An Exploratory Study of Pathways from White Matter Hyperintensities to Cognitive Impairment through Depressive Symptoms Using Structural Equation Modeling: A Cross Sectional Study in Patients with Dementia

2020 ◽  
Vol 26 (7) ◽  
pp. 679-689
Author(s):  
Chang Hyun Lee ◽  
Do Hoon Kim
Keyword(s):  
Cognitive Impairment ◽  
Structural Equation Modeling ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
White Matter ◽  
Structural Equation ◽  
White Matter Hyperintensities ◽  
Mediating Effect ◽  
Equation Modeling ◽  
Cross Sectional

AbstractObjective:The aim of this study was to model the relationships among white matter hyperintensities (WMHs), depressive symptoms, and cognitive function and to examine the mediating effect of depressive symptoms on the relationship between WMHs and cognitive impairment.Methods:We performed structural equation modeling using cross-sectional data from 1158 patients from the Clinical Research for Dementia of South Korea (CREDOS) registry who were diagnosed with mild-to-moderate dementia. Periventricular white matter hyperintensities (PWMHs) and deep white matter hyperintensities (DWMHs) were obtained separately on the protocol of magnetic resonance imaging (MRI). Depression and cognitive function were assessed using the Korean Form of the Geriatric Depression Scale (KGDS) and the Seoul Neuropsychological Screening Battery (SNSB), respectively.Results:The model that best reflected the relationships among the variables was the model in which DWMHs affected cognitive function directly and indirectly through the depressive symptoms; on the other hand, PWMHs only directly affected cognitive function.Conclusions:This study presents the mediation model including the developmental pathway from DWMHs to cognitive impairment through depressive symptoms and suggests that the two types of WMHs may affect cognitive impairment through different pathways.

scholarly journals Bone and Lean Mass Loss and Cognitive Impairment for Healthy Elder Adults: Analysis of the Nutrition and Health Survey in Taiwan 2013–2016 and a Validation Study With Structural Equation Modeling

2021 ◽  
Vol 8 ◽  
Author(s):  
Sheng-Feng Lin ◽  
Yen-Chun Fan ◽  
Wen-Harn Pan ◽  
Chyi-Huey Bai
Keyword(s):  
Cognitive Impairment ◽  
Structural Equation Modeling ◽  
Bone Density ◽  
Mass Loss ◽  
Lean Mass ◽  
Structural Equation ◽  
Equation Modeling ◽  
Mineral Density ◽  
Cross Sectional ◽  
Elder Adults

Purpose: Bone and lean mass loss and cognitive impairment are prevalent in elder adults and have been hypothesized to share a potential link.Methods: This nationwide cross-sectional study systemically sampled elder adults aged ≥65 years and conducted the door-to-door survey. The causal diagrams help to decide which covariates were included in the generalized linear mixed models (GLMMs). The structural equation modeling (SEM) was performed for the validation.Results: A total of 535 participants were enrolled and categorized into the normal (67.3%), mild cognitive impairment (18.3%), and dementia groups (14.4%). With increasing in the severity of cognitive impairment, the bone marrow density and lean mass consistently showed the trend of decreasing values. In the GLMMs, a significant association existed between the decrease of the bone mineral density (BMD) and the Mini-Mental State Examination (MMSE) (β = 5.819 scores per g/cm2 decrease, p = 0.0305) with adjustment of the age, sex, and physical activity. The SEM models confirmed that the MMSE was significantly and directly predicted by the age (β = 0.1363, p = 0.0003) and BMD (β = 0.1251, p = 0.0006) independently and indirectly predicted by lean mass (β = 0.1138, p = 0.0003) through the bone density path.Conclusion: In conclusion, an independent association between bone loss and cognitive impairment was existed rather than the confounding effect and the decrease of lean mass indirectly contributed to cognitive impairment by influencing the bone density.

scholarly journals Stress and Its Impact on Academic and Social Life of Undergraduate University Students in Ghana: A Structural Equation Modeling Approach

2020 ◽  
Vol 2 (1) ◽  
pp. 37-44
Author(s):  
Koawo Edjah ◽  
Francis Ankomah ◽  
Ebenezer Domey ◽  
John Ekow Laryea
Keyword(s):  
Structural Equation Modeling ◽  
Undergraduate Students ◽  
Social Life ◽  
Structural Equation ◽  
Positive Impact ◽  
Survey Design ◽  
Equation Modeling ◽  
Cross Sectional Survey ◽  
Satisfaction Scale ◽  
Cross Sectional

