Trajectories of Depression and Their Predictors in a Population-Based Study of Korean Older Adults

Author(s):  
Hyun Ja Lim ◽  
Yanzhao Cheng ◽  
Rasel Kabir ◽  
Lilian Thorpe

The aim of this study was to determine trajectories of depression in older adults and to identify predictors of membership in the different trajectory groups. A total of 3983 individuals aged 65 or older were included. Latent class growth models were used to identify trajectory groups. Of 3983 individuals, 2269 (57%) were females, with a mean baseline age of 72.4 years ( SD = 6 years). Four depression trajectories were identified across 8 years of follow-up: “low-flat” ( n = 3636; 86.6%), “low-to-middle” ( n = 214; 9.2%), “low-to-high” ( n = 31; 1.3%), and “high-stable” ( n = 102; 2.9%). Compared to the low-flat depression group, high-stable depression group members were more likely to be female, have three or more chronic diseases, and were more likely not to own a home. Our findings will assist health policy decision-makers in planning intervention programs targeting those most likely to experience persistent depression in order to improve psychological well-being in the elderly.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yanzhao Cheng ◽  
Lilian Thorpe ◽  
Rasel Kabir ◽  
Hyun Ja Lim

Abstract Background Depression and anxiety are common mental health conditions in the older adult population. Understanding the trajectories of these will help implement treatments and interventions. Aims This study aims to identify depression and anxiety trajectories in older adults, evaluate the interrelationship of these conditions, and recognize trajectory-predicting characteristics. Methods Group-based dual trajectory modeling (GBDTM) was applied to the data of 3983 individuals, aged 65 years or older who participated in the Korean Health Panel Study between 2008 and 2015. Logistic regression was used to identify the association between characteristics and trajectory groups. Results Four trajectory groups from GBDTM were identified within both depression and anxiety outcomes. Depression outcome fell into “low-flat (87.0%)”, “low-to-middle (8.8%)”, “low-to-high (1.3%)” and “high-stable (2.8%)” trajectory groups. Anxiety outcome fell into “low-flat (92.5%)”, “low-to-middle (4.7%)”, “high-to-low (2.2%)” and “high-curve (0.6%)” trajectory groups. Interrelationships between depression and anxiety were identified. Members of the high-stable depression group were more likely to have “high-to-low” or “high-curved” anxiety trajectories. Female sex, the presence of more than three chronic diseases, and being engaged in income-generating activity were significant predictors for depression and anxiety. Conclusions Dual trajectory analysis of depression and anxiety in older adults shows that when one condition is present, the probability of the other is increased. Sex, having more than three chronic diseases, and not being involved in income-generating activity might increase risks for both depression and anxiety. Health policy decision-makers may use our findings to develop strategies for preventing both depression and anxiety in older adults.


2021 ◽  
Author(s):  
Yanzhao Cheng ◽  
Lilian Thorpe ◽  
Rasel Kabir ◽  
Hyun Ja Lim

Abstract Background: Depression and anxiety are common mental health conditions for elderly population. Understanding the trajectory developments of them will help us implementing treatments and interventions.Aims: This study aims to identify depression and anxiety trajectories in the elderly, evaluate the interrelationship of these conditions, and recognize trajectory-predicting characteristics.Methods: Group-based dual trajectory modeling (GBDTM) was applied to the data of 3,983 individuals, aged 65 years or older who participated in the Korean Health Panel Study between 2008 and 2015. Logistic regression was used to identify the association between characteristics and trajectory groups.Results: Four trajectory groups from GBDTM were identified in both the depression and anxiety outcomes. Depression has: “low-flat (87.0%)”, “low-to-middle (8.8%)”, “low-to-high (1.3%)” and “high-stable (2.8%)” trajectory groups. Anxiety has: “low-flat (92.5%)”, “low-to-middle (4.7%)”, “high-to-low (2.2%)” and “high-curve (0.6%)” trajectory groups. Interrelationship between depression and anxiety were identified. Members of the high-stable depression group were more likely to have “high-to-low” or “high-curved” anxiety trajectories. Female sex, the presence of more than three chronic diseases, and having income generating activity were significant factors in depression and anxiety.Conclusions: Dual trajectory analysis of depression and anxiety in older adults shows that when one condition is present, the probability of the other is increased. Sex, having more chronic disease, and income generating activity might be at increased risks for both depression and anxiety. Health policy decision-makers can use our findings in developing strategies for prevention of both depression and anxiety in older adults.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 626-627
Author(s):  
Jeremy Hamm ◽  
Carsten Wrosch ◽  
Meaghan Barlow ◽  
Ute Kunzmann

