Higher Risk Of Depressive Symptoms Research Articles

GENDER DIFFERENCES IN SLEEP QUALITY, FATIGUE, AND DEPRESSIVE SYMPTOMS AMONG ADULTS OVER 50 WITH TOTAL BLINDNESS

Abstract Visual limitations and blindness have been associated with poor sleep quality, increased fatigue, and a higher risk of depressive symptoms in the aging population. In this study, we aimed to investigate sleep quality, fatigue, and depressive symptoms in US adults over the age of 50 with total blindness, and to examine potential gender differences. The study included 88 participants (59 females, mean age 61.34±8.04; 19 males, mean age 62.32±8.17) who completed an online survey providing data on socioeconomic status, comorbidities, sleep quality, fatigue, and depressive symptoms. Descriptive and bivariate analyses were performed using R software and its required packages. While females slept less than males (t = -2.98, p <.05), there was no significant difference in sleep quality (t = 1.82, p = .08) or depressive symptoms (t = 0.51, p = 0.62). Fatigue levels were significantly higher in females than males (t = 2.53, p <.05). Poorer sleep quality was associated with increased fatigue and severe depressive symptoms in both subgroups. The findings indicate potential gender effects, however, given the small sample size and limitations of the cross-sectional design, further longitudinal research is needed to fully understand gender differences in sleep quality, fatigue, and depressive symptoms among adults over 50 with visual limitations.

PERCEIVED HOUSING PROBLEMS AND DEPRESSIVE SYMPTOMS AMONG MIDDLE-AGED AND OLDER AMERICANS

Abstract Background Housing insecurity has been shown to be associated with worse mental health. However, previous studies mostly examined one dimension of housing insecurity (e.g., affordability) and few focused on older adults. This study examined the relationship of perceived housing problems with depressive symptoms among middle-aged and older Americans. Method Longitudinal data from the Health and Retirement Study 2006-2018 were used. A total of 7,285 respondents (aged 50+ at baseline) were followed-up every 4 years. Respondents self-reported the status, severity, and duration of their housing problems. Depressive symptoms were assessed by the Center for Epidemiological Studies-Depression Scale (CESD). Mixed-effect models were used to examine the association between perceived housing problems and depressive symptoms, adjusting for individual-level, household-level, and housing-related confounders. Results About 5%-7% of respondents had housing problems during every study visit and 5.67% of them experienced persistent housing problems over the study period of 12 years. Having housing problems was associated with higher risk of depressive symptoms (IRR=1.30, 95% CI=1.23, 1.36). A dose-response relationship was observed in the severity and duration of housing problems, with greater increase of depressive symptoms risk among those experiencing more severe or longer duration of housing problems. Results were similar when modelling the risk of elevated depressive symptoms using a binary measure (CESD score ≥ 4). Conclusion Perceived housing problems were associated with worse mental health among middle-aged and older Americans. The dose-response pattern highlighted the importance of early intervention and consistent assistance to those experiencing housing problems.

Living alone and the risk of depressive symptoms: a cross-sectional and cohort analysis based on the China Health and Retirement Longitudinal Study

BackgroundThere were a few studies that examined the longitudinal association between living alone and depressive symptoms, and the vast majority of them were conducted in patients with certain diseases, such as heart failure, cancer, and glaucoma. This study aimed to examine the association between living alone and depressive symptoms in a large representative older Chinese population.MethodsThe China Health and Retirement Longitudinal Study (CHARLS) data from 2015 to 2018 were used. Living alone was defined as participants who did not live with others ever or more than 11 months in the past year at baseline. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies-Depression Scale (CES-D10). The multivariate logistic regression was used to estimate the relationship between living alone and depressive symptoms.ResultsThere were 5,311 and 2,696 participants ≥ 60 years old included in the cross-sectional and cohort analysis, respectively. The risk of depressive symptoms in participants who lived alone was significantly higher than those who lived with others in both cross-sectional (OR:1.33; 95%CI:1.14,1.54) and cohort analysis (OR:1.23; 95%CI:0.97,1.55). There was a significant interaction between financial support and living alone (Pinteraction = 0.008) on the risk of depressive symptoms. Stratified analyses showed that, compared to those who lived with others, the risk of depressive symptoms in participants who lived alone increased by 83% (OR:1.83; 95%CI:1.26,2.65) in participants receiving lower financial support. However, we did not find statistically significant associations in participants with medium (OR:1.10; 95%CI: 0.74,1.63) and higher financial support (OR: 0.87; 95%CI: 0.53,1.41).ConclusionLiving alone was associated with a higher risk of depressive symptoms in the Chinese older population, and this association was moderated by the receipt of financial support. Living alone may be an effective and easy predictor for early identification of high-risk populations of depression in the older population.

