Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study

Implications of helplessness in depression: diagnosing mild cognitive impairment and analyzing its effects on cognitive decline in older adults

Background

This study focuses on how elements of depression correlate with mild cognitive impairment (MCI) in older adults and the diagnostic efficacy of combining these components with the Mini-Mental State Examination (MMSE). The study also investigated the connection between individual depression components and overall cognitive function, as measured by the total score (TS) of the consortium to establish a registry for Alzheimer's disease (AD) assessment battery.

Methods

The study included 196 nondemented adults aged 65 to 90 years at a university hospital and community. Comprehensive clinical assessments including the 30-item Geriatric Depression Scale (GDS) to measure components of depressive symptoms, TS, and blood nutritional biomarkers.

Results

Our stepwise logistic regression analysis highlighted the 'helplessness item' (odds ratio = 4.531, 95% CI = 2.218 to 9.258, p < 0.001) as a significant predictor for MCI diagnosis. Further, models incorporating 'helplessness item + MMSE' demonstrated markedly enhanced accuracy in diagnosing MCI, surpassing the performance of the MMSE used independently. Notably, the group characterized by helplessness showed a significant reduction in TS (B = -5.300, SE = 1.899, β = -0.162, p = 0.006), with this trend being particularly pronounced in individuals exhibiting lower levels of physical activity. Interestingly, this correlation did not manifest in participants with higher physical activity levels.

Conclusion

Our findings suggest that helplessness is highly effective in diagnosing MCI and is linked to a decrease in cognitive function. Therefore, when addressing MCI and AD-related cognitive decline, clinicians should consider helplessness.

Association between accelerometer-derived physical activity and depression: a cross-sectional study using isotemporal substitution analysis

OBJECTIVES

Depression is a significant public health concern, and physical activity has been identified as a non-pharmacological intervention. Understanding the dose-response relationship between physical activity and depression is crucial for designing effective exercise interventions and recommending physical activity to individuals with depression. The isotemporal substitution model is considered the gold standard for estimating the dose-response effects of physical activity. This study aims to investigate the dose-response association between depression and accelerometer-measured physical activity in the Korean population.

DESIGN

Cross-sectional analysis.

SETTING

A non-probability sample of the community population was drawn from the 2014 and 2016 Korean National Health and Nutrition Examination Survey.

PARTICIPANTS

The study included 1543 adults aged 19-64 years who completed the Patient Health Questionnaire-9 (PHQ-9) and volunteered to wear an accelerometer.

MAIN OUTCOME MEASURES

Physical activity was measured using a GT3X+ accelerometer for 7 consecutive days, and activity was categorised as sedentary behaviour (SB) or light, moderate or vigorous physical activity. Depression was assessed using the PHQ-9.

RESULTS

Physical activity and SB were associated with depression. In the single-parameter model, moderate-vigorous physical activity (MVPA) showed a significant association with reduced odds of depression (OR: 0.817, 95% CI: 0.678 to 0.985). Substituting 30 min of SB with 30 min of MVPA (OR: 0.815, 95% CI: 0.669 to 0.992) was linked to a decrease in the odds of depression. Conversely, replacing 30 min of MVPA with 30 min of SB (OR: 1.227, 95% CI: 1.008 to 1.495) was associated with an increase in the odds of depression.

CONCLUSIONS

This study provides evidence of an association between physical activity and depression in the Korean population, highlighting the importance of reducing SB and increasing MVPA to prevent and manage depression. Further research is needed to confirm causality and determine optimal levels of physical activity for preventing depression in different populations.

Association of perceived childhood socio-economic status and health with depressive symptoms among middle-aged and older adults in India: using data from LASI Wave I, 2017-2018

BACKGROUND

Childhood adverse experience has been linked with poor health outcomes across the life course. Nevertheless, whether such an association or direction could be projected to older people's life remains still unclear and needs to generate more evidence, particularly in India. Therefore, this study was conducted to examine the association of childhood socio-economic status and health with depressive symptoms amongst middle- aged and older adults in India.

METHODS

The data for the study was drawn from national representative survey "Longitudinal Ageing Study in India (LASI)" Wave I, 2017-2018 in order to conduct cross-sectional study. Multivariable regression analysis was used to examine the association of childhood socioeconomic status and health with depressive symptoms in the older population.

RESULTS

Poor childhood health was significantly and positively associated with depressive symptoms (AoR: 1.56, CI: 1.19, 2.04). Likewise, respondents who were bedridden for a month during their childhood had high odds of developing depressive symptoms (AoR: 1.16 CI: 1.01, 1.34). In addition to this, the odds of having depressive symptoms increased significantly among the average (AoR: 1.28 CI: 1.08, 1.51) and poor childhood socioeconomic status group (AoR: 1.31 CI: 1.11, 1.55) as compared to the higher socioeconomic category.

