Number Of Depressive Symptoms Research Articles

Chronotype and depression in adolescence: Results from a UK birth cohort study

AbstractBackgroundResearch has established a bidirectional association between sleep disturbances and depression in both adults and youth, as well as links between depression and circadian rhythms and chronotype, predominantly in adult populations. However, the link between chronotype and depression in the general adolescent population, independently of poor sleep and prior mental health problems, remains unclear.MethodsThis study investigated the association between time‐to‐sleep (TTS) and depressive symptoms in middle adolescence (age 14 years) using data from a large, nationally representative birth cohort from the UK. The relationship between TTS and self‐reported number of depressive symptoms was adjusted for individual, family, and neighborhood characteristics, including sleep quality, earlier mental health, diet and family meal routines, body‐mass index, screen time, physical activity, chronic illness, special educational needs, peer victimization, socioeconomic status, maternal mental health, area safety and the built environment (air pollution).ResultsAn “evening” chronotype was positively associated with depressive symptoms, and biological sex moderated this association—with eveningness being more strongly related to depressive symptoms in females. TTS inconsistency between non‐school and school nights was associated with depressive symptoms and sleeping later on non‐school nights predicted fewer depressive symptoms. The results were robust to further sensitivity analyses that used the sleep midpoint on non‐school nights and controlled for sleep duration.LimitationsThis was a correlational study. The independent and dependent variables were self‐reported, and there was no clinical screening for sleep disorders. The TTS variables were provided in crude hour slots.ConclusionsA robust association was found between evening chronotype and depressive symptoms in middle adolescence, even after adjustment for a wide range of confounders. Eveningess and depressive symptoms were more strongly associated in females.

Impacts of Caregiving on Health of New Spousal Caregivers to Older Adults in the United States: A Coarsened Exact Matching Analysis.

Spousal caregivers of older adults, especially new spousal caregivers, face increased risks of negative health outcomes due to the demands of caregiving and their own health decline. Estimating the impacts of caregiving on health without controlling for caregivers' own aging-related health decline could exaggerate the negative health consequences of caregiving, while focusing solely on caregivers could result in selection bias where healthier individuals enter and/or remain in caregiving. This study aims to estimate the impacts of caregiving on health of new spousal caregivers while controlling for observable confounders. We utilized coarsened exact matching analysis to compare health outcomes between new spousal caregivers and spousal non-caregivers using pooled panel data from 2006 to 2018 in the Health and Retirement Study. We analyzed 242,123 person-wave observations from 42,180 unique individuals, among whom 3,927 were new spousal caregivers. Variables used for matching were classified into three categories: care needs, willingness to provide care, and ability to provide care. Two-year outcomes assessed are spouse's self-rated health, depressive symptoms, and cognitive functioning. A total of 3,417 (87.01%) new spousal caregivers were matched with 129,798 observations of spousal non-caregivers. Regression analysis indicated being a new spousal caregiver was associated with a 0.18 (SE=0.05) unit increase in number of depressive symptoms. No statistically significant results were identified for self-rated health and cognitive functioning. Our results highlighted the needs to address mental health among new spousal caregivers and emphasized the importance of addressing mental health in long-term care programs and policies.

Decrease in Gait Speed Over Time Is Associated With Increase in Number of Depression Symptoms in Older Adults With Type 2 Diabetes.

We examined the cross-sectional and longitudinal relationships of motor functions with depression in older adults with type 2 diabetes (T2D). Participants (n = 984) were from the longitudinal Israel Diabetes and Cognitive Decline (IDCD) study. They were initially cognitively normal and underwent evaluations of motor functions (grip strength and gait speed) and of depression (using the 15-item version of the Geriatric Depression Scale [GDS]) approximately every 18 months. We applied Hierarchical Linear Mixed Models (HLMM) to investigate the associations between motor functions and depression adjusting for sociodemographic, cardiovascular factors, overall cognitive score, and subjective report of exhaustion. Participants' baseline characteristics were 72 (±5) years of age (59.6% males), 13 (±4) years of education, Mini-Mental Status Exam (MMSE) score of 28.01 (±1.78), and a GDS score of (2 ± 2.00), consistent with normal cognitive status and lack of major affective symptomatology. Slower gait speed at baseline was associated with higher GDS scores (p = .001) and with their increase over time (p = .049). A decrease in walking speed from baseline was associated with an increase in GDS scores (p = .015). Lower grip strength at baseline was associated with higher GDS scores (p = .002), but not with trajectories in GDS scores over time. A faster decrease in grip strength from baseline was associated with a faster increase in GDS scores (p = .022). Both gait speed and grip strength are cross-sectionally associated with depression. However, only gait speed and its decrease over time can potentially be used to predict incident depression symptoms, thus facilitating the introduction of depression prevention strategies.