Depressive symptoms among adolescents in six sub-Saharan African countries: A pooled analysis of associated factors

There is a need to identify risk factors, including nutrition-related factors, for depressive disorders among sub-Saharan African (SSA) adolescents. We examined the association of multiple measures with depressive symptoms among adolescents living across six SSA countries. Building on previous analyses, we used data from a cross-sectional study conducted from 2015 to 2017 among adolescents aged 10–19 years in six SSA countries (N = 7512). Depressive symptoms were defined as highest tertile of the 6-item Kutcher Adolescent Depression Scale score. Using mixed-effects Poisson regression models, we pooled data across sites and examined the association of sociodemographic, nutrition, and other indices with depressive symptoms. We additionally assessed effect modification by sex, age, and school-going status. We observed higher risk of depressive symptoms among girls (adjusted risk ratio [RR]: 1.29, 95 % confidence interval [95 % CI]: 1.05–1.58, P = 0.016), older adolescents (RR for 18–19 years: 1.59, 95 % CI: 1.44–1.76, P < 0.001), and adolescents experiencing bullying (RR: 1.43, 95 % CI: 1.26–1.62, P < 0.001) or violence (RR: 1.34, 95 % CI: 1.24–1.45, P < 0.001). Adolescents experiencing food insecurity also had a higher risk of depressive symptoms (RR: 1.90, 95 % CI: 1.64–2.19, P < 0.001) along with those consuming ≥ 5 servings of fruit and vegetables per day (RR: 1.18, 95 % CI: 1.03–1.34, P = 0.015); conversely, those who consumed grains, roots and tubers in the past day were at decreased risk (RR: 0.73, 95 % CI: 0.69–0.77, P < 0.001). There was no strong evidence of effect modification of associations. This study reinforces the potential role of multiple sociodemographic and nutrition-related measures on risk of depressive symptoms in these populations.

A Link between Prenatal Stage of Life during the Great Chinese Famine and Subsequent Depressive Symptoms among Middle-Aged and Older Adults

Prenatal malnutrition may increase the risk of depressive symptoms in adulthood. This study investigated the association between prenatal exposure to malnutrition with risk of depressive symptoms in middle-aged and older adults using the Chinese Great Famine of 1959–1961 as a natural experiment. Data were obtained from the China Health and Retirement Longitudinal Study baseline survey (2011). A total of 5391 individuals born from 1956 to 1965 were included in the study. Depressive symptoms were ascertained via the Center for Epidemiological Studies Depression Scale short form. Famine severity was measured using the cohort size shrinkage index. Difference-in-differences models were used to explore the association between prenatal famine exposure and later-life depressive symptoms. Compared with the post-famine cohort (1963–1965), famine cohorts (1959–1962) were 4.74 times (95% CI = 1.28–8.20) as likely to develop depressive symptoms. The stratified analysis found that prenatal exposure to famine was associated with depressive symptoms in rural residents but not those living in urban areas. In rural females, prenatal malnutrition was associated with a higher risk of depressive symptoms. However, there was no significant association between prenatal malnutrition and depressive symptoms in rural males. Our results indicated that prenatal malnutrition may contribute to a higher risk for depressive symptoms in later life among female rural residents.

