, and the prestigiousness of social networks. Predictors for higher levels of Type-1 resilience included higher levels of financial and emotional support and more options for places of leisure. Predictors for higher levels of Type-2 resilience included greater access to medical care. The prestigiousness of social networks, higher levels of emotional support and instrumental support, access to medical care, and more options of places of leisure were positively associated with resilience in the low-adversity group (first tertile of adversity), only satisfaction with financial situation was positively correlated with the resilience of the middle-adversity group (second tertile), while better self-rated health, satisfaction with financial situation, and financial support yielded greater resilience in the high-adversity group (third tertile). CONCLUSIONS We examined two types of resilience among older adults in rural China, and found that they have shared and unique associated factors. In addition, the potential factors influencing resilience varied with the level of adversity.
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Affiliation(s)
- Yun Qiu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zhen Cong
- School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Xiaoxuan Wang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shuzhuo Li
- Center for Aging and Health Research, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
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Tan GJ, Kioh SH, Mat S, Tan MP, Chan SHL, Lee JMY, Tan YW. Psychosocial Determinants of Knee Osteoarthritis Progression: Results from the Promoting Independence in Our Seniors with Arthritis Study. Ann Geriatr Med Res 2023; 27:346-352. [PMID: 37899274 PMCID: PMC10772335 DOI: 10.4235/agmr.23.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/11/2023] [Accepted: 10/24/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a common cause of physical disability among older adults. While established risk factors for knee OA include age and increased body weight, few studies have examined psychosocial risk factors or progression of knee OA. METHODS The Promoting Independence in our Seniors with Arthritis study recruited participants aged 65 years and over from orthopedic outpatients and community engagement events. Participants were invited to annual visits during which knee OA symptoms were assessed with the Knee Injury and Osteoarthritis Outcome Score (KOOS), social network using the 6-item Lubben Social Network Scale and anxiety and depression using the Hospital Anxiety and Depression scale. Knee OA worsening was defined by a 5% reduction in mean KOOS scores at the last visit compared to the first visit. RESULTS Data were available from 148 participants, mean age 66.2±6.5 years and 74.1% female, of whom 28 (18.9%) experienced OA worsening over a median follow-up period of 29 months. Univariate analyses revealed that age, sex, height, grip strength, and social network were associated with OA worsening. Social network remained statistically significantly associated with OA worsening after adjustment for age and sex difference (odds ratio=0.924; 95% confidence interval, 0.857-0.997). The relationship between social network and OA worsening were attenuated by both depression and handgrip strength at baseline. CONCLUSION Psychological status and muscle strength may be modifiable risk factors for social network which may in turn prevent knee OA worsening and should be targeted in future intervention studies.
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Affiliation(s)
- Guo Jeng Tan
- Department of General Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Sheng Hui Kioh
- Department of Chiropractic, Centre Of Complementary and Alternative Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Sumaiyah Mat
- Centre for Health Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Department of General Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | | | | | - Yee Wen Tan
- Department of Anaesthesiology, Hospital Umum Sarawak, Kuching, Sarawak, Malaysia
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Rho Y, Kim M, Beon J, Kim Y, Yoon S, Nam YJ, Hong S, Cho YH, Son SJ, Hong CH, Roh HW. Moderators of the Association Between Contact Frequency With Non-Cohabitating Adult Children and Depressive Symptoms Among Community-Dwelling Older Adults. Psychiatry Investig 2023; 20:758-767. [PMID: 37559480 PMCID: PMC10460971 DOI: 10.30773/pi.2023.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/08/2023] [Accepted: 05/25/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE Contact frequency with adult children plays a critical role in late-life depression. However, evidence on possible moderators of this association remains limited. Moreover, considering alterations in contact modes after the coronavirus disease-2019 pandemic, there is a need to investigate this association post-pandemic to develop effective therapeutic interventions. METHODS This study included 7,573 older adults who completed the Living Profiles of the Older People Survey in Korea. Participants' contact frequency and depressive symptoms were analyzed. Regression analysis was performed after adjusting for covariates. The moderating effects of variables were verified using a process macro. RESULTS Multivariable logistic regression analysis revealed that infrequent face-to-face (odd ratio [OR]=1.86, 95% confidence interval [CI]=1.55-2.22) and non-face-to-face contact (OR=1.23, 95% CI=1.04-1.45) in the non-cohabitating adult children group was associated with a higher risk of late-life depression compared to that in the frequent contact group. Linear regression analysis indicated consistent results for face-to-face and non-face-to-face contact (estimate=0.458, standard error [SE]=0.090, p<0.001 and estimate=0.236, SE= 0.074, p=0.001, respectively). Moderation analysis revealed that the association between late-life depression and frequency of face-toface contact was moderated by age, household income quartiles, number of chronic diseases, physical activity frequency, presence of spouse, nutritional status, and whether the effect of frequency of non-face-to-face contact on late-life depression was increased by participation in social activity, frequent physical activity, and good cognitive function (p for interaction<0.05). CONCLUSION Frequent contact with non-cohabitating children lowers the risk of depression later in life. Several variables were identified as significant moderators of contact frequency and depression symptoms.
