Depression Status Research Articles

Associations between sleep duration, depression status, and cognitive function among Chinese elderly: A community-based study

BackgroundThe associations of sleep duration and depressive status on cognitive function among the elderly remain controversial. This study aimed to investigate the associative effects and mediating mechanisms between sleep duration and depressive status on cognitive function in elderly adults. MethodsParticipants were recruited from cross-sectional and cohort surveys of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We identified thresholds for sleep duration and depression and used logistic regression to explore their independent and joint effects on cognitive impairment. Further, we analyze the mediating effects of depressive status on the association between sleep duration and cognitive function. ResultsOf 13840 elderly (median age: 84 years, female: 54.6 %), 2835 (20.5 %) had cognitive impairment. Compared with those who slept 6–8 h, the ORs (95%CIs) for those who slept < 6 h and > 8 h were 0.98 (0.85, 1.12) and 1.48 (1.32, 1.66). Compared with non-depressed, the OR (95%CI) for the depressed participants was 1.74 (1.53, 1.98). Compared with those with sleep 6–8 h and none-depression, those with sleep > 8 h and depression had the highest odds of cognitive impairment (OR = 2.40, 95%CI: 1.88–3.07). Additionally, Compared with those who slept 6–8 h, the associations between depression-mediated short and long sleep and cognitive impairment were 51.1 % and 6.5 %, respectively. LimitationsCross-sectional studies require caution in the interpretation of causal associations. ConclusionsLong sleep and depression were independently and jointly associated with higher odds of cognitive impairment among the Chinese elderly, and short sleep increased the risk of cognitive impairment by promoting the prevalence of depression.

Path analysis of COVID-19 cognition, social support, and mental health of pregnant women with interventional prenatal diagnosis during the COVID-19 pandemic based on structural equation modeling.

This study aims to investigate the relationship between Corona Virus Disease 2019 (COVID-19) cognition, social support, and mental health among pregnant women proposed for undergoing interventional prenatal diagnosis in Sichuan Province during the COVID-19 pandemic. A total of 2270 pregnant women (2232 valid) who were proposed to undergo interventional prenatal diagnosis at a tertiary hospital prenatal diagnosis center in Sichuan Province from January to December 2022 were selected by Convenience sampling and surveyed using a self-administered general information questionnaire, social support rating scale, mental health questionnaire (including: Self-Rating Anxiety Scale, Self-Rating Depression Scale), and self-administered COVID-19 cognition questionnaire. Structural equation modeling showed that social support negatively predicted anxiety (β = -0.34, t = -14.98, P < .001) and negatively predicted depressive status (β = -0.21, t = -9.57, P < .001); COVID-19 cognition negatively predicted anxiety (β = -0.76, t = -5.34, P < .001) and depression (β = -0.40, t = -2.99, P < .01); anxiety positively predicted anxiety (β = 0.73, t = 37.34, P < .001). The overall knowledge rate of COVID-19 cognition among 2232 pregnant women who were to undergo interventional prenatal diagnosis was 76.40%. The fit indices of the model were: CMIN/DF = 3.071, GFI = 0.999, AGFI = 0.993, CFI = 0.999, RMSEA = 0.030, NFI = 0.998, and TLI = 0.992, indicating that the model had a good fit and the model was scientifically valid. Pregnant women in Sichuan province who are to undergo prenatal interventional diagnosis have a medium level of COVID-19 awareness, and their level of COVID-19 awareness and social support will directly affect their anxiety and depression level, and their anxiety level will also affect their depression level. We should give more attention to pregnant women, especially those in particular situations such as advanced age, poor maternal history, family history of genetic disease, etc, they should be given adequate care and social support, and multiple channels and types of health education should be provided for the COVID-19 to improve the pregnant women's knowledge of COVID-19, which is important for improving the mental health of pregnant women.

