Individual-Level and Couple-Level Discordant Chronic Conditions: Longitudinal Links to Functional Disability

Abstract Background Multiple chronic conditions may erode physical functioning, particularly in the context of complex self-management demands and depressive symptoms. Yet, little is known about how discordant conditions (i.e., those with management requirements that are not directly related and increase care complexity) among couples are linked to functional disability. Purpose We evaluated own and partner individual-level discordant conditions (i.e., discordant conditions within individuals) and couple-level discordant conditions (i.e., discordant conditions between spouses), and their links to levels of and change in functional disability. Methods The U.S. sample included 3,991 couples drawn from nine waves (1998–2014) of the Health and Retirement Study. Dyadic growth curve models determined how individual-level and couple-level discordant conditions were linked to functional disability over time, and whether depressive symptoms moderated these links. Models controlled for age, minority status, education, each partner’s baseline depressive symptoms, and each partner’s number of chronic conditions across waves. Results Wives and husbands had higher initial disability when they had their own discordant conditions and when there were couple-level discordant conditions. Husbands also reported higher initial disability when wives had discordant conditions. Wives had a slower rate of increase in disability when there were couple-level discordant conditions. Depressive symptoms moderated links between disability and discordant conditions at the individual and couple levels. Conclusions Discordant chronic conditions within couples have enduring links to disability that partly vary by gender and depressive symptoms. These findings generate valuable information for interventions to maintain the well-being of couples managing complex health challenges.

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Discordant Chronic Conditions and Depressive Symptoms: Longitudinal Associations Among Middle-Aged and Older Couples

The Journals of Gerontology Series B ◽

10.1093/geronb/gbz137 ◽

2019 ◽

Author(s):

Courtney A Polenick ◽

Kira S Birditt ◽

Angela Turkelson ◽

Benjamin C Bugajski ◽

Helen C Kales

Keyword(s):

Depressive Symptoms ◽

Marital Quality ◽

Chronic Conditions ◽

Later Life ◽

Well Being ◽

Middle Aged ◽

Older Couples ◽

Individual Level ◽

The Individual ◽

Over Time

Abstract Objectives Individuals often manage chronic conditions in middle and later life that may diminish well-being. Little is known, however, about discordant conditions (i.e., two or more conditions with competing self-management requirements) among older couples and their links to depressive symptoms. We considered discordant conditions at both the individual level and the couple level (i.e., between spouses), along with their long-term implications for depressive symptoms. Methods The U.S. sample included 1,116 middle-aged and older couples drawn from five waves (2006–2014) of the Health and Retirement Study. Longitudinal actor-partner interdependence models evaluated whether individual-level and couple-level discordant chronic health conditions were concurrently linked to depressive symptoms, and whether these associations became stronger over time. Models controlled for age, minority status, education, prior wave depressive symptoms, and each partner’s baseline report of negative marital quality and number of chronic conditions in each wave. Results Wives and husbands reported significantly greater depressive symptoms when they had individual-level discordant conditions about 2 years after baseline, and these links intensified over time. Beyond this association, husbands had significantly greater depressive symptoms when there were couple-level discordant conditions. Discussion Individual-level and couple-level discordant conditions may have lasting implications for depressive symptoms during midlife and older adulthood.

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DISCORDANT CHRONIC CONDITIONS AND DEPRESSIVE SYMPTOMS AMONG MIDDLE-AGED AND OLDER COUPLES

Innovation in Aging ◽

10.1093/geroni/igz038.226 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S58-S58

Author(s):

Courtney A Polenick ◽

Kira S Birditt ◽

Angela Turkelson ◽

Benjamin Bugajski ◽

Helen C Kales

Keyword(s):

Depressive Symptoms ◽

Marital Quality ◽

Chronic Conditions ◽

Later Life ◽

Well Being ◽

Minority Status ◽

Middle Aged ◽

Older Couples ◽

Individual Level ◽

Retirement Study

Abstract Discordant chronic conditions (i.e., those with competing management requirements) have adverse consequences for well-being, yet little is known about their implications among couples. We evaluated how depressive symptoms are linked to discordant conditions within individuals and between spouses across an 8-year period. The U.S. sample included 1,116 middle-aged and older couples from five waves (2006 – 2014) of the Health and Retirement Study. Longitudinal actor-partner interdependence models controlled for age, minority status, education, depressive symptoms in the previous wave, and each partner’s report of baseline marital quality and number of chronic conditions in each wave. Wives and husbands with their own discordant conditions reported higher depressive symptoms, and this association intensified over time. Over and above this link, husbands had higher depressive symptoms when there were discordant conditions between spouses. Both individual-level and couple-level discordant chronic conditions appear to have enduring implications for depressive symptoms in middle and later life.

