Association between contact with a general practitioner and depressive symptoms during the COVID-19 pandemic and lockdown: a large community-based study in Hangzhou, China

ObjectivesTo determine the association of general practitioner (GP) contact with depressive symptoms during the COVID-19 pandemic and lockdown in China.DesignIn April 2020, a follow-up survey was conducted on the basis of a baseline survey conducted between October 2018 and May 2019.SettingThe survey was embedded in the Stanford Wellness Living Laboratory-China (WELL China) study, an ongoing prospective community-based cohort study during 2018–2019.ParticipantsThe survey was conducted by telephone interview among 4144 adult urban residents participating in the WELL China study at baseline. We collected information on sociodemographic characteristics, depressive symptoms and GP contact during the lockdown period (February to March 2020).Primary and secondary outcome measuresDepressive symptoms were measured using the WHO-Five Well-being Index, comprising five questionnaire items that briefly indicate psychological well-being. Logistic regression models were applied to assess the association between GP contact and depressive symptoms.ResultsIn total, 3356 participants responded to the survey; 203 were excluded owing to missing data on depressive symptoms, leaving 3153 participants in the present study. During lockdown, 449 participants had GP contact. GP contact was significantly negatively associated with prevalent depressive symptoms (OR, 0.67; 95% CI 0.51 to 0.89; p<0.01) and incident depressive symptoms (OR 0.68; 95% CI 0.51 to 0.93; p<0.05). Stratified analysis showed a significant negative association between depressive symptoms and GP contact in individuals who were 45–64 years old (p<0.01), had a middle or high education (p<0.01) and had self-reported non-communicable diseases (p<0.05).ConclusionsContact with GPs during the COVID-19 pandemic and lockdowns may have a negative association with depressive symptoms in community-dwelling populations. Given the possibility of further surges in COVID-19 infections, GPs’ contact in the community should be enhanced.

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Do opposite ends of same factors underlie life satisfaction vs. depressive symptoms among older people?

Aging Clinical and Experimental Research ◽

10.1007/s40520-020-01765-z ◽

2021 ◽

Author(s):

Katja Pynnönen ◽

Katja Kokko ◽

Milla Saajanaho ◽

Timo Törmäkangas ◽

Erja Portegijs ◽

...

Keyword(s):

Life Satisfaction ◽

Depressive Symptoms ◽

Older People ◽

Executive Functions ◽

Physical Performance ◽

Well Being ◽

Community Dwelling ◽

Satisfaction With Life Scale ◽

Financial Situation ◽

Self Acceptance

Abstract Background Although depressive symptoms are more common among older than younger age groups, life satisfaction tends to remain stable over the life course, possibly because the underlying factors or processes differ. Aim To study whether the factors that increase the likelihood of high life satisfaction also decrease the likelihood of depressive symptoms among older people. Methods The data were a population-based probability sample drawn from community-dwelling people aged 75, 80, and 85 years (n = 1021). Participants’ life satisfaction was measured with the Satisfaction with Life Scale and depressive symptoms with the Centre for Epidemiologic Studies Depression Scale (CES-D). Physical performance, perceived financial situation, executive functions, loneliness, self-acceptance, and having interests in one’s life were studied as explanatory variables. The data were analyzed using cross-sectional bivariate linear modeling. Results Better physical performance, not perceiving loneliness, having special interests in one’s life, and higher self-acceptance were associated with higher life satisfaction and fewer depressive symptoms. Better financial situation was related only to life satisfaction. Executive functions were not associated with either of the outcomes. Discussion The opposite ends of the same factors underlie positive and negative dimensions of mental well-being. Conclusion Further studies are warranted to better understand how people maintain life satisfaction with aging when many resources may diminish and depressive symptoms become more prevalent.

