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Zheng H, Fan X, Liu Y, Wu Y, Liu Y, Xu Y, Zhi J, Yang C, Liao J. How dyadic appraisal moderate the association between dyadic coping and diabetes management efficacy. J Health Psychol 2024:13591053241240735. [PMID: 38584333 DOI: 10.1177/13591053241240735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024] Open
Abstract
To explore the moderating role of dyadic appraisal in the association between dyadic coping and diabetes management efficacy. Two hundred seventy six middle-aged and older couple pairs with one spouse who had diabetes were recruited from 14 community healthcare centers across Guangzhou. The moderating role of dyadic appraisal was investigated using the actor-partner interdependence moderation model. When both couples considered diabetes to be a shared condition, statistically-significant associations were found between patients' negative (β = -22.7, p = 0.008) and neutral behaviors (β = 13.6, p = 0.017), plus spouses' positive behaviors (β = 22.8, p = 0.009) on their own diabetes management efficacy, respectively (i.e. actor effects); as well as between spouses' positive (β = 16.8, p = 0.028), negative (β = -28.5, p < 0.001), and neutral behaviors (β = 16.9, p = 0.006) on patient's diabetes management efficacy (i.e. partner effects). Dyadic appraisal moderates the association between dyadic coping and diabetes management efficacy.
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Affiliation(s)
| | | | - Yuyang Liu
- Sun Yat-sen University, China
- Shenzhen Health Development Research and Data Management Center, China
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Varghese JS, Lu P, Choi D, Kobayashi LC, Ali MK, Patel SA, Li C. Spousal Concordance of Hypertension Among Middle-Aged and Older Heterosexual Couples Around the World: Evidence From Studies of Aging in the United States, England, China, and India. J Am Heart Assoc 2023; 12:e030765. [PMID: 38054385 PMCID: PMC10863781 DOI: 10.1161/jaha.123.030765] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/24/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Health concordance within couples presents a promising opportunity to design interventions for disease management, including hypertension. We compared the concordance of prevalent hypertension within middle-aged and older heterosexual couples in the United States, England, China, and India. METHODS AND RESULTS Cross-sectional dyadic data on heterosexual couples were used from contemporaneous waves of the HRS (US Health and Retirement Study, 2016/17, n=3989 couples), ELSA (English Longitudinal Study on Aging, 2016/17, n=1086), CHARLS (China Health and Retirement Longitudinal Study, 2015/16, n=6514), and LASI (Longitudinal Aging Study in India, 2017/19, n=22 389). Concordant hypertension was defined as both husband and wife in a couple having hypertension. The prevalence of concordant hypertension within couples was 37.9% (95% CI, 35.8-40.0) in the United States, 47.1% (95% CI, 43.2-50.9) in England, 20.8% (95% CI, 19.6-21.9) in China, and 19.8% (95% CI, 19.0-20.5) in India. Compared with wives married to husbands without hypertension, wives married to husbands with hypertension were more likely to have hypertension in the United States (prevalence ratio, 1.09 [95% CI, 1.01- 1.17), England (prevalence ratio, 1.09, 95% CI, 0.98-1.21), China (prevalence ratio, 1.26 [95% CI, 1.17-1.35), and India (prevalence ratio, 1.19 [95% CI, 1.15-1.24]). Within each country, similar associations were observed for husbands. Across countries, associations in the United States and England were similar, whereas they were slightly larger in China and India. CONCLUSIONS Concordance of hypertension within heterosexual couples was consistently observed across these 4 socially and economically diverse countries. Couple-centered interventions may be an efficient strategy to prevent and manage hypertension in these countries.
