Neighborhood language isolation and depressive symptoms among elderly U.S. Latinos

Purpose

Neighborhood segregation related to cultural factors, such as language use, may influence elderly Latino depression. We examined the association between neighborhood-level Spanish language segregation and individual depressive symptoms among elderly Latinos.

Social support and depressive symptoms in the elderly.

The purpose of this study was to examine the effect of characteristics of social networks and support on depressive symptoms in the elderly. The subjects were 1,962 noninstitutionalized persons 65 years and older from the New Haven Establishment of Populations for Epidemiologic Study of the Elderly in 1982, who were available to give a complete follow-up interview in 1985. Baseline depression, functional disability in 1982, and any change in disability by 1985 were considered as additional influences on 1985 depression, requiring adjustment along with sociodemographic variables. Multiple regression procedures were used to simultaneously examine the variables. Baseline depression, functional disability, and change in functional disability made the largest contribution to explaining the variance in depression. Among the social support and network characteristics, loss of a spouse, adequacy of emotional support, and its change during 1982-1985 made the largest contributions. Other significant characteristics in relative order of magnitude of effect, based on contrast tests, included tangible support adequacy and its change, loss of a confidant between 1982 and 1985, number of children making weekly visits and change in this number by 1985, and the absence of a confidant in both 1982 and 1985. For mental health outcomes, these findings emphasize the need to consider specific dimensions of social support and networks rather than global measures.     

Drug utilization by the elderly with depressive symptoms

OBJECTIVE: Obtain a picture of non-psychiatric medication use and depressogenic medication use by elderly people suffering from depression. DESIGN: Cross-sectional, self-reported by respondents. METHOD: Information about medication usage and the presence of chronic diseases was obtained from 183 depressive respondents and 96 control respondents. The respondents were aged 55 years or over. They were recruited between April 1996 and May 1998 in the provinces Groningen, Drenthe and Friesland, the Netherlands. Recruitment was via Regional Institutes for Outpatient Mental Health Care (RIAGGs), a psychiatric outpatient clinic, general practitioners participating in the 'Groningen longitudinal ageing study' (GLAS), a survey under the elderly within the general population, and screening with the 'Geriatric depression scale' (score > or = 6) in the GLAS main file. RESULTS: Respondents with subsyndromal depression recruited via screening were prescribed more depressogenic medication (mean: 3.26 drugs per patient, of which 45.6% depressogenic) than the control group (respective figures: 1.78; 26.1%) and the depressive groups recruited via general practitioners (2.77; 31.8%) or those recruited via RIAGGs/psychiatric outpatient clinic (2.60; 38.3%).     

Neighborhood characteristics and depressive symptoms of older people: Local spatial analyses

Depressive symptoms in community-dwelling older people significantly increase the risk of developing clinically diagnosable depressive disorders. Knowledge of the spatial distribution of depressive symptoms in the older population can add important information to studies of neighborhood contextual factors and mental health outcomes, but analysis of spatial patterns is rarely undertaken. This study uses spatial statistics to explore patterns of clustering in depressive symptoms using data from a statewide survey of community-dwelling older people in New Jersey from 2006 to 2008. A significant overall pattern of clustering in depressive symptoms was observed at the state level. In a subsequent local clustering analysis, places with high levels of depressive symptoms near to other places with high levels of depressive symptoms were identified. The relationships between the level of depressive symptoms in a place and poverty, residential stability and crime were analyzed using geographically weighted regression. Significant local parameter estimates for the three independent variables were observed. Local parameters for the poverty variable were positive and significant almost everywhere in the state. The significant local parameters for residential stability and crime varied in their association with depressive symptoms in different regions of the state. This study is among the first to examine spatial patterns in depressive symptoms among community-dwelling older people, and it demonstrates the importance of exploring spatial variations in the relationships between neighborhood contextual factors and health outcomes.     

