Relationships between Chronic Diseases and Depression among Middle-aged and Elderly People in China: A Prospective Study from CHARLS

Summary Given the rapid increase in the prevalence of chronic diseases in aging populations, this prospective study including 17 707 adults aged ≥45 years from China Health and Retirement Longitudinal Study was used to estimate the associations between chronic disease, multimorbidity, and depression among middle-aged and elderly adults in China, and explore the mediating factors. Depressive symptoms were assessed using the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) questionnaire. Twelve chronic physical conditions, including hypertension, diabetes, dyslipidemia, cancer, chronic lung disease, liver disease, heart failure, stroke, kidney disease, arthritis or rheumatism, asthma, digestive disease were assessed. The prevalence rates for physical multimorbidity and depression (CES-D-10 ≥10) were 43.23% and 36.62%, respectively. Through multivariable logistic models and generalized estimating equation (GEE) models, we found all 12 chronic physical conditions, and multimorbidity were significantly associated with depression. Both mobility problems and chronic pain explained more than 30% of the association for all chronic conditions, with particularly high percentages for stroke (51.56%) and cancer (51.06%) in mobility problems and cancer (53.35%) in chronic pain. Limited activities of daily living (ADL) explained 34.60% of the stroke-cancer relationship, while sleep problems explained between 10.15% (stroke) and 14.89% (chronic lung disease) of the association. Individuals with chronic diseases or multimorbidity are significantly more likely to be depressed. Functional symptoms involving limitations of ADL and mobility difficulties mediated much of the association between chronic diseases and incident depression. These symptoms could be targeted for interventions to ameliorate the incidence of depression among individuals with chronic conditions.

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A Prospective Study of Chronic Lung Disease in Cotton Textile Workers

Annals of Internal Medicine ◽

10.7326/0003-4819-97-5-645 ◽

1982 ◽

Vol 97 (5) ◽

pp. 645 ◽

Cited By ~ 59

Author(s):

GERALD J. BECK

Keyword(s):

Prospective Study ◽

Lung Disease ◽

Chronic Lung Disease ◽

Cotton Textile ◽

Textile Workers ◽

A Prospective Study

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1846 CHILDREN'S RESPIRATORY STUDY (CRS) OF TUCSON: A PROSPECTIVE STUDY OF ACUTE AND CHRONIC LUNG DISEASE

Pediatric Research ◽

10.1203/00006450-198504000-01864 ◽

1985 ◽

Vol 19 (4) ◽

pp. 418A-418A ◽

Cited By ~ 1

Author(s):

L M Taussig ◽

A L Wright ◽

C G Ray ◽

H R Harrison

Keyword(s):

Prospective Study ◽

Lung Disease ◽

Chronic Lung Disease ◽

A Prospective Study ◽

Respiratory Study

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The use of spirometry testing prior to cardiac surgery may impact the Society of Thoracic Surgeons risk prediction score: A prospective study in a cohort of patients at high risk for chronic lung disease

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2009.10.010 ◽

2010 ◽

Vol 139 (3) ◽

pp. 686-691 ◽

Cited By ~ 12

Author(s):

Niv Ad ◽

Linda Henry ◽

Linda Halpin ◽

Sharon Hunt ◽

Scott Barnett ◽

...

Keyword(s):

Cardiac Surgery ◽

High Risk ◽

Prospective Study ◽

Lung Disease ◽

Risk Prediction ◽

Chronic Lung Disease ◽

Prediction Score ◽

A Prospective Study

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Chronic Pain And Depressive Symptoms In Chinese Middle-Aged And Older Adults:A Follow Up Study

10.21203/rs.3.rs-1090917/v1 ◽

2021 ◽

Author(s):

Jialin Liu ◽

Zixuan Chen ◽

Yuke Yu ◽

Qin Wang ◽

Xiuxiu Liu ◽

...

Keyword(s):

