scholarly journals Food Insecurity and Geriatric Hospitalization

2019 ◽  
Vol 16 (13) ◽  
pp. 2294
Author(s):  
Rachel S. Bergmans ◽  
Briana Mezuk ◽  
Kara Zivin
Keyword(s):  
Older Adults ◽  
Best Practices ◽  
Food Insecurity ◽  
Short Form ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Increased Risk ◽  
Bidirectional Relationship ◽  
Longitudinal Associations ◽  
Retirement Study

Food insecurity (FI) has been associated with hospitalization, although the pathways underlying this relationship are poorly understood, in part due to the potential for a bidirectional relationship. This study aimed to determine associations of FI with concurrent and future hospitalization among older adults; mediation by depression and; whether hospitalization increased risk of FI. Participants came from the 2012 and 2014 waves of the Health and Retirement Study (HRS; n = 13,664). HRS is a prospective cohort representative of U.S. adults over the age of 50. Primary analyses included those who were not hospitalized in 2012 (n = 11,776). Not having enough money to buy necessary food or eating less than desired defined food insecurity. The Composite International Diagnostic Interview Short Form provided depression symptomology. Logistic and linear regression examined concurrent and longitudinal associations of FI in 2012 and 2014 with hospitalization in 2014. Path analysis tested mediation of FI with hospitalization frequency by depression symptomology. Finally, logistic regression examined whether hospitalization in 2012 was longitudinally associated with FI in 2014. FI was not associated with future hospitalization (odds ratio (OR) = 1.1; 95% confidence interval (CI) = 0.9–1.4), however; FI was associated with concurrent hospitalization status (OR = 1.4; 95% CI = 1.1–1.8). Depression symptomology explained 17.4% (95% CI = 2.8–32.0%) the association of FI with concurrent hospitalization frequency. Additionally, hospitalization was associated with becoming food insecure (OR = 1.5; 95% CI = 1.2–2.0). Findings may inform best practices for hospital discharge among older adults.

scholarly journals Depression as a Risk Factor for Physical Illness and Multimorbidity in a Cohort with No Prior Comorbidity: La Dépression Comme Facteur de Risque de Maladie Physique et de Multimorbidité Dans Une Cohorte Sans Comorbidité Antérieure

2020 ◽  
pp. 070674372097483
Author(s):  
Allanah Li ◽  
Laura C. Rosella ◽  
Paul Kurdyak ◽  
Walter P. Wodchis
Keyword(s):  
Short Form ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Physical Illness ◽  
Administrative Databases ◽  
Annual Household Income ◽  
Increased Risk ◽  
Nationally Representative ◽  
Regular Doctor

Objective: This study examines whether depression is associated with the development of physical illness and multimorbidity, after controlling for socioeconomic, behavioral, and other potential confounders. Methods: This is a retrospective cohort study in which adult respondents to three nationally representative population health surveys were linked to health administrative databases in Ontario, Canada, and followed for 10 years from survey index. Respondents with any of the study outcome conditions at baseline were excluded to create a final cohort of 29,838 participants. The main exposure of interest was depression, measured using the Composite International Diagnostic Interview–Short Form for Major Depression. We controlled for age, body mass index, marital status, immigrant status, annual household income, smoking, alcohol consumption, physical activity, health status, and having a regular doctor. The outcome measure was the development of physical illness over 10 years of follow-up, defined as 1 of 15 common chronic conditions using administrative data. Results: Among the 29,838 participants (15,259 [51%] female), 8% of females and 4% of males had depression at baseline. In this cohort with no comorbidities at baseline, even in the fully adjusted model, depression increased the risk of developing a first physical illness for females (hazard ratio [HR] 1.16; 95% CI, 1.07 to 1.26) and males (HR 1.20; 95% CI, 1.07 to 1.36) and increased the risk of developing a second physical illness for females (HR 1.16; 95% CI, 1.02 to 1.33) over 10 years of follow-up. Conclusions: For individuals with no prior comorbidities, depression is associated with a greater risk of developing subsequent physical illness and multimorbidity over time. Thus, depression identifies a population of people who may benefit from early identification, additional screening, and intervention. Further study needs to be done to determine whether interventions to manage and support people with depression can prevent or delay the increased risk of multimorbidity.

scholarly journals Shades of Blue and Gray: A Comparison of the Center for Epidemiologic Studies Depression Scale and the Composite International Diagnostic Interview for Assessment of Depression Syndrome in Later Life

2019 ◽  
Vol 60 (4) ◽  
pp. e242-e253 ◽  
Author(s):  
Linh Dang ◽  
Liming Dong ◽  
Briana Mezuk
Keyword(s):  
Short Form ◽  
Depression Scale ◽  
Composite International Diagnostic Interview ◽  
Later Life ◽  
Epidemiologic Studies ◽  
Diagnostic Interview ◽  
Psychiatric Research ◽  
And Gender ◽  
Ethnicity And Gender ◽  
Design And Methods

