Cross-Lagged Panel Analysis between Physical Frailty, Cognitive Function, and Falls by Sex

Relationships between resilience, perceived social support, and mental health in military personnel: a cross-lagged analysis

BACKGROUND

Despite the growing application of the Dual-factor model of mental health (DFM), there is a paucity of research on military personnel. Additionally, existing cross-sectional studies indicate that resilience and perceived social support are associated with military mental health, but the lack of cross-lagged studies precludes researchers from making causal interpretations. This study aimed to explore the longitudinal relationship between resilience, perceived social support, negative dimension of mental health (depressive symptom), and positive dimension (life satisfaction) among military personnel using cross-lagged analysis.

METHODS

A total of 215 military personnel were investigated longitudinally over a 12-week, two-phase period. The Connor-Davidson Resilience Scale (CD-RISC), Perceived Social Support Scale (PSSS), Patients' Health Questionnaire Depression Scale-9 Item (PHQ-9), and Satisfaction with Life Scale (SWLS) were employed to measure their resilience, perceived social support, depression symptoms, and life satisfaction, respectively. Pearson correlation analysis was used to examine the correlations between the aforementioned variables, and a paired t-test was employed to ascertain whether the variables changed over time. A cross-lagged panel analysis was employed to explore cross-lagged relationships between these variables in military personnel.

RESULTS

All participants in this study were male. At Time 1, the mean age of all participants was 22.98 years (SD = 2.99), and the mean scores for the CD-RISC, PSSS, PHQ-9, and SWLS were 71.61 (SD = 14.86), 68.60 (SD = 10.22), 1.74 (SD = 2.89), and 28.08 (SD = 5.51), respectively. Cross-lagged analysis showed that prior resilience significantly predicted later depression symptoms (β = -0.19, p = 0.028) and life satisfaction (β = 0.17, p = 0.038). Prior perceived social support significantly predicted later life satisfaction (β = 0.15, p = 0.040) but not depression symptoms (β = -0.04, p = 0.652). Prior depression symptoms significantly predicted later life satisfaction (β = -0.26, p < 0.001), and prior life satisfaction also predicted later depression symptoms (β = -0.23, p = 0.002).

CONCLUSIONS

The negative and positive dimensions of military mental health can interact with each other. Moreover, enhancing resilience and perceived social support may be a novel perspective for improving the mental health of military personnel.

Mental health and meaning in life in Chinese military personnel: a cross-lagged analysis

BACKGROUND

The burgeoning field of research on the dual-factor model of mental health (DFM) has highlighted its significance, yet the applicability of the DFM in military personnel and its longitudinal relationships with different dimensions of meaning in life remains unclear. This study aimed to clarify the applicability of the DFM for military personnel and to investigate longitudinal relationships between the dual factors of mental health (negative factor, positive factor) and the two dimensions of meaning in life (presence of meaning, search for meaning) in military personnel.

METHODS

In this study, data were collected in two waves (April and August 2023) from 227 Chinese military personnel. We constructed a dual-factor model with depression as the negative factor and subjective well-being as the positive factor, and we compared it with a single-factor model to determine if DFM could be applied to military personnel. We also constructed a cross-lagged model to investigate longitudinal relationships between depression, subjective well-being, presence of meaning, and search for meaning.

RESULTS

According to the findings, military personnel fit better with the DFM than with the single-factor model. Cross-lagged analysis results revealed that both the presence of meaning and the search for meaning negatively predicted depression and positively predicted subjective well-being.

CONCLUSIONS

The DFM had good applicability among military personnel. Both the presence of meaning and the search for meaning could improve military mental health, suggesting that both dimensions of meaning in life may be potential targets for improving military mental health.

A longitudinal study of factors associated with cognitive frailty in middle-aged and elderly population based on the health ecology model

BACKGROUND

Cognitive frailty (CF) is an important geriatric syndrome and is reversible. It is crucial to develop preventive interventions for CF. We aimed to explore the associations between CF and its associated factors in Chinese aged 45 years and above.

METHODS

Based on the available data of 3 waves in China Health and Retirement Longitudinal Study from 2011 to 2015, 16,071 individuals aged 45 years and above from 3 waves were included. Based on the health ecology model, the associated factors were classified as downstream, midstream and upstream factors. Generalized hierarchical linear model including time level, individual level, and province level was applied to analyze the associations between factors and CF.

RESULTS

Multilevel factors have different effects on physical and cognitive function. In the downstream, old age, female, underweight, chronic diseases, and depression were risk factors of reversible CF and potentially reversible CF, and overweight was their protective factor. In the midstream, short or long night sleep duration was their risk factor, and > 30 and ≤ 60 min afternoon naps, alcohol drinking, and participation in social activities were their protective factors. In the upstream, living in rural areas was their risk factor, and high educational level, household consumption and GDP per capita were their protective factors.

CONCLUSIONS

Physical function and cognitive function are affected differently by multiple factors. The occurrence and development of physical frailty and cognitive impairment may have some common mechanisms. CF can be influenced by multilevel factors, and multilevel and comprehensive management of CF should be achieved.

KEY POINTS

Cognitive frailty was correlated with multilevel factors, including downstream, midstream, and upstream factors. It is crucial to focus on individual interventions such as physiological factors, psychological factors and health behaviors, especially the elderly, women and those with depression. Socioeconomic status was associated with the lower prevalence of cognitive frailty.