Chronic illness and depressive symptoms in the elderly: a population-based study

A cross-sectional study of the distribution of depressive symptoms and association between depressed mood and chronic illness was conducted in a geographically defined population in southern California of 1617 men and women aged 65 years and older. The prevalence of depressed mood for the total population was 5.2%. Women exhibited a significantly higher mean depressive symptom score and a prevalence rate almost twice that of men. Depressive symptoms were associated with several risk factors in both sexes, including age, self-perception of current health status, number of reported chronic diseases and medications and amount of exercise. However, the relationship between physical illness and depressive symptoms appeared to differ by sex with respect to the nature of the disease or disability and the type of medication currently used. These findings indicate that the risk of depression does not diminish with age among the elderly as other studies have suggested.     

自评儿女孝顺与老年抑郁症之间的关系

目的 通过分析自评儿女孝顺与老年人抑郁症之间的关系,试图为我国老年人心理健康的干预提供参考依据.方法 利用描述性分析、Person χ²检验和logistic回归模型分析“2010年中国城乡老年人状况调查数据”中18 234名≥60岁老年人自评儿女孝顺与老年抑郁症之间的关系.结果 老年人抑郁症检出率为22.50%;自评儿女不孝顺的老年人比例为1.66%;多元logistic回归分析显示,控制了人口、社会经济特征、家庭环境后,自评儿女不孝顺的老年人出现抑郁症的可能性显著高于自评儿女一般孝顺(OR=1.88,95%CI:1.71～2.07)、孝顺(OR=3.15,95%CI:2.41～4.12)的老年人.结论 自评儿女不孝顺会增加老年人出现抑郁症的可能性.通过改善代际之间的关系、降低子女赡养老年人的压力,有助于改善老年人的心理健康.     

老年人抑郁症状与慢性病及日常生活活动能力的关联性研究

目的 分析老年人慢性病、抑郁症状及日常生活活动能力三者之间的相互关系,探讨老年人抑郁症状和老年人日常生活活动能力受限的危险因素.方法 采用多阶段整群抽样方法,应用老年抑郁短量表、Katz日常生活活动量表（Katz-ADL）和Lawton工具性日常生活活动量表（Lawton-IADL）,对济宁市部分县区≥65岁的504例老年人进行问卷调查.结果 济宁市部分县区老年人总患病率为74.01％,抑郁症状阳性率为7.14％,ADL、IADL功能受限率分别为19.05％和66.67％,男性老年人抑郁症状阳性率及ADL、IADL功能受限率低于女性（x2分别为18.15、12.31、30.18,P均＜0.05）;老年人现患有慢性病的种类数是抑郁症状和ADL受限的危险因素（OR分别为1.71、1.53）,ADL和IADL受限也是老年人抑郁症状的危险因素（OR分别为3.15、9.36）;控制性别、年龄因素后,患有慢性病种类数对老年人抑郁症状、ADL、IADL的影响以及ADL和IADL受限对老年人抑郁症状的影响均无统计学意义.结论 性别、年龄是老年人抑郁症状、ADL和IADL受限的最根本的危险因素,家庭和社会在对老年人照护时,应积极锻炼提高老年人的日常生活活动能力,提升老年人的正性情绪,减少抑郁症状的发生.     

福州地区军队干休所老干部抑郁症状调查

目的 了解福州地区军队离退休老干部的抑郁症状检出率及其相关的影响因素.方法 采用整群抽样与分层抽样相结合的方法,选取福州地区14所军队干休所离退休老干部作为调查对象,以流调用抑郁自评量表(CES-D)为评定工具,采取面对面调查方式,调查老干部抑郁症状的检出率.结果 共调查500例,CES-D平均得分为(5.56±7.01)分,总分≥16分者44例,抑郁症状总体检出率为8.8％.单因素分析显示,婚姻状况、居住方式(独居)、吸烟史、需要生活照料者等分别对抑郁症状的发生率有显著影响,差异有统计学意义(P＜0.05);年龄、性别、文化程度、饮酒史及抑郁症状发生率比较差异无统计学意义.结论 福州地区军队离退休老干部抑郁症状检出率较高,并受多种因素影响,应该引起关注,重视老干部的心理健康.     