Characteristics and Impact of Long COVID at a Neurology Clinic

Introduction: Long COVID can also lead to neurological sequelae that affect existing diseases. This study explored how COVID-19 infection affects neurological patients and the relationship between long COVID and exacerbating factors. Methods: This retrospective study was conducted on 85 patients with neurological diseases after COVID-19 at the Neurology Department, Inje University Busan Paik Hospital, Korea. The data were collected between August and October 2022. The patients had a medical history, including COVID-19 infection, and completed symptom questionnaires. A long COVID questionnaire consisting of 35 inquiries in 10 categories was completed. Anxiety, depression, fatigue, functional difficulties, QOL, and health status changes were assessed. Results: The analysis comprised 85 participants (age: 56.4 ± 15.2 years; 63.5% women). Of the categories, neurological symptoms (68.2%) were the most prevalent, followed by systemic symptoms (64.7%) and cardiopulmonary symptoms (56.5%). Anxiety, depression, and fatigue symptoms were reported by 36.5%, 34.1%, and 42.4% of the participants. Subjective neurological deterioration after COVID-19 was reported in 28 participants (28/81, 34.6%). Anxiety, depression, and fatigue were influenced by long COVID symptoms and the subjective deterioration of neurological conditions. Conclusion: This study analyzed the long COVID symptoms in patients with preexisting neurological conditions and their impact on mental health and quality of life. One-third of the participants reported a subjective worsening of their preexisting neurological conditions. This study highlights the need for comprehensive follow-ups and a multidisciplinary approach for patients with neurological conditions and prolonged COVID-19 symptoms.

Visual analysis of research hotspots and trends of external therapies in traditional Chinese medicine for depression

ObjectiveBased on the visualization and analysis of the CiteSpace software, we aimed to explore the current research status and development trend of depression caused by external therapies in traditional Chinese medicine (TCM) and to provide a reference for further research in this field. MethodsIn the China National Knowledge Infrastructure, Wanfang, Web of Science, and PubMed databases, relevant articles on external therapies in TCM for depression were selected as the research objects, and CiteSpace performed the bibliometric analysis. ResultsIn total, 1672 Chinese and 441 English articles were included after CiteSpace was used to remove duplicate articles and perform manual screening. The Chinese articles were analyzed, and the overall issuance showed an upward trend; the core author was Tu Ya, and the institution with the highest article production was Heilongjiang University of Traditional Chinese Medicine. The English articles were analyzed, and the overall issuance showed an upward trend; the core author was Macpherson, Hugh, and the institution with the highest article production was Guangzhou University of Traditional Chinese Medicine. China ranked first in terms of number and centrality of publications, followed by the United States. The keywords of Chinese and English articles were analyzed to conclude that the research trends in this field were an exploration of therapeutic mechanisms, acupoint application therapy, and assessment of sleep quality, and the research hotspots were the clinical application of external therapies in TCM and the types of underlying diseases. ConclusionThis study comprehensively and objectively summarized the relevant literature on external therapies in TCM for depression. It highlights the direction for further exploration by revealing and analyzing the research hotspots and trends in this field.

Oxidative balance and mental health: Exploring the link between prooxidant-antioxidant balance and depression in hypertensive and normotensive individuals, accounting for sex differences

BackgroundExisting studies have suggested a link between oxidative stress levels and depression. Additionally, factors such as gender and conditions like hypertension have been shown to influence oxidative stress. This ten-year follow-up cohort study aims to examine the association between prooxidant-antioxidant balance (PAB) and the onset of depression and its symptoms in both hypertensive and normotensive individuals, while considering gender differences. MethodsThe data for this study was obtained from the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) study, a cohort study conducted in eastern Iran. Serum PAB levels were measured in 1702 hypertensive and 4096 normotensive individuals aged 35 to 65 years. After ten years, the participants' depression status was evaluated using the Beck questionnaire, and depression symptoms were investigated using the BDI-II structural model, which includes somatic, affective, and cognitive symptoms. ResultThe analysis indicates that in hypertensive male participants, the highest tertile of PAB is associated with an increased risk of depression (β: 1.22, 95 % CI: −0.046, 2.485; P = 0.059) and symptoms of depression, including cognitive (β: 2.937, 95 % CI: 0.511, 5.362; P = 0.018) and somatic (β: 2.654, 95 % CI: 0.37, 4.939; P = 0.023) symptoms. However, there was no significant association between affective symptoms and PAB tertiles. Additionally, there was no significant link between depression and depressive symptoms in female hypertensive and normotensive individuals. ConclusionIn male hypertensive patients, but not in normotensive individuals of both genders and hypertensive women, depression and its associated symptoms, including somatic and cognitive symptoms, are associated with elevated levels of oxidative stress, as evidenced by higher serum PAB values. PAB is not associated with affective symptoms. Future studies should focus on the gender-specific nature of this relationship and work to clarify its underlying mechanisms.