Friendship in Later Life: APathway Between Volunteering Hours and Depressive Symptoms.

Friendships are essential in the face of social network changes in later life and friendships may be important for reducing depression risk. Social participation through volunteering is also associated with fewer depressive symptoms. What is less well-understood is whether friendships serve as a pathway in the link between volunteering and depression. We used panel data from the Health and Retirement Study (2010, 2014, 2018). Negative binomial regression within the SEM modeling framework was employed to analyze the association between volunteering and friendship, focusing on the indirect effect of friendships for understanding the volunteering and depressive symptoms relationship. Volunteer hours were positively associated with friendship (1-99 hr: β=0.17, p < .001, 100-199 hr: β=0.15, p < .001, 200hr and more: β=0.23, p < .001) and negatively associated with number of depressive symptoms (1-99 hr: β=-0.07, p=.06, 100-199 hr: β=-0.14, p < .001, 200hr and more: β=-0.17, p < .001). Friendship mediated the relationship between volunteer hours and depressive symptoms (indirect effects; 1-99 hr: β=-0.01, 95% confidence interval [CI]=[-0.02, -0.00], p=.03), 100-199 hr: β=-0.01, 95% CI=[-0.02, -0.00], p=.03), 200hr and more: β=-0.02, 95% CI=[-0.03, -0.00], p=.03). Our findings underscored the role of volunteering in generating and maintaining friendships, as well as for friendships as a pathway between volunteer hours and depressive symptoms. Providing opportunities to maintain and grow friendships in later life may be a possible intervention strategy for older adults at risk of depression.

Aging With Incarceration Histories: An Intersectional Examination of Incarceration and Health Outcomes Among OlderAdults.

Experiences with incarceration are linked to poor mental and physical health across the life course. The purpose of this research is to examine whether incarceration histories are associated with worse physical and mental health among older adults. We apply an intersectionality framework and consider how the intersection of sexism and racism leads to unequal health outcomes following incarceration among women and people of color. We employ 2 measures of health (i.e., number of depressive symptoms and physical limitations) to broadly capture mental and physical health. Using data from Waves 11 and 12 of the Health and Retirement Study, we estimated a series of general linear models to analyze differences in health by incarceration history, gender/sex, and race/ethnicity. Findings suggest that experiences with incarceration are associated with a greater number of physical limitations and more depressive symptoms among older men and women, net of sociodemographic characteristics, early-life conditions, and lifetime stressful events. Formerly incarcerated women, particularly women of color, had more physical limitations and depressive symptoms relative to other groups. These findings suggest that incarceration histories have far-reaching health implications. Older women of color with incarceration histories experience markedly high levels of physical limitations and depressive symptoms in later life.

Allostatic load as a mediator of childhood maltreatment and adulthood depressive symptoms: A longitudinal analysis

Childhood maltreatment (CM) is associated with several negative outcomes in adulthood, including major depression. People who experience CM that go on to develop symptoms of major depression in adulthood tend to have earlier depressive symptom onset and greater symptom severity than those who do not experience CM. Studies have utilized allostatic load (AL) to understand how CM “gets under the skin” to contribute to depressive symptoms. However, studies largely utilize cross-sectional designs and limited biomarkers. The present study uses data from Wave 2 and Wave 3 of the Midlife Development in the United States study in regression-based analyses, examining if AL mediates the relationship between CM and the number of depressive symptoms in adulthood. AL was measured at Wave 2 using the system risk method with 27 biomarkers across seven different systems. CM was measured using the Childhood Trauma Questionnaire at Wave 2. Number of depressive symptoms were measured using the Composite International Diagnostic Interview-Short Form at Wave 3. Past month perceived stress, age, household income, education, sex, racial/ethnic identity, and current prescription medication use at Wave 2 were included as controls. Analyses identified that CM was associated with AL cross-sectionally, and that both CM and AL at were associated with the number of depressive symptoms prospectively. AL partially mediated the effects of CM on the number of depressive symptoms. The present study is the first to identify the mediating role of AL in the relationship between CM and adulthood depressive symptoms in a longitudinal design.