Job dissatisfaction as a risk factor of depressive symptoms and suicidal ideation among female workers: evidence from a nationwide longitudinal study in South Korea.

This study aimed to investigate the relationship between job dissatisfaction (JD) and depressive symptoms and suicidal ideation among female workers. Additionally, it examined how the cumulative exposure to JD over multiple years can exacerbate the effect. We conducted our analyses on a nationwide sample of 6111 female workers from the Korean Longitudinal Survey of Women and Family (Waves 5-7). Depressive symptoms were measured using the 10-item version of the Centre for Epidemiologic Studies Depression Scale. JD was classified into quartiles (Q1-Q4), and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using generalised estimating equations. The overall prevalence of depressive symptoms and suicidal ideation among study participants was 13.9% and 2.4%, respectively. Our findings revealed that female workers with the highest level of JD (Q4) had a significantly greater risk of depressive symptoms (OR [95% CI]: 1.61 [1.37-1.89]) and suicidal ideation (OR [95% CI]: 2.08 [1.37-3.17]) after 2-year follow-up compared to those with the lowest level of JD (Q1). Consecutive exposure to JD over multiple years was also associated with depressive symptoms and suicidal ideation after a 2-year follow-up. For instance, women exposed to JD for three consecutive waves exhibited a high risk of depressive symptoms (OR [95% CI]: 1.61 [1.33-1.95]) and suicidal ideation (OR [95% CI]: 1.67 [1.04-2.70]). JD was positively associated with depressive symptoms and suicidal ideation. Our study suggests that JD is a risk factor for mental health problems in female workers.

Prevalence and determinants of depressive symptoms among community-dwelling older adults in China based on differences in living arrangements: a cross-sectional study

BackgroundOlder adults with different living arrangements may have different mental health statuses and different factors that influence their mental health. The aim of the present study is to investigate the prevalence and determinants of depressive symptoms among community-dwelling older adults in China based on differences in their living arrangements.MethodsParticipants were 6,055 older adults from the 2015 China Health and Retirement Longitudinal Study. Depressive symptoms and their determinants were evaluated using the 10-item Center for Epidemiologic Studies Depression Scale and multivariate logistic regression analysis, respectively.ResultsThe prevalence of depressive symptoms among older adults living alone, as a couple, and with children was 47.8%, 33.2%, and 39.5%, respectively. The common risk factors for depressive symptoms were shorter sleep duration, poorer activities of daily living, and poorer self-rated health. Women, those with lower educational levels, and those suffering from chronic diseases had a higher risk of depressive symptoms among older adults living as a couple and those living with children. Smoking and participation in economic activities were also risk factors of depressive symptoms among older adults living with children and those living alone, respectively.ConclusionsThe findings suggest that older adults living as couples had the lowest prevalence of depressive symptoms, while those living alone had the highest prevalence of depressive symptoms. The determinants of depressive symptoms differed by living arrangement; hence, they should be considered in future interventions.

Association of a lesser number of teeth with more risk of developing depressive symptoms among middle-aged and older adults in Japan: A 20-year population-based cohort study

ObjectivesThis 20-year prospective cohort study aimed to longitudinally explore the relationship between the number of teeth and the incidence of depressive symptoms among community-dwelling middle-aged and older adults. MethodsData were collected from the National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA) database from 2002 to 2022 (3rd–9th waves). Data of adults aged ≥40 years were analyzed and those who had depressive symptoms at baseline (3rd wave), had missing data, or did not participate in follow-up, were excluded. We collected data on the number of teeth at baseline. Depressive symptoms were defined as a score of ≥16 on the Center for Epidemiologic Studies Depression Scale. The generalized estimating equation (GEE) model was used to examine the longitudinal relationships between the number of teeth at baseline and the subsequent incidence of depressive symptoms. ResultsThe final analysis included 1668 participants, with a mean (standard deviation) age of 58.8 (11.1) years and a mean follow-up time of 12.9 years. After GEE analysis with adjustment for multiple covariates, compared to participants with ≥20 teeth, participants with 10–19 teeth and < 10 teeth at baseline were associated with a higher risk of depressive symptoms. The subgroup analysis showed that the effect was stronger in men than in women. ConclusionsAmong middle-aged and older community dwellers, particularly men, a small number of teeth after the age of 40 was associated with the future incidence of depressive symptoms.

