Physical Health Factors Research Articles

Do Patients Reporting Fractures Experience Food Insecurity More Frequently Than the General Population?

The economic burden of traumatic injuries forces families into difficult tradeoffs between healthcare and nutrition, particularly among those with a low income. However, the epidemiology of food insecurity among individuals reporting having experienced fractures is not well understood. (1) Do individuals in the National Health Interview Survey reporting having experienced fractures also report food insecurity more frequently than individuals in the general population? (2) Are specific factors associated with a higher risk of food insecurity in patients with fractures? This retrospective, cross-sectional analysis of the National Health Interview Survey was conducted to identify patients who reported a fracture within 3 months before survey completion. The National Health Interview Survey is an annual serial, cross-sectional survey administered by the United States Centers for Disease Control, involving approximately 90,000 individuals across 35,000 American households. The survey is designed to be generalizable to the civilian, noninstitutionalized United States population and is therefore well suited to evaluate longitudinal trends in physical, economic, and psychosocial health factors nationwide. We analyzed data from 2011 to 2017 and identified 1399 individuals who reported sustaining a fracture during the 3 months preceding their survey response. Among these patients, 27% (384 of 1399) were older than 65 years, 77% (1074) were White, 57% (796) were women, and 14% (191) were uninsured. A raw score compiled from 10 food security questions developed by the United States Department of Agriculture was used to determine the odds of 30-day food insecurity for each patient. A multivariate logistic regression analysis was performed to determine factors associated with food insecurity among patients reporting fractures . In the overall sample of National Health Interview Survey respondents, approximately 0.6% (1399 of 239,168) reported a fracture. Overall, 17% (241 of 1399) of individuals reporting broken bones or fractures in the National Health Interview Survey also reported food insecurity. Individuals reporting fractures were more likely to report food insecurity if they also were aged between 45 and 64 years (adjusted odds ratio 4.0 [95% confidence interval 2.1 to 7.6]; p < 0.001), had a household income below USD 49,716 (200% of the federal poverty level) per year (adjusted OR 3.1 [95% CI 1.9 to 5.1]; p < 0.001), were current tobacco smokers (adjusted OR 2.8 [95% CI 1.6 to 5.1]; p < 0.001), and were of Black race (adjusted OR 1.9 [95% CI 1.1 to 3.4]; p = 0.02). Among patients with fractures, food insecurity screening and routine nutritional assessments may help to direct financially vulnerable patients toward available community resources. Such screening programs may improve adherence to nutritional recommendations in the trauma recovery period and improve the physiologic environment for adequate soft tissue and bone healing. Future research may benefit from the inclusion of clinical nutritional data, a broader representation of high-energy injuries, and a prospective study design to evaluate cost-efficient avenues for food insecurity interventions in the context of locally available social services networks. Level III, prognostic study.

Autologous Human Mesenchymal Stem Cell-Based Therapy in Infertility: New Strategies and Future Perspectives.

Infertility could be associated with a few factors including problems with physical and mental health, hormonal imbalances, lifestyles, and genetic factors. Given that there is a concern about the rise of infertility globally, increased focus has been given to its treatment for the last several decades. Traditional assisted reproductive technology (ART) has been the prime option for many years in solving various cases of infertility; however, it contains significant risks and does not solve the fundamental problem of infertility such as genetic disorders. Attention toward the utilization of MSCs has been widely regarded as a promising option in the development of stem-cell-based infertility treatments. This narrative review briefly presents the challenges in the current ART treatment of infertility and the various potential applications of autologous MSCs in the treatment of these reproductive diseases.

The temporal dependencies between social, emotional and physical health factors in young people receiving mental healthcare: a dynamic Bayesian network analysis.