Abstract Using two studies, we examined the late life prevalence and health consequences of discrete positive emotions posited to motivate rest and recovery (calmness) or pursuit of novelty and stimulation (excitement). Study 1 assessed the salience of these discrete emotions in older adults (n=73, Mage=73) relative to younger adults (n=73, Mage=23) over a one-week period. Multilevel models showed that older (vs. younger) adults reported higher calmness and lower excitement. Study 2 examined the longitudinal health consequences of calmness and excitement in old age (n=336, Mage=75), as moderated by perceived control. Multilevel growth models showed that calmness, but not excitement, buffered against 10-year declines in psychological well-being (perceived stress, depressive symptoms) and physical health (physical symptoms, chronic conditions) for older adults with low perceived control. Results suggest that positive emotions with disparate motivational functions become more (calmness) or less (excitement) salient and have diverging implications for health in old age.


Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1118
Author(s):  
Ralf Wagner ◽  
David Peterhoff ◽  
Stephanie Beileke ◽  
Felix Günther ◽  
Melanie Berr ◽  
...  

SARS-CoV-2 infection fatality ratios (IFR) remain controversially discussed with implications for political measures. The German county of Tirschenreuth suffered a severe SARS-CoV-2 outbreak in spring 2020, with particularly high case fatality ratio (CFR). To estimate seroprevalence, underreported infections, and IFR for the Tirschenreuth population aged ≥14 years in June/July 2020, we conducted a population-based study including home visits for the elderly, and analyzed 4203 participants for SARS-CoV-2 antibodies via three antibody tests. Latent class analysis yielded 8.6% standardized county-wide seroprevalence, a factor of underreported infections of 5.0, and 2.5% overall IFR. Seroprevalence was two-fold higher among medical workers and one third among current smokers with similar proportions of registered infections. While seroprevalence did not show an age-trend, the factor of underreported infections was 12.2 in the young versus 1.7 for ≥85-year-old. Age-specific IFRs were <0.5% below 60 years of age, 1.0% for age 60–69, and 13.2% for age 70+. Senior care homes accounted for 45% of COVID-19-related deaths, reflected by an IFR of 7.5% among individuals aged 70+ and an overall IFR of 1.4% when excluding senior care home residents from our computation. Our data underscore senior care home infections as key determinant of IFR additionally to age, insufficient targeted testing in the young, and the need for further investigations on behavioral or molecular causes of the fewer infections among current smokers.


Motricidade ◽  
2018 ◽  
Vol 14 (1) ◽  
pp. 73 ◽  
Author(s):  
André Ramalho ◽  
João Petrica ◽  
António Rosado

This systematic review aimed to synthesize the scientific evidence about the relationship between sedentary behaviours and various psychological outcomes in older adults. The study searches were conducted in the following databases: PubMed, PsycINFO, ISI Web of Knowledge and ScienceDirect. We selected 15 observational quantitative studies according to specific eligibility criteria. The data extraction was performed independently by different authors, including the evaluation of the risk of bias of the studies and the classification of the force of evidence. The results showed a tendency of showing no associations between the sedentary behaviours, the well-being and quality of life of the elderly. Concerning life satisfaction and perceived stress, it seems that active sedentary activities have positive effects on these indicators. Evidence has also suggested that some sedentary behaviours may help maintain some cognitive functions in the elderly population, namely in different types of memory. In other studies, it has been demonstrated a tendency that too much time in passive sedentary activities has been associated with depressive symptomatology. However, this review suggested that the evidence is not yet consistent in the relationship between the sedentary behaviours of the elderly and the indicators analysed, and more research is needed.