Depressive symptoms and their predictors among school-teachers in Southern Tunisia during the COVID-19 outbreak: A representative cross-sectional study

IntroductionTeachers’ mental health could be affected as a result of significant changes imposed by the COVID-19 pandemic, including everyday responsibilities outside of their profession. In this context, we aimed to explore the prevalence of depressive symptoms (DS) among school teachers in Sfax, Southern Tunisia, and to investigate their main determinants. MethodsIt was a cross-sectional study involving public-school-teachers of all levels: primary, middle and high schools in Sfax Governorate, Southern Tunisia between March and April 2021 during the third wave of COVID-19 pandemic. The DS were evaluated using a French validated 20-item-version of the self-reported Depression Scale of the Centre for Epidemiologic Studies Depression Scale (CES-D). A cut-off point of 16 was recommended to define DS. ResultsOf the 525 teachers, 292 cases were females (55.6%), 256 teachers (48.8%) worked at high-schools and 478 cases were married (91%). The teachers’ median age was 48 years (Interquartile range (IQR) = [41–53] years). There were 245 teachers (46.7%) suffering from DS. In the multivariate analysis, female gender (Adjusted Odds Ratio (AOR) = 2.3; p < 0.001), history of chronic diseases (AOR = 2.5; p < 0.001) and having close contact with COVID-19 cases (AOR = 1.4; p = 0.04) were independently associated with depressive symptoms. Besides, university educational level (AOR = 0.56; p = 0.015), perceived workplace safety (AOR = 0.4; p < 0.001), consumption of coffee (AOR = 0.5; p = 0.006) and regular mask wearing in public spaces (AOR = 0.52; p = 0.048) were independently associated with lower prevalence of DS among teachers. In the multivariate analysis, female gender (Adjusted Odds Ratio (AOR) = 2.3; p < 0.001), history of chronic diseases (AOR = 2.5; p < 0.001) and having close contact with COVID-19 cases (AOR = 1.4; p = 0.04) were independently associated with depressive symptoms. Besides, university educational level (AOR = 0.56; p = 0.015), perceived workplace safety (AOR = 0.4; p < 0.001), consumption of coffee (AOR = 0.5; p = 0.006) and regular mask wearing in public spaces (AOR = 0.52; p = 0.048) were independently associated with lower prevalence of DS among teachers. ConclusionPersonal, occupational and pandemic-related factors were found to be associated with higher risk of DS among teachers. Therefore, promoting awareness through offering psychological assistance and educational sessions about screening of mental health disorders among teachers is crucial for early detection and management.

Study on the trajectory of depression among middle-aged and elderly disabled people in China: Based on group-based trajectory model

BackgroundPrevious studies have shown that middle-aged and elderly adults with disabilities are at higher risk for depressive symptoms. However, there are few studies on the long-term trajectories of depressive symptoms in the Chinese middle-aged and elderly disabled population. ObjectiveThis study aimed to identify the different development trajectories of depressive symptoms and their influencing factors in middle-aged and elderly people with disabilities in China. MethodsUsing data from the China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013, 2015, and 2018, a longitudinal cohort was formed for the study. A total of 2053 participants underwent at least two measures of depressive symptoms, assessed using the Center for Epidemiological Studies Depression Scale (CES-D10), a depression symptom assessment scale. We constructed a Group-Based Trajectory Model (GBTM) to identify the development trajectory of depressive symptoms in 2053 middle-aged and elderly disabled individuals, screened the potential predictors using lasso regression, and analyzed the factors affecting the development trajectory of depression through multivariate logistic regression. ResultsWe identified four depression symptom trajectories throughout the follow-up process: “low depressive symptom group”, “worsening depressive symptom group”, “relieved depressive symptom group”, and “high depressive symptom group”. We found that there were differences in basic characteristics among different subgroups of depression trajectory. However, middle-aged and elderly disabled women living in rural areas, with limited ADL or IADL, physical pain, poor self-reported health and self-reported memory, short sleep time, and no relatives and friends to take care of them were the key groups for the prevention and treatment of depressive symptoms. ConclusionThere is heterogeneity in the trajectories of depressive symptoms in the Chinese middle-aged and elderly disabled population, it is necessary to focus on the characteristics of the trajectories of different subgroups.