The needs of young people attending mental healthcare can be complex and often span multiple domains (e.g., social, emotional and physical health factors). These factors often complicate treatment approaches and contribute to poorer outcomes in youth mental health. We aimed to identify how these factors interact over time by modelling the temporal dependencies between these transdiagnostic social, emotional and physical health factors among young people presenting for youth mental healthcare. Dynamic Bayesian networks were used to examine the relationship between mental health factors across multiple domains (social and occupational function, self-harm and suicidality, alcohol and substance use, physical health and psychiatric syndromes) in a longitudinal cohort of 2663 young people accessing youth mental health services. Two networks were developed: (1) 'initial network', that shows the conditional dependencies between factors at first presentation, and a (2) 'transition network', how factors are dependent longitudinally. The 'initial network' identified that childhood disorders tend to precede adolescent depression which itself was associated with three distinct pathways or illness trajectories; (1) anxiety disorder; (2) bipolar disorder, manic-like experiences, circadian disturbances and psychosis-like experiences; (3) self-harm and suicidality to alcohol and substance use or functioning. The 'transition network' identified that over time social and occupational function had the largest effect on self-harm and suicidality, with direct effects on ideation (relative risk [RR], 1.79; CI, 1.59-1.99) and self-harm (RR, 1.32; CI, 1.22-1.41), and an indirect effect on attempts (RR, 2.10; CI, 1.69-2.50). Suicide ideation had a direct effect on future suicide attempts (RR, 4.37; CI, 3.28-5.43) and self-harm (RR, 2.78; CI, 2.55-3.01). Alcohol and substance use, physical health and psychiatric syndromes (e.g., depression and anxiety, at-risk mental states) were independent domains whereby all direct effects remained within each domain over time. This study identified probable temporal dependencies between domains, which has causal interpretations, and therefore can provide insight into their differential role over the course of illness. This work identified social, emotional and physical health factors that may be important early intervention and prevention targets. Improving social and occupational function may be a critical target due to its impacts longitudinally on self-harm and suicidality. The conditional independence of alcohol and substance use supports the need for specific interventions to target these comorbidities.

Social and physical predictors of mental health impact in adult women who have an FMR1 premutation

PurposeClear understanding of mental health phenotypes and associated socioeconomic, physical health and well-being impacts in adult women with an FMR1 premutation (PM) is needed for counseling and primary healthcare. MethodsA questionnaire captured mental health conditions in women with a PM, using lifetime diagnosis and nested psychometric scales (Liebowitz Social Anxiety Scale; Depression and Anxiety Stress Scale). Socioeconomic, physical health and well-being data were entered into 2 multivariable logistic regression models (1 with depression status as the outcome variable and 1 with social anxiety as the outcome). Results137 participants were included. Depression was found in ∼30% and social anxiety in ∼38%. With depression status the outcome variable, strongest associations were for low education, diagnosis of migraine, diagnosis of irritable bowel syndrome, and self-reported hearing loss symptoms. With social anxiety status as the outcome, strongest associations were with education, migraine, irritable bowel syndrome, relationship status, and subjective memory complaints. ConclusionMental health impacts were found in more than 1 in 3 women. Poor mental health was significantly associated with socioeconomic and physical health factors. Findings may inform health care professionals about personalized treatment options for women with a PM.

Mental health, physical health, and psychosocial risk factors in employees of four European countries: baseline characteristics of an RCT

Mental health, physical health, and psychosocial risk factors in employees of four European countries: baseline characteristics of an RCT

주기적인 건강재활운동 참여자의 건강 상태, 건강 위기감 및 건강증진행위의 관계

In order to verify the relationship between health status, sense of crisis, and health promotion behaviors of middle-aged men and women participating in health rehabilitation exercise, this study conducted a questionnaire survey targeting middle-aged people participating in rehabilitation exercises at hospitals and rehabilitation centers located in the metropolitan area. There are 218 copies of data used for statistical analysis. Through this procedure, the following results were obtained. First, as a result of regression analysis on the relationship between health status and sense of crisis, emotional crisis was found to be significant in mental and physical health factors. Factors with a sense of loss of vitality were significant in physical health factors, whereas life dissatisfaction, marriage dissatisfaction, and child relationship were found to be significant. As for the dissatisfaction factors, it was significantly found in the mental health factors. Second, as a result of regression analysis on the relationship between health status and health promotion behavior, both physical health and mental health were found to be meaningfully explained. Third, as a result of regression analysis on the relationship between sense of crisis and health promotion, it was found that all factors of emotional crisis, loss of vitality, life dissatisfaction, marriage dissatisfaction, and child relationship dissatisfaction were significantly explained.

Systematic review of the evidence to support expert practice in the education and care of children and young people with special educational needs and disability in the UK

Scopus, EBSCO, ERIC and British Education Index were interrogated in a systematic review of primary research since 2014 addressing expert practice and outcomes in education and care for young people with special educational needs and disability in the UK. Grey literature and studies of medical settings, preschool children, mainstream education or professional education were excluded. Quality was gauged by effect sizes, risk of bias and the Critical Appraisal Skills Programme. The search identified 7058 items. Twenty‐eight studies were included, with 1839 participants of 4–22 years. Risk of bias was low, with effect sizes from small to extremely large. The qualitative studies were rigorous. Expert practice with positive outcomes was evidenced in comprehensive assessment, enhancing engagement and personalised interventions. Correction of visual problems, use of humanoid robots, and tested models were generally effective. There was rigorous evidence for efficacy of frameworks and reasonable evidence for creative approaches to physical activity. Drama lessons were valued. Standing frame use improved peer interaction or caused segregation. Disparity between problem identification and planned support in education health and care plans, and addressing personal and physical health factors were problematic. The voice of young people was lacking. More training was required in augmented and alternative communication.