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Depression and Psychological Well-Being as Distinct Constructs: Mutually Exclusive Associations With Biomarker

Innovation in Aging ◽

10.1093/geroni/igaa057.808 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 251-251

Author(s):

Kheng Siang Ted Ng ◽

Shu Cheng Wong ◽

Glenn Wong ◽

Ee Heok Kua ◽

Anis Larbi ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Depressive Symptoms ◽

Factor Score ◽

Well Being ◽

Community Dwelling ◽

The Other ◽

Factor Scores ◽

Psychological Well Being ◽

Wide Range

Abstract Despite increasing emphasis on assessing the mental health of older adults, there has been inconclusive evidence on whether depression and psychological well-being (PWB) are fundamentally distinct constructs or representations of the opposite ends of the mental health spectrum. To instantiate either hypothesis, investigation of the associations between mental health scales and biomarkers have been proposed. First, we assessed depressive symptoms and PWB in community-dwelling older adults (N=59, mean age=67) using the Self-Rating Depression Scale (SDS) and Ryff’s Scale of PWB (comprising six sub-scales). We measured a wide range of immune markers employing ELISA and flow cytometry. Subsequently, we used principal component analysis (PCA) to aggregate and derived biomarker factor scores. Lastly, multiple linear regressions were performed to examine the associations between the scales and the derived biomarker factor scores, controlling for covariates. PCA extracted six biomarker factors. Biomarker factor score 1 was significantly associated with PWB (β=-0.029, p=0.035) and the PWB sub-scale, self-acceptance (β=-0.089, p=0.047), while biomarker factor score 4 was significantly associated with the PWB sub-scale, purpose in life (β=-0.087, p=0.025). On the other hand, biomarker factor 6 was significantly associated with SDS (β=-0.070, p=0.008). There were mutually- exclusive associations between the scales with biomarker factor scores, supporting the hypothesis of distinct constructs. Our findings expanded the biomarkers of depression and PWB, deepening understanding of the biological underpinnings of depressive symptoms and PWB. These findings have implications in field work, since researchers could not infer one construct from the other, the examination of both constructs are essential.

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1089 Water Intake Moderates the Relationship Between Sleep Quality and Depressive Symptoms: The Latino Health and Well-Being Study

SLEEP ◽

10.1093/sleep/zsaa056.1084 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A414-A415

Author(s):

J Blanc ◽

N Williams ◽

G Jean-Louis ◽

S Lemon ◽

M Rosal

Keyword(s):

Depressive Symptoms ◽

Sleep Quality ◽

Water Intake ◽

Depression Scale ◽

Well Being ◽

Epidemiologic Studies ◽

Community Based ◽

Latino Adults ◽

The Relationship ◽

Health And Well Being

Abstract Introduction This study examined the relationships between sleep quality and depressive symptoms, and whether this relationship is moderated by frequency of water intake in a sample of Latino adults. Methods Participants in this community-based study were 574 Latino adults from Lawrence, Massachusetts. Assessments included surveys and anthropological measures. Variables in this study included sleep quality (Pittsburgh Sleep Quality Index- PSQI), depressive symptoms (Center for Epidemiologic Studies Depression Scale -CES-D) and frequency of water intake in the previous three months (investigator-developed question). Covariates included demographics, stress (Perceived Stress Scale-PSS), and body mass index (BMI). Multiple linear regression analyses were conducted to explore associations between sleep and depressive symptoms. Potential moderating effect of frequency of water intake was assessed using hierarchical, moderated, multiple regression analysis. Results The sample was 51.2% female, with a mean age of 46.6 years (SD=15.4) and mean BMI of 29.6 (SD=5.9); 31% of the sample had CES-D scores > 22 (cut off for elevated depressive symptoms), the mean PSQI score was 13.11(SD=3.4) and 92% reported water intake two or more times daily. Sleep quality correlated positively with depression (r=.558; p=.000). After adjusting for covariates, sleep quality was strongly associated with depression (B = .417; SE=13; p =.000). The relationship between sleep quality and depressive symptoms was moderated by frequency of water intake (B= -.186, SE =1.107; p= 0.11). Conclusion This study is among the first to examine the association between sleep quality and depressive symptoms among Latino adults, and to show that frequency of water intake may moderate this association in this population. Support This study was supported by funding from the NIH: R01 MH085653; 1U48DP006381; and T32HL129953.