Depressive Symptoms and Associated Factors among Employees in Public Utility Places of Zhejiang Province, China

Depression has been known to adversely influence the working performance of employees. However, compared with physical health, few studies have reported the prevalence of depressive symptoms among employees in workplaces. This study aimed to investigate the current situation and the relationships among the prevalence of depressive symptoms, physical health, social–psychological factors, working conditions, environmental perception, and workplace performance of employees in public utility places in Zhejiang Province, China. A cross-sectional study was conducted during the fourth quarter of 2019. A total of 1232 individuals responded to the survey. Six types of information—sociodemographic characteristics, working conditions, psychosocial factors, four groups of physical symptoms, working performance, and depressive symptoms—were collected. Logistic regression analysis was performed. The survey results showed that the prevalence of depressive symptoms among employees in public utility places in Zhejiang Province was 17.9%. Perceptions of a poor work environment, poor interpersonal relationships, an unfulfilling life, and frequent ocular and general uncomfortable symptoms were associated with a higher risk of depressive symptoms. Strong work ability, fulfilment in life, and taking the initiative to wear or use protective equipment at work were associated with a lower risk of depressive symptoms. The results of this study will provide valuable guidance for the scientific intervention for depressive symptoms among public utility place employees in the future.

Lower HbA1C of glycemic control is associated with higher risk of depressive symptoms in elderly with type 2 diabetes mellitus–A Nationwide Community-based study

ObjectiveWe investigated the correlation between glycemic control status and depressive symptoms in type 2 diabetes elderly. MethodsA total of 1527 participants with type 2 diabetes aged 55 years and older from the Healthy Aging Longitudinal Study in Taiwan study were included in this cross-sectional study. The Center for Epidemiologic Studies Depression Scale (CESD) (20 items) score of ≥16 was indicative of depressive symptoms. The participants were divided into HbA1c ≥ 6.5% and < 6.5% representing the glycemic control. Multiple logistic regression (MLR) and Generalized linear model (GLM) were used. ResultsThe MLR analysis showed that the low HbA1c group had significant two-fold increased odds of depressive symptoms compared to the high HbA1c group (OR 1.89, 95% CI 1.17–3.05). The risk of depressive symptoms was lower among males (OR 0.49, 95% CI 0.30–0.80) and those with higher BMI (OR 0.93, 95% CI 0.86–1.00); whereas the risk was higher among those who lived alone (OR 2.37, 95% CI 1.31–4.27) and with ADL disability (OR 3.01, 95% CI 1.85–4.89). The GLM showed that the dimension of depressive affect reached statistical significance with lower HbA1c. ConclusionThis nationwide community-based study shows that depressive symptoms are associated with lower HbA1C, reminding us that more attention should be paid to the presence of depressive symptoms in those with lower HbA1C. Further research is needed to clarify the causal relationship.

Adverse Childhood Experiences and Depression: The Mediating Role of Resilience and Emotional Regulation.

The current study examined the mediating roles of resilience and emotional regulation in the association between childhood trauma and depressive symptoms among individuals who experienced adverse childhood experiences (ACEs). Data from 200 women aged 17 to 77 years who were psychiatric outpatients were collected using self-reported questionnaires assessing child adversity, depressive symptoms, resilience, and emotional regulation. A positive correlation was found between a subscale of the ACE-IQ and depression. Childhood trauma was associated with higher risk of depressive symptoms among participants with lower resilience (an association that was partly explained by resilience level [mediation]). Emotional regulation was not a significant mediator in the childhood trauma-depression association. Our findings indicate that resilience is a key mediator between childhood trauma and depression. Individuals who experienced childhood trauma may benefit from evidence-based interventions focused on strengthening resilience and improving coping strategies. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 45-54.].

