scholarly journals Factors associated with improvement in depressive symptoms among older persons after hospitalisation – a prospective design with two follow‐ups

Author(s):  
Britt‐Marie Sjölund ◽  
Annakarin Olsson ◽  
Maria Engström

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e034248
Author(s):  
Julia Spaltenstein ◽  
Christophe Bula ◽  
Brigitte Santos-Eggimann ◽  
Helene Krief ◽  
Laurence Seematter-Bagnoud

ObjectiveThis study examines potential risk and protective factors associated with going outdoors frequently among older persons, and whether these factors vary according to physical limitations.DesignCross-sectional analysis.Setting and participantsCommunity-dwelling participants of the Lausanne cohort Lc65+ in 2016, aged 68–82 years (n=3419).MethodsAssociations between going outdoors frequently and physical limitations, sociodemographic, health, psychological and social variables were examined using logistic regression models. Subgroup analyses were performed according to the severity of physical limitations.Main outcome measures‘Going outdoors frequently’ was defined as going out ≥5 days/week and not spending most of the time sitting or lying down.ResultsThree in four (73.9%) participants reported going outdoors frequently. Limitations in climbing stairs (adjusted OR (AdjOR) 0.61, 95% CI 0.47 to 0.80) and walking (AdjOR 0.24, 95% CI 0.18 to 0.31), as well as depressive symptoms (AdjOR 0.58, 95% CI 0.47 to 0.70), dyspnoea (AdjOR 0.60, 95% CI 0.48 to 0.75), age (AdjORolder age group 0.73, 95% CI 0.59 to 0.92) and fear of falling (AdjOR 0.75, 95% CI 0.62 to 0.91) reduced the odds of going outdoors frequently. In contrast, living alone (AdjOR 1.30, 95% CI 1.08 to 1.56), reporting a dense (AdjOR 1.57, 95% CI 1.26 to 1.96) and a high-quality (AdjOR 1.28, 95% CI 1.06 to 1.53) social network increased the odds of going outdoors frequently. Among participants with severe limitations, 44.6% still went outdoors frequently. Among this subgroup, a new emotional relationship (AdjOR 2.52, 95% CI 1.18 to 5.38) was associated with going outdoors, whereas cognitive complaints (AdjOR 0.66, 95% CI 0.47 to 0.93), urinary incontinence (AdjOR 0.67, 95% CI 0.46 to 0.97), dyspnea (AdjOR:0.67, 95%CI:0.48-0.93), and depressive symptoms (AdjOR 0.67, 95% CI 0.48 to 0.93) lowered the odds of going outdoors.ConclusionPhysical limitations are associated with decreased odds of going outdoors frequently. However, social characteristics appear to mitigate this association, even among older persons with severe limitations. Further studies are needed to determine causality and help guide interventions to promote going outdoors as an important component of active ageing.



Author(s):  
Lan-Ping Lin ◽  
Li-Yun Wang ◽  
Tai-Wen Wang ◽  
Yun-Cheng Chen ◽  
Jin-Ding Lin

Homeless individuals have many negative experiences with inequality regarding access to and the use of primary healthcare services, so policies to eliminate the disparities in and barriers to primary care access for these people are needed. The aim of this study was to explore the use and determinants of free hospital outpatient services for homeless people, in order to describe the provision of free healthcare policies for this vulnerable population in Taipei. One cross-sectional survey was conducted to recruit homeless people aged 45 years old and over in Taipei in 2018. A structured questionnaire was used, and face-to-face interviews were conducted by three social workers to collect the data. Finally, 129 participants were recruited in the study. The results show that 81.4% of the homeless people had made free hospital outpatient care visits (mean = 5.9 visits) in the last three months. An unadjusted logistic regression analysis showed that those homeless people who reported having usual healthcare providers, with higher depressive symptom scores, who used medication and had been hospitalized within one year, and had more chronic diseases, were significantly more likely to make free hospital outpatient visits. The adjusted logistic regression model indicates that homeless people with severe depressive symptoms (odds ratio (OR) = 9.32, 95% CI = 1.15–56.07), who had received medication (OR = 3.93; 95% CI = 1.06–14.52), and who had more than five chronic diseases (OR = 1.06, 95% CI = 1.35–13.27), were significantly more likely to make free hospital outpatient visits than their counterparts. The findings highlight that homeless people have higher healthcare requirements than the general population, and the healthcare system should pay more attention to factors associated with higher outpatient service use, such as homelessness, severe depressive symptoms, the receipt of medication and chronic diseases.