Football, migration, and mental illness: analysing the problematic nature of international transfers

The process of international migration can be stressful – it is rarely simple or straightforward. Whilst the heterogeneous nature of migratory experiences means that the stress associated with migration may not result in common mental disorders (CMDs) for all migrants, scholars have argued that some migrant groups face greater exposure to risk factors associated with the development of CMDs than others. In this conceptual paper, I draw on scholarship tracing the migrations of general populations to show that migrant professional footballers may be one such group who are exposed to a greater risk of developing CMDs when they engage in the process of international transfer. Specifically, I identify how having little power within the transfer process can lead some players to experience a loss of status and/or diminished sense of self; how the often-unpredictable nature of international transfers can result in some players experiencing poor self-esteem and an inability to adjust; and how separation from physical support networks can result in some players suffering from loneliness, isolation, and an increased vulnerability to the development of a number of depressive symptoms. Taking these factors into account, I make a series of recommendations that could allow clubs to better manage players through these specific periods of vulnerability.

Age at Arrival and Depression among Mexican Immigrant Women in Alabama: The Moderating Role of Culture.

Mexican-born women in the U.S. are at high risk of depression. While acculturation is the primary analytical framework used to study immigrant mental health, this research suffers from (1) a lack of specificity regarding how cultural models of living and being take shape among migrants converging in new destinations in the U.S., and (2) methods to empirically capture the impact of cultural positioning on individual health outcomes. Instead of relying on proxy measures of age at arrival and time in the U.S. to indicate where an individual is located on the acculturation spectrum, this study uses cultural consensus analysis to derive the substance and structure of a cultural model for la buena vida (the good life) among Mexican immigrant women in Birmingham, Alabama, and then assesses the extent to which respondents are aligned with the model in their everyday lives. This measure of ‘cultural consonance’ is explored as a moderating variable between age at arrival in the U.S. and number of depressive symptoms. Results demonstrate that for those who arrived at an older age, those with lower consonance are at the highest risk for depression, while those who are more aligned with la buena vida are at lower risk.

Does physical activity moderate the association between device-measured sedentary time patterns and depressive symptoms in adults?

To investigate the association between sedentary time (ST) patterns and depressive symptoms, and whether moderate-to-vigorous physical activity (MVPA) can moderate this association. This cross-sectional study included a representative sample of 243 adults (mean age 41.8±16.7 years, 56.4% women) from a city in Southeast Brazil. Depressive symptoms were estimated through the Hospital Anxiety and Depression Scale (HADS). ST patterns (i.e., number of breaks, mean length of sedentary bouts, and number of long sedentary bouts), total ST, and MVPA were assessed using accelerometers. Poisson regression models revealed associations of total ST (ß = 0.063; 95%CI 0.011 to 0.116) and number of long bouts (0.108; 0.047 to 0.171) with depressive symptoms among men. MVPA moderated the associations of breaks and longer bouts of ST with depressive symptoms, with an increase of one break/hour, the increase of one long bout, and a decrease of 1 minute in mean bout length being associated with a reduction of 0.211 and increases of 0.081 and 0.166, respectively, in the number of depressive symptoms among men with physical inactivity (breaks = -0.211; -0.360 to -0.063; mean bout length = 0.081; 0.003 to 0.158; number of long bouts = 0.166; 0.090 to 0.242). Interventions that encourage breaking up ST should be helpful to reduce depressive symptoms among people with physical inactivity.