Sleep duration and depressive symptoms in Chinese middle-aged and older adults: The moderating effects of grip strength

BackgroundEvidence on the combined effect of sleep duration and grip strength on depressive symptoms is scarce. This study aimed to explore the moderating effect of grip strength on the association between sleep duration and depressive symptoms in a large cohort of middle-aged and older adults. MethodData were extracted from the China Health and Retirement Longitudinal Study (CHARLS) 2011–2018 wave. Grip strength and sleep duration were assessed by dynamometer and self-report, respectively. Depressive symptoms were determined by the Centre for Epidemiological Studies Depression scale (CESD-10). Multivariable cox regression model was used to explore the associations between sleep duration, and depressive symptoms, and assess moderation by grip strength. ResultsA total of 4337 participants aged 57.0 ± 8.1 years (45.1 % females) were included in this study. During the 7-year follow up period, 1508 participants developed depressive symptoms. Short sleep duration (<6 h/d) was significantly associated with an increased risk of depressive symptoms [Hazard ratio (HR):1.24, 95 % confidence interval (CI):1.09, 1.40)]. This association remained in individuals with the low (HR:1.22, 95%CI:1.00, 1.49) and middle grip strength (HR:1.32, 95%CI: 1.07, 1.63), but attenuated in individuals with high grip strength (HR:1.11, 95%CI: 0.86, 1.43). ConclusionsHigh grip strength mitigated the association between short sleep duration and higher risk of depressive symptoms. Thus, improving sleep duration and strengthening muscle strength are recommended to prevent depressive symptoms in middle-aged and older adults.

Early Life Disadvantage and the Risk of Depressive Symptoms among Young Black Women.

We examined the association between early-life socioeconomic disadvantage and depressive symptoms in adulthood and assessed whether social factors in adulthood modify the association. The11-item Center for Epidemiologic Studies-Depression Scale (CES-D) assessed adult depressive symptoms among 1612 Black women and other participants with a uterus (hereafter participants) in the Study of Environment, Lifestyle and Fibroids. Baseline self-reported childhood factors (i.e., parents in the household, mother's educational attainment, food insecurity, neighborhood safety, childhood income, and quiet bedroom for sleep) were included in a latent class analysis to derive an early life disadvantage construct. Multivariable log-binomial models estimated the association between early life disadvantage and adult depressive symptoms. Potential effect modifiers included adult educational attainment, social support, and financial difficulty. Participants classified as having high early life disadvantage had 1.34 times (95% CI: 1.20, 1.49) the risk of high depressive symptoms than those in the low early life disadvantage class after adjusting for age, first born status, and childhood health. Adult educational attainment and social support modified the association. Early life disadvantage increased the risk of depressive symptoms in adulthood. Participants with at least some college education and with high social support had greater risk than those with less than college education and low social support, respectively. Thus, the mental health ofBlack women and other participants with a uterusexposed to early life disadvantage do not necessarily benefit from higher education or from social support.

Relationship between dietary pattern and depressive symptoms: an international multicohort study