COGNITIVE RESERVE, PHYSICAL HEALTH, AND COGNITIVE FUNCTIONING IN OLDER ADULTS

Abstract Prior research has shown positive relationships between cognitive reserve (CR), physical health, and cognition, meaning that higher levels of physical health and CR are associated with higher cognitive functioning and vice versa. A group of community-dwelling older adults (N = 45, mean age = 70.5 years) completed a measure of CR (Life Experiences Questionnaire; LEQ), as well as cognitive tests, with number of physician diagnosed health conditions and number of medications measuring physical health. Initially, we ran correlations with the intention of running a mediation model (physical health factor as the independent variable, LEQ as the mediator, and cognitive test scores as dependent variables). Significant correlations were found between physical health and CR (r = -0.44, p = .01) with a medium effect size, and between CR and some test scores. However, there were no correlations between physical health and cognitive scores. Therefore, using linear regression analyses, the LEQ significantly predicted scores on some tests of executive functioning (DKEFS: Colour-Word Interference Test; Trial 3: F(1,39) = 7.42, p = .010), and processing speed (DKEFS: combined colour naming/reading: F(1,32) = 4.32, p = .046). However, the LEQ did not significantly predict verbal fluency, any set-switching tests, or a set-switching and inhibition test. Additionally, when physical health was added to the model, there was no significant improvement. The results suggest that CR may predict some types of executive functioning test scores, but not other executive functioning tests. Additionally, physical health did not predict cognitive test scores in this sample.

LIFE LESSONS: THE EXPERIENCES OF OLDER ADULTS LIVING IN PUERTO RICO DURING COVID-19

Abstract What life lessons emerge from a group of older Puerto Ricans concerning their experiences with COVID-19. We will review study participants’ reports of how they spent their time during the pandemic, what they found most difficult to cope with, and life lessons they learned as a result. We will use Erickson’s life course theory of psychosocial development to frame their responses to these questions, including the crises (and strengths) of generativity versus stagnation (care) and ego integrity versus despair (wisdom). We will report evidence of care and wisdom as core ego strengths resulting from their lived experience. We will also review how isolation, sense of community, and key mental and physical health factors seemed to influence how their responses suggest coping strengths. We will discuss our findings in the context of social and cultural norms of current cohorts of older Puerto Ricans, highlighting the salience of community and family relations. (150 words)

THE EXPERIENCE OF THE COVID-19 PANDEMIC AMONG OLDER ADULTS IN PUERTO RICO

Abstract Older age groups and racial and ethnic populations are more likely to have medical conditions that increase their risks for illness, hospitalization and death from COVID-19. Puerto Rico has a high prevalence of acute and chronic health conditions and the lowest percent of people reporting good / excellent health of all U.S. states and territories. The effects of poor health on the island have been compounded in recent years by economic and political instability and by major natural disasters; yet, as of February 2022, 95% of persons aged 65 and older had received at least one vaccination and 88% were fully vaccinated. This symposium comprises five papers based on a study of personal, social, physical health, and mental health factors associated with COVID-19 in a community sample of 213 adults aged 60 and over in Puerto Rico. The first paper will introduce the study, including its purpose, theoretical framework, and methodology. Next, we will address methodological and ethical challenges of conducting research with older adults during the pandemic and strategies we used to overcome these. The third paper will report on the core focus of the project: to assess the knowledge, attitudes, and practices of older Puerto Ricans toward COVID-19. The fourth paper will focus on mental health effects of loneliness and loss, two of the most challenging exigencies of the pandemic for older adults. Finally, we will consider participants’ responses to open-ended questions about how they have coped with the pandemic and made meaning of their experiences.