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Day-to-Day Variability in Subjective Age and Ageist Attitudes and Their Association With Depressive Symptoms

The Journals of Gerontology Series B ◽

10.1093/geronb/gbaa125 ◽

2020 ◽

Cited By ~ 1

Author(s):

Ehud Bodner ◽

Amit Shrira ◽

Yaakov Hoffman ◽

Yoav S Bergman

Keyword(s):

Mental Health ◽

Older Adults ◽

Depressive Symptoms ◽

Interactive Effect ◽

Well Being ◽

Daily Basis ◽

Community Dwelling ◽

Subjective Age ◽

Assimilation Process ◽

Time Lagged

Abstract Objectives Evidence of daily fluctuations in subjective age and their association with older adults’ well-being was recently obtained. Yet, neither the simultaneous tracking of two daily views on aging (i.e., daily subjective age and daily ageist attitudes) nor their interactive effect on mental health (i.e., depressive symptoms) has been explored. We hypothesized that (a) at days on which older adults feel older or report high ageist attitudes they would report higher depressive symptoms, (b) combined older subjective age and high ageist attitudes will be associated with the highest daily depressive symptoms. Method Community-dwelling older adults (N = 134, mean age = 69.66) completed measures of subjective age, ageist attitudes, and depressive symptoms for 10 consecutive days. Results Daily older subjective age and higher ageist attitudes were related to higher depressive symptoms, but there was no combined effect of both on depressive symptoms. There was a significant three-way interaction between subjective age, ageist attitudes, and chronological age, demonstrating the interactive effect of subjective age and ageist attitudes on depressive symptoms only among the old-old respondents. Time-lagged analyses further showed that ageist attitudes during previous days predicted feeling older and more depressed on following days, but not vice versa. Discussion Results suggest that old-old individuals are more susceptible to a combination of negative views on aging on daily basis. Findings further support a daily assimilation process, whereby previous-day stereotypes are assimilated and manifested into one’s identity and mental health, so that one feels older and more depressed on subsequent days.

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Pain and symptoms of depression in older adults living in community and in nursing homes: the role of activity restriction as a potential mediator and moderator

International Psychogeriatrics ◽

10.1017/s1041610214000970 ◽

2014 ◽

Vol 26 (10) ◽

pp. 1679-1691 ◽

Cited By ~ 15

Author(s):

Almudena López-Lopez ◽

José L. González ◽

Miriam Alonso-Fernández ◽

Noelia Cuidad ◽

Borja Matías

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Nursing Homes ◽

Older People ◽

Pain Intensity ◽

Nursing Home Residents ◽

Well Being ◽

Community Dwelling ◽

Activity Restriction

ABSTRACTBackground:Chronic pain is likely to lead to depressive symptoms, but the nature of this relationship is not completely clear. The aim of the present study is to analyze the role of activity restriction in the pain-depression relationship in older people, and to test the hypothesis that this role is more relevant in community-dwelling older people than in nursing home residents.Method:Depressive symptoms, pain intensity, and activity restriction were measured in a sample of 208 older adults with osteoarthritis, 102 living in nursing homes (NH), and 106 in the community. Analyses were carried out using moderation and moderated mediation analyses approach, treating activity restriction as a confounder.Results:Results showed a significant confounding effect of activity restriction, interaction effect between pain intensity and activity restriction on depression, and modifying effect of pain intensity on depression by adding activity restriction into the model. These results suggest a potential mediating and moderating effects of activity restriction. Moreover, analyses suggest that, surprisingly, the strength of the mediation could be higher in nursing homes.Conclusions:Overall, it may be that what is really important to emotional well-being is not so much pain itself, but rather the way in which the pain alters older people's lives. The greater strength of the mediation in NH might be understood within the scope of self-determination theory. Generally speaking, the NH context has been considered as a coercive setting, promoting non-autonomous orientation. In this context, when events are objectively coercive, people may lack perceived autonomy and hence be at greater risk of depression.

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2313

Journal of Clinical and Translational Science ◽

10.1017/cts.2017.258 ◽

2017 ◽

Vol 1 (S1) ◽

pp. 73-73

Author(s):