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Chronic Condition Discordance and Physical Activity: Longitudinal Associations Among Older Couples

Innovation in Aging ◽

10.1093/geroni/igaa057.2044 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 605-605

Author(s):

Courtney Polenick ◽

Kira Birditt ◽

Angela Turkelson ◽

Helen Kales

Keyword(s):

Physical Activity ◽

Chronic Condition ◽

Later Life ◽

Functional Health ◽

Older Couples ◽

Individual Level ◽

Growth Curve Models ◽

Lower Baseline ◽

The Individual ◽

Retirement Study

Abstract Chronic condition discordance (i.e., the extent that two or more conditions have non-overlapping self-management requirements) is detrimental for functional health but little is known about mechanisms accounting for these associations. We examined links between chronic condition discordance at both the individual level and the couple level (i.e., between spouses) and physical activity over time. Participants included 1,095 couples from five waves (2006-2014) of the Health and Retirement Study. Dyadic growth curve models showed that greater individual-level discordance was associated with lower baseline physical activity among individuals and their partners. When husbands had greater individual-level discordance, wives and husbands had faster declines in physical activity. The findings highlight the importance of considering both members of a couple when examining the implications of chronic illness for physical activity in middle and later life.

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Considering All of the Data on Digital-Media Use and Depressive Symptoms: Response to Ophir, Lipshits-Braziler, and Rosenberg (2020)

Clinical Psychological Science ◽

10.1177/2167702619898179 ◽

2020 ◽

Vol 8 (2) ◽

pp. 379-383

Author(s):

Jean M. Twenge ◽

Thomas E. Joiner ◽

Megan L. Rogers ◽

Gabrielle N. Martin

Keyword(s):

Depressive Symptoms ◽

Digital Media ◽

Media Use ◽

Large Data ◽

Well Being ◽

Large Data Sets ◽

Data Sets ◽

Individual Level ◽

Monitoring The Future ◽

The Individual

We have documented increases since 2012 in depressive symptoms, suicide-related outcomes, and suicide and identified associations between digital-media use and depressive symptoms and suicide-related outcomes across two data sets: Monitoring the Future (MtF) and the Youth Risk Behavior Surveillance System (YRBSS). Ophir, Lipshits-Braziler, and Rosenberg’s criticisms of the MtF data (this issue; pp. 374–378) are addressed by the YRBSS data, which included a measure of digital-media use in hours. Ophir et al. assumed that the displacement of nonscreen activities by screen activities occurs only at the individual level, whereas in fact, time displacement at the group or cohort level may be more important. Some discrepancies in the literature can be traced to the use of percentage variance explained; in fact, heavy (vs. light) digital-media users are considerably more likely (often twice as likely) to be depressed or low in well-being across several large data sets.

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Social Media Use and Depressive Symptoms—A Longitudinal Study from Early to Late Adolescence

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165921 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5921 ◽

Cited By ~ 2

Author(s):

Kati Puukko ◽

Lauri Hietajärvi ◽

Erika Maksniemi ◽

Kimmo Alho ◽

Katariina Salmela-Aro

Keyword(s):

Social Media ◽

Depressive Symptoms ◽

Media Use ◽

Well Being ◽

Late Adolescence ◽

Social Media Use ◽

Individual Level ◽

The Individual ◽

Age Range ◽

The Impact

An increasing number of studies have addressed how adolescents’ social media use is associated with depressive symptoms. However, few studies have examined whether these links occur longitudinally across adolescence when examined at the individual level of development. This study investigated the within-person effects between active social media use and depressive symptoms using a five-wave longitudinal dataset gathered from 2891 Finnish adolescents (42.7% male, age range 13–19 years). Sensitivity analysis was conducted, adjusting for gender and family financial status. The results indicate that depressive symptoms predicted small increases in active social media use during both early and late adolescence, whereas no evidence of the reverse relationship was found. Yet, the associations were very small, statistically weak, and somewhat inconsistent over time. The results provide support for the growing notion that the previously reported direct links between social media use and depressive symptoms might be exaggerated. Based on these findings, we suggest that the impact of social media on adolescents’ well-being should be approached through methodological assumptions that focus on individual-level development.

