Physical activity characteristics and depressive symptoms in older Latino adults

BackgroundPhysical activity (PA) has been consistently associated with fewer depressive symptoms in observational and intervention studies. Emphasis on leisure-time PA, reliance on self report measures of PA, and lack of inclusion of racial/ethnic minority populations have contributed to uncertainty regarding the minimal and optimal dose (minutes/day), intensity (i.e., light, moderate, or vigorous), bout duration (i.e., incidental vs. 10-min bouts), and domain (i.e., leisure-time, occupational, and household) of PA for reducing and preventing depressive symptoms across diverse populations.PurposeTo investigate the relationship between PA characteristics (i.e., dose, intensity, bout duration, and domain) and depressive symptoms in older Latinos using both objective and subjective measures of PA.MethodsOlder Latinos (n = 174) completed questionnaires and wore accelerometers for seven days. Accelerometer output provided daily minutes of sedentary, light, and moderate-vigorous PA (MVPA) overall and in 10-min bouts. The Community Healthy Activity Model Program for Seniors (CHAMPS) questionnaire provided daily minutes of leisure-time PA, household PA, and sedentary activities. Hierarchical linear regression analysis was used to predict Center for Epidemiological Studies Depression Scale (CES-D) score.ResultsAfter controlling for established correlates of depressive symptoms (i.e., demographics, acculturation, and health characteristics), MVPA in ≥10-min bouts independently predicted fewer depressive symptoms (β = ?.231, ΔR2 = .052, p ≤ .01) and household PA greater depressive symptoms (β = .263, ΔR2 = .056, p ≤ .001).ConclusionsResults suggest that PA intensity, bout duration, and domain influence the strength and direction of the relationship between PA and depressive symptoms in older Latino adults.     

Changes in intensity of physical exercise as predictors of depressive symptoms among older adults: an eight-year follow-up

BACKGROUND: Epidemiological research suggests that regular physical activity may be associated with reduced depressive symptoms. The present study examines the predictive value of physical exercise in relation to depressive symptoms among samples of adults aged 65+ during an 8-year period. METHODS: The subjects (N = 663) who participated both at the baseline (1988) and the follow-up (1996) interviews were selected for the analyses. The dependent variable depressive symptoms was assessed by the Finnish modified version of Beck's 13-item depression scale. The independent variable was the intensity of physical exercise. RESULTS: The intensity of physical exercise decreased among the older men and women. Those who had reduced their intensity of physical exercise during the 8 years reported more depressive symptoms at the follow-up than those who had remained active or increased their physical activity. Depressive symptoms were predicted by the intensity of baseline physical exercise, earlier depressive symptoms, older age, gender, having three or more chronic somatic conditions, and difficulties in performing ADL activities. CONCLUSIONS: Age-related decrease in the intensity of physical exercise increases the risk of depressive symptoms among older adults. This calls for effective measures in maintaining and supporting an adequate level of physical exercise among the aging population.     

Social relations and depressive symptoms in older adults with knee osteoarthritis

Depressive symptoms often occur as a comorbid condition in the context of chronic illnesses such as arthritis. However, the role of both social support and social strain in relation to depressive symptoms has not been adequately explored. This study investigates the association of support and strain with depressive symptoms among a sample of older men and women in the USA (N = 298, mean age 71 years) who have knee osteoarthritis (OA). Data were collected from a survey mailed to residents who had previously participated in the Osteoarthritis Study in Seniors (OASIS), a longitudinal observational study of OA progression (survey response rate was 77%). Hierarchical regression analyses revealed significant associations of both support and strain with depressive symptoms, while statistically controlling for a variety of demographic, psychosocial and disease-related variables. In addition, social support significantly buffered the relation between social strain and depressive symptoms. The interaction effect was not significantly different for women and men, nor were the individual associations of support and strain with depressive symptoms conditioned by participant gender. The results add to the ongoing discussion regarding gender and social relations as well as highlight the role of both positive (social support) and negative (social strain) aspects of social interactions in relation to the psychological functioning of older adults coping with a chronic illness.     

Mediterranean diet and depressive symptoms among older adults over time

Objective

To examine whether adherence to a Mediterranean-based dietary pattern is predictive of depressive symptoms among older adults.

Design

Generalized estimating equation models were used to test the association between a Mediterranean-based dietary pattern and depressive symptoms over time. Models were adjusted for age, sex, race, education, income, widowhood, antidepressant use, total calorie intake, body mass index, smoking, alcohol consumption, number of self-reported medical conditions, cognitive function, and physical disability.

Setting

Chicago, Illinois.

Participants

Community-dwelling participants (n=3502) of the Chicago Health and Aging Project aged 65+ years (59% African American) who had no evidence of depression at the baseline.