Older Adults ◽

Chronic Pain ◽

Depressive Symptoms ◽

Health Status ◽

Elderly People ◽

Elderly Care ◽

Univariate Analysis ◽

Depression Scale ◽

Middle Aged

Abstract Objective: This study aimed to analyze the effects of chronic pain on the occurrence of depressive symptoms in Chinese middle-aged and older adults, and to provide a scientific basis for reducing the incidence of depressive symptoms, improving the quality of life in middle-aged and older adults, and reducing the disease burden in the aging population.Methods: a prospective study was conducted to select adults aged 45 years or older from the longitudinal study of China Health and elderly care follow-up survey (Charls) (2015 and 2018). Pain was assessed according to the patient's self exposure, and depression was assessed using the Chinese version of the center for epidemiological research Depression Scale (CES-D). Univariate analysis and binary logistic regression model were used for analysis. Results: The 3-year cumulative incidence of depression in chronic pain patients was 52.4% and the annual incidence was 17.5% in the middle-aged and elderly Chinese population. Univariate analysis showed statistically significant differences in the incidence of depressive symptoms between the different genders, age, residence, education level, marriage, self perceived health status, nocturnal sleep time, number of social activities in the past month, smoking, alcohol consumption, impaired ADL and Medicare insurance coverage. This study, after controlling for demographic characteristics, health status and health behaviors, Different pain conditions remained statistically significant for depression in middle-aged and older adults. Compared with middle-aged and older adults without pain, both Unisomatic pain (OR = 1.388) and Multiple somatic pain (OR= 1.869) increased the risk of depression in the middle-aged and older populations. Conclusion: chronic pain is associated with the risk of depressive symptoms in middle-aged and elderly people, and the incidence of depression in middle-aged and elderly people in China is not optimistic.

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Corrigendum to publication entitled with “Depressive symptoms and chronic lung disease in middle-aged and older Chinese adults: Prospective bidirectional association and mediation analysis”. Journal of Affective Disorders Volume 297 pages 283-293

Journal of Affective Disorders ◽

10.1016/j.jad.2021.12.100 ◽

2022 ◽

Author(s):

Jiali Zheng ◽

Jingmeng Li ◽

Tianduo Pei ◽

Tianren Zhu ◽

Io Hong Cheong ◽

...

Keyword(s):

Depressive Symptoms ◽

Lung Disease ◽

Chronic Lung Disease ◽

Mediation Analysis ◽

Affective Disorders ◽

Middle Aged ◽

Chinese Adults ◽

Bidirectional Association ◽

Older Chinese ◽

Older Chinese Adults

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Chronic Conditions, Socioeconomic Risks, and Behavioral Problems in Children and Adolescents

PEDIATRICS ◽

10.1542/peds.85.3.267 ◽

1990 ◽

Vol 85 (3) ◽

pp. 267-276 ◽

Cited By ~ 3

Author(s):

Steven L. Gortmaker ◽

Deborah K. Walker ◽

Michael Weitzman ◽

Arthur M. Sobol

Keyword(s):

Behavior Problems ◽

Behavioral Problems ◽

Chronic Conditions ◽

Chronic Health Condition ◽

Health Condition ◽

Chronic Health ◽

Physical Conditions ◽

Childhood Conditions ◽

Chronic Physical Conditions ◽

Chronic Childhood

Children with a chronic health condition have long been considered at excess risk for psychosocial morbidity. Despite an increasing prevalence of chronic childhood conditions and heightened concerns for the quality of life of the chronically ill, population-based studies of behavior problems among children with chronic physical conditions are rare. Findings on the epidemiology of behavior problems in a nationally representative sample of 11 699 children and adolescents aged 4 to 17 years in the United States are reported. Data included a 32-item parent-reported behavior problem index, measures of chronic childhood conditions, measures of school placement and performance, and sociodemographic variables. Analyses confirmed that chronic physical conditions were a significant risk factor for behavior problems, independent of sociodemographic variables. Among children these differences were observed across all subscales; among adolescents the largest differences were found for the Depression/Anxiety and Peer Conflict/Social Withdrawal subscales. Rates of extreme behavior problem scores (those in the top 10th percentile) were 1.55 times higher among children with a chronic health condition compared with children without a chronic condition (95% confidence interval 1.29 to 1.86). These independent odds were lowered to 1.44 when covariates for confounding were introduced via a multivariate logistic regression. Other independent risks included the absence of either biologic parent (odds ratio 2.05), male gender (1.53), low vs high family income (1.30), low vs high maternal education (1.51), and young vs old maternal age at childbirth (2.57). Chronic health conditions were also a major risk factor for placement in special education classes and having to repeat grades. Despite evidence for effective interventions, health services for children with chronic conditions—particularly mental health services—remain fragmented, signaling the need for increased attention to behavioral problems and their treatment among all health professionals caring for children.

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Cognitive complaints in age-related chronic conditions: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0253795 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0253795

Author(s):