RELATIONSHIP BETWEEN PHYSICAL AND MENTAL HEALTH WITH SUBJECTIVE COGNITIVE DECLINE AMONG OLDER ADULTS IN PUERTO RICO

Abstract Worse physical and mental health are risk factors for cognitive decline in older adults. In Puerto Rico, existing healthcare services are lacking, further exacerbating this risk. This study examines how mental and physical health factors affect subjective cognitive decline for older adults in Puerto Rico. Data comes from the 2020 Behavioral Risk Factor Surveillance System, restricted to adults age 60+ residing in Puerto Rico (n = 1603). Subjective cognitive decline was measured with two dichotomous variables (no/yes): increases in confusion or memory loss and difficulty making decisions in the past year. Multivariate logistic regression models were run for each outcome variables. Predictor variables were number of days in past month with poor mental health, diagnosis of depression or mood disorder, self-rated health, and access to healthcare services, along with covariates. Higher number of days with poor mental health (B = 2.44, p &amp;lt; .001), diagnosis of depression or mood disorder (B = 3.76, p &amp;lt; .001), and cost barriers to accessing healthcare (B = 2.90, p = .002) were associated with increased odds of increased confusion or memory loss. Significant predictors of increased odds of decision-making difficulty included higher number of days of poor mental health (B = 1.88, p &amp;lt; .001), diagnosis of depression or mood disorder (B = 3.80, p &amp;lt; .001), and worse self-rated health (B = 2.13, p &amp;lt; .001). To promote better cognitive health, intervention efforts should focus on those with poor mental and physical health, including identify strategies to improve access to healthcare services.

Lifestyle Patterns of Children Experiencing Homelessness: Family Socio-Ecological Correlates and Links with Physical and Mental Health

Diet, screen time, physical activity, and sleep combine into lifestyle patterns with synergistic effects on health. This study aimed to identify lifestyle patterns in children without housing and assess their associations with physical and mental health and family socio-ecological factors. In the 2013 ENFAMS cross-sectional survey (children aged 6-12 experiencing homelessness, Greater Paris area, n = 235), parents reported socio-ecological factors, children's behaviours, and mental health (the latter was also child-reported). Nurses measured children's haemoglobin concentrations and body mass index. Principal component analysis was used to derive sex-specific lifestyle patterns. Hierarchical linear regressions and "outcome-wide" analyses assessed, respectively, these patterns' relations to health and family socio-ecological factors. A rather healthy lifestyle pattern-similarly characterized by diverse diet and high sleep time-was identified, with slight differences by sex. Scores for this pattern were higher for children in food-secure or higher-income households, whose parents were proficient in French, who slept longer, or who received more social support compared to their counterparts, with some nuances by sex. Higher scores for this pattern were associated with higher prosocial behaviour scores (girls) and lower anxiety and hyperactivity-inattention symptoms scores (boys), but not with physical health. For this underserved and understudied population, the results highlight the importance of family socio-ecological factors in shaping the lifestyles and mental health of children.

Effect of Marriage on Burnout among Healthcare Workers during the COVID-19 Pandemic

Since the onset of the COVID-19 pandemic, burnout symptoms have been prevalent among healthcare workers. Living with spouses can be complex and was associated with an increased burnout risk during the COVID-19 pandemic. This study investigated the relationship between living with spouses and burnout among healthcare workers during the COVID-19 pandemic. We distributed questionnaires to participants working in a hospital affiliated with a medical university in Taiwan. The questionnaires were the Copenhagen Burnout Inventory, which comprises personal burnout (PB), work-related burnout (WB), and client burnout subscales; the Nordic Musculoskeletal Questionnaire; and information on basic demographic variables, family factors, living habits, work-related factors, and physical health factors. Multiple linear regression and mediation analysis were used. We obtained 1615 (63.81%) valid questionnaires. After analysis revealed that marriage was an independent risk factor for PB; however, the effect of marriage on WB was nonsignificant after controlling for risk factors. Parenthood, less alcohol use, reported sleep duration less than six hours, less overtime, less shift work, and participation in leisure activities with family and friends were found to be mediators between marriage and a lower WB level. In addition, chronic diseases, frequent neck pain, and shoulder pain were suppression factors. In summary, marriage was associated with an increased risk of PB. Married individuals sustain a high WB level because of changes in family roles, living conditions, and work conditions. Overall, helping healthcare workers to maintain well-being in marriage or family living may be effective in decreasing burnout during the COVID-19 pandemic.