Intergenerational Strain and Subjective Well-being: The Role of Leisure Activity Engagement

Family strain is associated with higher numbers of depressive symptoms and lower levels of life satisfaction. Leisure activities are observed to buffer the negative effects of family strain among younger adults, however, this phenomenon is understudied among older adults. This study examines the relationship between intergenerational strain and depressive symptoms and life satisfaction among persons aged 50 and older. The study also examines the moderating effects of gender and leisure activities. The analysis uses the Health and Retirement Study to addresses these questions. The results suggest that intergenerational strain (p=.000) and being female (p.=000), are associated with more depressive symptoms, while engagement in social leisure activities (p.=04) is associated with fewer. Intergenerational strain (p=.000) and being female (p=.03) are associated with lower levels of life satisfaction, while engagement in solitary (p=.000) and social leisure activities (p=.000) are associated with higher levels. Results from moderation models suggest that as intergenerational strain increases, women have lower life satisfaction and more depressive symptoms as compared to men (p=.000). Also, the association between intergenerational strain and life satisfaction is reduced among respondents who engaged in leisure activities (p=.002-social and p=.000-solitary). Further, the positive relationship between intergeneration strain and depressive symptoms is lower for persons who engage in leisure activities (p=.027-solitary and p=.013-social). Finally, women who engage in social and solitary leisure activities have fewer depressive symptoms than men (p=.037). The study findings imply that the subjective well-being of older persons may be improved in terms of intergeneration strain if they engage in leisure activities.

Gait speed is associated with changes in number of depression symptoms in older adults with type 2 diabetes

AbstractBackgroundWe examined the longitudinal relationships between motor function and number of depression symptoms, both important predictors of poor health‐related outcomes, including cognitive impairment, in old age. Analyses were based on initially cognitively normal older adults with type 2 diabetes (T2D) participating in the longitudinal Israel Diabetes and Cognitive Decline (IDCD) study.MethodSubjects [n=984; mean age 72 (SD=5); 40.4% female] underwent evaluations of motor functions‐ gait speed, measured by time to walk 3 meters (mean = 4.37 seconds; SD=2.35) and handgrip strength (mean 29 Kg; SD=10), and number of depression symptoms, assessed by the 15‐item version of the Geriatric Depression Scale (GDS) (mean=2, SD=2), at baseline and approximately every 18 months thereafter. Hierarchical Linear Mixed Models (HLMM), adjusting for demographic and cardiovascular risk factors as well as overall cognition, modeled the effects of motor function on repeated GDS scoresResultLower mean gait speed (based on all gait speed measurements) was associated with higher mean GDS scores (p=0.003) (based on all GDS measurements). A greater change in gait speed between measurements was associated with greater degree of change in GDS scores over the study period (p=0.034). Handgrip strength was not associated with number of depression symptoms or with their change over timeConclusionIn older adults with T2D, lower gait speed was associated with a greater number of depression symptoms. The degree of change in walking speed was associated with degree of change in GDS, such that greater increase in 3‐meters' walking time was associated with a greater increase in number of depression symptoms over time. Future studies should examine why gait speed, but not grip strength, was associated with depression. Slower gait speed due to depression, i.e. reverse causality, cannot be ruled out. Whether strategies for improvement of gait speed (e.g. physical activity) are effective in treatment or prevention of depressive symptoms in older adults with T2D merits investigation.

Discordance Between Patient-Reported Outcomes and Physician-Rated Motor Symptom Severity in Early-to-Middle-Stage Spinocerebellar Ataxia Type 3

Assessment of patient-reported outcome measures (PROMs) in spinocerebellar ataxias (SCAs) could provide valuable insights into self-perceived health status. Although they are considered additional endpoints in future clinical trials, determinants and interactions of different PROMs in early disease stages remain largely unknown. The aims of the present study were to evaluate health-related quality of life, depressive symptoms, fatigue, and physical activity in mildly to moderately affected SCA3 patients and to examine interrelations between these PROMs and objective disease severity indices. Twenty SCA3 patients and twenty healthy controls of comparable age and sex completed the EQ-5D-5L, Patient Health Questionnaire-9, Profile of Mood States, and International Physical Activity Questionnaire. Disease severity was quantified by the Scale for the Assessment and Rating of Ataxia (SARA) and Inventory of Non-Ataxia Signs (INAS). Mildly to moderately affected SCA3 patients reported lower quality of life (p = 0.049), more depressive symptoms (p = 0.028), and higher levels of fatigue (p = 0.001) than healthy controls. The amount of physical activity did not differ between both groups. Linear regression analyses revealed that quality of life was primarily determined by fatigue and not by ataxia severity, while physical activity was independently associated with SARA score and INAS count but not fatigue. Depressive symptoms were related to disease duration and fatigue but not to markers of motor disease progression. Taken together, decreased quality of life, increased levels of fatigue, and a higher number of depressive symptoms do not merely reflect motor impairment in early-to-middle-stage SCA3 patients. The observed discordance between patient-reported and clinician-based outcomes indicates that these measures genuinely evaluate distinct aspects of disease and emphasizes their complementariness in therapeutic trials. By contrast, the volume of self-reported physical activity is not associated with fatigue, reflects both ataxia severity and extracerebellar involvement, and could therefore represent a useful marker of motor impairment in a home setting.