健康相关社会资本对中老年社区居民抑郁症状的影响

目的 研究中老年社区居民群体健康相关社会资本对抑郁症状的影响,为提升其心理健康水平提供依据。方法 采用多阶段分层整群抽样的方法,抽取成都市中老年居民1432人进行问卷调查。抑郁症状采用流调中心抑郁水平评定量表（CES-D）,健康相关社会资本由自编社会资本量表测量。应用多因素logistic回归分析中老年居民社会资本对其抑郁症状的影响。结果 中老年社区居民抑郁症状发生率为25.4%。不同性别、婚姻状况、文化程度、工作状况、健康状况的中老年人社会资本不同（P<0.05）;在控制人口学特征、健康危险因素等变量的情况下,家庭关系较好的中老年人产生抑郁症状的可能性较低（OR=0.555, 95%CI: 0.429~0.720）、社区信任与归属感得分较高的老年人产生抑郁症状的可能性较低（OR=0.726, 95%CI: 0.553~0.952）。结论 家庭关系、社会归属与信任感是影响社区中老年居民心理健康的主要社会资本因素,应对影响居民抑郁症状的因素采取有针对性的措施进行干预。     

Family, religion, and depressive symptoms in caregivers of disabled elderly

STUDY OBJECTIVE: To explain the variations in depressive symptomatology among primary caregivers of community dwelling activities of daily living disabled elderly and to evaluate the role of family and religiosity on the mental health consequences of caregiving in Spain. DESIGN: Cross sectional study. SETTING: City of Leganés in the metropolitan area of Madrid, Spain. PARTICIPANTS: All caregivers of a representative sample of community dwelling activities of daily living disabled persons, aged 65 and over were approached. The response rate was 85% (n = 194). Depression was assessed by the Center for Epidemiologic Studies Depression (CES-D) Scale. MAIN RESULTS: Controlling for caregivers' income, education, health status, and caregiving stress, religiosity was associated with more depressive symptoms among children caregivers while for spouses the association was negative. Emotional support was negatively associated with depression, but instrumental support was not significant. CONCLUSIONS: Depressive symptomatology is frequent among Spanish caregivers of disabled elderly. This study concludes that religiosity and family emotional support play an important part in the mental health of Spanish caregivers. The role of religiosity may be different according to kinship tie and needs further investigation.     

我国农村老年人抑郁症状性别差异及影响因素研究

目的 了解我国农村老年人抑郁的性别差异及影响因素,为缩小农村老年人抑郁性别差异、促进两性健康公平提供参考依据。方法 利用2015年中国健康与养老追踪调查（China health and retirement longitudinal study,CHARLS）数据库中抑郁相关数据进行Fairlie分解,分析农村老年人抑郁现状及性别差异。结果 农村老年人抑郁患病率为39.09%,女性高于男性（47.82% vs 32.43%）,差异有统计学意义（χ²=97.05,P<0.001）。多因素回归分析表明,地域、睡眠时长、日常生活能力（activity of daily living,ADL）、自评健康、疼痛是男女两性抑郁的共同影响因素,婚姻状况、社会活动是男性抑郁的影响因素。Fairlie分解结果显示,农村老年人抑郁性别差异中的72.06%是可观测因素造成的,另外27.94%是性别属性造成的。结论 农村老年男性抑郁患病率低于老年女性。生活方式、生理健康、疼痛是造成农村老年人抑郁性别差异的主要因素。     

中国中老年人抑郁症状与其吸烟行为关系的队列研究

目的 探索中老年人抑郁症状与吸烟行为的关联,以及社会人口学特征对这种关联的影响。方法 本研究使用CHARLS2011年与2015年的调查数据,选取基线不吸烟的7 722例中老年人作为研究对象。采用10项流调中心抑郁量表（CES - D10）评估抑郁症状,运用logistic 回归模型分析抑郁症状对吸烟行为的影响。结果 随访4年后,有7.17%（554例）的中老年人出现吸烟行为。logistic回归分析显示,有抑郁症状的中老年人出现吸烟行为的风险是无抑郁症状者的1.35倍（OR = 1.35,95%CI:1.09～1.68）。分层分析发现,与无抑郁症状者相比,有抑郁症状的女性（OR = 1.67,95%CI:1.11～2.52）、45～59岁（OR = 1.52,95%CI:1.11～2.09）、居住地在农村者（OR = 1.55, 95%CI:1.17～2.06）吸烟行为风险更高,差异具有统计学意义 (P＜0.05)。结论 中国中老年人的抑郁症状与吸烟行为显著相关,且在女性、45～59岁和居住在农村的人中更为显著。建议未来的研究进一步探索中老年人临床抑郁与吸烟行为的关系研究。     