CONCLUSIONS

Childhood socioeconomic status and health have a significant role in determining mental health in later life. Results suggest that considering childhood socioeconomic status and health is important while diagnosing depression in older population in order to identify the significant associated factors in early childhood and thus help in preventing depressive symptoms in later life.

The Influence of Guozhuang Dance on the Subjective Well-Being of Older Adults: The Chain Mediating Effect of Group Identity and Self-Efficacy

BACKGROUND

In the context of the gradually accelerating aging of the population, the subjective well-being of older adults has received extensive research attention. Guozhuang Dance is a collective aerobic exercise that plays an important role in the physical activity of older Chinese adults. Studying the intrinsic relationship between Guozhuang Dance and the subjective well-being can help improve the quality of life and well-being of older adults in their later years. This study was conducted in Chengdu City, Sichuan Province, China, where many older adults practice Guozhuang Dance. Previous studies pointed out that group identity and self-efficacy can influence well-being in a collective exercise.

METHODS

For this study, we recruited 520 adults (male = 228, female = 292) aged 65 years or older from Chengdu who participated in Guozhuang Dance, to conduct a survey to understand the effect of this exercise on their subjective well-being. The Guozhuang Dance exercise scale, the group identity scale, the self-efficacy scale, and the subjective well-being scale were used in the study. We used SPSS for the descriptive statistical analysis, and AMOS for the structural equation modeling.

RESULTS

The results of the study show that Guozhuang Dance has a positive effect on enhancing the subjective well-being of older adults and can increase the subjective well-being through the chain mediating effect of group identity and self-efficacy.

CONCLUSIONS

We suggest that effective measures should be taken to encourage older adults to participate in Guozhuang Dance, in order to enhance their subjective well-being.

The effect of childhood socioeconomic status on depressive symptoms in middle-old age: the mediating role of life satisfaction

BACKGROUND

Some studies have shown that childhood socioeconomic status (SES) can influence the development and progression of depression in adulthood. This study aimed to analyze the effects of childhood SES on depressive symptoms in individuals of middle-old age and examine the potential mediating role of life satisfaction based on national data in China.

METHODS

Data were derived from the 2018 China Health and Retirement Longitudinal Study (CHARLS) data. A total of 17,129 individuals who were aged 45 years and older were included. The dependent variable was depressive symptoms in middle-old age. Childhood SES was the independent variable, and life satisfaction was the mediator. This study controlled four factors: general demographic characteristics, adult SES, childhood adversity and health and living status. Pearson correlations and hierarchical multiple regression analysis were performed, and the Baron and Kenny method was used to test the mediating role.

RESULTS

The score of depressive symptoms among all participants was 7.88 ± 6.65. Gender, age, adult SES, childhood adversity and health and living status all affected the development of depression symptom in middle-aged and elderly individuals in China. After adjusting for all covariates, the higher the childhood SES, the lower the depressive symptom score (β = - 0.422, P < 0.001). Life satisfaction had a partial mediating effect between childhood SES and depressive symptoms. Low childhood SES may improve life satisfaction (β = 0.051, P < 0.001) and life satisfaction indirectly decreases depressive symptom scores (β = - 0.403, P < 0.001).

CONCLUSIONS

Life satisfaction was a partial mediator between childhood SES and depressive symptoms in middle and old age. Improving life satisfaction may serve as an intervention to reduce the incidence of depression symptoms in the future.

Neurological and Psychological Determinants of Depression, Anxiety, and Life Quality

Background:

This study aimed to determine the major neurological and psychological elements affecting depression, anxiety (DEPXITY), and the overall quality of life.

Methods:

This analytical descriptive study was carried out on 141 respondents with formal mood disorder diagnosis, with mental illness identity, with current depression and anxiety symptoms of at least moderate severity and people with mild symptoms. Data were analyzed using descriptive statistics, correlation test, reliability test, and separate regression models. Statistical significant level was set as 0.05.

Results:

The findings showed that external control by others on one's own life (EC) is the most significant factor (0.45) related to depression and the social conflict (SC) was found to be the most influential factor (0.28) for the anxiety. Internal control over own personal life (IC) is the most significant factor to cure or regulate some of the negative symptoms of the anxiety (−0.66). Good performance in personal life (PP) is a common positive factor to regulate both depression (DEP) and anxiety (XITY). This study shows that DEPXITY is associated with negative life quality.