Measurements

Adherence to a Mediterranean-based dietary pattern was assessed by the MedDietScore. Dietary evaluation was performed with a food frequency questionnaire at baseline and related to incident depression as measured by the presence of four or more depressive symptoms from the 10-item version of the Center for Epidemiologic Studies Depression scale.

Results

Over an average follow-up of 7.2 years, greater adherence to a Mediterranean-based diet was associated with a reduced number of newly occurring depressive symptoms (parameter estimate = ?0.002, standard error = 0.001; p = 0.04). The annual rate of developing depressive symptoms was 98.6% lower among persons in the highest tertile of a Mediterranean-based dietary pattern compared with persons in the lowest tertile group.

Conclusion

Our results support the hypothesis that adherence to a diet comprised of vegetables, fruits, whole grains, fish, and legumes may protect against the development of depressive symptoms in older age.     

A meta-analysis of the prevalence of depressive symptoms in Chinese older adults

空巢老人属于社会弱势群体,有着特殊的生活状态和精神状态,是抑郁发病的高危人群。本文从流行病学角度出发,从源头上了解空巢老人抑郁发病情况,进行一级预防,系统综述了空巢老人抑郁患病的高危因素,并针对抑郁防控提出相关建议。     

The mediating role of disability and social support in the association between low vision and depressive symptoms in older adults

Purpose

Vision loss is highly prevalent in old age and has a substantial impact on different aspects of quality of life including depressive symptoms. Our objective was to examine the mediating role of disability and social support in the association between low vision and depressive symptoms.

Methods

Differences in disability, social support, and depressive symptoms between 148 persons with low vision and a reference population (N = 4,792) all ≥57 years were compared. The association between low vision and depressive symptoms and the mediating role of disability and social support was examined by the means of regression.

Results

A significant effect of low vision on depressive symptoms was identified even after the adjustment for disability and social support (standardized beta 0.053, P < 0.001). The association between low vision and symptoms of depression was partially mediated by disability, while social support was identified as a suppressor variable. Low vision, disability, and social support showed unique contributions to depressive symptoms.

Conclusions

Prevention of disability and the increase in social support may help to reduce symptoms of depression in older adults with low vision. By taking such information into account in their intervention work, health professionals working in this area may improve their care quality.     

基于组基轨迹建模的中国老年人抑郁症状发展轨迹研究

目的 识别中国老年人抑郁症状的不同发展轨迹及其影响因素.方法 使用2011年、2013年、2015年、2018年的中国健康与养老追踪调查数据,利用组基轨迹模型识别5 585名≥60岁老年人的抑郁症状发展轨迹,运用多分类lo-gistic 回归分析抑郁轨迹发展轨迹的影响因素.结果 识别出"无抑郁症状组"(58.58％)、...     

Prospective associations of social isolation and loneliness with poor sleep quality in older adults

Purpose

There is evidence for negative associations between social isolation and loneliness and sleep quality in older adults. However, it is unclear to what extent these two factors independently affect sleep quality. This study examined the simultaneous associations of social isolation and loneliness with sleep quality in a longitudinal study of older adults.

Methods

Data were analyzed from the Social Environment and Biomarkers of Aging Study in Taiwan collected in 2000 and 2006, involving a cohort of 639 participants (mean age?=?66.14, SD 7.26). Poisson regression models were conducted to examine the association of social isolation and/or loneliness with sleep quality at follow-up after adjusting for multiple confounding variables.

Results

Univariate analysis showed that sleep quality was inversely associated with both social isolation and loneliness. After demographic, health, cognitive factors, and depressive symptoms were controlled in multivariable analysis, social isolation at the baseline still predicted poor sleep quality 6 years later (incident rate ratio, IRR 1.14; 95% CI 1.04–1.24; p?<?0.01), while the association between loneliness and sleep quality was no longer significant (IRR 1.08; 95% CI 0.94–1.23; p?=?0.27). The results were unchanged when participants who had poor sleep quality at the baseline were excluded from the analysis.

Conclusions

These findings confirm an adverse effect of social isolation on the sleep quality of older adults, but indicate that this effect is independent of loneliness. Social isolation and loneliness seem to have distinct pathways in affecting the sleep quality of older adults.

