Different patterns of alcohol consumption and the incidence and persistence of depressive and anxiety symptoms among older adults in Ireland: A prospective community-based study

Psychache status and associated contributing factors among the Hakka elderly in Fujian, China

BACKGROUND

Little is known about the state of psychological distress of the elderly in China, and research on specific subgroups such as Hakka older adults is almost lacking. This study investigates psychache and associated factors among Hakka elderly in Fujian, China.

METHODS

The data analysed in this study were derived from China's Health-Related Quality of Life Survey for Older Adults 2018. The Chinese version of the Psychache Scale (PAS) was used to assess the frequency and intensity of psychache in Hakka older adults. Generalized linear regression analysis was conducted to identify the main socio-demographic factors associated with psychache overall and its frequency and intensity.

RESULTS

A total of 1,262 older adults participated, with mean scores of 18.27 ± 6.88 for total PAS, 12.50 ± 4.79 for PAS-Frequency and 5.77 ± 2.34 for PAS-Intensity. On average, females scored higher than males on PAS-Frequency (β = 0.84, 95% CI = 0.34, 1.35) and PAS-Intensity (β = 0.48, 95% CI = 0.22, 0.73). Older adults currently living in towns (β = -2.18, 95% CI = -2.81, -1.54), with their spouse only (β = -3.71, 95% CI = -4.77, -2.65), or with children (β = -3.24, 95% CI = -4.26, -2.22) were more likely to score lower on PAS-Frequency. Conversely, older adults who were regular sleepers (β = -1.19, 95% CI =-1.49, -0.88) or lived with their spouse only (β = -1.25, 95% CI = -1.78, -0.72) were more likely to score lower on PAS-Intensity.

CONCLUSION

Among Hakka elderly, we found a higher frequency and greater intensity of psychache in females, those with poor health status, irregular sleepers, rural residents, solo dwellers, those with below CNY 10,000 in personal savings, and the medically uninsured. The study's findings indicate that policymakers should give more attention to the susceptible population and implement practical interventions to reduce their psychological burden.

Bidirectional associations between alcohol drinking and depressive symptom scores among US older adults

BACKGROUND

This study examines the bidirectional associations between alcohol drinking and depression in which low to moderate alcohol drinking may reduce the risk of depression, while the occurrence of depression may increase the amount of alcohol drinking as a coping strategy.

METHOD

Data for the community-dwelling older adults from the Medicare Current Beneficiary Survey (MCBS) 2016 to 2019 were analyzed using random intercept cross-lagged panel models to explore the within-individual causal associations for males and females separately. Socioeconomic status (SES), smoking and comorbidities were adjusted in the models.

RESULTS

Among 3388 older adults with three measures for the number of alcohol drinks and Patient Health Questionnaire (PHQ) depression scores, a prior increase in the number of drinks was related to a moderate non-significant decrease in PHQ scores in the follow-up, but a previous increase in the PHQ scores was significantly associated with a decrease in the number of drinks at the follow-up visit in the adjusted models (regression coefficient = -0.144, p = 0.017 for males; and coefficient = -0.11, p < 0.001 for females).

CONCLUSION

Prior depression may lead to reduced drinking in the follow up visits, but no bidirectional association was found among US older adults.

The Effects of a Healthy Lifestyle on Depressive Symptoms in Older Chinese Adults: The Mediating Role of Psychological Resilience

Objectives This study aimed to validate the interrelationships and potential pathways of influence between healthy lifestyles, psychological resilience, and depressive symptoms in the Chinese elderly population. Methods We utilized data from the Chinese Elderly Health Influential Factors Tracking Survey 2018 and included 9448 samples for the study after screening according to the qualifying conditions. The interrelationships among healthy lifestyles, psychological resilience and depressive symptoms were analyzed using stepwise regression, and the robustness of mediation effects was assessed using Sobel and Bootstrap test. Results Among Chinese older adults, healthy lifestyles were negatively associated with depressive symptoms (β = -0.310, 95% CI: -0.405, -0.215), positively associated with psychological resilience (β = 0.137, 95% CI:0.071, 0.023), and psychological resilience was negatively associated with depressive symptoms (β = -1.014, 95% CI: -1.037, -0.990). Conclusions Psychological resilience partially mediated the association between healthy lifestyles and depressive symptoms, with the mediating effect accounting for 44.8% of the total effect. Our study contributes to the understanding of the relationship between healthy lifestyles and depressive symptoms in the elderly population and emphasizes the important role of psychological resilience. It is recommended that the government and policymakers improve depressive symptoms among older adults through comprehensive measures such as promoting healthy lifestyles and education, providing psychological support services, and creating a favorable environment.