The development of depressive symptoms in elderly following onset of severe physical illness

This study followed a group of elderly patients (ill group) with recent onset of life-threatening or severely debilitating illness to determine development of depressive symptoms. Age- and sex-matched control patients were included for comparison. Depressive symptoms increased significantly in the group of ill male patients when compared with controls. Depressive symptoms did not show an increase in the group of ill female patients. Other variables also predicted increased depression: (1) an initial placement in nursing home, (2) a prior history of depression or higher initial level of depressive symptoms, (3) the presence of larger numbers of additional medical illnesses, and (4) following the occurrence of stressful life events. The increase in depression in the male test group was still present and significant when controlling for these additional four factors.     

Smoking behaviours and contextual influences on adolescent nicotine dependence

Objective: The objectives of the study were to analyse nicotine‐dependence patterns among secondary school students in New Zealand (NZ), and identify factors associated with levels of nicotine dependence. Method: This study uses data from the 2004 Youth Lifestyle Study, a survey of Year 10 and 12 students from randomly selected schools in NZ. The analysis included 625 current adolescent smokers. Nicotine dependence was measured with the Hooked on Nicotine Checklist (HONC). Potential dependence‐associated factors studied include: socio‐demographic factors; smoking behaviours; and smoking contexts. Results: A large percentage (87.9%) of the current adolescent smokers reported at least one HONC symptom, with a mean HONC score of 4.9 out of a possible 10. Multivariate analyses identified: school decile; age at which started smoking monthly; lifetime cigarette consumption; and peers smoking as statistically significant predictors of nicotine dependence. Conclusions: Adolescent smokers are very likely to become dependent on nicotine. Students from the highest school decile had markedly lower HONC scores. Earlier onset of monthly smoking, heavier overall consumption and peers smoking were associated with higher HONC scores. These findings provide important insights into factors that may need to be modified to help reduce nicotine dependence among adolescents.     

A review of epidemiological studies on the relationship of social networks and support to depressive symptoms in the elderly

This paper reviews evidence concerning the relationship of social support and networks to psychological well-being in elderly people. Although few studies have used comparative concepts and featured measurements of social networks and social support, the overall findings are that depressive symptoms in elderly people are associated with (a) smaller size of social networks which are supportive, (b) lower emotional support which is anticipated or received, (c) lower instrumental support which is anticipated, and (d) not providing support to others, and that depressive symptoms are greater when the amount of received instrumental support is larger. There is evidence consistent with both direct effects of social networks and support on reducing depressive symptoms, and buffering effects to protect persons from adverse effects of stressful life events. In addition, physical health status, activities of daily living, income, and marital status are associated with depression among the elderly. A well-conducted longitudinal study is essential for research in this area in Japan.     

中国中老年人群抑郁症状与代谢综合征的关联分析

目的  分析中国中老年人抑郁症状对代谢综合征(metabolic syndrome, MS)患病的影响。方法  选取2015年中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS)数据库中重要变量完整的6 963名年龄≥45岁的中老年人为研究对象,采用简版流调中心抑郁水平评定量表(the center for epidemiological studies depression scale, CES-D10)评估抑郁症状,根据2020年中华医学会糖尿病学分会(Chinese Diabetes Society, CDS)提出的诊断标准评估MS的患病情况。采用倾向性评分匹配法,在均衡潜在混杂因素的基础上估计抑郁症状对中国中老年人MS患病的平均处理效应(average treatment effect on the treated, ATT),以探究抑郁症状对MS影响。结果  6 963例研究对象中,有33.10%(95% CI: 32.00%~34.21%)的中老年人存在抑郁症状,MS检出率为18.44%(95% CI: 17.53%~19.35%)。经倾向性评分均衡混杂因素后发现,抑郁症状对中老年人是否患MS没有影响(ATT=-0.002~0.002,均P>0.05)。结论  中国中老年人群的抑郁症状和MS检出率较高,但有抑郁症状与该人群是否患MS无明显关联。