Latent class growth modeling of depression and anxiety in older adults: an 8-year follow-up of a population-based study

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.

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A Group-based Dual Trajectory of Depression and Anxiety in Older Adults: An 8-year Follow-up of Population-based Study

10.21203/rs.3.rs-263107/v1 ◽

2021 ◽

Author(s):

Yanzhao Cheng ◽

Lilian Thorpe ◽

Rasel Kabir ◽

Hyun Ja Lim

Keyword(s):

Older Adults ◽

Panel Study ◽

Policy Decision ◽

The Elderly ◽

Population Based ◽

Decision Makers ◽

Depression And Anxiety ◽

Population Based Study ◽

Health Policy Decision

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.

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

The International Journal of Aging and Human Development ◽

10.1177/0091415020944405 ◽

2020 ◽

pp. 009141502094440

Author(s):

Hyun Ja Lim ◽

Yanzhao Cheng ◽

Rasel Kabir ◽

Lilian Thorpe

Keyword(s):

Older Adults ◽

Latent Class ◽

Growth Models ◽

Policy Decision ◽

Well Being ◽

The Elderly ◽

Population Based ◽

Depression Group ◽

Health Policy Decision ◽

Group Members

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.

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Mental Health and Older Adults

Encyclopedia of Social Work ◽

10.1093/acrefore/9780199975839.013.1355 ◽

2020 ◽

Author(s):

Hee Yun Lee ◽

William Hasenbein ◽

Priscilla Gibson

Keyword(s):

Mental Health ◽

Older Adults ◽

Old Age ◽

Social Isolation ◽

Older Adult ◽

Adult Population ◽

Depression And Anxiety ◽

Health Issues ◽

Mental Health Issues ◽

Older Adult Population

As the older adult population continues to grow at a rapid rate, with an estimated 2.1 billion older adults in 2050, social welfare researchers are determined to fill the shortage of gerontological social workers and structural lag to best serve the baby boomers who are expected to need different services than previous generations. Mental illness impacts over 20% of older adults in the world and the United States. The major mental health issues in older adults include depression, anxiety, loneliness, and social isolation. Depression is considered one of the most common mental health issues among this population; however, the prevalence could be underestimated due to older adults linking relevant symptoms to other causes, such as old age, instead of as possible depression. Like depression, anxiety symptoms are often mistaken as results of aging. It is also difficult for providers to diagnose anxiety in this population due to anxiety frequently being coupled with other illnesses and the psychological stress that comes with old age. Because the presence of loneliness or social isolation can manifest depression and anxiety symptoms in older adults, it is also difficult to separate these two issues. With the anticipated increase of the older adult population within the next few years, measurement tools have been created to assess depression and anxiety specifically for older adults. In addition to adapting assessment tools, interventions tailored to older adults are essential to ensure treatment coherence, even though medications are the go-to treatment option.

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Prevalence and Correlates of Individuals Screening Positive for Depression and Anxiety on the PHQ-4 in the German General Population: Findings from the Nationally Representative German Socio-Economic Panel (GSOEP)

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17217865 ◽

2020 ◽

Vol 17 (21) ◽

pp. 7865

Author(s):

André Hajek ◽

Hans-Helmut König

Keyword(s):