Nikhil Satchidanand ◽

Jeffrey Fine ◽

Gregory S. Cherr

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Health Status ◽

Physical Function ◽

Psychosocial Factors ◽

Health Survey ◽

Well Being ◽

Mental Health Status ◽

Community Dwelling ◽

Physical And Mental Health

OBJECTIVES/SPECIFIC AIMS: To explore associations among bio-psychosocial factors predictive of overall physical and mental health status as assessed using the SF-12 Health Survey. METHODS/STUDY POPULATION: Community-dwelling, male and female elders with peripheral arterial disease (PAD) were administered an assessment battery to identify factors associated with self-assessed physical and mental health status using the SF-12 Health Survey. The battery included an assessment of pain, depressive symptoms, perceived social support, perceived psychological stress, physical function, as well as selected demographic variables. RESULTS/ANTICIPATED RESULTS: Preliminary linear regression analyses have identified several factors predictive of physical and mental health status including depressive symptoms, pain, perceived stress, and physical function. A more in-depth examination using path analysis is anticipated to reveal important mediational associations, wherein physical function is a strong mediator between bio-psychosocial factors and overall physical and mental health status. DISCUSSION/SIGNIFICANCE OF IMPACT: Aging is often associated with a reduction in physical and mental well-being, frequently exacerbated by the development and progression of chronic disease. PAD is a common chronic condition that places significant burden on the older patient and their family. Identifying and developing a more in-depth understanding of the factors that impact health status in PAD is an important and timely objective. We anticipate that our findings will inform development of more targeted and effective intervention strategies we can employ to improve the quality of life among elders struggling to manage PAD.

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The Association Between the Use of Digital Health Management Tools and Subjective Well-Being Among Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.1914 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 498-498

Author(s):

Mai See Yang ◽

Haowei Wang ◽

Yong Kyung Choi

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Technology Use ◽

Health Management ◽

Digital Health ◽

Later Life ◽

Well Being ◽

Community Dwelling ◽

Subjective Well Being ◽

Management Tools

Abstract This study aims to examine the association between the use of digital health management tools and subjective well-being in later life. Research is limited about technology use (e.g., participation in online wellness program, finding medical information, using devices to monitor health) among community dwelling older adults. This study used data from the Health and Retirement study 2012 Module “Technology Use: Barriers and Benefits” (N = 1,416). We used multiple regression methods to test the association between technology use and subjective well-being (i.e., self-rated health, life satisfaction, and depressive symptoms). Over half of the participants reported using technology (58%). The mean age for this group was 68.7 (SD 9.6). Majority of the respondents were female (55%). About 18% were non-Hispanic Blacks, 2% were non-Hispanic other, 11% were Hispanic, and 68% were non-Hispanic Whites. For this sample of technology users, the usage of digital health management included online exercise programs (16%), online wellness programs or health monitoring programs (7%), searching for medical and health information online (43%), digital devices to monitor health (31%), and physical activity-based video game such as Wii Fit (7%). Over 88% of the sample have used at least one of these formats to monitor their health. Results from regression models suggested that the use of any digital health management tools was related to fewer depressive symptoms and better self-reported health. Findings from this study provide insight into how digital health management can protect older adults from poor subjective well-being in later life.

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Social Roles of Family and Friends Differ in Social Networks of Older Adults Who Live Alone

Innovation in Aging ◽

10.1093/geroni/igab046.2365 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 623-624

Author(s):

Sato Ashida ◽

Ellen Schafer ◽

Lena Thompson

Keyword(s):

Older Adults ◽

Social Networks ◽

Depressive Symptoms ◽

Social Roles ◽

Well Being ◽

Community Based ◽

The Social ◽

Non Local ◽

Network Approaches ◽

Local Family

Abstract Social networks consisting of family and friends tend to better facilitate older adults’ emotional well-being than networks consisting of only family or only friends. This study assessed the heterogeneity of older adults’ network compositions based on the network members’ relationship (family vs. friends) and proximity (local vs. non-local) and evaluated the types of interactions between older adults and types of members. Adults 60 years and older living in a U.S. Midwestern city participated in a one-time structured survey (n=133), and reported about 1,730 social network members. Compared to participants who lived with others, those who lived alone reported more depressive symptoms and higher frequency of feeling lonely (p=0.002). Those who lived alone also had higher proportions of local friends in their networks than those who lived with others (p=0.02). Whereas the social roles of family and friends were similar in networks of older adults who lived with others, those who lived alone were less likely to identify family as who they co-engaged in social activities with (local family OR=0.55, non-local family OR=0.27) and who provided companionship (local family OR=0.33, non-local family OR=0.11) compared to their local friends. Having more members who co-engaged in activities was associated with lower depressive symptoms (p=0.05) and less frequency of feeling lonely (p<0.01). Providing supportive infrastructure for community-based older adults to develop and maintain co-engaging relationships with local friends may be beneficial. Network approaches can be used to identify existing network members who may be inspired to play this role.