Effect of Repetitive Transcranial Magnetic Stimulation on Post-Stroke Comorbid Cognitive Impairment and Depression: A Randomized Controlled Trial.

There are currently no uniform treatments for post-stroke comorbid cognitive impairment and depression (PSCCID). To verify whether repetitive transcranial magnetic stimulation (rTMS) can improve PSCCID symptoms and explore the underlying roles of resting-state functional magnetic resonance imaging (rs-fMRI). Thirty PSCCID patients were randomized in a 1 : 1 ratio to receive 4 weeks of rTMS (intervention group) or sham rTMS (control group) over the left dorsolateral prefrontal cortex (DLPFC). rs-fMRI was acquired to analyze the functional plasticity of brain regions at baseline and immediately after the last intervention. Cognition, depression status, and neural electrophysiology were improved in both intervention and control groups after treatment (p = 0.015-0.042), and the intervention group had more significant improvement than the control group. Analysis of functional connectivities (FCs) within the default mood network (DMN) showed that the connection strength of the left temporal pole/left parahippocampal cortex and right lateral temporal cortex/right retrosplenial cortex in the intervention group were enhanced compared with its pre-intervention and that in the control group after treatment (p < 0.05), and the both FC values were positively correlated with MMSE scores (p < 0.001). The intervention group had stronger FCs within the DMN compared with the control group after treatment, and some of the enhanced FCs were correlated with the P300 latency and amplitude. rTMS over the left DLPFC is an effective treatment for improving both cognitive impairment and depression among patients with PSCCID. The enhanced FCs within the DMN may serve as a compensatory functional recombination to promote clinical recovery.

Walking away from depression: the mediating role of walking activity in depression impacting blood glucose levels of people with diabetes or prediabetes.

Depression can exacerbate diabetes by impairing self-care behaviors and increasing the risk of complication; however, the underlying mechanism is still unclear. Given the suggested associations between walking activity, depression status, and blood glucose levels this study explores the intricate relationship between depression and blood glucose (BG) control, with a focus on walking activity as a behavioral mediator. The purpose of this study is to examine walking activity's mediating role in depression's impact on BG levels, investigating and validating the non-linear association between BG levels and walking activity. This retrospective real-world study demonstrates the potential of regular walking activity as a simple and accessible intervention to mitigate the negative effects of depression on BG levels in T2D and prediabetes. A cohort of 989 users with T2D and prediabetes, who regularly tracked their steps levels and BG levels for 12 months using the Dario digital health platform was evaluated. The mediating role of the monthly average number of steps on the relationship between the self-reported depression status and lagged monthly average BG was assessed. Additionally, the association between monthly walking activity and monthly average BG was tested using a piecewise linear mixed effects model. Users with self-reported depression demonstrated increased BG levels compared to users without depression (B=8.00, P=.01). The association between depression and monthly average number of steps was significant (B=-.27, P<.005) and monthly average number of steps significantly predicted the following months' average BG (B=-.81, P=.001), adjusting for depression. The monthly average number of steps significantly mediated the effect of self-reported depression on the following month's average BG (M=.22, P<.005). Further sensitivity analysis demonstrated model robustness over various periods. Finally, non-linear dynamics of walking activity over time was validated using unseen data showing a decrease in monthly average BG for users with over an average of 400 steps per day (B=-1.87, P<.01). This study shows how regular walking may reduce the negative impact of depression on BG levels in people with T2D. Our findings advocate for the integration of walking activity into treatment protocols as a cost-effective, accessible intervention strategy to improve glycemic management and depressive symptoms in this population.

Ambient Air Pollution and Depressed Mood in the National Longitudinal Study of Adolescent to Adult Health (Add Health) Wave IV.