Conclusions:

The lack of internal control and the control by others on one's own personal life are associated with impaired cognitive, affective, and behavioral functioning. The results of this study can also be a good indicator and confirmation that the medial prefrontal cortex is able with the support of IC and PP to coordinate self-appraisal processes by regulating activity in the posterior cingulate cortex area of the brain.

Risk Factors for Depression in Long-term Care: A Prospective Observational Cohort Study

Objectives: Depression among older adults in long-term care remains a problem, despite the uptake of antidepressants and the development of intervention programs. A better understanding of the risk factors for depression is much needed. Guided by a systematic assessment of the evidence, this prospective observational cohort study sought to clarify existing evidence, identify modifiable risk factors and explore novel variables. Methods: Adults aged ≥65 (T1 n=147, T2 n= 81) were recruited from 15 long-term-care facilities in Melbourne, Australia. Cognitive impairment, functional impairment, pain, sleep disturbance, social support, and person-environment fit were investigated as risk factors. Outcomes were depressive symptoms and indicated Major Depressive Episode. Results: Generalized Estimating Equations (GEE) identified that changes in pain (b= 0.06, p<.05), sleep disturbance (b= 0.02, p< .001), social support (b= -0.02, p< .001) and person-environment fit (b= -0.02, p= <.01) were significantly associated with changes in depression score. Conclusions: Pain, sleep disturbance, social support, and person-environment fit are modifiable risk factors, making them strongly positioned to strategically inform prevention and intervention strategies. Clinical Implications: Individuals with clinically significant symptoms on these risk factors for depression should be selected for interventions that target these risk factors. For depressed individuals, psychotherapy should prioritize the potential role of these risk factors. Finally, these risk factors should be used as screening and monitoring variables: clinically significant changes in symptoms warrant investigation.

Are Lipids Possible Markers of Suicide Behaviors?

Suicides and suicidal behaviors are very important causes of mortality and morbidity and have become a serious global problem. More than 800,000 people die from suicide every year. Previous researches have established that lipids play an important role in the pathogenesis of suicide. Moreover, lipid levels might be a biological marker of suicide. A lot of researchers have tried to identify biological markers that might be related to depressive disorder, bipolar disorder or schizophrenia and suicidal behavior. It was also important to consider the usefulness of an additional tool for prevention actions. Metabolic deregulation, particularly low total cholesterol and low-density lipoproteins-cholesterol levels may cause higher suicide risk in patients with these psychiatric disorders.

The Association Between the Basic Old-Age Pension and Depression of the Older Adults in Korea

OBJECTIVES

The purpose of this study was to investigate the association between the Basic Old-Age Pension (BOP), which is a noncontributory pension, and depression in BOP beneficiaries in Korea.

METHODS

We used the second and third waves (2007-2008) of the Korea Welfare Panel Study to identify the effect of the BOP on mental health in the year of its introduction. The Center for Epidemiological Studies-Depression Scale, applied in a Korean context, was used to evaluate mental health. To analyze the effect of the BOP, a difference-in-difference approach was used in analyses of all subjects and subgroups.

RESULTS

For this study population of 760 adults, the BOP did not have a statistically significant relationship with depression in its beneficiaries. After controlling for type of household, the BOP was still not associated with lower reporting of depression, either in single-beneficiary or double-beneficiary households, in the year of the benefit.

CONCLUSIONS

The BOP policy had no significant relationship with the level of depression among recipients. However, this should not be interpreted as implying that income subsidy programs for older adults, such as the BOP, do not affect mental health, considering the importance of economic hardship in this population and the program's socioeconomic effects.

The Assessment Effect of Spiritual Care on Hopelessness and Depression in Suicide Attempts

The purpose of this study was to assess the effect of spiritual care on hopelessness and depression among suicide attempts. This semi-experimental study that 60 suicide attempts and these samples were divided in to two cases and control groups. For case group, service package of spiritual care was designed and conducted during their visits to psychiatrists' offices. Findings showed that there was a significant difference after performing spiritual care in depression in both groups (X² = 22, P = 0.002) and their hopelessness (X² = 20, P = 0.001). The use of spiritual intervention is suggested in order to implement holistic nursing care during treatment should be considered as a matter of principle.