AbstractStress is concomitant with students’ life and can have a significant impact on their lives, and even how they go about their academic work. Globally, in every five visits by patients to the doctor, three are stress-related problems. This study examined stress and its impact on the academic and social life among students of a university in Ghana. The descriptive cross-sectional survey design was employed. Using the stratified and simple random (random numbers) sampling methods, 500 regular undergraduate students were engaged in the study. A questionnaire made up of Perceived Stress Scale and Students’ Life Satisfaction Scale was used to gather data for the study. Frequencies, percentages, means and standard deviation, and Structural Equation Modeling (SEM), with AMOS were used for the analyses. It was found that majority of the students were moderately stressed. Paramount among the stressors were academic stressors, followed by institutional stressors, and external stressors. Stress had a significant positive impact on the academic and social life of students. It was concluded that undergraduate students, in one way or the other, go through some kind of stress during the course of their study. It was recommended that the university, through its Students’ Affairs, and Counselling Sections, continue to empower students on how to manage and deal with stress in order to enhance their academic life.

Fostering Product Innovation Through Digital Transformation and Absorptive Capacity

2020 ◽  
Vol 17 (06) ◽  
pp. 2050040
Author(s):  
Alejandro Coronado-Medina ◽  
Jose Arias-Pérez ◽  
Geovanny Perdomo-Charry
Keyword(s):  
Structural Equation Modeling ◽  
Survey Data ◽  
Absorptive Capacity ◽  
Product Innovation ◽  
Structural Equation ◽  
Digital Transformation ◽  
Mediating Effect ◽  
Equation Modeling ◽  
The Relationship

This paper analyzes the mediating effect of absorptive capacity (AC) on the relationship between digital transformation from e-business capabilities (EBC) perspective and product innovation (PI). Structural equation modeling (SEM) was carried out with the survey data from a sample of firms that belong mainly to highly digitalized sectors. The results indicate the existence of a full mediation, which means knowledge derived from the digital operation of the business can only result in PI if AC plays an intermediation role. Hence, this finding calls into question the idea that digitalization alone and automatically acts as a PI driver.

One-week prevalence of depressive symptoms and psychotropic drug treatments among old people with different levels of cognitive impairment living in institutional care: changes between 1982 and 2000

2010 ◽  
Vol 22 (7) ◽  
pp. 1154-1160 ◽  
Author(s):  
Hugo Lövheim ◽  
Ellinor Bergdahl ◽  
Per-Olof Sandman ◽  
Stig Karlsson ◽  
Yngve Gustafson
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
Antidepressant Treatment ◽  
Antidepressant Drug ◽  
Institutional Care ◽  
Old People ◽  
Cross Sectional ◽  
Moderate Cognitive Impairment ◽  
Drug Treatments

ABSTRACTBackground: Dementia and depression are common in advanced age, and often co-exist. There are indications of a decreased prevalence of depressive symptoms among old people in recent years, supposedly because of the manifold increase in antidepressant treatment. Whether the prevalence of depressive symptoms has decreased among people in different stages of dementia disorders has not yet been investigated.Methods: A comparison was undertaken of two cross-sectional studies, conducted in 1982 and 2000, comprising 6864 participants living in geriatric care units in the county of Västerbotten, Sweden. Depressive symptoms were measured using the Multi-Dimensional Dementia Assessment Scale (MDDAS), and the cognitive score was measured with Gottfries’ cognitive scale. Drug data were obtained from prescription records.Results: There was a significant decrease in depressive symptom score between 1982 and 2000 in all cognitive function groups except for the group with moderate cognitive impairment. Antidepressant drug use increased in all cognitive function groups.Conclusion: The prevalence of depressive symptoms decreased between 1982 and 2000, in all levels of cognitive impairment except moderate cognitive impairment. This might possibly be explained by the depressive symptoms having different etiologies in different stages of a dementia disorder, which in turn might not be equally susceptible to antidepressant treatment.

scholarly journals Implementation of Online Hospitals and Factors Influencing the Adoption of Mobile Medical Services in China: Cross-Sectional Survey Study (Preprint)

2020 ◽  
Author(s):  
Huanlin Wang ◽  
LanYu Liang ◽  
ChunLin Du ◽  
YongKang Wu
Keyword(s):  
Structural Equation Modeling ◽  
Structural Equation ◽  
Western China ◽  
Medical Services ◽  
Equation Modeling ◽  
Cross Sectional ◽  
Medical Resources ◽  
Hypothesis Model ◽  
Effort Expectancy ◽  
Willingness To Use