     

Intergenerational relationships and depressive symptoms among older adults in urban China: The roles of loneliness and insomnia symptoms

The prevalence of depressive symptoms in older Chinese adults has increased recently. Intergenerational relationships play an important role in the mental health conditions of older adults, especially in Chinese culture. Therefore, this study aims to unravel the complex connection between intergenerational relationships and depression, and to explore the potential mediating roles of loneliness and nighttime insomnia symptoms within that connection. A cross‐sectional household survey was conducted in China with 2038 participants aged 65 years or above. Variables were measured using the Center for Epidemiologic Studies Short Depression Scale, the Intergenerational Relationship Quality Scale for Aging Chinese Parents (IRQS‐AP), three nighttime insomnia symptoms extracted from the Insomnia Severity Index and the De Jong Gierveld Six‐Item Loneliness Scale. The IRQS‐AP includes four subdimensions: consensual‐normative solidarity, structural‐associational solidarity, affectual closeness and intergenerational conflicts. Path analyses were performed in Mplus to investigate regression coefficients and mediating effects. Results showed that three general intergenerational relationships (consensual‐normative solidarity, affectual closeness and intergenerational conflicts) were significantly correlated with all mental health outcomes, including their symptoms of loneliness, insomnia and depression. A serial mediation model suggested that loneliness mediated the connection between those constructs of intergenerational relationships and depression, with an independent path to insomnia symptoms via loneliness. The proposed mediators fully mediated the effects of affectual closeness on depression. Nighttime insomnia symptoms alone mediated only the relationship between intergenerational conflicts and depression independently from paths involving depression. Removal of sleep item from CES‐D did not affect the results of paths. Our findings highlight the importance of intergenerational relationships for mental health, especially for the mediating effects of loneliness and nighttime insomnia symptoms on the relationship between intergenerational relationships and depression. Effective mental health services for older adults can address their feelings of loneliness and sleep problems, especially for those who have a poor relationship with their adult children.     

Age group differences in depressive symptoms among older adults with functional impairments

This study used data from the 2000 interview wave of the Health and Retirement Study to examine age group differences in the likelihood of self-reported depressive symptomatology among a nationally representative sample of 3,035 adults age 55 years or older who had at least one activities of daily living (ADL) or instrumental activities of daily living (IADL) limitation. Depression was defined as scoring three points or higher on the eight-point Center for Epidemiological Studies Depression Scale. The results show that respondents age 75 years or older with one ADL/IADL impairment or more were significantly less likely to be depressed than were those between ages 55 and 64 with the same degree of functional impairment. It is recommended that doctors, social workers, and other health care and social services providers pay special attention to younger old adults with health problems and functional limitations because they have a greater risk of being depressed.     

Comorbid depressive symptomatology: isolating the effects of chronic medical conditions on self-reported depressive symptoms among community-dwelling older adults

Advances in medical technology and surgical knowledge have greatly extended the life expectancy of older individuals with chronic disabilities. Among the older adult population the prevalence of comorbid chronic illness and depressive symptoms has often been investigated. Yet there continues to be a lack of understanding about the consequences of specific chronic illnesses on depressive symptoms. Using cross-sectional data while simultaneously controlling the effects of various socioenvironmental, demographic, and other factors, this study analyzed the prevalence of self-reported depressive symptoms in relation to chronic illness. The cumulative effect of medical comorbidity and the specific effect of individual chronic illnesses were examined. The sample consisted of 359 older white Americans aged 55-93. Overall, the findings show that self-reports of depressive symptoms were greater among those individuals who also reported digestive disorders, respiratory ailments, and heart problems. These results suggest that for older white Americans these three chronic conditions may present a greater mental health burden than other chronic illnesses.     

Prevalence and correlates of depressive symptoms among older U.S. adults

Using data from telephone interviews conducted during 1985, we investigated the prevalence and correlates of depressive symptoms in a national probability sample of 1,232 noninstitutionalized U.S. residents 65 years of age and older. The association between depressive symptoms and personal attributes, personal resources, illness behavior, life events, and self-reported health was examined through chi-square and logistic regression analyses. We measured depressive symptoms with the Center for Epidemiologic Studies--Depression (CES-D) scale using a score of 16 or greater as an indication of high depressive symptoms. Prevalence of high depressive symptoms was 9.9% in the total sample. For black males the prevalence of depressive symptoms was 7.4%, and for white males it was 6.8%. For black females the prevalence of depressive symptoms was 20.8%, while for white females it was 11.5%. In the regression analysis, female gender, single marital status, poor self-reported assessment of health, illness behavior, and a low number of club/organization memberships were significantly associated with high depressive symptoms. In comparison to respondents reporting good to excellent health, those reporting poor to fair health were almost four times more likely to report a high number of depressive symptoms (odds ratio = 3.97).     