Death of a child, religion, and mental health in later life

Background and Objectives The death of a child may be one of the most stressful events for parents to experience. This study aims to assess how the death of a child prior to midlife is associated with the mental health of parents in later life, and how this association is contingent upon religious belief in a divine plan. Research Design and Methods Using data from aging parents (aged 65 and older) in the six waves (2006-2016) of the Health and Retirement Study (HRS), we conducted negative binomial regression analyses to examine the main effects of the death of a child prior to midlife on late-life depressive symptoms, and the buffering effect of religious beliefs on this main effect (N = 8,248). Growth curve modeling was used to analyze the trajectories of depressive symptoms (Obs. = 31,088). Results Experiencing the death of a child prior to midlife is positively associated with depressive symptoms among older adults. Yet, the association is mitigated among respondents who exhibit a high level of belief in a divine plan at baseline. Further, a gradual decline in the number of depressive symptoms over time was observed among the bereaved parents who reported a high level of belief in a divine plan. Discussion and Implications Belief in a divine plan has a protective effect on older adults who cope with the aftermath of child loss. The findings in the study advance our knowledge about the complex interrelationships among stress, religion, and mental health in later life.

Antepartum Depression and Preterm Birth: Pathophysiology, Epidemiology, and Disparities due to structural racism.

Informed by the evidence of links between physiology of stress and parturition, we review recent epidemiologic evidence (2015-2020) of antenatal depression as a risk factor for preterm birth (PTB). We also explain racial/ethnic disparities in depression and preterm birth as a consequence of structural racism. Epidemiologic evidence is consistent in linking antepartum depression with an elevated risk of PTB. Antidepressant usage has been linked with an elevated risk of PTB. However, recent evidence suggests that severity of depression is the underlying driver of the elevated risk attributed to antidepressant usage. The number of depressive symptoms, as a proxy for severity of maternal stress, may be a more informative predictor of PTB than criterion based predictors. Across various study designs, measurement modalities, and populations, antenatal depression predicts an elevated risk of delivering preterm. The physiology of stress provides a plausible explanation for this observation. Excessive stress-induced elevations in maternal and then fetal HPA hormones can alter maternal and fetal homeostasis and hasten the timing of parturition. Antenatal depression and exposure to structural racism are two stressors that can trigger the maternal stress response. Chronically elevated levels of stress hormones among women of color in the USA provide a likely physiologic explanation for Black-White disparities in the risk of PTB. Focusing on the number of depressive symptoms as the more informative predictor of PTB raises several questions. We consider these questions as well as directions for future research in the context of recent advances in the field.

Predictors of Mild Cognitive Impairment Stability, Progression, or Reversion in the Lothian Birth Cohort 1936.

Background:Mild cognitive impairment (MCI) describes a borderland between healthy cognition and dementia. Progression to and reversion from MCI is relatively common but more research is required to understand the factors affecting this fluidity and improve clinical care interventions.Objective:We explore these transitions in MCI status and their predictive factors over a six-year period in a highly-phenotyped longitudinal study, the Lothian Birth Cohort 1936.Methods:MCI status was derived in the LBC1936 at ages 76 (n = 567) and 82 years (n = 341) using NIA-AA diagnostic guidelines. Progressions and reversions between healthy cognition and MCI over the follow-up period were assessed. Multinomial logistic regression assessed the effect of various predictors on the likelihood of progressing, reverting, or maintaining cognitive status.Results:Of the 292 participants who completed both time points, 41 (14%) participants had MCI at T1 and 56 (19%) at T2. Over the follow-up period, 74%remained cognitively healthy, 12%transitioned to MCI, 7%reverted to healthy cognition, and 7%maintained their baseline MCI status. Findings indicated that membership of these transition groups was affected by age, cardiovascular disease, and number of depressive symptoms.Conclusion:Findings that higher baseline depressive symptoms increase the likelihood of reverting from MCI to healthy cognition indicate that there may be an important role for the treatment of depression for those with MCI. However, further research is required to identify prevention strategies for those at high risk of MCI and inform effective interventions that increase the likelihood of reversion to, and maintenance of healthy cognition.