BACKGROUND Online hospitals are part of an innovative model that allows China to explore telemedicine services based on national conditions with large populations, uneven distribution of medical resources, and lack of quality medical resources, especially among residents needing to be protected from COVID-19 infection. OBJECTIVE In this study, we built a hypothesis model based on the unified theory of acceptance and use of technology in order to analyze the factors that may influence patients’ willingness to use mobile medical services. This research was designed to assist in the development of mobile medical services. Residents who do not live in urban areas and cannot access medical assistance would greatly benefit from this research, as they could immediately go to the online hospital when needed. METHODS A cross-sectional study based at the West China Hospital, Sichuan University, was conducted in July 2020. A total of 407 respondents, 18 to 59 years old, in Western China were recruited by convenience sampling. We also conducted an empirical test for the hypothesis model and applied structural equation modeling to estimate the significance of path coefficients so that we could better understand the influencing factors. RESULTS Out of 407 respondents, 95 (23.3%) were aware of online hospitals, while 312 (76.7%) indicated that they have never heard of online hospitals before. Gender (<i>P</i>=.048) and education level (<i>P</i>=.04) affected people’s willingness to use online hospitals, and both of these factors promoted the use of online hospitals (odds ratio [OR] 2.844, 95% CI 1.010-8.003, and OR 2.187, 95% CI 1.031-4.636, respectively). According to structural equation modeling, the results of the path coefficient analysis indicated that performance expectancy, effort expectancy, and facilitating conditions have positive effects on patients’ willingness to use online hospitals. CONCLUSIONS The goal of our research was to determine the factors that influence patients’ awareness and willingness to use online hospitals. Currently, the public’s awareness and usage of online hospitals is low. In fact, effort expectancy was the most important factor that influenced the use of online hospitals; being female and having a high education also played positive roles toward the use of mobile medical services.

scholarly journals Loneliness, Emotion Dysregulation, and Internalizing Symptoms During Coronavirus Disease 2019: A Structural Equation Modeling Approach

2021 ◽  
Vol 11 ◽  
Author(s):  
Patrizia Velotti ◽  
Guyonne Rogier ◽  
Sara Beomonte Zobel ◽  
Rosetta Castellano ◽  
Renata Tambelli
Keyword(s):  
Structural Equation Modeling ◽  
Los Angeles ◽  
Internalizing Symptoms ◽  
Emotion Dysregulation ◽  
Structural Equation ◽  
Demographic Data ◽  
Clinical Intervention ◽  
Equation Modeling ◽  
Emotional States ◽  
Cross Sectional

Background: Our study aimed to test the hypotheses that an increased level of loneliness experienced during coronavirus disease 2019 (COVID-19) confinement was predictive of internalizing symptoms and that this pathway was mediated by emotion dysregulation levels.Methods: To reach this aim, we performed an online longitudinal survey recruiting 1,330 participants at Time 1 (at the beginning of the lockdown) and 308 participants at Time 2 (few days before the end of the lockdown). All filled out a set of questionnaires: demographic data, University of California, Los Angeles Loneliness scale, Difficulties in Emotion Regulation Scale−18 items, and Depression Anxiety and Stress Scale−21 items. Hypotheses were tested using structural equation modeling in two steps and controlling for age. First, hypotheses were tested on cross-sectional data. Then, a cross-lagged panel analysis was performed on longitudinal data.Results: Models obtained a good fit and evidenced the predictive role of loneliness levels on the three outcomes (i.e., depression, anxiety, and stress). Moreover, we found that emotion dysregulation levels partially mediated the longitudinal relationship between loneliness and both depression and stress but not between loneliness and anxiety levels.Conclusions: This study points out that a central goal of clinical intervention could be the ability to regulate negative emotional states.

scholarly journals Cyberchondria severity and quality of life among Lebanese adults: the mediating role of fear of COVID-19, depression, anxiety, stress and obsessive–compulsive behavior—a structural equation model approach

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Clara Rahme ◽  
Marwan Akel ◽  
Sahar Obeid ◽  
Souheil Hallit
Keyword(s):  
Quality Of Life ◽  
Structural Equation ◽  
Equation Model ◽  
Mediating Effect ◽  
Equation Modeling ◽  
Obsessive Compulsive ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Compulsive Disorder