Depression is a major contributor to the global burden of disease. There is limited understanding of how environmental exposures may contribute to depression etiology. We used Wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health) to examine associations between low-level ambient air pollution exposure and depressed mood in a generally healthy population of over 10,000 24-32 year olds. Annual mean PM2.5 levels in the 2008-2009 study were close to the current U.S. standard. In fully adjusted quasi-binomial logistic regression models, there were no meaningful associations between IQR increases in air pollutant and change in depressed mood status regardless of specific pollutant or moving average lags. In interaction effects models, an IQR increase in lag day 0-30 PM2.5 resulted in 1.20 (95% CI, 1.02-1.41) times higher likelihood of having depressed mood, but only for persons with chronic lung disease (interaction P=0.04); the association was null for participants without chronic lung disease (OR 0.98, 95% CI, 0.91, 1.05). Our findings suggest that among persons with a lifetime history of chronic lung disease, greater exposure to even low-level PM2.5, PM10, and sulfate may be associated with modest increases in the likelihood of having depressed mood.

Side-effect expectations are associated with disability, physical fitness, and somatic symptoms 3 months after post-COVID neurological inpatient rehabilitation

IntroductionThe COVID-19 pandemic, caused by SARS-CoV-2, has led to long-term health issues known as post-COVID-19 condition, including fatigue and cognitive disruptions. Despite its recognition as a public health concern, the efficacy of therapeutic interventions, especially in neurological rehabilitation, remains unclear. This study examines how treatment expectations are associated with psychological and physical outcomes in post-COVID-19 condition neurological rehabilitation. MethodsIn an observational cohort study 61 patients with confirmed post-COVID-19 condition were included. Baseline (T0) data on treatment and side effect expectations were collected, before participants underwent a 4–6 week multidisciplinary rehabilitation program. Primary outcome was illness-related disability (Pain Disability Index). Secondary outcomes included depressive symptoms (PHQ-9), anxiety levels (GAD-7), functional status (PCFS), fatigue (CFS), and physical fitness (6MWT). Regression models analyzed the associations of baseline expectations with outcomes at the end of rehabilitation (T1) and three months post-rehabilitation (T2). ResultsAfter adjusting for multiple testing, higher baseline side-effect expectations were associated with greater illness-related disability (β = 0.42, p = 0.007), reduced physical fitness (β = − 0.24, p = 0.04), and more somatic symptoms (β = 0.33, p = 0.006) at follow-up (T2). Positive treatment expectations were associated with poorer functional status (β = 0.35, p = 0.011) at T2. ConclusionThis study highlights the associations of side-effect expectations with post-COVID-19 condition rehabilitation outcomes. Higher side-effect expectations were associated to poorer outcomes, indicating a nocebo effect. Surprisingly, positive expectations were linked to worse outcomes, possibly due to unrealistic optimism. Managing patient expectations realistically and addressing side-effect concerns seems crucial for optimizing rehabilitation outcomes.

Language use in depressed and non-depressed mothers and their adolescent offspring

BackgroundApproximately 10% of mothers experience depression each year, which increases risk for depression in offspring. Currently no research has analysed the linguistic features of depressed mothers and their adolescent offspring during dyadic interactions. We examined the extent to which linguistic features of mothers' and adolescents' speech during dyadic interactional tasks could discriminate depressed from non-depressed mothers. MethodsComputer-assisted linguistic analysis (Linguistic Inquiry and Word Count; LIWC) was applied to transcripts of low-income mother-adolescent dyads (N = 151) performing a lab-based problem-solving interaction task. One-way multivariate analyses were conducted to determine linguistic features hypothesized to be related to maternal depressive status that significantly differed in frequency between depressed and non-depressed mothers and higher and lower risk offspring. Logistic regression analyses were performed to classify between dyads belonging to the two groups. ResultsThe results showed that linguistic features in mothers' and their adolescent offsprings' speech during problem-solving interactions discriminated between maternal depression status. Many, but not all effects, were consistent with those identified in previous research using primarily written text, highlighting the validity and reliability of language behaviour associated with depressive symptomatology across lab-based and natural environmental contexts. LimitationsOur analyses do not enable to ascertain how mothers' language behaviour may have influenced their offspring's communication patterns. We also cannot say how or whether these findings generalize to other contexts or populations. ConclusionThe findings extend the existing literature on linguistic features of depression by indicating that mothers' depression is associated with linguistic behaviour during mother-adolescent interaction.