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Affiliation(s)
- Yujin Rho
- Department of Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Minji Kim
- Department of Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jungeun Beon
- Department of Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Yeojin Kim
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sunwoo Yoon
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - You Jin Nam
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sunhwa Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Yong Hyuk Cho
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
- Suwon Geriatric Mental Health Center, Suwon, Republic of Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
- Suwon Geriatric Mental Health Center, Suwon, Republic of Korea
| | - Hyun Woong Roh
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
- Suwon Geriatric Mental Health Center, Suwon, Republic of Korea
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Xi JY, Zhong SR, Zhou YX, Lin X, Hao YT. Effects of family multi-generational relationship on multimorbidity and healthy life expectancy for second generations: insight from the China Health and Retirement Longitudinal Study. BMC Geriatr 2023; 23:100. [PMID: 36800942 PMCID: PMC9938571 DOI: 10.1186/s12877-022-03714-z] [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: 09/14/2022] [Accepted: 12/23/2022] [Indexed: 02/19/2023] Open
Abstract
OBJECTIVE In the context of aging, Chinese families consisting of more than three generations (grandparents, parents, children) are the norm. The second generation (parents) and other family members may establish a downward (contact only with children) or two-way multi-generational relationship (contact with children and grandparents). These multi-generational relationships may have the potential effect on multimorbidity burden and healthy life expectancy in the second generation, but less is known about the direction and intensity of this effect. This study aims to explore this potential effect. METHODS We obtained longitudinal data from the China Health and Retirement Longitudinal Study from 2011 to 2018, which included 6,768 people. Cox proportional hazards regression was used to assess the association between multi-generational relationships and the number of multimorbidity. The Markov multi-state transition model was used to analyze the relationship between multi-generational relationships and the severity of multimorbidity. The multistate life table was used to calculate healthy life expectancy for different multi-generational relationships. RESULTS The risk of multimorbidity in two-way multi-generational relationship was 0.830 (95% CIs: 0.715, 0.963) times higher than that in downward multi-generational relationship. For mild multimorbidity burden, downward and two-way multi-generational relationship may prevent aggravation of burden. For severe multimorbidity burden, two-way multi-generational relationship may aggravate the burden. Compared with two-way multi-generational relationship, the second generations with downward multi-generational relationship has a higher healthy life expectancy at all ages. CONCLUSION In Chinese families with more than three generations, the second generations with severe multimorbidity burden may aggravate the condition by providing support to elderly grandparents, and the support provided by offspring to the second generations plays a vital positive role in improving the quality of life and narrowing the gap between healthy life expectancy and life expectancy.
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Affiliation(s)
- Jun-Yan Xi
- grid.12981.330000 0001 2360 039XDepartment of Medical Statistics, School of Public Health, Sun Yat-Sen University, 74Th Zhongshan 2Nd Rd, Yuexiu District, Guangzhou, 510080 China
| | - Si-Rui Zhong
- grid.12981.330000 0001 2360 039XDepartment of Medical Statistics, School of Public Health, Sun Yat-Sen University, 74Th Zhongshan 2Nd Rd, Yuexiu District, Guangzhou, 510080 China
| | - Yu-Xiao Zhou
- grid.12981.330000 0001 2360 039XDepartment of Medical Statistics, School of Public Health, Sun Yat-Sen University, 74Th Zhongshan 2Nd Rd, Yuexiu District, Guangzhou, 510080 China
| | - Xiao Lin
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, 74Th Zhongshan 2Nd Rd, Yuexiu District, Guangzhou, 510080, China.
| | - Yuan-Tao Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, 74Th Zhongshan 2Nd Rd, Yuexiu District, Guangzhou, 510080, China. .,Peking University Center for Public Health and Epidemic Preparedness & Response, Xueyuan Road, Haidian District, 100191, Beijing, China. .,Sun Yat-Sen Global Health Institute, Sun Yat-Sen University, Guangzhou, 510080, China. .,Center for Health Information Research, Sun Yat-Sen University, Guangzhou, 510080, China.
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