Gender-specific characteristics of alcohol use in community-dwelling older adults in Belgium

OBJECTIVES

Gender has been identified as an important social determinant for health. This study investigates gender-specific characteristics for alcohol use (AU) among community-dwelling older adults.

METHODS

This is a retrospective cross-sectional study in 1.406 community-dwelling older adults. We used standardized questionnaires to collect self-reported data on alcohol use behavior, mental health, drinking motives and resilience by using, respectively, the Alcohol Use Identification Test (AUDIT), the Brief Symptom Inventory (BSI), the Drinking Motives Questionnaire (DMQ), and the Connor-Davidson Resilience Scale (CD-RISC). Multiple linear regression was used to identify the joint contribution of those factors on AU. Hierarchical regression was used to investigate the influence of the interaction between gender and those factors on AU.

RESULTS

Linear regression analyses showed different associations with AU in men and women. Hierarchical regression analyses showed that gender presented a two-way interaction effect with enhancement and anxiety variables related to AU.

CONCLUSIONS

Different characteristics were found as predictors for AU among older men and women.

CLINICAL IMPLICATIONS

Clinicians and health-care providers should be aware of these differences in order to provide tailored screening and intervention programs to reduce AU in older adults.

Resilience, depression and anxiety and hazardous alcohol use behaviour among community dwelling older adults

INTRODUCTION

We examined the psychometric properties of the CD-RISC, including factor structure. Secondly, we examined if resilience factors moderate the association between negative affect and hazardous alcohol use.

METHOD

The sample population consisted of 1,368 community-dwelling older adults. We used standardized questionnaires to collect self-reported data on alcohol use behaviour, depression and anxiety and resilience by using respectively the Alcohol Use Identification Test (AUDIT), the Brief Symptom Inventory (BSI) and the Connor-Davidson Resilience Scale (CD-RISC).

RESULTS

Of the total sample (N 1.368), 80.1% reported using alcohol. The total sample and the drinking sample reported, respectively, a mean of 65.75 (SD 15.40) and 65.79 (SD 15.90) on the CD-RISC. Concerning the CD-RISC, exploratory factor analysis presents four factors of which three with a good reliability. Moderation analyses reflects that older adults with higher levels of resilient characteristics didn't report an association between negative affect and hazardous drinking. Alternatively, low resilient older adults did report an positive and significant association between negative affect and hazardous drinking.

CONCLUSION

The CD-RISC appeared to be a reliable instrument, containing three factors. In our sample, high resilience moderated the association between negative affect and hazardous drinking and may serve as a buffer against hazardous drinking.

Development and validation using NHANES data of a predictive model for depression risk in myocardial infarction survivors

Background

Depression after myocardial infarction (MI) is associated with poor prognosis. This study aimed to develop and validate a nomogram to predict the risk of depression in patients with MI.

Methods

This retrospective study included 1615 survivors of MI aged >20 years who were selected from the 2005–2018 National Health and Nutrition Examination Survey database. The 899 subjects from the 2005–2012 survey comprised the development group, and the remaining 716 subjects comprised the validation group. Univariate and multivariate analyses identified variables significantly associated with depression. The least absolute shrinkage and selection operator (LASSO) binomial regression model was used to select the best predictive variables.

Results

A full predictive model and a simplified model were developed using multivariate analysis and LASSO binomial regression results, respectively, and validated using data from the validation group. The receiver operator characteristic curve and Hosmer–Lemeshow goodness of fit test were used to assess the nomogram's performance. The full nomogram model included 8 items: age, BMI, smoking, drinking, diabetes, exercise, insomnia, and PIR. The area under the curve for the development group was 0.799 and for the validation group was 0.731, indicating that our model has good stability and predictive accuracy. The goodness of fit test showed a good model calibration for both groups. The simplified model includes age, smoking, PIR, and insomnia. The AUC of the simplified model was 0.772 and 0.711 in the development and validation groups, respectively, indicating that the simplified model still possessed good predictive accuracy.

Conclusion

Our nomogram helped assess the individual probability of depression after MI and can be used as a complement to existing depression screening scales to help physicians make better treatment decisions.

The Role of Psychological Distress in the Relationship between Drinking Motives and Hazardous Drinking in Older Adults

INTRODUCTION

Drinking motives seem to be the most proximal predictors of alcohol outcomes. Consequently, these are an essential factor to consider as they may influence the extent to which alcohol is used in a risky way, even in older adults.

OBJECTIVE

We studied the moderating effect of distress on the relationship between drinking motives and drinking behaviour in a community-dwelling older adult sample.

METHOD

In a retrospective cross-sectional research study, participants were community-dwelling older adults aged 65 years and older. All respondents completed a questionnaire covering the Drinking Motives Questionnaire (DMQ), the Alcohol Use Disorders Identification Test (AUDIT), and the General Severity Index (GSI) of the Brief Symptom Inventory (BSI).