Effect of multimorbidity on depressive status in older Chinese adults: evidence from the China Health and Retirement Longitudinal Study (CHARLS)

ObjectiveThis study aims to further explore the relevant influencing factors of depression and explore the correlation between multimorbidity coexistence and depression to find the goals and methods of early intervention...

Healthy Dietary Pattern Improves Cognitive Function in Elderly Persons With Periodontitis: A Cross-Sectional Study of NHANES

AimCognitive decline is more prevalent in elderly persons with periodontitis. Greater adherence to Healthy Eating Index (HEI)-2015 has been reported to improve cognitive function in the elderly population. However, whether the benefits of HEI-2015 on cognitive function apply to elderly patients with periodontitis remains unknown. MethodsThis is a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES). The data were extracted from database 2011–2014. Cognitive function was measured through the Consortium to Establish a Registry for Alzheimer's Disease battery for immediate recall (CERAD-WL) and delayed recall (CERAD-DR), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). The data of HEI-2015 were acquired from 24-hour dietary recalls. Weighted linear regression models were performed to investigate the association between HEI-2015 and cognitive function in elderly patients with periodontitis. The associations were further investigated in subgroups of sex, cardiovascular disease status, and depression status. ResultsA total of 1862 participants were included, and 1223 of them had periodontitis. Periodontitis was negatively associated with cognitive function (β = −0.45; 95% confidence interval [CI], −0.87 to −0.03). No statistically significant relationship was observed between HEI-2015 and cognitive function (β = 0.33; 95% CI, −0.02 to 0.69). Low HEI-2015 score was associated with high odds of cognitive decline in patients with periodontitis (β = −0.73; 95% CI, −1.25 to −0.21; P for trend = .01). Higher HEI-2015 was related to the lower incidence of cognitive function decline in patients with periodontitis who were female (β = −0.53; 95% CI, −1.03 to −0.03), had a socioeconomic status from 0 to 3 (β = −0.55; 95% CI, −1.00 to −0.09), did not have cardiovascular disease (β = −0.60; 95% CI, −1.14 to −0.05), and did not have depression (β = −0.57; 95% CI, −1.11 to −0.03). ConclusionsGreater HEI-2015 adherence may improve cognitive function amongst elderly patients with periodontitis. Further studies were needed to investigate this association in elderly persons with periodontitis.

Usability of Ordinal Logistic Regression Analysis for Beck Depression Inventory

Objective: In the study; For the Beck Depression Scale, the usability of the Ordinal logistic regression model was evaluated, taking into account the situation in which this scale was ordinal. Materials and Methods: The study was conducted in the first and second-year students of the ……. University, Health Services Vocational School. A total of 664 volunteer students who accepted to participate in the study were included in the study, and no sample was taken from the population. The students were asked 8 questions including socio-demographic characteristics, as well as questions of the 21-item Beck Depression Scale. Depression status with 4 order categories (Normal-Mild-Moderate-Severe) was taken as the dependent variable in the study, and the relationship of other socio-demographic variables with the depression status variable was examined. Results: In the study, Nagelkerke pseudo R2 value, one of the goodness of fit criteria, was found to be 0.062. In addition, the model fit criterion -2LL (Log-likelihood) test statistic (p

Relationship between Depression and Physical Activity Frequency in Spanish People with Low, Medium, and High Pain Levels.

Depression is a mental disorder that causes great discomfort, is associated with unhealthy lifestyle habits, and affects the quality of life. People with pain show high depressive symptoms and a prevalence of physical inactivity. This study aimed to analyse the associations between depression (self-reported depression, depression status, depressive symptoms, and depression types) and physical activity frequency (PAF) in leisure time in middle-aged and older people with different pain levels (low, medium, and severe) living in Spain. A cross-sectional study based on the European Health Survey data from Spain (2014-2020) was carried out, with a final sample of 13,686 people with pain. Associations between depression-related variables and PAF were studied at the three levels of pain, comparing the prevalence of depression as a function of PAF. Regression models were performed to assess adjusted risk factors for depression (self-reported depression and depression status). It was found that PAF was related to depression at all three pain levels. Inactive people at each pain level had higher depression prevalence (self-reported depression, depression status, depression symptoms, and depressive types). Physical inactivity emerged as a risk factor for depression, both for self-reported depression and for depression status. Thus, increased PAF could help prevent or reduce depression and depressive symptoms in people with pain.