Abstract Background and Objectives Psychiatric research lacks the equivalent of a thermometer, that is, a tool that accurately measures mental disorder regardless of context. Instead, the psychometric properties of scales that purport to assess psychopathology must be continuously evaluated. To that end, this study evaluated the diagnostic agreement between the eight-item Center for Epidemiologic Studies Depression Scale (CESD-8) and the Composite International Diagnostic Interview—short form (CIDI-SF) in the Health and Retirement Study (HRS). Research Design and Methods Data come from 17,613 respondents aged >50 from the 2014 wave of the HRS. Kappa coefficients were used to assess the agreement between the 2 instruments on depression classification across a range of thresholds for identifying case status, including variation across subgroups defined by age, race/ethnicity, and gender. Results The point prevalence of depression syndrome estimated by the CESD was higher than that estimated by the CIDI-SF (CESD: 9.9%–19.5% depending on the cutoff applied to the CESD vs CIDI-SF: 7.7%). Assuming CIDI-SF as the gold standard, the CESD yielded a sensitivity of 56.2%–70.2% and specificity of 84.7%–94.0% across the range of cutoffs. The agreement on depression classification was weak (κ = 0.32–0.44). Discussion and Implications Depression cases identified by the CESD have poor agreement with those identified by the CIDI-SF. Conceptually, psychological distress as measured by the CESD is not interchangeable with depression syndrome as measured by the CIDI-SF. Population estimates of depression among older adults based on the CESD should be interpreted with caution.

scholarly journals Physical Functioning Decline and Mortality in Older Adults With Multimorbidity: Joint Modeling of Longitudinal and Survival Data

2018 ◽  
Vol 74 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Melissa Y Wei ◽  
Mohammed U Kabeto ◽  
Andrzej T Galecki ◽  
Kenneth M Langa
Keyword(s):  
Older Adults ◽  
Mortality Risk ◽  
Physical Functioning ◽  
Survival Data ◽  
Short Form ◽  
Joint Modeling ◽  
Full Spectrum ◽  
Increased Risk ◽  
The Impact

Abstract Background Multimorbidity is common among older adults and strongly associated with physical functioning decline and increased mortality. However, the full spectrum of direct and indirect effects of multimorbidity on physical functioning and survival has not been quantified. We aimed to determine the longitudinal relationship of multimorbidity on physical functioning and quantify the impact of multimorbidity and multimorbidity-attributed changes in physical functioning on mortality risk. Methods The Health and Retirement Study (HRS) is a nationally representative population-based prospective cohort of adults aged 51 or older. In 2000, participants were interviewed about physician-diagnosed chronic conditions, from which their multimorbidity-weighted index (MWI) was computed. Between 2000 and 2011, participants reported their current physical functioning using a modified Short Form-36. With MWI as a time-varying exposure, we jointly modeled its associations with physical functioning and survival. Results The final sample included 74,037 observations from 18,174 participants. At baseline, participants had a weighted mean MWI of 4.6 ± 4.2 (range 0–36.8). During follow-up, physical functioning declined: −1.72 (95% confidence interval [CI] −1.77, −1.67, p < .001) HRS physical functioning units per point MWI in adjusted models. Over follow-up, 6,362 (34%) participants died. Mortality risk increased 8% (hazard ratio 1.08, 95% CI 1.07–1.08, p < .001) per point MWI in adjusted models. Across all population subgroups, MWI was associated with greater physical functioning decline and mortality risk. Conclusions Multimorbidity and its associated decline in physical functioning were significantly associated with increased mortality. These associations can be predicted with an easily interpreted and applied multimorbidity index that can better identify and target adults at increased risk for disability and death.

scholarly journals The Moderating Effects of Coping Strategies on Major Depression in the General Population

2002 ◽  
Vol 47 (2) ◽  
pp. 167-173 ◽  
Author(s):  
JianLi Wang ◽  
Scott B Pat ten
Keyword(s):  
Major Depression ◽  
General Population ◽  
Coping Strategies ◽  
Life Stress ◽  
Depressive Disorders ◽  
Short Form ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
World Health ◽  
Moderating Effects