BackgroundSeveral previous studies have shown that dietary patterns are associated with the incidence of depressive symptoms. However, the results have been inconsistent. This study aimed to prospectively investigate the association between dietary patterns and the risk of depressive symptoms in two large cohort studies.MethodsThe Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort study included a total of 7,094 participants living in Tianjin, China from 2013 to 2019, and the UK Biobank cohort study includes 96,810 participants who were recruited from 22 assessment centers across the UK taken between 2006 and 2010. All participants were free of a history of cardiovascular disease (CVD), cancer, and depressive symptoms at baseline. Dietary patterns at baseline were identified with factor analysis based on responses to a validated food frequency questionnaire in TCLSIH or Oxford WebQ in UK Biobank. Depressive symptoms were evaluated using the Chinese version of the Zung Self-Rating Depression Scale (SDS) in TCLSIH or hospital inpatient records in UK Biobank. Cox proportional hazards regression models were used to estimate the association between dietary patterns and depressive symptoms.ResultsA total of 989, and 1,303 participants developed depressive symptoms during 17,410 and 709,931 person-years of follow-up. After adjusting for several potential confounders, the multivariable HRs (95% CIs) of the depressive symptoms were 0.71 (0.57, 0.88) for traditional Chinese dietary pattern, 1.29 (1.07, 1.55) for processed animal offal included animal food dietary pattern, and 1.22 (1.02, 1.46) for sugar rich dietary pattern in TCLSIH (all Q4 vs Q1). In the UK Biobank, the HRs (95% CIs) of depressive symptoms were 1.39 (1.16, 1.68) for processed food dietary pattern (Q4 vs Q1), 0.90 (0.77, 1.00) for healthy dietary pattern (Q3 vs Q1), and 0.89 (0.75, 1.05) for meat dietary pattern (Q4 vs Q1) in the final adjusted model.ConclusionDietary patterns rich in processed foods were associated with a higher risk of depressive symptoms, and following a traditional Chinese dietary pattern or healthy dietary pattern was associated with a lower risk of depressive symptoms, whereas meat dietary pattern was not associated.

Exploring the reciprocal relationship between activities of daily living disability and depressive symptoms among middle-aged and older Chinese people: a four-wave, cross-lagged model

BackgroundEarly studies have shown a relationship between activities of daily living (ADL) disability and depressive symptoms in older people. However, discussions on the direction of this relationship are insufficient. The study’s objective was to assess the reciprocal relationship between ADL disability and depressive symptoms among middle-aged and older Chinese people.MethodData was collected in four waves of a nationwide survey, the China Health and Retirement Longitudinal Study (CHARLS), which was carried out in 2011, 2013, 2015, and 2018. In total, this study included 4,124 participants aged ≥ 45 years at baseline. A summing score of the eleven items for basic activities of daily living (BADL) and instrumental activities of daily living (IADL) was calculated to indicate the degree of ADL disability. The 10-item Centre for Epidemiological Studies Depression Scale (CESD-10) was adopted to measure depressive symptoms. The reciprocal relationship between ADL disability and depressive symptoms was tested by cross-lagged models.ResultAt baseline, 911 (22.1%) participants were classified as having difficulties with ADL, and the prevalence of depressive symptoms was 34.4% (1,418). Among middle-aged and older people in China, there was a significant reciprocal and longitudinal relationship between ADL disability and depressive symptoms. People who had difficulty with ADL faced a higher risk of depressive symptoms, and those who suffered from depressive symptoms were accompanied by an increase in ADL disability in the following years. The subgroup analysis on age also showed that ADL disability was reciprocally and longitudinally related to depressive symptoms. However, only women showed similar results in the subgroup analysis on gender.ConclusionThis study shows that ADL disability is bi-directionally related to depressive symptoms in middle-aged and older Chinese people over time. The results suggest we should identify ADL disability and bad psychological conditions in time to prevent subsequent mutual damage among middle-aged and older Chinese people, a vulnerable group rising in the future.