RESULTS

In this sample of 1,148 older adults, drinking motives and hazardous alcohol use were associated (enhancement motives r = 0.478, p < 0.001; coping motives r = 0.367, p < 0.001; and social motives r = 0.235, p < 0.001). Furthermore, moderation analysis showed that older adults drinking predominantly for enhancement or coping motives (respectively, β = 0.433, CI [95%] = 2.557-3.222 and β = 0.327, CI [95%] = 1.077-1.491, p < 0.001), and older adults who had higher levels of psychological distress (β = 2.518, CI [95%] = 2.017-3.019, p < 0.001) were more likely to report higher degree of hazardous alcohol use.

CONCLUSION

The relations between coping drinking motives and enhancement drinking motives on hazardous drinking depended on the level of distress. The associations between drinking for coping and drinking for enhancement were stronger in high levels of distress. Although causality cannot be interpreted from cross-sectional data, tackling psychological distress and drinking to cope with negative affect or to enhance positive affect might have strong effects on reducing hazardous drinking behaviour among older adults.

Moderate to severe generalized anxiety disorder symptoms are associated with physical inactivity in people with HIV/AIDS: a study from Uganda

The aim of this cross-sectional study was to explore the prevalence of moderate to severe generalized anxiety disorder (GAD) symptoms and its association with physical activity in people living with HIV (PLHIV) in Uganda. Two hundred and ninety-five PLHIV (median [interquartile range] age = 37.0 years [16.0]; 200 women) completed the GAD-7, Physical Activity Vital Sign, Patient Health Questionnaire-9, and the Alcohol Use Disorders Identification Test. An adjusted odds ratio for physical inactivity in people with moderate to severe GAD symptoms was calculated using binary logistic regression analyses. The prevalence of moderate to severe GAD symptoms was 9.1%. Those with moderate to severe GAD symptoms had a 16.8 times higher odds (95% CI = 5.0-55.9) for not complying with the physical activity recommendations. The current study shows that moderate to severe GAD symptoms are strongly associated with physical inactivity in PLHIV living in a country such as Uganda.

Effect of alcohol use disorders and alcohol intake on the risk of subsequent depressive symptoms: a systematic review and meta-analysis of cohort studies

BACKGROUND AND AIMS

Alcohol use disorders (AUD) are often comorbid with depressive symptoms. Cohort studies on the association between AUD and subsequent depressive symptoms have produced inconsistent results. Moreover, regarding alcohol intake, the risk of developing depressive symptoms might vary with alcohol intake level. We aimed to investigate the association between AUD, alcohol intake and subsequent depressive symptoms.

DESIGN AND SETTING

We conducted a systematic search in PubMed, Embase and PsycINFO for cohort studies on the association between AUD or alcohol intake and subsequent depressive symptoms.

PARTICIPANTS

We included 338 426 participants from 42 studies. Six and four studies analyzed only females and males, respectively.

MEASUREMENTS

We combined risk estimates for developing depressive symptoms using a random-effects model. We divided alcohol intake into abstinence, light (0-84 g/week), moderate (85-168 g/week) and heavy drinking (> 168 g/week or > 48 g/day at least weekly). We conducted a categorical analysis to compare the risk of depressive symptoms between abstinence and different intake categories. Further, we conducted a dose-response analysis to investigate the alcohol-depression association.

FINDINGS

We analyzed 42 studies (follow-up time: 1-40 years). AUD was associated with significantly increased risk of subsequent depressive symptoms [relative risk (RR) = 1.57, 95% confidence interval (CI) = 1.41-1.76]. Regarding alcohol intake, heavy drinking had an increased risk of depressive symptoms; however, the association was only significant when controls were limited to non-heavy drinkers (RR = 1.13, 95% CI = 1.05-1.22). Taking into consideration the possibility of publication bias and confounding factors made the association non-significant. We observed J-shaped associations in both categorical and dose-response analyses where light-moderate drinking had a significantly decreased risk of depression, while heavy drinking did not show a significant association with depressive symptoms compared with non-drinkers.

CONCLUSION

Alcohol use disorders are associated with increased the risk of subsequent depressive symptoms. Heavy drinking does not significantly predict occurrence of depressive symptoms after adjusting for potential confounders.

Associations of self-reported physical activity and anxiety symptoms and status among 7,874 Irish adults across harmonised datasets: a DEDIPAC-study

BACKGROUND

Anxiety is an adaptive response to an objective or perceived threat; however, when symptoms become severe and chronic it that can become a maladaptive anxiety disorder. Limited evidence suggests that physical activity may be associated with prevention against anxiety. This study uses data from The Irish Longitudinal Study on Ageing (TILDA) and The Mitchelstown Cohort Study to investigate cross-sectional associations between physical activity and anxiety symptoms and status among Irish adults.