Objectives: To evaluate the moderating effects of various coping strategies on the as sociation between stressors and the prevalence of major depression in the general population. Methods: Subjects from the Alberta buy- incomponent of the 1994 –1995 National Population Health Survey (NPHS) were included in the analysis ( n = 1039). Each subject was asked 8 questions about coping strategies that dealt with unexpected stress from family problems and personal crises. Major depression was measured using the World Health Organization's (WHO) Composite International Diagnostic Interview-Short Form (CIDI- SF) for major depression. The im pacts of coping strategies in relation to psychological stres sors on the prevalence of major depression were de ter mined by examining interactions between coping and life stress on major depression using logistic regression modelling. Results: No robust impact of coping strategies in relation to various categories of stress evaluated in the NPHS was observed. There was evidence that the use of “pray and seek religious help” and “talks to others about the situations” as coping strategies by women moderated the risk of major depression in the presence of financial stress and relation ship stress (with a partner). Using emotional expression as a coping strategy by women might de crease the risk of major depression in the presence of 1 or more re cent life events, personal stress, relationship stress (with a partner), and environmental stress. Conclusion: Different coping strategies may have a differential impact on the prevalence of major depression in specific circumstances. These findings may be important both to prevent and to treat depressive disorders.

scholarly journals Comorbid Depression among Untreated Illicit Opiate Users: Results from a Multisite Canadian Study

2005 ◽  
Vol 50 (9) ◽  
pp. 512-518 ◽  
Author(s):  
T Cameron Wild ◽  
Nady el-Guebaly ◽  
Benedickt Fischer ◽  
Suzanne Brissette ◽  
Serge Brochu ◽  
...  
Keyword(s):  
Major Depression ◽  
Drug Use ◽  
Service Use ◽  
Short Form ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Quebec City ◽  
Comorbid Depression ◽  
Chi Square ◽  
Targeted Interventions

Objectives: This study aimed to describe patterns of major depression (MDD) in a cohort of untreated illicit opiate users recruited from 5 Canadian urban centres, identify sociodemographic characteristics of opiate users that predict MDD, and determine whether opiate users suffering from depression exhibit different drug use patterns than do participants without depression. Method: Baseline data were collected from 679 untreated opiate users in Vancouver, Edmonton, Toronto, Montreal, and Quebec City. Using the Composite International Diagnostic Interview Short Form for Major Depression, we assessed sociodemographics, drug use, health status, health service use, and depression. We examined depression rates across study sites; logistic regression analyses predicted MDD from demographic information and city. Chi-square analyses were used to compare injection drug use and cocaine or crack use among participants with and without depression. Results: Almost one-half (49.3%) of the sample met the cut-off score for MDD. Being female, white, and living outside Vancouver independently predicted MDD. Opiate users suffering from depression were more likely than users without depression to share injection equipment and paraphernalia and were also more likely to use cocaine ( Ps < 0.05). Conclusions: Comorbid depression is common among untreated opiate users across Canada; targeted interventions are needed for this population.

Reliability, validity and factor structure of the GHQ-28 used among elderly Iranians

2006 ◽  
Vol 19 (4) ◽  
pp. 623-634 ◽  
Author(s):  
Seyed Kazem Malakouti ◽  
Paridokht Fatollahi ◽  
Arash Mirabzadeh ◽  
Taher Zandi
Keyword(s):  
Urban Areas ◽  
Roc Analysis ◽  
Short Form ◽  
General Health Questionnaire ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Face Validity ◽  
Receiver Operating Curve ◽  
Elderly Subjects ◽  
Cutoff Score

Background: The object of this study was to develop an Iranian version of the General Health Questionnaire-28 (GHQ-28) for use with elderly subjects.Methods: The GHQ-28 Farsi version was evaluated for face validity among 204 elderly subjects aged 59 years or older, chosen randomly from residents of Tehran. The Composite International Diagnostic Interview (CIDI) was used to establish a gold standard diagnosis of mental disorders.Results: The GHQ-28 was an internally consistent measure. Cronbach's α, split-half coefficients and test-retest reliability were 0.9, 0.89 and 0.58 respectively. Four factors were extracted using factor analysis: “depression,” “psychosocial activity,” “anxiety,” and “somatic.” Using receiver operating curve (ROC) analysis, the optimum cutoff score for the GHQ-28 in this group was 19/20 (sensitivity 0.83, specificity 0.76). Using a loading of 0.6 or greater, a short form of the instrument (GHQ-15) (α = 0.9) was derived and correlated well with the longer form of the scale (r = 0.97). Using ROC analysis, the optimum cutoff score was 10/11 (sensitivity 0.83, specificity 0.69).Conclusions: The short and long forms of the GHQ-28 are suitable screening instruments for elderly Iranian residents, particularly those living in urban areas.

scholarly journals Disentangling and Quantifying Mechanisms of Increased Fall Risk Among Older Adults With Depression

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 266-266
Author(s):  
Matthew Lohman ◽  
Nicholas Resciniti ◽  
Anwar Merchant
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Relative Strength ◽  
Drug Study ◽  
Injurious Falls ◽  
Mediating Mechanisms ◽  
Causal Mediation Analysis ◽  
Significant Mediator