The role of dietary inflammatory index and physical activity in depressive symptoms: Results from NHANES 2007–2016

BackgroundDepression is a major public health problem. This study was aimed to analyze the relationship between Dietary Inflammatory Index (DII), physical activity, and depressive symptoms, and to explore the effect of different lifestyles on depressive symptoms by combining DII and physical activity to form four lifestyle groups. MethodsThis study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. A total of 21,785 subjects were involved. Depressive symptoms and dietary inflammation were measured by the Patient Health Questionnaire (PHQ-9) and Energy-adjusted Dietary Inflammatory Index, respectively. The participants were divided subgroups by different physical activity combined pro-inflammatory or anti-inflammatory diet groups. ResultsBoth pro-inflammatory diet and inactivity were positively associated with depressive symptoms. Compared with the anti-inflammatory diet & active group, the risk of depressive symptoms was 2.061 times higher in the pro-inflammatory diet & inactive group, 1.351 times higher in the pro-inflammatory diet & active group, and 1.603 times higher in the anti-inflammatory diet & inactive group. Physical inactivity was associated with a higher risk of depressive symptoms than a pro-inflammatory diet. Females and the 20–39 age group showed a strong association between lifestyles and depressive symptoms. LimitationsBecause of the cross-sectional study, no causal conclusions could be drawn. Moreover, PHQ-9 is a relatively basic method of identifying depressive symptoms, more and further research is needed. ConclusionsBoth a pro-inflammatory diet and physical inactivity were associated with higher risk of depressive symptoms, especially for young and female population.

Long-Term Apparent Temperature, Extreme Temperature Exposure, and Depressive Symptoms: A Longitudinal Study in China.

Temperature is increasingly understood to impact mental health. However, evidence of the long-term effect of temperature exposure on the risk of depressive symptoms is still scarce. Based on the China Health and Retirement Longitudinal Study (CHARLS), this study estimated associations between long-term apparent temperature, extreme temperature, and depressive symptoms in middle-aged and older adults. Results showed that a 1 °C increase or decrease from optimum apparent temperature (12.72 °C) was associated with a 2.7% (95% CI: 1.3%, 4.1%) and 2.3% (95% CI: 1.1%, 3.5%) increased risk of depressive symptoms, respectively. This study also found that each percent increase in annual change in ice days, cool nights, cool days, cold spell durations, and tropical nights was associated with higher risk of depressive symptoms, with HRs (95%CI) of 1.289 (1.114-1.491), 2.064 (1.507-2.825), 1.315 (1.061-1.631), 1.645 (1.306-2.072), and 1.344 (1.127-1.602), respectively. The results also indicated that people living in northern China have attenuated risk of low apparent temperature. Older people were also observed at higher risk relating to more cool nights. Middle-aged people, rural residents, and people with lower household income might have higher related risk of depressive symptoms due to increased tropical nights. Given the dual effect of climate change and global aging, these findings have great significance for policy making and adaptive strategies for long-term temperature and extreme temperature exposure.

Hierarchical multiple regression investigating factors associated with depressive symptoms in the middle-aged and elderly undergoing haemodialysis

BackgroundDepressive moods are commonly seen in patients who receive haemodialysis. This can cause a lack of compliance in their treatment procedures and increase the rate of hospitalization. This study aimed to investigate the relationship between social support and degree of depression in middle-aged and elderly patients undergoing haemodialysis and the predictors of depressive symptoms.MethodsA cross-sectional correlational study was designed with a structured questionnaire survey. Patients over 40 years of age were included from five haemodialysis centres. Measures embraced a demographic and clinical characteristics questionnaire, the Centre for Epidemiologic Studies Depression Scale, and the Personal Resource Questionnaire 2000. Statistical analysis was performed using hierarchical multiple regression analysis.ResultsA total of 179 patients over 40 years of age were included from five haemodialysis centres in the analysis. The mean CES-D score was 19.0(12.3); the majority of participants (60.3%) had a CES-D score ≥ 15, indicating likely depressive status. The mean PRQ2000 score was 75.7(15.9). The proportional mean of the PRQ2000 was 72.11%, indicating moderate social support for participants in this study. Data disclosed that marital status, number of comorbidities, exercise behaviour, and social support could significantly predict depressive symptoms; total explanatory variance was 31.3%.ConclusionHealth care professionals should identify those at high risk of depressive symptoms when they provide care to the middle-aged and elderly patients undergoing haemodialysis. These findings may lead to greater insights into the nursing and rehabilitative care of patients treated by chronic maintenance haemodialysis.