Longitudinal associations between neighbourhood physical environments and depressive symptoms of older adults in Hong Kong: The moderating effects of terrain slope and declining functional abilities

Little is known about the accumulative impacts of neighbourhood physical environments on older adults’ depressive symptoms over time. Based on a cohort study of 2081 older adults in Hong Kong, this study examined longitudinal relationships between neighbourhood physical environments and depressive symptoms among older adults, with a particular focus on the moderating effects of terrain slope and individual functional ability using latent growth curve modelling. Results indicated that the availability of community centres and passive leisure facilities reduced depressive symptoms over time. The protective effects of residential surrounding greenness on depressive symptoms among older adults differed by the terrain slope types. Longitudinal associations between neighbourhood physical environments and depressive symptoms varied between older adults with and without functional limitations. This study has implications for the Ecological Theory of Ageing by identifying the dynamic interplay of environment demands and individual functional ability. Planning policies for building age-friendly neighbourhoods are discussed.     

Indicators of material hardship and depressive symptoms among homebound older adults living in North Carolina

This study used the concept of material hardship to understand how unmet needs related to food, housing, and health influence depressive symptoms among homebound older adults (N = 345) in North Carolina. Using data from the Nutrition and Function Study, 37% reported high levels of depressive symptoms and 17.4% indicated not receiving needed health care. Approximately 10% of respondents were food insecure; 30.7% were at risk for food insecurity; and 39.7% reported having to choose between either food and medication or food and paying bills. Adjusted logistic regression model revealed that food insecurity status (OR = 4.9) and age 60-74 y (OR = 2.4) were significantly associated with a greater number of depressive symptoms. Other indicators of material hardship, such as having a major financial difficulty, unmet health need, and inadequate housing, were not significant. By far, food insecurity was the most salient influence on depressive symptoms. These findings have important implications for service providers, researchers, and policymakers.     

Social participation reduces depressive symptoms among older adults: An 18-year longitudinal analysis in Taiwan

Background  

Relatively little empirical attention has focused on the association between social participation and depressive symptoms amongst older adults in Asian nations, where persons over the age of 65 represent a rapidly growing segment of the population. This study explores the dynamic relationship between participation in social activities and trajectories of depressive symptomatology among older Taiwanese adults surveyed over 18 years.     

Social participation reduces depressive symptoms among older adults: An 18-year longitudinal analysis in Taiwan

Background

Sickness absence has represented a growing public health problem in many Western countries over the last decade. In Sweden disorders of the musculoskeletal system cause approximately one third of all sick leave. The Social Insurance Agency (SIA) and the health care system are important actors in handling the sickness absence process. The objective was to study how patients with personal experience of sickness absence due to musculoskeletal disorders perceived their contact with these actors and what they considered as obstructing or facilitating factors for recovery and return to work in this situation.

Methods

In-depth interviews using open-ended questions were conducted with fifteen informants (aged 33-63, 11 women), all with experience of sickness absence due to musculoskeletal disorders and purposefully recruited to represent various backgrounds as regards diagnosis, length of sick leave and return to work. The interviews were audio-recorded, transcribed verbatim and analysed using content analysis.

Results

The informants' perceived the interaction with the SIA and health care as ranging from coherent to fragmented. Being on sick leave was described as going through a process of adjustment in both private and working life. This process of adjustment was interactive and included not only the possibilities to adjust work demands and living conditions but also personal and emotional adjustment. The informants' experiences of fragmented interaction reflected a sense that their entire situation was not being taken into account. Coherent interaction was described as facilitating recovery and return to work, while fragmented interaction was described as obstructing this. The complex division of responsibilities within the Swedish rehabilitation system may hamper sickness absentees' possibilities of taking responsibility for their own rehabilitation.

Conclusions

This study shows that people on sick leave considered the interaction with the SIA and health care as an important part of the rehabilitation process. The contact with these actors was perceived as affecting recovery and return to work. Working for a more coherent process of rehabilitation and offering professional guidance to patients on sick leave might have an empowering effect.     

Effects of neighborhood violence and perceptions of neighborhood safety on depressive symptoms of older adults

Violent crime within a neighborhood as well as perceptions of neighborhood safety may impact the depressive symptoms experienced by community-dwelling older people. Most studies examining the influences of neighborhood characteristics on mental health have included either objective indicators or subjective perceptions and most operationalize neighborhood as a function of socioeconomic status. This study examines the effects that objectively assessed neighborhood violent crime and subjective perceptions of neighborhood safety in tandem have on depressive symptoms. The sample identified using random-digit-dialing procedures included 5688 persons aged 50–74 living in New Jersey (USA). Using multilevel structural equation analyses, we tested the hypothesis that higher levels of neighborhood violent crime and poorer perceptions of neighborhood safety are associated with higher levels of depressive symptoms, controlling for age, sex, and household income. Results supported the hypotheses. We conclude that interventions at the neighborhood level that reduce violent crime may be needed to compliment efforts at the individual level in order to reduce the depressive symptoms experienced by older people.