Effect of Immune Thrombocytopenic Purpura Medications on Depression Risk: An Analysis of NHANES Data.

Immune thrombocytopenic purpura (ITP) in adults typically develops slowly and insidiously. The ITP medications might be linked to psychological disorders, but the connection is not well-understood. This study aimed to examine the association between ITP medication use and the risk of depression among participants in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Using data from 70 190 NHANES participants, we conducted a cross-sectional study, excluding individuals under 18 years, with hypertension, HIV, hepatitis C, and various comorbidities. A total of 17 299 individuals were included in the analysis of this study. We identified 2 populations within this study: those using ITP medications, including prednisone, dexamethasone, and rituximab and those not using ITP drugs. Depression status was assessed using the Patient Health Questionnaire-9 (PHQ-9), and the relationship between ITP medication use and depression was analyzed through multivariate logistic regression. There was no significant association between ITP medication use and an increased risk of depression after adjusting for demographic and health-related variables. Notably, among the study participants, 1.8% of the non-depressed population were on ITP medication compared with 0.3% in the depressed population. The analysis revealed varying depression risks associated with different sociodemographic factors. For instance, the correlation between ITP medication and depression risk was influenced by a combination of age, race, income, and smoking status. The study suggests that ITP medication use does not independently increase the risk of depression. This finding is crucial for guiding clinical decisions and managing patient expectations regarding ITP treatment and its psychological impacts.

Postoperative chronic operation-related symptoms after minimally invasive lung surgery: a prospective observational protocol

IntroductionSignificant numbers of patients undergoing minimally invasive lung surgery develop chronic symptoms such as chronic pain and chronic cough after surgery, which may lead to a reduced quality of life...

Association between pain intensity and depressive status in patients with hip fracture: An observational study.

Identifying depression symptoms in patients with hip fractures and studying the relationship between depression and pain intensity and pain location in hip fracture patients is of great significance for disease recovery in hip fracture patients. This cohort study analyzed 5 wave data from the China Health and Retirement Longitudinal Study in 2011, 2013, 2015, 2018, and 2020, focusing on 1222 patients with hip fractures. The study utilized the CESD-10 Depression Scale to assess depressive symptoms in hip fracture patients and conducted analyses to explore the relationship between depression symptoms, pain, and pain intensity, including binary logistic regression and examination of interaction terms between pain variables and pain intensity in key body parts. Depression symptoms are strongly associated with pain intensity in hip fracture patients, particularly in key body areas. Severe pain significantly increases the risk of depressive symptoms. Moreover, absence of pain in other key body parts is linked to depressive symptoms. Multivariate analysis reveals that higher education levels, marriage, urban residence, and self-rated good health serve as protective factors against depression, while diabetes and heart disease pose significant risks for depressive symptoms in hip fracture patients. Hip fracture pain can induce discomfort and trigger depressive symptoms, showing varied trajectories among patients. Pain intensity predicts the course of depressive symptoms, emphasizing the importance of tailored pain management strategies including medication, physical therapy, and nonpharmacological interventions. Personalized rehabilitation and mental health plans should be designed based on individual patient needs and differences.

The effect of different exercise on physical fitness, cognition, and mental health in healthy older adults

