The mediating and moderating effect of health-promoting lifestyle on frailty and depressive symptoms for Chinese community-dwelling older adults: A cross-sectional study

The relationships between self-neglect and depression, social networks, and health literacy in Turkish older adults: a cross-sectional study

BACKGROUND

Self-neglect is common among older adults and may have devastating health consequences.

OBJECTIVE

This study aims to examine the relationships between self-neglect and depression, social networks, and health literacy (HL) in older adults.

METHODS

The cross-sectional study was conducted between March and May 2024 at four family health centres located in a district of Istanbul, Turkey. A total of 370 older adults, aged 65 years and above, were selected by simple random sampling from among those who visited the family health centres during the study period. A Sociodemographic Information Form, the Revised Turkish version of Mini Mental State Examination, the Istanbul Medical School Elder Self-Neglect Questionnaire, the Lubben Social Network Scale, the Geriatric Depression Scale-Short Form, and the Turkish Health Literacy Scale-32 were used for data collection. Data were analysed using descriptive statistics, Pearson's correlation analysis, hierarchical linear regression analysis, and serial multiple mediation analysis.

RESULTS

The mean age of the participants was 71.42 ± 5.54 (65-90) years, and 55.7% were women. The prevalence of self-neglect among the participants was 34.9%, and the prevalence of depressive symptoms was 46.2%. The HL levels of 62.7% of the participants were inadequate, and those of 31.6% were problematic-limited. HL, depression, social networks, gender, education status, and income status were statistically significant predictors of self-neglect (R2 = 0.508, p < 0.001). Depression had a significant direct effect on self-neglect (effect = -0.148, p < 0.001), as did social networks (effect = 0.107, p < 0.001) and HL (effect = 0.107, p < 0.001). The mediating effect of social networks in the relationship between depression and self-neglect was significant (LLCI = -0.043, ULCI = -0.015), with an effect size of -0.028. The mediating effect of HL in the relationship between depression and self-neglect was also significant (LLCI = -0.121, ULCI = -0.063), with an effect size of -0.089.

CONCLUSION

Our findings showed that HL, depression, and social networks play a critical role in predicting self-neglect in older adults, and social networks and HL partially mediate the relationship between depression and self-neglect. Based on these results, efforts to improve HL and strengthen social support systems would be beneficial in mitigating the effects of depression and reducing self-neglect in older adults.

The mediation effect of social participation in the relationship between Internet use and health behaviors among middle-aged and older individuals

Objectives

The increasing popularity and influence of the Internet in modern society have greatly impacted individuals' lives. This population-based study elucidated the dynamic linkage between Internet use (IU) and health behaviors (HBs), particularly emphasizing the intermediary function of social participation (SP) in middle-aged and older adults (MOA) in China.

Methods

Data were obtained from the China Health and Retirement Longitudinal Study in 2020. This study employed binary logistic regression to investigate the influence of IU on the HBs of MOA in China. Additionally, binary logistic and multiple linear regressions were used to test whether SP regulates the relationship between IU and HBs (i.e. nonsmoking, non-drinking, physical activity, and physical examination). Furthermore, the Karlson-Holm-Breen method was employed to assess the mediating role of SP.

Results

IU had a positive effect on nonsmoking (OR: 1.113, p < 0.05), physical activity (OR: 1.775, p < 0.001), and physical examination (OR: 1.226, p < 0.001). However, this study revealed that IU had a significant negative effect on non-drinking (OR: 0.775, p < 0.001). Moreover, the mediating effect analysis demonstrated that SP played a mediating role in the relationship between IU and the HBs.

Conclusion

Active engagement in social activities is an effective method for enhancing the positive impact of IU on the adoption of physical activity and physical examinations. In order to meet individuals' needs, it is essential to design and promote Internet health services and social activities tailored to their age group and cultural background. Furthermore, greater efforts should be employed to implement public policy initiatives aimed at providing care for MOA.

Parallel Mediating Roles of Social Support and Self-Efficacy in the Relationship Between Frailty and Depression in Elderly Patients After Percutaneous Coronary Intervention

AIM

To examine chain mediating roles of social support and self-efficacy between quality of frailty and depression in elderly people after percutaneous coronary intervention (PCI).

BACKGROUND

Frailty is a cause of depression among elderly patients after PCI. Although previous studies have shown that frailty, social support, self-efficacy and depression are significantly related, the interaction mechanism remains unclear.

METHODS

Employing a cross-sectional research design and convenience sampling methodology, data were collected at a tertiary hospital in China. Participants completed the FRAIL Scale, Social Support Rate Scale, General Self-Efficacy Scale and the Hospital Anxiety and Depression Scale. We utilised the PROCESS macro in SPSS to ascertain the mediating roles of social support and self-efficacy between frailty and depression.

REPORTING METHOD

The study used the STROBE checklist for reporting.

RESULT

A total of 241 elderly patients were included in the study, with an average age of 68.05 (6.04) years. Among them, 63.1% of the participants had experienced depression. Elderly patients after PCI's frailty score was negatively correlated with social support and self-efficacy, and positively correlated with depression. Social support was significantly positively correlated with self-efficacy, significantly negatively correlated with depression. Finally, self-efficacy was significantly negatively correlated with depression. Social support and self-efficacy mediated 11.61% and 29.46% of the total depressive role in elderly after frailty and PCI, respectively.

CONCLUSION

Frailty in elderly PCI patients is directly associated with depression and indirectly related through social support or self-efficacy.

RELEVANCE TO CLINICAL PRACTICE

To enhance the quality of life for elderly patients following PCI, healthcare providers should address the impact of frailty on depression and develop intervention strategies based on the levels of social support and self-efficacy.

PATIENT OR PUBLIC CONTRIBUTION

Questionnaires filled out by patients were used to understand the relationship between frailty, social support, self-efficacy and depression.