Mental Health Impact of the Confinement Measures During the COVID-19 Pandemic

Background. Mid-March 2020, with exponentially increasing COVID-19 infections, Luxembourg closed schools and businesses, and declared a crisis (état de crise) to implement confinement measures, including orders to not leave the home unless to fulfill essential needs. The psychological consequences of these policy responses to the pandemic on older people, considered a high-risk group, were unknown at the time. The aim of this study was to use the nationally representative CON-VINCE study that assessed mental health at the height of the confinement measures mid-April 2020, to assess the psychological impact of quarantine on older adults. Method. A total of 451 participants aged 60+ years (55.0% male) filled in the CES-D, the GAD-7 and the 3-item loneliness scale that measured depressive symptoms, level of anxiety, and feelings of social isolation. Results. Mean age was 67.7 years (SD 5.5), average number of school years were 13.1 (SD 3.6). The participants were mainly of Luxembourgish nationality (87.8%), and a majority (69.8%) was married. Clinically relevant depression scores were present in 13.1%, generalized anxiety in 1.8%, and self-perceived isolation in 16.9% of participants. Number of depressive symptoms was associated with perceived isolation (p<0.001) and current exercise levels (p=0.02). Discussion. The rate of older adults with clinically relevant impaired mental health was similar to pre-pandemic levels in Luxembourg, suggesting that negative mental health consequences of the confinement measures were largely absent. Possible explanations are that confinement was considered a universal experience, and that the healthcare system remained functional, unlike in other countries at the time.

Moderating Effect of Psychological Resilience on Functional Impairment in Relation to Subsequent Depression

The growing prevalence of functional impairment is a serious concern due to its relation to decreased quality of life in later life. Guided by the social convoy model and the stress process model, the present study investigated whether psychological resilience, particularly optimism and mastery moderated an association between functional impairment and subsequent depressive symptoms in later life. This study used data derived from two population-based national studies in the United States: 2012 and 2016 waves of the Health and Retirement Study (N = 5,035) and 2004 and 2013 waves of the Midlife in the United States (N = 2,476). Ordinary least squares regression was used to estimate the impact of optimism and mastery, respectively, on the associations between functional impairment (baseline measure at wave(t-1), changes over the study period from wave(t-1) to wave(t)) on subsequent changes in depressive symptoms. Across both studies, we found that having and developing functional impairment are related to increased number of depressive symptoms. Optimism independently predicted decreased depressive symptoms over the study periods and buffered the negative effects of functional impairment on depressive symptoms across the two studies. Specifically, the mitigating effects of optimism on depressive symptoms were greater for those with more numbers of functional limitations. The findings suggest that psychological resilience plays a key role in decreasing depressive symptoms, especially for midlife and older adults with functional impairment. The results also demonstrate the importance of examining both optimism and mastery when investigating psychological resilience and emotional well-being in older adults.