Chronic Diseases ◽

Adult Population ◽

Population Based ◽

Depression And Anxiety ◽

Cross Sectional ◽

Self Rated Health ◽

Patient Health ◽

General Adult Population ◽

Nationally Representative ◽

Probable Depression

Our aim was to estimate the prevalence and correlates of probable depression and anxiety in the general adult population in Germany. Repeated cross-sectional data (i.e., cross-sectional data observed at different time points: year 2012 and year 2014) were derived from the innovation sample of the German Socio-Economic Panel, a population-based study of German households. The validated Patient Health Questionnaire (PHQ-4) was used to measure probable depression and anxiety. In the analytical sample, n equaled 2952 individuals. According to the PHQ-4 cut-off values, 10.4% of the individuals had probable depression and 9.8% of the individuals had probable anxiety. Regressions revealed that the likelihood of depression was positively associated with lower age (OR: 0.98 (95% CI: 0.98–0.99)), being unmarried (and living together with spouse) (OR: 0.75 (0.58–0.98)), worse self-rated health (OR: 1.99 (1.73–2.27)), and more chronic diseases (OR: 1.18 (1.07–1.31)). Furthermore, the likelihood of anxiety was positively associated with being female (OR: 1.36 (95% CI: 1.04–1.76)), lower age (OR: 0.98 (95% CI: 0.97–0.99)), low education (medium education, OR: 0.69 (0.50–0.95)), worse self-rated health (OR: 2.00 (1.74–2.30)), and more chronic diseases (OR: 1.15 (1.03–1.27)). The magnitude of depression and anxiety was highlighted. Clinicians should be aware of the factors associated with probable depression and anxiety.

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Multimorbidity patterns and their relationship to mortality in the US older adult population

PLoS ONE ◽

10.1371/journal.pone.0245053 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245053

Author(s):

D. Diane Zheng ◽

David A. Loewenstein ◽

Sharon L. Christ ◽

Daniel J. Feaster ◽

Byron L. Lam ◽

...

Keyword(s):

Older Adults ◽

Older Adult ◽

Chronic Conditions ◽

Latent Class ◽

Adult Population ◽

Cognitively Impaired ◽

Cross Sectional ◽

Respiratory Condition ◽

The Us ◽

Older Adult Population

Background Understanding patterns of multimorbidity in the US older adult population and their relationship with mortality is important for reducing healthcare utilization and improving health. Previous investigations measured multimorbidity as counts of conditions rather than specific combination of conditions. Methods This cross-sectional study with longitudinal mortality follow-up employed latent class analysis (LCA) to develop clinically meaningful subgroups of participants aged 50 and older with different combinations of 13 chronic conditions from the National Health Interview Survey 2002–2014. Mortality linkage with National Death Index was performed through December 2015 for 166,126 participants. Survival analyses were conducted to assess the relationships between LCA classes and all-cause mortality and cause specific mortalities. Results LCA identified five multimorbidity groups with primary characteristics: “healthy” (51.5%), “age-associated chronic conditions” (33.6%), “respiratory conditions” (7.3%), “cognitively impaired” (4.3%) and “complex cardiometabolic” (3.2%). Covariate-adjusted survival analysis indicated “complex cardiometabolic” class had the highest mortality with a Hazard Ratio (HR) of 5.30, 99.5% CI [4.52, 6.22]; followed by “cognitively impaired” class (3.34 [2.93, 3.81]); “respiratory condition” class (2.14 [1.87, 2.46]); and “age-associated chronic conditions” class (1.81 [1.66, 1.98]). Patterns of multimorbidity classes were strongly associated with the primary underlying cause of death. The “cognitively impaired” class reported similar number of conditions compared to the “respiratory condition” class but had significantly higher mortality (3.8 vs 3.7 conditions, HR = 1.56 [1.32, 1.85]). Conclusion We demonstrated that LCA method is effective in classifying clinically meaningful multimorbidity subgroup. Specific combinations of conditions including cognitive impairment and depressive symptoms have a substantial detrimental impact on the mortality of older adults. The numbers of chronic conditions experienced by older adults is not always proportional to mortality risk. Our findings provide valuable information for identifying high risk older adults with multimorbidity to facilitate early intervention to treat chronic conditions and reduce mortality.

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Examining Health Service Rates Among Residents of Retirement Homes and Other Older Adult Populations in Ontario, Canada: A Population-Based Cohort Study

10.1101/2021.09.17.21263742 ◽

2021 ◽

Author(s):

Derek R Manis ◽

Jeffrey W Poss ◽

Aaron Jones ◽

Paula A Rochon ◽

Susan E Bronskill ◽

...