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Linking Religious Identity, Participation, and Faith to Domains of Mental Health in Late Life

Innovation in Aging ◽

10.1093/geroni/igab046.1097 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 284-284

Author(s):

Eva Kahana ◽

Poshan Dahal ◽

Tirth Bhatta ◽

Polina Ermoshkina

Keyword(s):

Life Satisfaction ◽

Depressive Symptoms ◽

Negative Affect ◽

Positive Affect ◽

Religious Coping ◽

Religious Identity ◽

Church Attendance ◽

Well Being ◽

Community Dwelling ◽

Over Time

Abstract Religiosity in late life has been linked to psychological well-being outcomes. However, there has been insufficient attention to complex associations between different domains of religiosity and domains of psychological wellbeing. We explored associations between religious identity, religious participation, religious coping (trust in God), and mental health indicators of depressive symptoms, life satisfaction, and positive/negative affect among 797 independent, retirement community-dwelling older adults. At baseline, religious identity (expressed as self- concept) and religious participation (church attendance) each were associated with fewer depressive symptoms (b=-0.47, p<0.05; b=-0.19, p<0.05). Religious identity, however, was significantly associated with both life satisfaction and positive affects but not with negative affect. Religious coping was associated with greater life satisfaction and positive affect. Our longitudinal analysis documented a statistically significant decline in depressive symptoms, and increase in life satisfaction and positive affect, with corresponding increase in religious identity over time. However, changes in religious identity did not lead to significant changes in negative affect over time. Religious coping and church attendance fully explained the influence of religious identity on changes in life satisfaction. Although the influence of religious identity on depressive symptoms and positive affect was weakened, its significant influence was maintained even after the consideration of religious coping and church attendance. Beyond religious identity, we also observed a significant increase in positive affect with a corresponding increase in religious coping. Overall, our findings support expectations that religious identification and practices are associated with greater psychological well-being among community dwelling old- old adults.

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Annual high-dose vitamin D3and mental well-being: randomised controlled trial

The British Journal of Psychiatry ◽

10.1192/bjp.bp.110.087544 ◽

2011 ◽

Vol 198 (5) ◽

pp. 357-364 ◽

Cited By ~ 100

Author(s):

Kerrie M. Sanders ◽

Amanda L. Stuart ◽

Elizabeth J. Williamson ◽

Felice N. Jacka ◽

Seetal Dodd ◽

...

Keyword(s):

Mental Health ◽

Vitamin D ◽

Depressive Symptoms ◽

Controlled Trial ◽

Well Being ◽

Community Dwelling ◽

High Dose ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Mental Well Being

BackgroundEpidemiological evidence supports a relationship between vitamin D and mental well-being, although evidence from large-scale placebo-controlled intervention trials is lacking.AimsTo examine if vitamin D supplementation has a beneficial effect on mood in community-dwelling older women; if a single annual large dose of vitamin D has a role in the prevention of depressive symptoms; and if there is an association between serum 25-hydroxyvitamin D levels and mental health.MethodA double-blind, randomised, placebo-controlled trial of women aged 70 or older (the Vital D Study: ISRCTN83409867 and ACTR12605000658617). Participants were randomly assigned to receive 500 000 IU vitamin D3(cholecalciferol) orally or placebo every autumn/winter for 3–5 consecutive years. The tools utilised at various time points were the General Health Questionnaire, the 12-item Short Form Health Survey, the Patient Global Impression–Improvement scale and the WHO Well-Being Index. Serum 25-hydroxyvitamin D levels were measured in a subset of 102 participants.ResultsIn this non-clinical population, no significant differences between the vitamin D and placebo groups were detected in any of the measured outcomes of mental health. Serum 25-hydroxyvitamin D levels in the vitamin D group were 41% higher than the placebo group 12 months following their annual dose. Despite this difference, scores from the questionnaires did not differ. Furthermore, there was no interaction between those on antidepressant/anxiety medication at baseline and the treatment groups.ConclusionsThe lack of improvement in indices of mental well-being in the vitamin D group does not support the hypothesis that an annual high dose of vitamin D3is a practical intervention to prevent depressive symptoms in older community-dwelling women.

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