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Affiliation(s)
- Jithin Sam Varghese
- Hubert Department of Global Health, Rollins School of Public HealthEmory UniversityAtlantaGA
- Emory Global Diabetes Research Center of Emory University and Woodruff Health Sciences CenterAtlantaGA
| | - Peiyi Lu
- Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkNY
| | - Daesung Choi
- Hubert Department of Global Health, Rollins School of Public HealthEmory UniversityAtlantaGA
- Emory Global Diabetes Research Center of Emory University and Woodruff Health Sciences CenterAtlantaGA
| | - Lindsay C. Kobayashi
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMI
| | - Mohammed K. Ali
- Hubert Department of Global Health, Rollins School of Public HealthEmory UniversityAtlantaGA
- Emory Global Diabetes Research Center of Emory University and Woodruff Health Sciences CenterAtlantaGA
- Department of Family and Preventive Medicine, School of MedicineEmory UniversityAtlantaGA
| | - Shivani A. Patel
- Hubert Department of Global Health, Rollins School of Public HealthEmory UniversityAtlantaGA
- Emory Global Diabetes Research Center of Emory University and Woodruff Health Sciences CenterAtlantaGA
| | - Chihua Li
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMI
- Survey Research CenterUniversity of MichiganAnn ArborMI
- Department of EpidemiologySchool of Public Health, Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
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Yuan X, Liu W, Ni W, Sun Y, Zhang H, Zhang Y, Yin P, Xu J. Concordance of Non-Alcoholic Fatty Liver Disease and Associated Factors among Older Married Couples in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1426. [PMID: 36674180 PMCID: PMC9859299 DOI: 10.3390/ijerph20021426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases which affects mainly middle-aged and older adults, resulting in a considerable disease burden. Evidence of concordance on NAFLD and lifestyle factors within older married couples in China is limited. This study aimed to evaluate spousal concordance regarding lifestyle factors and NAFLD among older Chinese couples. Methods: We conducted a cross-sectional study using data from 58,122 married couples aged 65 years and over recruited from Shenzhen, China during 2018−2020. Logistic regression analyses were used to estimate the reciprocal associations in NAFLD within couples after incremental adjustment for potential confounders. Results: There was a marked concordance regarding NAFLD among older married couples in our study. After adjustment for confounders, the odds of having NAFLD were significantly related to the person’s spouse also having NAFLD (1.84 times higher in husbands and 1.79 times higher in wives). The spousal concordance of NAFLD was similar, irrespective of gender. Couples with both a higher educational level and abdominal obesity were more likely to have a concordance of NAFLD compared to couples with both a lower educational level and no abdominal obesity, respectively (p < 0.05). Conclusion: Our results indicated that health care professionals should bear in mind the marked spousal concordance with respect to risk factors and NAFLD for the prevention and early detection of the highly prevalent disease in older Chinese adults.
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Affiliation(s)
- Xueli Yuan
- Department of Elderly Health Management, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China
| | - Wei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Wenqing Ni
- Department of Elderly Health Management, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China
| | - Yuanying Sun
- Department of Elderly Health Management, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China
| | - Hongmin Zhang
- Department of Elderly Health Management, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China
| | - Yan Zhang
- Department of Elderly Health Management, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Jian Xu
- Department of Elderly Health Management, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China
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Lin B, Pan L, He H, Hu Y, Tu J, Zhang L, Cui Z, Ren X, Wang X, Nai J, Shan G. Spousal Similarities in Cardiovascular Risk Factors in Northern China: A Community-Based Cross-Sectional Study. Int J Public Health 2023; 68:1605620. [PMID: 36895713 PMCID: PMC9988901 DOI: 10.3389/ijph.2023.1605620] [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: 11/23/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Objectives: The aim of this study was to explore spousal similarities in cardiovascular risk factors in northern China. Methods: We conducted a cross-sectional study of married couples from Beijing, Hebei, Gansu, and Qinghai provinces between 2015 and 2019. A total of 2,020 couples were included in the final analyses. The spousal similarities for metabolic indicators and cardiovascular risk factors (including lifestyle factors and cardiometabolic diseases) were evaluated using Spearman's correlation and logistic regression analyses, respectively. Results: All metabolic indicators showed positive spousal correlations (p < 0.001), with the strongest for fasting blood glucose (r = 0.30) and the lowest for high-density lipoprotein cholesterol (r = 0.08). Significant husband-wife associations were observed for several cardiovascular risk factors except for hypertension in multivariable models, with the strongest association for physical inactivity (odds ratios with 95% confidence intervals of 3.59 [2.85, 4.52] and 3.54 [2.82, 4.46] for husbands and wives, respectively). In addition, the interaction of age with spousal overweight/obesity status was statistically significant, and the association was stronger in people ≥50 years. Conclusion: There were spousal similarities in cardiovascular risk factors. The finding may have public health implications that targeted screening and interventions for spouses of people with cardiovascular risk factors.