Consensus elements for observational research on COVID-19-related long-term outcomes.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its long-term outcomes may be jointly caused by a wide range of clinical, social, and economic characteristics. Studies aiming to identify mechanisms for SARS-CoV-2 morbidity and mortality must measure and account for these characteristics to arrive at unbiased, accurate conclusions. We sought to inform the design, measurement, and analysis of longitudinal studies of long-term outcomes among people infected with SARS-CoV-2. We fielded a survey to an interprofessional group of clinicians and scientists to identify factors associated with SARS-CoV-2 infection and subsequent outcomes. Using an iterative process, we refined the resulting list of factors into a consensus causal diagram relating infection and 12-month mortality. Finally, we operationalized concepts from the causal diagram into minimally sufficient adjustment sets using common medical record data elements. Total 31 investigators identified 49 potential risk factors for and 72 potential consequences of SARS-CoV-2 infection. Risk factors for infection with SARS-CoV-2 were grouped into five domains: demographics, physical health, mental health, personal social, and economic factors, and external social and economic factors. Consequences of coronavirus disease 2019 (COVID-19) were grouped into clinical consequences, social consequences, and economic consequences. Risk factors for SARS-CoV-2 infection were developed into a consensus directed acyclic graph for mortality that included two minimally sufficient adjustment sets. We present a collectively developed and iteratively refined list of data elements for observational research in SARS-CoV-2 infection and disease. By accounting for these elements, studies aimed at identifying causal pathways for long-term outcomes of SARS-CoV-2 infection can be made more informative.

Applying the Stress Process Theory to Assess Correlates of Suicide Ideation-to-Action Among Persons on Parole in the United States.

There is limited knowledge regarding precipitating factors associated with suicidality among persons on parole. Pairing the suicide ideation-to-action framework and stress process theory, the present study aimed to characterize sources of major stress (drug use, physical health, and mental health) and their associations to suicide ideation, planning, and attempt among a national sample of persons on parole. This study included a subsample of persons on parole (N = 1725) using pooled national data from the National Survey on Drug Use and Health (2015-2019). A series of logistic regression results indicate that various drug use, physical health, and mental health factors significantly influenced all three suicidality measures. Due to this population's unique experiences and numerous barriers following release from prison, it is essential to personalize interventions geared toward this population to meet their specific needs and address suicidality based on where they fall on this continuum.

Assessing Quality of Life with Community Dwelling Elderly Adults: A Mass Survey in Taiwan.

With the growing life expectancy for older adults, this study aims to examine the correlation among sociodemographic characteristics and the combined effect of QoL-related domains including physical health, psychological health, social relationships, and environmental factors with the overall QoL level of older adults in Taiwan. The WHOQOL-BREF Taiwanese Version questionnaire was adopted and conducted using a randomized telephone interview system from community household elders. In total, 1078 participants aged 65 years and older were recruited. A multiple regression model was used to examine the statistical significance between the overall QoL score as the dependent variable and the sociodemographic characteristics, and 26 items of QoL-related questionnaires as the independent variables. Categories including female, aged 85 years and above, higher education level, and better financial situation had significantly higher overall QoL level. Except the physical health domain and six items, the correlations among all other domains and their including items of questionnaires with overall QoL level were significant. The Taiwanese WHOQOL-BREF questionnaire can be used to examine the overall QoL level of elders in Taiwan. Nevertheless, the robust systems of universal health care and long-term care in Taiwan may have led to the no significance of the six items.

Suicide among young-old and old-old adults in rural China: A case-control psychological autopsy study.

Late-life suicide is a vital public health concern. Though gerontological research suggested the young-old and old-old phases were heterogeneous, age differences in the elderly suicide have not been well studied due to the lack of comparable control groups and small samples. The study aimed to examine the age-specific suicidal characteristics and risk factors among the young-old (60-79) and old-old (over 80) elderly. Two hundred and forty two suicide decedents and 242 living comparisons were enrolled in a 1:1 matched case-control psychological autopsy study in rural China: 173 young-old and 69 old-old in each group. Suicidal characteristics, demographic characteristics, living arrangements, physical health, mental disorder, and psychosocial factors were collected. We used logistic regression models to assess risk factors of suicide and test for interactions between age and each risk factor. Pesticide suicide was more prevalent among young-old suicides than old-old suicides (56.07% vs. 40.58%, p=0.029). Non-currently married, unemployment, mental disorder, higher disability in physical activities of daily living, higher hopelessness and higher depressive symptom were significantly associated with suicide among older adults. The effect of poor function in physical activities of daily living on suicide was significantly greater during younger ages (p for interaction=0.038). Findings indicated that most suicidal characteristics and risk factors for completed suicide were generally similar among young-old and old-old adults. But poor function in physical activities of daily living predicted increase suicide risk only at younger ages. In addition to common risk factors, age-specific factors should also be noted in suicide prevention. According to the ICMJE, purely observational studies (those in which the assignment of the medical intervention is not at the discretion of the investigator) will not require registration. Our study was not registered because this is a case-control study. But all procedures of the study were carried out in accordance with the latest version of the Declaration of Helsinki. The study were approved by the Institutional Review Boards of the Central South University, Shandong University, and Guangxi Medical University.

