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Zeng Q, Ding J, Tu R, He H, Wang S, Huang Y, Wang Z, Chen Q, Lu G, Li Y. The mediating effect of depressive symptoms on the association between childhood friendship and physical function in middle-aged and older adults: Evidence from the China Health and Retirement Longitudinal Study (CHARLS). J Affect Disord 2024; 359:196-205. [PMID: 38777265 DOI: 10.1016/j.jad.2024.05.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND This study examines the extent to which depressive symptoms mediate the link between childhood friendship (CF) and physical function among middle-aged and older adults in China. METHODS China Health and Retirement Longitudinal Study (CHARLS) data were used; specifically, CHARLS life history survey (conducted from June 1-December 31, 2014) and follow-up health survey (conducted from July 1-September 30, 2015) data were used. The Sobel test, Bootstrap test and multivariable logistic regression were performed to examine the mediating role of depressive symptoms (measured by the 10-item Center for Epidemiologic Studies Depression Scale) in the association between CF (measured by a standardized retrospective questionnaire) and physical function, which was measured by basic activities of daily living (BADL) disability, instrumental activities of daily living (IADL) disability, and grip strength. RESULTS A total of 12,170 participants aged 45 years or older were included in this cross-sectional study. After controlling for covariates, low-quality CF was associated with an increased prevalence of BADL disability (OR = 1.18; 95 % CI = 1.05-1.32), IADL disability (OR = 1.25; 95 % CI = 1.12-1.40), and low grip strength (OR = 1.21; 95 % CI = 1.09-1.34). The proportion of the mediating effect of depressive symptoms was 48 % for CF and BADL, 40 % for CF and IADL, and 11 % for CF and grip strength. Depressive symptoms and worse CF have a joint effect on BADL disability (OR = 3.30; 95 % CI = 2.82-3.85), IADL disability (OR = 3.52; 95 % CI = 3.03-4.09), and low grip strength (OR = 1.65; 95 % CI = 1.43-1.92). LIMITATIONS Not all potential confounding factors (such as childhood behavioural problems, genetic factors, and memory function) were measured in the analysis, and there may have been recall bias in the retrospective collection of CF data. CONCLUSIONS Individuals with high-quality CF were more likely to have a decreased prevalence of impaired physical function in later life. Depressive symptoms acted as a mediator associated with the development of CF.
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Affiliation(s)
- Qingping Zeng
- Neuro-Intensive Care Unit, Department of Neurosurgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China; School of Nursing, Medical College of Yangzhou University, Yangzhou University, China
| | - Jiali Ding
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, China
| | - Raoping Tu
- School of Health Management, Fujian Medical University, Fuzhou, Fujian, China
| | - Huihui He
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, China
| | - Suhang Wang
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, China
| | - Yujia Huang
- Neuro-Intensive Care Unit, Department of Neurosurgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
| | - Zhiyao Wang
- Neuro-Intensive Care Unit, Department of Neurosurgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
| | - Qi Chen
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, China
| | - Guangyu Lu
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, China.
| | - Yuping Li
- Neuro-Intensive Care Unit, Department of Neurosurgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.
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Zhao X, Ruan Z, Tian Y, Du W, Fan L. Estimating the joint effect of household solid fuel use and social isolation on depression among middle-aged and older adults in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 901:166411. [PMID: 37611698 DOI: 10.1016/j.scitotenv.2023.166411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/28/2023] [Accepted: 08/16/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Household solid fuel use and social isolation are reported to increase the risk of depressive symptoms, but their joint effect has not yet been examined. This study aimed to explore the separate and joint effects of household solid fuel use and social isolation on depression. METHODS We used data from the latest four waves (2011-2018) of the China Health and Retirement Longitudinal Study (CHARLS). Depression was defined as a score of ≥12 using the Center for Epidemiologic Studies Depression Scale (CES-D 10). Cox proportional hazards models were applied to explore the separate and joint associations of household solid fuel use and social isolation with incident depression. RESULTS During the seven-year follow-up, 2793 (30.25 %) out of the 9232 participants were identified with depressive symptoms. Solid fuel use for household heating or cooking was significantly associated with more hazards of depressive symptoms after adjusting for potential confounders (cooking: HR = 1.280, 95 % CI = 1.175-1.394; heating: HR = 1.142, 95 % CI = 1.054-1.238). High social isolation at baseline was also a significant predictor of incident depressive symptoms (HR = 1.139, 95 % CI = 1.053-1.231). Participants exposed to both solid fuel use and high social isolation were found to have higher hazards of experiencing depressive symptoms than those exposed to none or only one of these two risk factors (heating: HR for 'solid fuel use + high social isolation'=1.308 versus HR for other groups = 1-1.185; cooking: HR for 'solid fuel use + high social isolation' = 1.430 versus HR for other groups = 1-1.255). CONCLUSION Household solid fuel use and social isolation were separately and jointly associated with higher risks of incident depression. Appropriate interventions to reduce solid fuel use and social isolation are recommended to improve the psychological health among middle-aged and older adults in China.
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Affiliation(s)
- Xinyu Zhao
- School of Public Health, Southeast University, Nanjing 210009, China
| | - Zengliang Ruan
- School of Public Health, Southeast University, Nanjing 210009, China
| | - Yong Tian
- School of Public Health, Southeast University, Nanjing 210009, China
| | - Wei Du
- School of Public Health, Southeast University, Nanjing 210009, China
| | - Lijun Fan
- School of Public Health, Southeast University, Nanjing 210009, China.