Author(s):  
Hyejung Lee ◽  
Ki-Eun Kim ◽  
Mi-Young Kim ◽  
Chang Gi Park ◽  
Jung Yeol Han ◽  
...  

The purposes of this study were to investigate the trajectory groups of depressive symptoms and anxiety in women during pregnancy and to identify the factors associated with those groups. Participants were recruited from the outpatient clinic of a women’s health hospital in Seoul, Korea. Pregnant women (n = 136) completed a survey questionnaire that included questions on depressive symptoms, anxiety, and pregnancy stress; additionally, their saliva was tested for cortisol hormone levels three times during their pregnancies. The group-based trajectory modeling approach was used to identify latent trajectory groups. Ordinal logistic regressions were used to explore the association of latent trajectory groups with sociodemographic factors and pregnancy stress. Three trajectory groups of depressive symptoms were identified: low-stable (70%), moderate-stable (25%), and increased (5%). Four trajectory groups of anxiety were identified: very low-stable (10%), low-stable (67%), moderate-stable (18%), and high-stable (5%). The only factor associated with both the depressive symptoms and anxiety trajectory groups was pregnancy stress (p < 0.001). Most participants showed stable emotional status; however, some participants experienced higher levels of depressive symptoms and anxiety related to higher pregnancy stress. These pregnant women may need additional care from healthcare providers to promote their wellbeing during pregnancy.



2009 ◽  
Vol 14 (3-4) ◽  
pp. 161-174 ◽  
Author(s):  
L. Nilsson Schönnesson ◽  
M. Williams ◽  
J. Atkinson ◽  
S. Timpson


2017 ◽  
Vol 35 (1) ◽  
pp. 18-31 ◽  
Author(s):  
Rosanne Freak-Poli ◽  
M. Arfan Ikram ◽  
Oscar H Franco ◽  
Albert Hofman ◽  
Henning Tiemeier


2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Xu Wang ◽  
Biyu Shen ◽  
Xun Zhuang ◽  
Xueqin Wang ◽  
Weiqun Weng

Aim.To assess the depressive symptoms status of chronic kidney diseases in Nantong, China, with type 2 diabetes and to identify factors associated with depressive symptoms.Methods.In this cross-sectional analytic study, 210 type 2 diabetic patients were recruited from the Second Affiliated Hospital of Nantong University. Depressive symptoms were assessed with the depression subscale of the Hospital Anxiety and Depression Scale (HAD-D). The quality of life was measured with the RAND 36-Item Health Survey (SF-36). And the independent risk factors of depressive symptoms were assessed by using a stepwise forward model of logistic regression analysis.Results.The mean age of the study subjects was 57.66 years (SD: 11.68). Approximately 21.4% of subjects reported depressive symptoms (n=45). Forward stepwise logistic regression analysis showed that female gender (P=0.010), hypertension (P=0.022), Stage IV (P=0.003), and Stage V (P<0.001) were significant risk factors for depressive symptoms. The quality of life of individuals with HAD-D score <11 was significantly better compared with individuals with HAD-D score ≥ 11.Conclusions.These results indicate that clinicians should be aware that female patients with chronic kidney diseases with T2DM in their late stage with hypertension are at a marked increased risk of depressive symptoms. Providing optimal care for the psychological health of this population is vital.



Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 475
Author(s):  
Hye-Young Jang ◽  
Ji-Hye Kim

This study was conducted to identify the factors associated with frailty according to gender of older adults living alone in Korea. Data from the National Survey of the Living Conditions of Korean Elderly in 2017 were used. Participants were 2340 older adults who live alone. Frailty was determined based on the frailty criteria developed by van Kan et al. that consist of fatigue, resistance, ambulation, and illness. The collected data were analyzed using descriptive statistics, chi-squared test, t-test, Jonckheere–Terpstra test and multinomial logistic regression. Among the older men living alone, 47.7% were in the pre-frail and 5.1% were in the frail. On the other hand, 51.8% were in the pre-frail and 12.2% were in the frail among the older women living alone. The factors associated with frailty according to gender are as follows. In males, depressive symptoms, limitation in IADL, and number of medications in pre-frail; BMI, limitation in IADL, and number of chronic diseases in frail. In females, depressive symptoms, number of chronic diseases, age, and nutritional status in pre-frail; limitation in IADL, depressive symptoms, age, number of chronic diseases, number of medications, nutritional status in frail. Based on the findings of this study, it is considered necessary to approach frailty management considering gender as well as the classification of frailty.



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