Abstract Background: Older adults with depression are up to four times more likely to fall, yet the mechanisms by which depression increases fall risk are unclear. This study sought to quantify and compare the relative strength of selected mechanisms mediating the association between depression and falls. Methods: We used longitudinal linked data (2006 – 2010) from the Health and Retirement Study and Prescription Drug Study. The analytic sample included non-institutionalized adults age &gt; 65 with data on physical functioning and medication use (n=3,565). Falls and injurious falls over the past two years were self-reported outcomes. Depression was measured using the Composite International Diagnostic Interview (CIDI). We used causal mediation analysis to estimate the total and direct associations between depression and falls and compared strength of three potential mediating mechanisms – frailty, cognition, and antidepressant (AD) use. Results: Of 190 participants reporting depression in 2006, 85 (44.7%) fell and 30 (15.8%) were injured from a fall between 2008 and 2010. Depressed individuals were 92% more likely to fall compared to non-depressed (OR=1.92, p&lt;.01). We found significant indirect effects of AD use (indirect OR=1.17, p&lt;.01) and frailty (OR=1.12, p=.013) representing 19% and 13% of the total effect of depression on falls, respectively. Cognition was not a significant mediator. Results were similar for falls leading to injury. Discussion: Results suggest that AD use and frailty explain a significant portion of the elevated risk for falls among depressed individuals. Identification of these and other mechanisms may inform clinical treatment decisions for older adults with depression.

scholarly journals Myocardial infarction and generalised anxiety disorder: 10-year follow-up

2012 ◽  
Vol 200 (4) ◽  
pp. 324-329 ◽  
Author(s):  
Annelieke M. Roest ◽  
Marij Zuidersma ◽  
Peter de Jonge
Keyword(s):  
Myocardial Infarction ◽  
Anxiety Disorder ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Adverse Outcomes ◽  
Generalised Anxiety Disorder ◽  
Cardiovascular Prognosis ◽  
Increased Risk ◽  
And Gender

BackgroundFew studies have addressed the relationship between generalised anxiety disorder and cardiovascular prognosis using a diagnostic interview.AimsTo assess the association between generalised anxiety disorder and adverse outcomes in patients with myocardial infarction.MethodPatients with acute myocardial infarction (n = 438) were recruited between 1997 and 2000 and were followed up until 2007. Current generalised anxiety disorder and post-myocardial infarction depression were assessed with the Composite International Diagnostic Interview. The end-point consisted of all-cause mortality and cardiovascular-related readmissions.ResultsDuring the follow-up period, 198 patients had an adverse event. Generalised anxiety disorder was associated with an increased rate of adverse events after adjustment for age and gender (hazard ratio: 1.94; 95% confidence interval: 1.14–3.30; P = 0.01). Additional adjustment for measures of cardiac disease severity and depression did not change the results.ConclusionsGeneralised anxiety disorder was associated with an almost twofold increased risk of adverse outcomes independent demographic and clinical variables and depression.

scholarly journals War-related psychological stressors and risk of psychological disorders in Australian veterans of the 1991 Gulf War

2004 ◽  
Vol 185 (2) ◽  
pp. 116-126 ◽  
Author(s):  
Jillian F. Ikin ◽  
Malcolm R. Sim ◽  
Mark C. Creamer ◽  
Andrew B. Forbes ◽  
Dean P. McKenzie ◽  
...  
Keyword(s):  
Comparison Group ◽  
Psychological Disorders ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Gulf War ◽  
Post Traumatic Stress ◽  
War Veterans ◽  
Gulf War Veterans ◽  
Psychological Stressors ◽  
Increased Risk

BackgroundQuestions remain about the long-term health impacts of the 1991 Gulf War on its veterans.AimsTo measure psychological disorders in Australian Gulf War veterans and a military comparison group and to explore any association with exposure to Gulf War-related psychological stressors.MethodPrevalences of DSM–IV psychological disorders were measured using the Composite International Diagnostic Interview. Gulf War-related psychological stressors were measured using a service experience questionnaire.ResultsA total of 31% of male Gulf War veterans and 21% of the comparison group met criteria for a DSM–IVdisorder first present in the post-Gulf War period. The veterans were at greater risk of developing post-Gulf War anxiety disorders including post-traumatic stress disorder, affective disorders and substance use disorders. The prevalence of such disorders remained elevated a decade after deployment. The findings can be explained partly as a ‘war-deployment effect‘. There was a strong dose–response relationship between psychological disorders and number of reported Gulf War-related psychological stressors.ConclusionsService in the 1991 Gulf War is associated with increased risk of psychological disorders and these are related to stressful experiences.

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