METHODS

Both datasets were harmonized (n = 7874). The short form International Physical Activity Questionnaire measured physical activity. Participants were classified as meeting World Health Organization physical activity guidelines (≥150 min weekly of moderate intensity physical activity, ≥75 min weekly of vigorous intensity physical activity, or ≥ 600 MET-minutes) or not. They were also divided into three groups based on weekly MET-minutes of moderate-to-vigorous physical activity (Low: 0-599; Moderate: 600-1199; High: ≥1200), and three groups based on weekly minutes of walking (Low: 0-209; Moderate: 210-419; High: 420+). Anxiety symptoms were measured by the Hospital Anxiety and Depression Scale with a score of ≥8 indicating anxiety. Binomial logistic regression, adjusted for relevant confounders examined physical activity-anxiety associations.

RESULTS

Females had higher rates of anxiety than males (28.0% vs 20.0%; p < 0.001). Following adjustment for relevant covariates, meeting physical activity guidelines was associated with 13.5% (95% CI: 2.0-23.7; p = 0.023) lower odds of anxiety. Moderate and High physical activity were associated with 13.5% (- 11.0-32.6; p = 0.254) and 13.6% (1.4-4.2; p = 0.030) lower odds of anxiety compared to Low physical activity, respectively. Moderate and High walking were associated with 2.1% (- 14.5-16.3; p = 0.789) and 5.1% (- 9.3-17.6; p = 0.467) lower odds of anxiety compared to Low walking, respectively.

CONCLUSION

Meeting physical activity guidelines is associated with lower odds of anxiety, but the strength of associations did not increase considerably with increased physical activity levels.

Socio-demographic and psychiatric risk factors in incident and persistent depression: An analysis in the occupational cohort of ELSA-Brasil

BACKGROUND

Depression is a main source of disability worldwide. Identifying risk factors associated with incident and persistent episodes could inform clinical practice and hence mitigate their burden. However, previous research has focused on populations from developed countries. Thus, we evaluated sociodemographic risk factors and psychiatric comorbidities associated with incident and persistent depression in a large Brazilian occupational cohort.

METHODS

We examined baseline (2008-2010, n = 15,105) and follow-up (2012-2014) data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Based on the presence of depression diagnosis at two timepoints, we diagnosed persistent and incident depression. Simple and multiple logistic regression analyses were employed to explore risk factors associated with incident and persistent depression. As gender is associated with the exposure and outcome variables, analyses stratified by gender were also conducted.

RESULTS

Presence of any anxiety disorder, obsessive-compulsive disorder, and female gender were significant (p < 0.001) risk factors for depression incidence (odds ratios of 2.59, 3.6, and 1.82, respectively) and persistence (odds ratios of 6.94, 14.37, and 2.85, respectively) in multiple models, whereas having university degree decreased the odds of depression incidence (0.74) and persistence (0.45). In stratified analyses, the effects of low education were only evident in women.

LIMITATIONS

Brief depressive episodes could not be measured by our assessments.

CONCLUSION

In this occupational cohort, female gender, low education and psychiatric comorbidities were associated with unfavorable depression courses. Interventions targeting comorbidities could prevent depression incidence and persistence.

Prevalence, Demographic, and Clinical Correlates of Comorbid Depressive Symptoms in Chinese Psychiatric Patients With Alcohol Dependence

BACKGROUND

Depressive symptoms are common among psychiatric patients with alcohol dependence (AD). However, the prevalence and clinical correlates of comorbid depressive symptoms are less well studied in Chinese Han patients.

METHODS

In this hospital-based survey, we recruited 378 psychiatric patients diagnosed with AD according to the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV). All patients completed the Beck Depression Inventory (BDI) to evaluate depressive symptoms and the Alcohol Use Disorders Identification Test (AUDIT) to assess the severity of drinking.

RESULTS

Compared to patients without depressive symptoms, 48.9% (185/378) of the patients with comorbid depressive symptoms were younger, had a more unstable marital status, had a higher AUDIT total score, and had a higher adverse consequences subscore (all P < 0.05). Further logistic regression analysis showed that unstable marital status (Odds ratios [OR] = 2.20, 95% confidence interval [CI] 1.21-3.99) and AUDIT total score (OR=1.07, 95% CI 1.03-1.11) were significantly associated with depressive symptoms.

CONCLUSIONS

Our findings indicate high comorbidity between AD and depressive symptoms in Chinese psychiatric patients. Moreover, some variables are correlates of comorbid depressive symptoms. Particular attention should be paid to the early detection and intervention for this comorbid condition and its risk factors.