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Affiliation(s)
- Binbin Lin
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Yaoda Hu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Ji Tu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Ze Cui
- Department of Chronic and Non-Communicable Disease Prevention and Control, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Xiaolan Ren
- Department of Chronic and Non-Communicable Disease Prevention and Control, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Xianghua Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Tianjin, China
| | - Jing Nai
- Clinical Laboratory, Beijing Hepingli Hospital, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
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Yang C, Xu Y, Zhi J, Zheng H, Sun Z, Wu X, Liao J. Gender-Specific Effect of Couple-Based Intervention on Behavioral and Psychological Outcomes of Older Adults with Type 2 Diabetes during the COVID-19 Partial Lockdown in Guangzhou, China. Healthcare (Basel) 2022; 10:healthcare10112290. [PMID: 36421614 PMCID: PMC9690585 DOI: 10.3390/healthcare10112290] [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: 10/10/2022] [Revised: 10/29/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022] Open
Abstract
This study aimed to evaluate the gender-specific effect of a couple-based intervention on the management behaviors and mental well-being of community-dwelling older adults with type 2 diabetes mellitus during the COVID-19 partial lockdown in Guangzhou. Out of 207 participants involved in a prior randomized controlled trial (Trial no. ChiCTR1900027137), 156 (75%) completed the COVID-19 survey. Gendered differences in management behaviors and depressive symptoms between the couple-based intervention group and the patient-only control group were compared by distance to the high-risk areas cross-sectionally and longitudinally using random intercept models. Cross-sectionally, female patients of the intervention group had more positive behavior change scores (β = 1.53, p = 0.002) and fewer depressive symptoms (β = −1.34, p = 0.02) than the control group. Over time, female patients lived closer to the high-risk areas (<5 km) and showed decreasing depressive symptoms (β = −4.48, p = 0.008) in the intervention group vs. the control group. No statistically significant between-group difference was found for males. Females tended to benefit more from the coupled-based intervention than males did, particularly among these closer to the high-risk areas. Chronic disease management can be better sustained with active spousal engagement.
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Affiliation(s)
- Conghui Yang
- Department of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou 510080, China
| | - Yingxin Xu
- Department of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou 510080, China
| | - Jingyi Zhi
- Department of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou 510080, China
| | - Huiqiong Zheng
- Department of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhenhua Sun
- School of Nursing and Health, Guangzhou Nanfang College, Guangzhou 510970, China
| | - Xueji Wu
- Department of Integrated Profession Management, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Jing Liao
- Department of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou 510080, China
- Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou 510275, China
- Correspondence: ; Tel.: +86-020-8411-2657
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Wang J, Wang Q, Hou XY, Chen S, Guo Z, Du W, Fan L. Spousal Concordance in the Development of Functional Limitations Among Married Adults in China. JAMA Netw Open 2021; 4:e2125577. [PMID: 34581797 PMCID: PMC8479583 DOI: 10.1001/jamanetworkopen.2021.25577] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Functional limitation is increasingly common as people age and is often associated with negative consequences. Evidence of the dynamics of functional limitation within couples in China is still inadequate. OBJECTIVES To examine whether functional limitation was associated within middle-aged and older couples and to explore sex differences in spousal associations. DESIGN, SETTING, AND PARTICIPANTS In this nationwide, population-based cohort study performed from January 1, 2011, to December 31, 2018, participants were selected using multistage probability sampling, and 5207 community-dwelling couples (10 414 individuals) 45 years or older were included in the nationally representative China Health and Retirement Longitudinal Study. Data analysis was performed from January 1 to February 28, 2021. EXPOSURES The exposure variable was the presence of functional limitation in spouses. Functional