Keyword(s):

Older Adults ◽

Emergency Department ◽

Cohort Study ◽

Health Service ◽

Older Adult ◽

Adult Population ◽

Population Based ◽

Emergency Department Visits ◽

Service Rates ◽

Older Adult Population

Background: There are no standardized reporting systems or assessments specific to residents of retirement homes in North America. As such, little is known about these older adults as a distinct population. We created a new population-level cohort of residents of retirement homes and examined their health service rates relative to other older adult populations. Methods: We conducted a population-based retrospective cohort study in Ontario, Canada in 2018. The postal codes of all licensed retirement homes (n = 757) were classified and linked to individual-level health system administrative data to derive a cohort of residents of retirement homes. A generalized linear model with a gamma distribution and log link function was used to model rates of emergency department visits, hospitalizations, alternate levels of care (ALC) days, primary care visits, and specialist physician visits. Results: Residents of retirement homes comprised two percent of the older adult population in Ontario (n = 54,773; 2.3%). After adjustment for relevant characteristics, residents of retirement homes had 10 times the rate of emergency department visits (Relative Rate [RR] 10.02, 95% Confidence Interval [CI] 9.83 to 10.21), 20 times the rate of hospitalizations (RR 20.43, 95% CI 20.08 to 20.78), and 44 times the rate ALC days (RR 43.91, 95% CI 43.28 to 44.54) compared to community-dwelling older adults. Interpretation: Residents of retirement homes are a distinct older adult population with high rates of hospital-based care. Our findings contribute to policy debates about the provision of health care in privately operated congregate care settings for older adults.

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Frailty transitions and cognitive function among South Korean older adults

Scientific Reports ◽

10.1038/s41598-021-90125-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Fatima Nari ◽

Bich Na Jang ◽

Hin Moi Youn ◽

Wonjeong Jeong ◽

Sung-In Jang ◽

...

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Daily Living ◽

Mini Mental State Examination ◽

Adult Population ◽

Geriatric Syndrome ◽

South Korean ◽

Adl Disability ◽

Older Adult Population ◽

State Examination

AbstractFrailty is considered a multidimensional geriatric syndrome, manifested by the accumulation of age-associated deficits. The consequences of frailty transitions are still understudied. This study evaluated the influence of frailty transitions on cognitive function in the older adult population. We used data derived from the Korean Longitudinal Study of Aging (KLoSA) (2008–2018) on older adults aged ≥ 65 years. Frailty was assessed using a validated Korean frailty measure known as the frailty instrument (FI), and cognitive function was measured using the Korean version of the Mini-Mental State Examination (K-MMSE). Transitions in frailty and their relationship with cognitive function were investigated using lagged generalized estimating equations (GEE), t-tests, and ANOVA. Respondents who experienced frailty transitions (those with ameliorating frailty), those who developed frailty, and whose frailty remained constant, were more likely to have a lower cognitive function than those who were consistently non-frail. Older age, activities of daily living (ADL) disability, and instrumental ADL disability were more negatively associated with declining cognitive function, especially in the “frail → frail” group. Changes in all individual components of the frailty instrument were significantly associated with impaired cognitive function. The results suggest an association between frailty transitions and cognitive impairment. Over a 2-year span, the remaining frail individuals had the highest rate of cognitive decline in men, while the change from non-frail to frail state in women was significantly associated with the lowest cognitive function values. We recommend early interventions and prevention strategies in older adults to help ameliorate or slow down both frailty and cognitive function decline.

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The Brief Odor Detection Test (B-ODT) for Very Early Diagnosis of Cognitive Decline: A Preliminary Study

Brain Impairment ◽

10.1017/brimp.2017.7 ◽

2017 ◽

Vol 18 (2) ◽

pp. 197-210

Author(s):

Dimitra Savvoulidou ◽

Efthymia Totikidou ◽

Chariklia Varvesiotou ◽

Magda Iakovidou ◽

Ourania Sfakianaki ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Cognitive Decline ◽