The Effects of Exergames on Physical and Psychological Health in Young Adults.

Objective: This study aims to examine the effects of Kinect-based exergaming on physical (balance and reaction time) and psychosocial health factors (mental well-being and subjective happiness level) in young adults. Materials and Methods: A total of 22 men aged between 18 and 40, who play sedentary videogames at least once a week, were randomly divided into 2 groups to participate in either a Kinect-based exergame program (experimental group, n = 11) or to continue playing sedentary videogames without making any changes (control group, n = 11). The Kinect-based exergame program, including three exergames (Kinect Adventure: Reflex Ridge, Dance Central 3, Kinect Sports: Volleyball), was implemented with the experimental group for 5 weeks, three times a week, and 45 minutes per session. Balance and reaction time were assessed using SportKAT® 4000 Kinesthetic Ability Trainer and FitLight Trainer™ devices, respectively. To measure mental well-being and subjective happiness level, scales with proven psychometric qualities, whose validity and reliability studies were conducted, were used. Results: Results of the study showed statistically significant improvement for the experimental group on the measures of reaction time [t(10) = -4.69, P = 0.001], subjective happiness [t(10) = 8.94, P = 0.000], and mental well-being [t(10) = 4.62, P = 0.001]. In addition, the difference between the groups in reaction time [t(20) = 1.66, P = 0.01], right leg static balance [t(20) = -2.96, P = 0.008], mental well-being [t(20) = 2.77, P = 0.012], and subjective happiness levels (U = 0.50, P = 0.000) was found to be statistically significant in favor of the experimental group. Conclusion: The findings suggest that Kinect-based exergaming positively supports adults' reaction time, mental well-being, and subjective happiness.

Prevalence, incidence, and persistence of psychotic experiences in the general population: results of a 9-year follow-up study.

Psychotic experiences (PEs) frequently occur and are associated with a range of negative health outcomes. Prospective studies on PEs are scarce, and to date no study investigated PE prevalence, incidence, persistence, their risk indicators, and psychiatric comorbidity, in one dataset. Furthermore, most studies are based on self-report, and it is unclear how this compares to clinical interviews. Data are used from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a psychiatric cohort study among a representative sample of adults (baseline characteristics: N = 6646; 49.6% female; 18-64 years). Results are presented for self-reported and clinically validated PEs. Associations are assessed for mental disorders, socio-demographic, vulnerability, physical health, and substance use factors. Based on self-report, at baseline 16.5% of respondents had at least one PE in their lifetime, of those, 30.1% also reported a PE at 3-year follow-up. 4.8% had a first PE at 3-year follow up. The 3-year prevalence of PE was associated with almost all studied risk indicators. Generally, the strongest associations were found for mental health disorders. Prevalence and incidence rates were two to three times higher in self-report than in clinical interview but results on associated factors were similar. Validated prevalence and incidence estimates of PE are substantially lower than self-reported figures but results on associated factors were similar. Therefore, future studies on associations of PEs can rely on relatively inexpensive self-reports of PEs. The associations between PE and mental disorders underline the importance of assessment of PE in general practice.

Depressive symptoms in older adult couples: Associations with dyadic physical health, social engagement, and close friends.

ObjectiveThe objective of this study was to examine associations between level of depressive symptoms in older adult spouse/partner couples and their physical health and social factors (social activity and number of close friends).MethodsUsing data from 116 community-dwelling couples (age 76.2 ± 8.5), we simultaneously analyzed associations between depressive symptoms (Geriatric Depression Scale, range 0–11) and dyadic physical health, engagement in social activities, and connectedness with close friends.ResultsGreater engagement in social activities was associated with fewer depressive symptoms in men, whereas more close friendships were associated with fewer depressive symptoms in women, controlling for partner effects, age, education, and cognitive function, with good model fit. Additionally, more disparate physical health within the couple (latent incongruence score) was associated with greater depressive symptoms in men.DiscussionLess social activity and fewer close friends were associated with depressive symptoms in older adult couples, but may be distinctly influential depending on gender and in the context of the older adult couple's physical health.