Do Depressive Symptoms Link Chronic Diseases to Cognition among Older Adults? Evidence from the Health and Retirement Study in the United States

Author(s):  
Wentian Lu ◽  
Manacy Pai ◽  
Shaun Scholes ◽  
Baowen Xue
2016 ◽  
Author(s):  
Benjamin W. Domingue ◽  
Hexuan Liu ◽  
Aysu Okbay ◽  
Daniel W. Belsky

AbstractExperience of stressful life events is associated with risk of depression. Yet many exposed individuals do not become depressed. A controversial hypothesis is that genetic factors influence vulnerability to depression following stress. This hypothesis is most commonly tested with a “diathesis-stress” model, in which genes confer excess vulnerability. We tested an alternative model, in which genes may buffer against the depressogenic effects of life stress. We measured the hypothesized genetic buffer using a polygenic score derived from a published genome-wide association study (GWAS) of subjective wellbeing. We tested if married older adults who had higher polygenic scores were less vulnerable to depressive symptoms following the death of their spouse as compared to age-peers who had also lost their spouse and who had lower polygenic scores. We analyzed data from N=9,453 non-Hispanic white adults in the Health and Retirement Study (HRS), a population-representative longitudinal study of older adults in the United States. HRS adults with higher wellbeing polygenic scores experienced fewer depressive symptoms during follow-up. Those who survived death of their spouses during follow-up (n=1,829) experienced a sharp increase in depressive symptoms following the death and returned toward baseline over the following two years. Having a higher polygenic score buffered against increased depressive symptoms following a spouse's death. Effects were small and clinical relevance is uncertain, although polygenic score analyses may provide clues to behavioral pathways that can serve as therapeutic targets. Future studies of gene-environment interplay in depression may benefit from focus on genetics discovered for putative protective factors.


2019 ◽  
Vol 75 (3) ◽  
pp. 517-521
Author(s):  
Ryon J Cobb ◽  
Roland J Thorpe ◽  
Keith C Norris

Abstract Background With advancing age, there is an increase in the time of and number of experiences with psychosocial stressors that may lead to the initiation and/or progression of chronic kidney disease (CKD). Our study tests whether one type of experience, everyday discrimination, predicts kidney function among middle and older adults. Methods The data were from 10 973 respondents (ages 52–100) in the 2006/2008 Health and Retirement Study, an ongoing biennial nationally representative survey of older adults in the United States. Estimated glomerular filtration rate (eGFR) derives from the Chronic Kidney Disease Epidemiology Collaboration equation. Our indicator of everyday discrimination is drawn from self-reports from respondents. Ordinary Least Squared regression (OLS) models with robust standard errors are applied to test hypotheses regarding the link between everyday discrimination and kidney function. Results Everyday discrimination was associated with poorer kidney function among respondents in our study. Respondents with higher everyday discrimination scores had lower eGFR after adjusting for demographic characteristics (B = −1.35, p < .05), and while attenuated, remained significant (B = −0.79, p < .05) after further adjustments for clinical, health behavior, and socioeconomic covariates. Conclusions Our study suggests everyday discrimination is independently associated with lower eGFR. These findings highlight the importance of psychosocial factors in predicting insufficiency in kidney function among middle-aged and older adults.


Author(s):  
Ryon J Cobb ◽  
Lauren J Parker ◽  
Roland J Thorpe

Abstract Background This study examines the relationship between self-reported instances of major discrimination and inflammation among older adults, and explores whether this relationship varies in accordance with race/ethnicity. We hypothesized that self-reported instances of major discrimination would be associated with higher levels of high-risk inflammation and that this relationship would be stronger for racial/ethnic minorities than whites. Methods Data from the 2006/2008 Health and Retirement Study, an ongoing biennial nationally representative sample of older adults in the United States, were used to collect measures of self-reported instances of major discrimination and high-risk C-reactive protein (CRP), which was assayed from blood samples. Modified Poisson regression with robust standard errors was applied to estimate the prevalence ratios of self-reported instances of major discrimination, as it relates to high-risk CRP (CRP ≥ 22 kg/m2), and test whether this relationship varies by race/ethnicity. Results Respondents who experienced any instances of major discrimination had a higher likelihood of high-risk CRP (prevalence ratio [PR]: 1.14, 95% confidence interval [CI] = 1.07–1.22) than those who did not report experiencing any instances of major discrimination. This association was independent of differences in newly diagnosed health conditions and socioeconomic status. The relationship between any self-reported instance of major discrimination and high-risk CRP was weaker for blacks than whites (PR: 0.81, 95% CI = 0.69–0.95). Conclusions Our study confirms that self-reported instances of major lifetime discrimination is a psychosocial factor that is adversely associated with high-risk CRP among older adults; this association is especially pronounced among older whites. Future studies among this population are required to examine whether the relationship between self-reported instances of major discrimination and high-risk CRP changes over time.


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