ObjectiveThis study aimed to examine the effects of different exercise programs on physical fitness, cognition, and mental health in healthy older adults. MethodsA randomized controlled study was performed with 89 healthy older adults. They were separated into four groups: the control (Con; n = 20), physical activity (PA; n = 23), cognitive training (CT; n = 23), and physical activity coupled with cognitive training groups (PA + CT; n = 23). The subjects in PA, CT, and PA + CT groups received exercise programs that lasted 40 min daily, conducted at least three days a week for 20 weeks. The PA group received regular aerobic physical activity interventions, the CT group received cognitive training interventions, and the PA + CT group received physical activity combined with cognitive training interventions. Physical fitness (by chair stand, biceps curl, 2-min step, 8-step up and walk, and sit and reach tests), cognitive function (attention, simple reaction time, and spatial memory), and mental health (anxiety and depression status) were evaluated before and after 20 weeks. ResultsThe body composition results reveal no significant effects among the four groups after 20 weeks before and after aerobic exercise interventions (p > 0.05). Compared with Con, the PA, CT, and PA + CT groups significantly improved physical fitness parameters (p < 0.05). The post-hoc analysis demonstrated that the PA and PA + CT groups had higher fitness levels than the CT group. Similarly, a significant difference was observed in the cognitive index among the four groups (p < 0.05). As determined by post-hoc analysis, attention and simple reaction time differed sequentially between the Con, PA, CT, and PA + CT groups. The spatial memory was superior in the PA, CT, and PA + CT groups compared to the Con group (p < 0.05), with the PA + CT group exhibiting the highest level of performance. However, there was no significant difference in the mental health parameters among all the groups (p < 0.05). ConclusionA 20-week intervention involving different exercise methods can enhance physical fitness, cognition, and mental health in older adults. These methods include physical activity, cognitive training, and a combination of physical and cognitive training. The combined physical activity and cognitive training interventions yielded more favorable outcomes than individual physical or cognitive training interventions.

Effectiveness of a voice analysis technique in the assessment of depression status of individuals from Ho Chi Minh City, Viet Nam: A cross-sectional study

Effectiveness of a voice analysis technique in the assessment of depression status of individuals from Ho Chi Minh City, Viet Nam: A cross-sectional study

Posttraumatic Stress Disorder and Type 2 Diabetes Outcomes in Veterans

Posttraumatic stress disorder (PTSD) symptom reduction is linked with lower risk of incident type 2 diabetes (T2D), but little is known about the association between PTSD and comorbid T2D outcomes. Whether PTSD is a modifiable risk factor for adverse T2D outcomes is unknown. To determine whether patients with PTSD who improved and no longer met diagnostic criteria for PTSD had a lower risk of adverse T2D outcomes compared with patients with persistent PTSD. This retrospective cohort study used deidentified data from US Veterans Health Administration (VHA) historical medical records (from October 1, 2011, to September 30, 2022) to create a cohort of patients aged 18 to 80 years with comorbid PTSD and T2D. Data analysis was performed from March 1 to June 1, 2024. Diagnoses of PTSD and T2D. The main outcomes were insulin initiation, poor glycemic control, any microvascular complication, and all-cause mortality. Improvement of PTSD was defined as no longer meeting PTSD diagnostic criteria, per a PTSD Checklist score of less than 33. Entropy balancing controlled for confounding. Survival and competing risk models estimated the association between meeting PTSD criteria and T2D outcomes. Subgroup analyses examined variation by age, sex, race, PTSD severity, and comorbid depression status. The study cohort included 10 002 veterans. More than half of patients (65.3%) were aged older than 50 years and most (87.2%) were men. Patients identified as Black (31.6%), White (62.7%), or other race (5.7%). Before controlling for confounding with entropy balancing, patients who no longer met PTSD diagnostic criteria had similar incidence rates for starting insulin (22.4 vs 24.4 per 1000 person-years), poor glycemic control (137.1 vs 133.7 per 1000 person-years), any microvascular complication (108.4 vs 104.8 per 1000 person-years), and all-cause mortality (11.2 vs 11.0 per 1000 person-years) compared with patients with persistent PTSD. After controlling for confounding, no longer meeting PTSD criteria was associated with a lower risk of microvascular complications (hazard ratio [HR], 0.92 [95% CI, 0.85-0.99]). Among veterans aged 18 to 49 years, no longer meeting PTSD criteria was associated with a lower risk of insulin initiation (HR, 0.69 [95% CI, 0.53-0.88]) and all-cause mortality (HR, 0.39 [95% CI, 0.19-0.83]). Among patients without depression, no longer meeting PTSD criteria was associated with a lower risk of insulin initiation (HR, 0.73 [95% CI, 0.55-0.97]). The findings of this cohort study of patients with comorbid PTSD and T2D suggest that PTSD is a modifiable risk factor associated with a modest reduction in microvascular complications. Further research is needed to determine whether findings are similar in non-VHA health care settings.