Suicide in the Elderly: A Multidisciplinary Approach to Prevention

Suicide in the elderly is a growing problem. The elderly population is increasing, and elderly patients have multiple issues that place them at higher risk of suicidality. These issues include physical illnesses, mental illness, loss of functional status, isolation, and family, financial, and social factors. Access to firearms is another significant risk factor, because elderly patients are more likely to use firearms in suicide attempts; interventions to reduce firearms mortality may save lives. Tackling the difficult problem of suicide in the elderly may require a multidisciplinary, community-based series of interventions.

Association of low blood pressure with suicidal ideation: a cross-sectional study of 10,708 adults with normal or low blood pressure in Korea

Background

Whether constitutional low blood pressure (BP) causes substantive health problems has been controversial, and subjects with hypotension exhibit a range of symptoms, from mild typical conditions such as tiredness and dizziness to more specific psychological conditions and even cognitive disorders. This study investigated whether low BP is associated with suicidal ideation in the general population.

Methods

Four years of data from the 2010–2013 Korean National Health and Nutrition Examination Survey were used. Among the 23,163 participants, aged 19–101 years, 10,708 with normal or low BP were included in the analysis of the association between low BP and suicidal ideation. The criterion used for low BP was systolic BP (SBP) < 100 mmHg, and in comparative analyses, the criteria used for low BP were SBP < 110, < 95, and < 90 mmHg. The association of prehypertension or hypertension with suicidal ideation was also examined. Suicidal ideation was assessed by a questionnaire.

Results

Compared with the normotensive reference group, the odds ratios (ORs) for suicidal ideation were significantly higher in the three hypotensive groups after adjusting for sex, age, body mass index, total cholesterol level, household income, educational level, marital status, current smoking status, alcohol intake, and the interaction between sex and age (OR = 1.29, 95% confidence interval [CI], 1.08 to 1.55; OR = 1.44, 95% CI, 1.14 to 1.82; and OR = 1.71, 95% CI, 1.11 to 2.62 for SBP < 100, SBP < 95, and SBP < 90 mmHg, respectively). Adding the clinical morbidities of diabetes mellitus, stroke, myocardial infarction/angina pectoris, and depression as covariates had little effect on the strength of the associations (OR = 1.25, 95% CI, 1.04 to 1.50; OR = 1.43, 95% CI, 1.13 to 1.81; and OR = 1.74, 95% CI, 1.14 to 2.68 for SBP < 100, < 95, and < 90 mmHg, respectively).

Conclusions

Low SBP showed an association with suicidal ideation in the general Korean population. The association was significant for low BP, defined as a SBP < 100 mmHg, and the strength of the association increased as the criteria for low BP increased in strictness.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5106-5) contains supplementary material, which is available to authorized users.

[Mental health in older men in Chile: a reality to be prioritizedSaúde mental de homens idosos no Chile: uma realidade a ser priorizada]

Los problemas de salud mental constituyen un conjunto de condiciones de alto impacto. Las personas de 60 y más años presentan vulnerabilidades particulares que aumentan el riesgo de experimentar problemas de salud mental y consecuencias terminales como el suicidio. En este grupo etario, los hombres constituyen un subgrupo poco considerado como destinatarios particulares de acciones en salud. En el caso de Chile, este artículo busca caracterizar la realidad de la salud mental de los hombres adultos mayores mediante cifras provenientes de encuestas poblacionales realizadas en el país (Encuesta Nacional de Salud [ENS] 2003-2009, Estudio Nacional de Dependencia en las Personas Mayores [ENADEAM] 2009, Encuesta de Caracterización Socioeconómica Nacional [CASEN] 2015). El artículo aborda indicadores relativos a depresión y síntomas depresivos, suicidio e ideación suicida, y consultas de salud mental. Las cifras reportadas en las encuestas seleccionadas informan que, en Chile, los hombres adultos mayores son el grupo que presenta la mayor tasa de suicidio, el menor número de ideación e intento suicida, y la menor frecuencia reportada de consultas de salud mental. De igual modo, presentan menor reporte de depresión en comparación con mujeres. Estas cifras permiten aproximar a un perfil de salud mental en hombres mayores en Chile y cuestionar la pertinencia de los actuales modelos epidemiológicos para la identificación de perfiles de riesgo de salud mental en este grupo. Asimismo, emerge la urgente necesidad de diseñar programas de salud que incorporen dicha consideración de género, para lograr una adecuada pesquisa y aceptabilidad de las potenciales intervenciones dirigidas a promover la salud mental y reducir riesgos en hombres adultos mayores.

The Impact of the Financial Crisis on Lifestyle Health Determinants Among Older Adults Living in the Mediterranean Region: The Multinational MEDIS Study (2005-2015)

Objectives

By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands.

Methods

From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity.

Results

Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001).

Conclusions

A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.