Author(s):  
Vanessa Silva Lins ◽  
Marcia Queiroz de Carvalho Gomes

A demência é uma das principais causas de incapacidade entre a população idosa, sua prevalência vem crescendo com o aumento da longevidade e vem se tornando um problema de saúde pública. O idoso acometido por demência tem as ocupações e o desempenho ocupacional bastante comprometido, necessitando da assistência do terapeuta ocupacional. O objetivo do presente estudo é analisar as contribuições da Terapia Ocupacional na atenção ao idoso com demência, descritas nas produções científicas publicadas em periódicos na área de saúde. Trata-se de uma revisão sistemática, do tipo integrativa, realizada na plataforma BIREME, nas bases de dados da LILACS, SciELO e MEDLINE, usando os descritores “Demência AND Terapia Ocupacional” e “Doença de Alzheimer AND Terapia Ocupacional”, nos idiomas português e espanhol. Foram encontrados 33 artigos, desse total foram selecionados para análise 07 artigos, que estavam dentro dos critérios de inclusão. Esta revisão permitiu constatar que, apesar da tímida produção de publicações de terapeutas ocupacionais acerca da demência, nos dois idiomas pesquisados, a Terapia Ocupacional vem ampliando seu escopo de ação, para além das tradicionais abordagens cognitivas e centradas apenas no idoso, avançou na promoção de práticas preventivas e no manejo de sintomas psicológicos e comportamentais, que envolvem tanto o ambiente físico quanto o ambiente social do idoso. A Terapia Ocupacional tem desenvolvido e utilizado instrumentos próprios da profissão, tais como a DADL-Br e a COPM, fortalecendo sua identidade e especificidade. Vem contribuindo para a qualidade de vida e bem-estar do idoso com Demência e seus cuidadores/familiares, promovendo uma atenção integral e contextualizada. Abstract Dementia is one of the leading causes of disability among the elderly population. Its prevalence has increased with longevity growth and it has become a public health problem. The older adults person affected by dementia has his/her occupations and occupational performance quite compromised, requiring Occupational Therapy assistance. The objective of the present study is to analyze Occupational Therapy assistance contributions to the elderly with dementia, described in the scientific productions published in health journals. It is a review of the integrative type, performed in BIREME platform, in the databases of LILACS, SciELO and MEDLINE, using the descriptors "Dementia AND Occupational Therapy" and "Alzheimer's Disease AND Occupational Therapy", in Portuguese and Spanish.We have found 33 articles, from which 7 articles were selected for analysis, according to the inclusion criteria.This review showed that, in spite of the small number of publications about the performance of dementia in both languages, Occupational Therapy has expanded its scope of action. Beyond cognitive approaches focused on the older adults, it has been making progress on preventing and managing psychological and behavioral symptoms, involving both the physical and social environment of the older adults. Occupational Therapy has developed and used its own tests and evaluations, such as DADL-Br and COPM, strengthening its identity and specificity. It contributes to the quality of life and well-being of the elderly with Dementia and their caregivers / family, promoting integrated and contextualized care.Keywords: Dementia, Alzheimer's Disease, Elderly; Occupational Therapy.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S814-S814
Author(s):  
XinQi Dong ◽  
Melissa Simon

Abstract The increasing diversity in the aging population warrants systematic investigations regarding ethnic differences related to cognitive aging and ethnicity-unique risk factors. However, due to the great paucity of population-based longitudinal data on cognitive aging in racial/ethnic minority populations, our knowledge in this area remain limited. The purpose of this symposium is, therefore, to examine various psychological, socio-cultural, and physical factors associated with cognitive aging among U.S. Chinese older adults, representing one of the biggest and fastest growing older minority populations nationally. Using longitudinal data from a population-based prospective cohort study, namely The Population Study of ChINese Elderly in Chicago (PINE) with a sample size of 3,157, this symposium presents findings from five research projects. Session 1 investigates the relationship between psychological well-being and change of cognitive function over four years. Session 2 and 3 examine the relationships between two socio-cultural factors and cognitive function. Specifically, session 2 investigates the associations between immigration-related factors and the incidence of cognitive impairment. Session 3 explores the relationship between cognitive function and Tai-Chi practice. Session 4 and 5 examine the relationships between two physical health indicators and cognitive aging. Specifically, session 4 examines the relationship between physical function and change of cognitive function over two years. Session 5 explores the association between body mass index and cognitive function decline over two years. Taken together, this symposium aims to further our knowledge of cognitive aging among ethnically/culturally diverse populations. The research findings will identify unique factors related to cognitive aging in older minority populations.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S602-S603
Author(s):  
Emma Zang ◽  
Yuan Zhang