Abstract Background This study highlights the significant association between cyberchondria and quality of life among the Lebanese population in the time of COVID-19. The aim was to assess the association between cyberchondria and quality of life (QOL) of Lebanese community during the COVID-19 pandemic and assess the mediating effect of fear of COVID-19, depression, anxiety, stress and Yale-Brown Obsessive–Compulsive Scale in this association. Methods This cross-sectional study was carried out between December 2020 and January 2021, during the COVID-19 pandemic. A total of 449 persons participated in this study by filling the online questionnaire. Structural equation modeling (SEM) was performed to examine the structural relationship between cyberchondria severity, the mediator (anxiety, stress, depression, obsessive–compulsive disorder (OCD) and fear of COVID-19) and physical/mental QOL. Results Having a university level of education and older age were significantly associated with higher physical QOL scores, whereas higher obsession-compulsion disorder, higher stress and higher anxiety were significantly associated with lower physical QOL scores. Higher anxiety was significantly associated with lower mental QOL scores. The results of the SEM showed that stress, fear of COVID-19 and to a lesser limit OCD, mediated the association between cyberchondria severity and physical QOL, whereas anxiety, stress and fear of COVID-19 mediated the association between cyberchondria severity and mental QOL. Conclusion This research reported interesting results encouraging more exploration of cyberchondria and its association with quality of life during this unique period of the pandemic. However, this virus has altered the lives of individuals all across the world, and the consequences will last for a long time. Along with all of the steps done to stop the development of COVID-19 and improve physical outcomes, mental health requires immediate care. More research is needed to determine the coping techniques people are employing to deal with the pandemic.

scholarly journals Are Perfectionistic Thoughts an Antecedent or a Consequence of Depressive Symptoms? A Cross-Lagged Analysis of the Perfectionism Cognitions Inventory

2019 ◽  
Vol 38 (1) ◽  
pp. 99-111 ◽  
Author(s):  
Avi Besser ◽  
Gordon L. Flett ◽  
Simon B. Sherry ◽  
Paul L. Hewitt
Keyword(s):  
Depressive Symptoms ◽  
Life Events ◽  
Structural Equation ◽  
Longitudinal Research ◽  
Depression Scale ◽  
Automatic Thoughts ◽  
Equation Modeling ◽  
Major Life Events ◽  
Major Life ◽  
Cross Sectional

Perfectionistic automatic thoughts have been linked with depressive symptoms in numerous cross-sectional studies, but this link has not been assessed in longitudinal research. An investigation with two timepoints was conducted to test whether perfectionistic automatic thoughts, as assessed by the Perfectionism Cognitions Inventory (PCI), are contributors to subsequent depression or vice versa. The possible role of a third factor (major life events stress) was also evaluated. A sample of 118 university students completed the PCI, the Center for Epidemiologic Studies Depression Scale (CES-D), and the Life Experiences Survey on two occasions with a 5-month interval. A cross-lagged analysis using structural equation modeling showed that above and beyond within-time associations and across-time stability effects, perfectionism automatic thoughts contributed to subsequent depressive symptoms and not vice versa. Negative life events stress was correlated significantly with both depressive symptoms and perfectionism automatic thoughts but did not have an influence on Time 2 depressive symptoms or on perfectionistic automatic thoughts. Our discussion focuses on perfectionistic automatic thoughts as a contributor to depressive vulnerability according to the perfectionism cognition theory.

scholarly journals SOCIAL ENGAGEMENT AND DEPRESSIVE SYMPTOMS IN OLDER AFRICAN AMERICANS: A 6-YEAR CROSS-LAGGED PANEL ANALYSIS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S754-S755
Author(s):  
James Muruthi ◽  
J Tina Savla
Keyword(s):  
Depressive Symptoms ◽  
African Americans ◽  
Social Engagement ◽  
Structural Equation ◽  
Equation Modeling ◽  
Panel Analysis ◽  
Cross Sectional ◽  
Group Activities ◽  
Religious Services ◽  
Older African Americans

Abstract Although previous studies have extensively investigated the cross-sectional relationship between social engagement and depressive symptoms in late life, longitudinal studies have produced mixed results. Furthermore, studies on the associations between these two concepts among aging African Americans are few. Using a sample of 1688 older African Americans adults from waves 1 and 7 of the National Health and Aging Trends Study (60% women; Average age = 77 years), the present study investigates the longitudinal associations between social engagement (an index from scores on visiting friends and family, attending religious services, attending religious services, participating in group activities, and going out for enjoyment) and depressive symptoms across seven years. Structural equation modeling was used to test cross-lagged relationships between the variables. Findings suggest that social engagement at baseline significantly predicted subsequent depressive symptoms and social engagement. Depressive symptoms at baseline, however, were not significantly associated with subsequent social engagement. These findings suggest that low social engagement in older African Americans is directly associated with increased depressive symptoms over time, but not vice versa. The implications of these findings are discussed in relation to the barriers of social engagement for older African Americans and its effects on their mental health.

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