Depressive symptoms and risk of dementia in non‐depressed older adults

AbstractBackgroundThe relationship between depression and dementia is complex. Whether depression serves as a risk factor, prodromal symptom, or comorbidity of dementia remains unclear. Longitudinal studies that establish temporality of these conditions in late life may shed light on their relationship.MethodWe analyzed data from the Ginkgo Evaluation of Memory Study (GEMS) initiated in 2000 and followed for 8 years to determine incident dementia and its subtypes Alzheimer’s disease (AD) and vascular dementia (VaD). Inclusion criteria for enrollment in GEMS required participants to have a Center for Epidemiology Studies Depression score (CES‐D) &lt;16 or to be on treatment for depression. Dementia was determined by consensus of study neurologists based on standardized criteria using neuropsychiatric testing, MRI imaging, and comorbidities. Cox Proportional Hazards Regression was used to evaluate the associations of dementia (n=515), AD (without VaD, n=348) and VaD (with or without AD, n=145) with number of depressive symptoms at baseline. We determined the optimum cutpoint for depressive symptoms to predict dementia using Receiver Operating Characteristic (ROC) curves. Adjustments for age, gender, race, education, area level income, and study site were included in models.Result3,042 participants mean age 78.6 (SD 3.3), 46% women, mean follow‐up time 5.5 (SD 1.6) person‐years, were included in analyses. Mean number of CES‐D depressive symptoms at baseline was 3.5 (SD 3.2) with 525 participants reporting none. Number of depressive symptoms was associated with an increased risk of dementia (HR:1.09, 95% CI:1.06‐1.12, p&lt;0.001), AD (HR:1.10, 95% CI:1.07‐1.13, p&lt;0.001) and VaD (HR:1.05, 95% CI:1.00‐1.10, p=0.04). The optimum cutpoint based on the ROC curve was 2.6 with sensitivity of 0.64 and specificity of 0.49. Participants who reported &gt; 3 depressive symptoms had a 45% increased risk of dementia compared to those with fewer symptoms (HR: 1.45, 95% CI:1.04‐2.04, p=0.03). Effect modification by presence of mild cognitive impairment (MCI) was found (p interaction = 0.008). Results were only significant for those without MCI.ConclusionReporting just a few depressive symptoms in late life may indicate future onset of dementia. These results suggest the need for close clinical follow‐up of cognitive impairment in these non‐depressed older adults.

Health literacy supports active aging

From the individual viewpoint, active aging refers to the ability of older persons, depending on their goals, functional capacity and opportunities, to engage in desired activities. This study investigated the role of health literacy in active aging among persons differing in their number of chronic conditions. Data were collected from 948 individuals, 57% women, aged 75, 80 and 85 in 2017–2018 in the city of Jyväskylä in Central Finland. Health literacy was assessed with the 16-question version of the European Health Literacy Survey (HLS-EU-Q16), active aging with the University of Jyväskylä Active Aging Scale (UJACAS) and self-reported physician-diagnosed chronic conditions. Both health literacy (r = 0.40) and number of chronic conditions (r = −0.21) correlated with the active aging score. Linear regression models revealed that health literacy was a stronger predictor than chronic conditions of active aging (β 0.18, p < 0.001 vs. β −0.06, p = 0.030) and that its predictive value remained statistically significant after adjustment for cognitive capacity, number of depressive symptoms, physical performance and length of education. Higher health literacy can enable older persons, including those with multiple chronic conditions, to maintain higher levels of active aging. As more people are projected to live with chronic conditions to older ages, health literacy may help them to cope with illnesses and functional limitations and lead a fulfilling life. These cross-sectional findings lay a foundation for future prospective and experimental studies on health literacy and active aging.

Subjective well-being among male veterans in later life: the enduring effects of early life adversity

Objectives This study investigated the association between childhood and young adult adversities and later-life subjective well-being among older male veterans. We also explored whether early-life parent–child relationships and later-life social engagement served as moderators and mediators, respectively. Methods Data were from the 2008 to 2012 waves of the Health and Retirement Study for male veterans (N = 2026). Subjective well-being measures included depressive symptoms, self-rated health, and life satisfaction. Linear regression with the Process macro was employed to estimate the relationships. Results Adverse childhood experiences (ACEs) were positively associated with number of depressive symptoms and negatively related to life satisfaction. Combat exposure, a young adulthood adversity experience, was positively associated with depressive symptoms, but not with self-rated health or life satisfaction. Later-life social engagement mediated the relationship between ACEs and subjective well-being indices. Parent–child relationship quality did not moderate the association between the measures of adversity and any measure of subjective well-being. Discussion Childhood adversity and combat exposure were related to worse later life subjective well-being. Also, later-life social engagement mediated the association of two early life adversity measures and subjective well-being. Future research should examine subjective well-being and early life adversity for female veterans and should employ more detailed information about combat exposure.