Abstract Countries in East Asia have the largest aging population in the world. The consequences of aging largely depend on whether it is accompanied by a healthy, active, and high-quality life. This symposium aims to gain a better understanding of aging support and determinants of health in the contexts of two major East Asian countries - China and Japan. We will present new research using data from the Fukui Longitudinal Caregiver Study (FLCS) in Japan, and two most important aging surveys in China – the China Health and Retirement Longitudinal Study (CHARLS) and the Chinese Longitudinal Healthy Longevity Survey (CLHLS), addressing critical topics including retirement, family care, social mobility, and mortality. Song and Smith investigate the impact of hukou change on mental health in later life. Zang examines the effect of a man’s retirement on his wife’s mental and physical health in China. Zhang et al. explore the determinants of mortality in China by conducting a comprehensive analysis of life-course conditions, community characteristics, biological and physical functioning, and disease burden. Zeng et al. compare demographic, socioeconomic, behavioral characteristics and health phenotypes of centenarians in China and Italy. Wakui et al. focus on the emergence of compound caregiving and the relationship of caregiving status to burden, depression, and social support in Japan. The cross-national comparisons will be informative regarding aging in various contexts. We will discuss the potential for further investigations using population-based aging data from different countries.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S630-S630
Author(s):  
Chenxin Tan ◽  
Yun Zhou

Abstract Social participation is of great significance in healthy aging. While studies on social participation among Chinese elderly are growing, there is a lack of understanding the changes over time of the participation. Using datasets from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), this paper presents a comprehensive analysis on a decade’s trend of social participation among Chinese older adults. First, we use the method of Latent Class Analysis (LCA) to identify types of social participation; in this study, we concluded three types, no participation, the family-centered, and the society-oriented. Second, we examine the characteristics of the elderly by types of participation in terms of demographic, socioeconomic and health condition and analyze the changes in the characteristics over time. And third, we interpret the trend of social participation with broader social environment, or the fluctuant structural and institutional differences under the context of China’s unique social system. Our general conclusion is that while the overall level of participation holds relatively steady, there is a dynamic micro progress and complex mechanisms in this long period. In addition, although both the family-centered participants and the society-oriented possess broader scopes of social participation, the related attributes are different across time. This paper contributes to our knowledge of life of the elderly under the circumstances of fast aging process in China.


2020 ◽  
Vol 32 (2) ◽  
pp. 199-209
Author(s):  
Virginia Fernández-Fernández ◽  
Andrés Losada-Baltar ◽  
María Márquez-González ◽  
Teresa Paniagua-Granados ◽  
Carlos Vara-García ◽  
...  

ABSTRACTObjective:Although it is known that certain emotion regulation processes produce a buffering effect on the relationship between life events and well-being, this issue has been poorly studied in the elderly population. Thus, the aim of the present study is to test and confirm a comprehensive model of the impact that past life events have on older adults’ psychological distress, exploring the possible mediating roles of emotion regulation processes. These include rumination, experiential avoidance, and personal growth.Methods:In this cross-sectional study, 387 people over 60 years old residing in the community were assessed on life events, physical functioning, emotion regulation variables, psychological well-being, as well as symptoms of anxiety and depression.Results:The structural model tested achieved a satisfactory fit to the data, explaining 73% of the variance of older adults’ psychological distress. In addition, the main results suggest possible mediation effects of both the physical functioning and the emotional variables: rumination, experiential avoidance, and personal growth in the face of hardship.Conclusions:These findings confirm the importance of emotion regulation processes in the final stages of life. They reveal the various adaptive and maladaptive mechanisms that underlie the relationship between life events and psychological distress. The findings suggest – both in the explanatory models of psychological well-being and in psychotherapeutic interventions – the importance of emotion regulation in the elderly population’s health.


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