Adult Population ◽

Detection Threshold ◽

Community Dwelling ◽

Odor Detection ◽

Olfactory Impairment ◽

Older Adult Population ◽

Community Dwelling Older Adults

Olfactory impairment in older adults is associated with cognitive decline. This study describes the development of a Brief Odor Detection Test (B-ODT), and its pilot administration in community-dwelling older adults. The study aimed at examining whether the test could differentiate older adults with very mild cognitive impairment from their cognitively healthy counterparts. The sample consisted of 34 older adults (22 women), aged from 65 to 87 years. Participants were divided into two groups according to their general cognitive functioning. Odor detection was measured via vanillin solutions at the following concentrations: 150 mg/L, 30 mg/L, 15 mg/L, 3 mg/L, and .03 mg/L. The first condition of the test involved a scale administration of vanillin solutions. The second condition examined the change in air odour and it required vanillin solution of 30 mg/L and a metric ruler of 30 cm. The examiner had to place the solution at a specific distance point from each nostril. Odour identification sensitivity was secondarily measured. The results showed statistically significant differences in odour detection threshold between the two groups. In the unirhinal testing, left nostril differences of the two groups were definite. Hence, the B-ODT seems a promising instrument for very early cognitive impairment screening in older adult population.

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COLAEVA: Visual Analytics and Data Mining Web-Based Tool for Virtual Coaching of Older Adult Populations

Sensors ◽

10.3390/s21237991 ◽

2021 ◽

Vol 21 (23) ◽

pp. 7991

Author(s):

Jon Kerexeta Sarriegi ◽

Andoni Beristain Iraola ◽

Roberto Álvarez Sánchez ◽

Manuel Graña ◽

Kristin May Rebescher ◽

...

Keyword(s):

Older Adults ◽

Older Adult ◽

Visual Analytics ◽

Web Application ◽

Adult Population ◽

Research Area ◽

Web Based ◽

Virtual Coaching ◽

Evolution Analysis ◽

Older Adult Population

The global population is aging in an unprecedented manner and the challenges for improving the lives of older adults are currently both a strong priority in the political and healthcare arena. In this sense, preventive measures and telemedicine have the potential to play an important role in improving the number of healthy years older adults may experience and virtual coaching is a promising research area to support this process. This paper presents COLAEVA, an interactive web application for older adult population clustering and evolution analysis. Its objective is to support caregivers in the design, validation and refinement of coaching plans adapted to specific population groups. COLAEVA enables coaching caregivers to interactively group similar older adults based on preliminary assessment data, using AI features, and to evaluate the influence of coaching plans once the final assessment is carried out for a baseline comparison. To evaluate COLAEVA, a usability test was carried out with 9 test participants obtaining an average SUS score of 71.1. Moreover, COLAEVA is available online to use and explore.

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Peritraumatic Stress From a Disaster Increases Risk for Onset of Chronic Diseases Among Older Adults

Innovation in Aging ◽

10.1093/geroni/igab052 ◽

2022 ◽

Vol 6 (1) ◽

Author(s):

Laura P Sands ◽

Quyen Do ◽

Pang Du ◽

Rachel Pruchno

Keyword(s):

Older Adults ◽

Physical Health ◽

Lung Disease ◽

Chronic Diseases ◽

Hospital Admissions ◽

Panel Study ◽

Hurricane Sandy ◽

The Impact ◽

Disaster Exposure ◽

New Onset

Abstract Background and Objectives Our understanding of the impact of disaster exposure on the physical health of older adults is largely based on hospital admissions for acute illnesses in the weeks following a disaster. Studies of longer-term outcomes have centered primarily on mental health. Missing have been studies examining whether exposure to disaster increases the risk for the onset of chronic diseases. We examined the extent to which 2 indicators of disaster exposure (geographic exposure and peritraumatic stress) were associated with new onset of cardiovascular disease, diabetes, arthritis, and lung disease to improve our understanding of the long-term physical health consequences of disaster exposure. Research Design and Methods We linked self-reported data collected prior to and following Hurricane Sandy from a longitudinal panel study with Medicare data to assess time to new onset of chronic diseases in the 4 years after the hurricane. Results We found that older adults who reported high levels of peritraumatic stress from Hurricane Sandy had more than twice the risk of experiencing a new diagnosis of lung disease, diabetes, and arthritis in the 4 years after the hurricane compared to older adults who did not experience high levels of peritraumatic stress. Geographic proximity to the hurricane was not associated with these outcomes. Analyses controlled for known risk factors for the onset of chronic diseases, including demographic, psychosocial, and health risks. Discussion and Implications Findings reveal that physical health effects of disaster-related peritraumatic stress extend beyond the weeks and months after a disaster and include new onset of chronic diseases that are associated with loss of functioning and early mortality.

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