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Wang J, Zhang J, Lin H, Han Y, Tu J, Nie X. Economic development, weak ties, and depression: Evidence from China. J Affect Disord 2023; 334:246-257. [PMID: 37146909 DOI: 10.1016/j.jad.2023.04.097] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/06/2023] [Accepted: 04/24/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVES Weak ties are becoming mainstream in daily relationships and play an essential role in the improvement of individuals' mental health. Despite growing concerns on depression, inclusion of weak ties is limited. To address the gap, this study empirically shed light on the role of weak ties on individual depression in the context of economic development. METHOD A cross-sectional study was conducted based on 2018 China Health and Retirement Longitudinal Study (CHARLS) with a sample of 16,545 individuals. A moderated mediation model is constructed to evaluate the impact of economic development (GDP) on the degrees of depression, the mediating effect of weak ties, and the moderating effect of residents' residence types (living in urban or rural areas). RESULTS Economic development exerts a significant direct impact on depression (β=-1.027, p<0.001). Weak ties are significantly negatively correlated with depression (β=-0.574, p<0.001), and act as a mediator between economic development and local individual depression. In addition, the residence type plays a moderating role between economic development and weak ties (β=0.193, p<0.001). That is, living in urban areas would introduce the higher the level of weak ties. CONCLUSIONS Higher economic development is largely conducive to alleviating the degrees of depression, weak ties play a mediating role in economic development and depression, and residence types have a positive moderating effect on the economic development and weak ties.
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Affiliation(s)
- Jiangyan Wang
- School of Statistics and Data Science, Nanjing Audit University, Nanjing 211815, China.
| | - Jiahao Zhang
- School of Statistics and Data Science, Nanjing Audit University, Nanjing 211815, China
| | - Han Lin
- School of Information Engineering, Jiangsu Key Laboratory of Public Project Audit, Nanjing Audit University, Nanjing 211815, China.
| | - Yilong Han
- School of Economics and Management, Tongji University, Shanghai 200092, China.
| | - Juan Tu
- Key Laboratory of Modern Acoustics (MOE), School of Physics, Nanjing University, Nanjing 210093, China.
| | - Xinyu Nie
- Antai College of Economics and Management, Shanghai Jiaotong University Shanghai 200030, China.
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Wu Y, Li S, Han D, Zhang M, Zhao J, Liao H, Ma Y, Yan C, Wang J. The Mediating Role of Depression in Association Between Total Sleep Time and Instrumental Activities of Daily Living in China. Int J Public Health 2023; 68:1605678. [PMID: 37081904 PMCID: PMC10110912 DOI: 10.3389/ijph.2023.1605678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/15/2023] [Indexed: 04/07/2023] Open
Abstract
Objectives: This study aims to investigate the mediating role of depression and the moderating effect of gender in the relationship between total sleep time (TST) and instrumental activities of daily living (IADL) in middle-aged and elderly people (aged 45 or above).Methods: The data used in this study is from the China Health and Retirement Longitudinal Study (CHARLS), including a total of 10,460 respondents. Associations between TST, IADL, depression, and gender were analyzed using logistic regression and Karlson, Holm, and Breen (KHB) methods.Results: Short (OR = 1.42, 95% CI = 1.28–1.58 of ≤6 h) and long TST (OR = 1.16, 95% CI = 1.02–1.32 of 8–9 h; OR = 1.35, 95% CI = 1.19–1.54 of >9 h) were both associated with IADL. The mediation effect analyses observed that depression explained 64.80% of the total effect of short TST (≤6 h) and IADL, but was insignificant in long TST (8–9 h and >9 h). Meanwhile, gender has moderating effects on the mediation effect model.Conclusion: The study suggests that health interventions that focused on the dimensions of TST and depression are crucial for preventing functional disability while accounting for gender differences.
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Affiliation(s)
- Yunyi Wu
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sangsang Li
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dan Han
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mei Zhang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jie Zhao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Liao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Ma
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chaoyang Yan
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- The Key Research Institute of Humanities and Social Science of Hubei Province, Huazhong University of Science and Technology, Wuhan, China
- Institute for Poverty Reduction and Development, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Jing Wang,
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Zheng X, Jiang M, Ren X, Han L. The longitudinal association of remnant cholesterol with diabetes in middle-aged and elderly Chinese: A nationwide population-based cohort study. J Diabetes Complications 2023; 37:108360. [PMID: 36459863 DOI: 10.1016/j.jdiacomp.2022.108360] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS The association between remnant cholesterol (RC) and diabetes remains unclear in Chinese. METHODS AND RESULTS We used the data of 9464 Chinese adults aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS). Estimated RC level was calculated as total cholesterol minus high-density lipoprotein cholesterol minus low-density lipoprotein cholesterol. Cox proportional hazard models and restricted cubic spline models were used to assess the relationships between RC and diabetes. RESULTS After 6 years of follow-up, a total of 777 respondents experienced new-onset diabetes. In multivariable-adjusted analyses, the adjusted hazard ratios (95 % confidence intervals) for the highest versus lowest quartile of RC was 1.45 (1.19-1.75) for risk of diabetes, and each 1-SD increase of RC (19.52 mg/dl) was associated with 9 % (HRs = 1.09; 1.03-1.15) increased risk of diabetes. There were also significant linear associations between RC level and diabetes (P for linearity <0.001). CONCLUSION Elevated RC levels were positively associated with increased risk of diabetes in Chinese adult population, suggesting that RC could be considered as a preferential predictor and treatment target of diabetes in Chinese population. Future prospective studies are needed to verify our findings and to assess the effect of RC-lowering interventions in diabetes prevention.
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Affiliation(s)
- Xiaowei Zheng
- Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China.
| | - Minglan Jiang
- Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Xiao Ren
- Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Longyang Han
- Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China
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