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The Association between Multiple Chronic Conditions and Depressive Symptoms: Intersectional Distinctions by Race, Nativity, and Gender

Journal of Health and Social Behavior ◽

10.1177/00221465211040174 ◽

2021 ◽

pp. 002214652110401

Author(s):

Christy L. Erving ◽

Cleothia Frazier

Keyword(s):

Depressive Symptoms ◽

Black Women ◽

Chronic Conditions ◽

Hispanic Women ◽

Multiple Chronic Conditions ◽

Growth Curve Analysis ◽

Foreign Born ◽

And Gender ◽

Gender Groups ◽

Retirement Study

Using random coefficient growth curve analysis, this study utilizes 12 waves of data from the Health and Retirement Study (1994–2016; person-waves = 145,177) to examine the association between multiple chronic conditions (MCC) and depressive symptoms among older adults. Applying cumulative disadvantage and intersectionality theories, we also test whether the association between MCC and depressive symptoms differs by race, nativity, and gender. Findings reveal that MCC prevalence is highest among U.S.-born black women, whereas depressive symptoms are highest among foreign-born Hispanic women. Compared to men, MCC has a stronger effect on women’s depressive symptoms. Furthermore, the MCC–depressive symptoms association is strongest for foreign-born Hispanic women. Despite an increase in MCC in the transition from midlife to late life, all race–nativity–gender groups experience a decline in depressive symptoms as they age. The decline in depressive symptoms is steepest for U.S.-born black and foreign-born Hispanic women. Study implications are discussed.

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THE EFFECT OF WOMEN'S STATUS AND COMMUNITY ON THE GENDER DIFFERENTIAL IN CHILDREN'S NUTRITION IN INDIA

Journal of Biosocial Science ◽

10.1017/s002193201100006x ◽

2011 ◽

Vol 43 (5) ◽

pp. 513-533 ◽

Cited By ~ 30

Author(s):

SUNITA BOSE

Keyword(s):

Adult Literacy ◽

Family Health ◽

Well Being ◽

Women's Status ◽

Individual Level ◽

Supplemental Food ◽

Beneficial Effects ◽

Women’S Status ◽

The Individual ◽

Gender Differential

SummaryThis study uses the third National Family Health Survey (2005–06) in India to investigate whether differences in women's status, both at the individual and community levels, can explain the persistent gender differential in nutritional allocation among children. The results show that girls are less likely than boys to receive supplemental food and more likely to be malnourished. In general it appears that higher women's status within a community, as well as higher maternal status, have beneficial effects on a daughter's nutritional status. Further, the moderating effects of community appear to be more consistent and stronger than the individual-level characteristics. A positive relationship between the percentage of literate women in a community and the gender differential in malnutrition appears to be an exception to the general findings regarding the beneficial nature of women's status on a daughter's well-being, showing the need for more than just basic adult literacy drives in communities to overcome the problem of daughter neglect.

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Development, implementation and evaluation of nurse-led integrated, person-centred care with long-term conditions

Journal of Integrated Care ◽

10.1108/jica-01-2017-0003 ◽

2017 ◽

Vol 25 (3) ◽

pp. 186-195 ◽

Cited By ~ 3

Author(s):

Clare Lynette Harvey ◽

Jonathan Sibley ◽

Janine Palmer ◽

Andrew Phillips ◽

Eileen Willis ◽

...

Keyword(s):