Nikki L. Hill ◽

Sakshi Bhargava ◽

Monique J. Brown ◽

Hyejin Kim ◽

Iris Bhang ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Heart Disease ◽

Lung Disease ◽

Chronic Lung Disease ◽

Chronic Conditions ◽

Future Research ◽

Cognitive Complaints ◽

Age Related ◽

Review Team

Introduction Cognitive complaints in older adults may be indicative of progressive cognitive decline including Alzheimer’s disease (AD), but also occur in other age-related chronic conditions, complicating identification of early AD symptoms. To better understand cognitive complaints in aging, we systematically reviewed the evidence to determine their prevalence and characterization among older adults with the most common age-related chronic conditions. Methods This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the review protocol was prospectively registered with PROSPERO (ID: CRD42020153147). Searches were conducted in PubMed, CINAHL, PsycINFO, Web of Science, and ProQuest Dissertations & Theses A&I in June 2020. Two members of the review team independently determined article eligibility for inclusion and conducted quality appraisal. A narrative synthesis of results was used to integrate findings across studies and draw conclusions regarding the strength of the evidence in each chronic condition category. Results Thirty-seven articles met eligibility criteria and were included in the review. Conditions represented were diabetes (n = 20), heart disease (n = 13), hypertension (n = 10), chronic lung disease (n = 5), arthritis (n = 4), heart failure (n = 2), and hyperlipidemia (n = 2). In addition, 16 studies included a measure of multimorbidity. Overall, there was a higher prevalence of cognitive complaints in individuals with higher multimorbidity, including a potential dose-dependent relationship. Findings for specific conditions were inconsistent, but there is evidence to suggest that cross-sectionally, older adults with diabetes, heart disease, chronic lung disease, and arthritis have more cognitive complaints than those without these conditions. Conclusion There is strong evidence demonstrating that cognitive complaints are more common in older adults with higher multimorbidity, but little research examining these associations over time. Improving our understanding of the longitudinal trajectory of cognitive complaints, multimorbidity, and objective cognition in older age is an important area for future research.

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Depressive symptoms and chronic lung disease in middle-aged and older Chinese adults: prospective bidirectional association and mediation analysis

Journal of Affective Disorders ◽

10.1016/j.jad.2021.10.023 ◽

2021 ◽

Author(s):

Jiali Zheng ◽

Jingmeng Li ◽

Tianduo Pei ◽

Tianren Zhu ◽

Io Hong Cheong ◽

...

Keyword(s):

Depressive Symptoms ◽

Lung Disease ◽

Chronic Lung Disease ◽

Mediation Analysis ◽

Middle Aged ◽

Chinese Adults ◽

Bidirectional Association ◽

Older Chinese ◽

Older Chinese Adults

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Multimorbidity patterns and their association with survival in a large national cohort of older veterans with multiple myeloma.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.8033 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 8033-8033

Author(s):

Nathanael Fillmore ◽

Clark DuMontier ◽

David Cheng ◽

Diana Cirstea ◽

Sarvari Yellapragada ◽

...

Keyword(s):

Multiple Myeloma ◽

Substance Use ◽

Lung Disease ◽

Chronic Lung Disease ◽

Chronic Conditions ◽

Latent Class ◽

Triplet Chemotherapy ◽

National Cohort ◽

Minimal Disease ◽

The Impact

8033 Background: The majority of older adults carry two or more chronic conditions (multimorbidity). Although comorbidity in multiple myeloma (MM) has often been described with comorbidity counts, the impact of multimorbidity clusters has yet to be investigated. Methods: In a national cohort of 7815 patients aged ≥60 years diagnosed with and treated for MM in Veterans Affairs Healthcare System, we extracted 53 chronic conditions from claims in the 3 years preceding diagnosis using the Centers of Medicare and Medicaid Services-defined chronic and disabling conditions. We performed latent class analysis to identify patterns of multimorbidity that coexisted with MM at diagnosis. We then assessed whether these multimorbidity patterns were associated with survival in 5992 non-transplanted patients initially treated with either doublet or triplet chemotherapy regimens, adjusting for MM stage, sociodemographic factors, and prognostic lab values. Results: Mean follow up time was 3.1 years (SD, 2.6). We identified 6 multimorbidity clusters at the time of MM diagnosis: minimal disease (1302 patients, 16.7%), cardiovascular disease (2011, 25.7%), diabetes and complications (1820, 23.3%), psychiatric and substance use disorders (931, 11.9%), chronic lung disease (759, 9.7%), and multisystem impairment (992, 12.7%). In patients initially treated with doublet or triplet chemotherapy, survival varied across multimorbidity patterns (p < 0.001); patients with minimal disease had the best survival (median survival [MS] = 4.5 years, 5-year survival = 47.5%), and patients with multisystem impairment had the worst (MS = 2.4 years, 5-year survival = 24.3%). After adjustment for covariates, patients with clusters of chronic lung disease (HR = 1.40 [1.22-1.60]), psychiatric and substance use (HR = 1.57 [1.37-1.79]), and multisystem impairment (HR = 1.71 [1.50-1.94]) had higher hazards of death than patients with minimal disease. Conclusions: We found higher-impact and lower-impact multimorbidity clusters among older veterans with newly-diagnosed MM treated with chemotherapy. Unique combinations of chronic diseases may interact with MM itself to drive differences in mortality.

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