limitation was measured by the activities of daily living (ADLs) and instrumental activities of daily living (IADLs) scales and was defined as having difficulty in independently performing at least 1 ADL or IADL item. MAIN OUTCOMES AND MEASURES The main outcome was functional limitation in index participants. Multivariable logistic regression with generalized estimating equations was used to estimate the reciprocal association of functional limitation within couples over time. RESULTS A total of 5207 married, different-sex couples (mean [SD] age, 59.1 [8.8] years for husbands and 57.0 [8.2] years for wives) were included in the study. For husbands, the number (percentage) of participants classified with baseline functional limitation was 1140 (21.9%), the number (percentage) with ADL limitation was 684 (13.1%), and the number (percentage) with IADL limitation was 834 (16.0%). For wives, the number (percentage) of participants classified with baseline functional limitation was 1502 (28.8%), the number (percentage) with ADL limitation was 887 (17.0%), and the number (percentage) with IADL limitation was 1183 (22.7%). Longitudinal results demonstrated an association in spouses developing functional limitation (adjusted odds ratio [OR], 2.55; 95% CI, 2.41-2.69; P < .001), ADL limitation (adjusted OR, 2.26; 95% CI, 2.11-2.41; P < .001), and IADL limitation (adjusted OR, 2.58; 95% CI, 2.43-2.73; P < .001). Subgroup analyses by sex revealed similar patterns of spousal health concordance in terms of all studied outcomes, indicating no sex specificity. CONCLUSIONS AND RELEVANCE This population-based cohort study suggests that among Chinese middle-aged and older couples there is significant concordance in the development of functional limitation. This study of spousal functional ability from a dyadic perspective may help in the understanding of health risks within a wider familial context and offers novel insights for prioritizing policy focus from individual centered to couple based.
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Affiliation(s)
- Jingwen Wang
- Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, China
| | - Qian Wang
- Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiang-Yu Hou
- School of Health and Wellbeing, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Sunan Chen
- Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, China
| | - Zhen Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Wei Du
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Lijun Fan
- Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, China
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Naseri P, Amiri P, Zareie Shab-Khaneh A, Azizi F. Predictive value of women's weight trajectories in determining familial cardiovascular disorders: a family-based longitudinal study. Sci Rep 2021; 11:17317. [PMID: 34453070 PMCID: PMC8397790 DOI: 10.1038/s41598-021-96154-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/28/2021] [Indexed: 11/09/2022] Open
Abstract
Considering the dynamic nature of body mass index (BMI) and its importance in determining cardiovascular risks, this study aimed to investigate the life-course trajectory pattern of women’s BMI and its association with cardiovascular risk factors. A total of 1356 couples with 2976 children were recruited and followed up for an average period of 20 years. Latent growth curve modeling was applied to determine women's BMI trajectories; logistic regression was used to investigate the associations between trajectory patterns and cardiovascular risk factors, including hypertension (HTN), dyslipidemia, diabetes mellitus (DM), and obesity. Women were classified into three trajectories, including normal, stage 1 obesity, and stage 2 obesity. Compared to women’s in the normal trajectory group, those in obesity trajectories had higher odds ratios for HTN, DM, and dyslipidemia. Men with obese spouses showed a higher rate of HTN 1.54 (95% CI 1.05–2.25) and DM 1.55; (95% CI 1.00–2.44). The odds of men’s obesity were higher in obese spouses (OR 1.70; 95% CI 1.10–2.62). Offspring of stage 2 obese (OR 2.39; 95% CI 1.67–3.44) and stage 1 obese (OR 4.81; 95% CI 3.16–7.34) mothers were more likely to be obese. Our findings emphasized paying more attention to women with excessive weight to promote familial cardiovascular health in the communities.
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Affiliation(s)
- Parisa Naseri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-4763, Tehran, Islamic Republic of Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-4763, Tehran, Islamic Republic of Iran.
| | - Amirali Zareie Shab-Khaneh
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
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