Health Services ◽

Chronic Conditions ◽

Well Being ◽

Multiple Chronic Conditions ◽

Long Term Conditions ◽

Content Type ◽

Care Services ◽

Health Strategy ◽

Global Increase

Purpose The purpose of this paper is to outline a conceptual plan for innovative, integrated care designed for people living with long-term conditions (LTCs). Design/methodology/approach The conceptual plan delivers a partnership between the health system, the person with LTCs (chronic), their family, and the community. The partnership aims to support people at home with access to effective treatment, consistent with the New Zealand Government Health Strategy. This concept of people-owned care is provided by nurses with advanced practice skills, who coordinate care across services, locations and multiple LTCs. Findings With the global increase in numbers of people with multiple chronic conditions, health services are challenged to deliver good outcomes and experience. This model aims to demonstrate the effective use of healthcare resources by supporting people living with a chronic condition, to increase their self-efficacy and resilience in accordance with personal, cultural and social circumstance. The aim is to have a model of care that is replicable and transferable across a range of health services. Social implications People living with chronic conditions can be empowered to manage their health and well-being, whilst having access to nurse-led care appropriate to individual needs. Originality/value Although there are examples of case management and nurse-led coordination, this model is novel in that it combines a liaison nursing role that works in partnership with patients, whilst ensuring that care across a number of primary and secondary care services is truly integrated and not simply interfaced.

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Onset of Multiple Chronic Conditions and Depressive Symptoms: A Life Events Perspective

Innovation in Aging ◽

10.1093/geroni/igx022 ◽

2017 ◽

Vol 1 (2) ◽

Cited By ~ 7

Author(s):

Maureen Wilson-Genderson ◽

Allison R Heid ◽

Rachel Pruchno

Keyword(s):

Heart Disease ◽

Depressive Symptoms ◽

Pulmonary Disease ◽

Chronic Conditions ◽

Clinical Care ◽

Psychological Impact ◽

Multiple Chronic Conditions ◽

Care Providers ◽

The Subject ◽

Independent Effects

Abstract Background While the association between depressive symptoms and chronic illness has been the subject of many studies, little is known about whether depressive symptoms differ as a function of the illnesses people have as they transition to living with multiple chronic conditions. Methods Self-reports of five diagnosed chronic conditions (arthritis, diabetes, heart disease, hypertension, and pulmonary disease) and depressive symptoms were provided by 3,396 people participating in three waves of the ORANJ BOWLSM research panel. Longitudinal multilevel modeling was used to examine the effects that transitioning to having a diagnosis of multiple chronic conditions has on depressive symptoms. Results Between 2006 and 2014, controlling for age, gender, income, race, and a lifetime diagnosis of depression, people who transitioned to having a diagnosis of multiple chronic conditions had significantly higher levels of depressive symptoms than people who did not make this transition. The diagnosis of arthritis, diabetes, heart disease, and pulmonary disease, but not hypertension had independent effects, increasing depressive symptoms. Conclusions Having a diagnosis of multiple chronic conditions leads to increases in depressive symptoms, but not all illnesses have the same effect. Findings highlight the need for clinicians to be aware of mental health risks in patients diagnosed with multiple chronic conditions, particularly those with a diagnosis of arthritis, diabetes, heart disease, and pulmonary disease. Clinical care providers should take account of these findings, encouraging psychosocial supports for older adults who develop multiple chronic conditions to minimize the negative psychological impact of illness diagnosis.

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SEPARATED KIN: RURAL-URBAN MIGRATION AND MENTAL HEALTH TRAJECTORIES OF OLDER ADULTS LEFT BEHIND IN RURAL CHINA

Innovation in Aging ◽

10.1093/geroni/igz038.3223 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S880-S880

Author(s):

Zhiyong Lin

Keyword(s):

Mental Health ◽

Older Adults ◽

Depressive Symptoms ◽

Rural China ◽

Well Being ◽

Migrant Children ◽

Urban Migration ◽

Left Behind ◽

Rate Of Increase ◽

The Impact

Abstract As the processes of urbanization and globalization have intensified across the world, a burgeoning literature has documented the impact of emigration on the health of family members left behind in emigrant communities. Although the association between children’s migration and parental well-being is well documented, few have examined the health implications of children’s migration in the milieu of multiple children and further differentiated between children’s short-term and long-term migration. Therefore, I argue that it is not the geographic locality of a single child but the composition of all children’s location that matters. I further suggest that the impact of children’s migration on parental wellbeing is conditioned on the duration of children’s migration. Using a six waves longitudinal data (2001-2015) collected in rural China, this paper compares mental health (measured as depressive symptoms) trajectories of old adults (aged 60 and older) across different compositions of local and migrant children over a 14-year span. Results from growth curve models show that parents having more migrant children relative to local children experience a more rapid increase in depressive symptoms. In addition, older adults who have their most children migrate away for three or more waves of data have experienced the steepest rate of increase in depressive symptoms. These findings provide new evidence to support the life course processes of mental health disparities among older adults from the perspective of intergenerational proximity.

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