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Wang K, Li Y, Chen X, Veldheer S, Wang C, Wang H, Sun L, Gao X. Gardening and subjective cognitive decline: a cross-sectional study and mediation analyses of 136,748 adults aged 45+ years. Nutr J 2024; 23:59. [PMID: 38834985 DOI: 10.1186/s12937-024-00959-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/17/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Given the benefits of gardening for physical and psychological health, we explored whether gardening was associated with lower risks of subjective cognitive decline (SCD), a precursor of dementia, and SCD-related functional limitations. METHODS Included in this cross-sectional study were 136,748 participants aged 45 + years old from the Behavioral Risk Factor Surveillance System 2019 survey, who were then categorized into three groups according to self-reported exercise status: non-exercisers, gardeners, and other exercisers. SCD was assessed via a questionnaire, and SCD-related functional limitations were referred to as having difficulties in engaging in household or social activities due to SCD. The odds ratio (OR) and 95% confidence interval (CI) were calculated to assess the associations of gardening with SCD and SCD-related functional limitations, adjusted for age, sex, socioeconomic status, lifestyle factors, and health status. Mediation analyses were conducted to examine whether the observed association between gardening and SCD was mediated by energy expenditure (MET-hours/week), depression status, and consumption of fruits and vegetables. RESULTS Overall, 11.1% and 5.4% of participants self-reported experiencing SCD and SCD-related functional limitations, respectively. The adjusted OR for gardeners vs. non-exercisers, was 0.72 (95% CI 0.62-0.83) for SCD and 0.57 (95% CI 0.44-0.73) for SCD-related functional limitations. The observed association between gardening and SCD was explained by higher energy expenditure (39.0%), lower likelihood of having depression (21.5%), and higher consumption of fruits and vegetables (3.4%) (P<0.05 for all). Similar patterns were observed for SCD-related functional limitations. CONCLUSION In this nationally representative sample, gardening was associated with better cognitive status, which may be mainly attributed to better depression status and energy expenditure.
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Affiliation(s)
- Kaiyue Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200032, China
| | - Yaqi Li
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200032, China
| | - Xiao Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200032, China
| | - Susan Veldheer
- Departments of Family and Community Medicine and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Chen Wang
- Shanghai Institute of Sports Science, Shanghai, 200030, China
| | - Han Wang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Liang Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200032, China.
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200032, China.
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Kang M, Yang Y, Kim H, Jung S, Jin HY, Choi KH. The mechanisms of nature-based therapy on depression, anxiety, stress, and life satisfaction: examining mindfulness in a two-wave mediation model. Front Psychol 2023; 14:1330207. [PMID: 38187408 PMCID: PMC10768844 DOI: 10.3389/fpsyg.2023.1330207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
Background Nature-based therapy (NBT), which centers around engaging in activities within natural surroundings, has consistently demonstrated therapeutic benefits for mental health. While NBT highlights the potential of nature as a therapeutic resource for promoting mental health, there is limited knowledge regarding its underlying mechanisms. Methods Two hundred seventy-six Korean participants (204 women, mean age = 54.99 ± 23.25 years) participated in a 30-session gardening program held twice weekly for 15 weeks. Structural equation modeling with a two-wave autoregressive cross-lagged model was used to investigate the mediating effects of mindfulness. Results NBT significantly improved the mean scores of all psychological variables. The mediation model was partially confirmed, with mindfulness at post-intervention (T2) mediating the relationship between baseline (T1) depression and anxiety and post-intervention (T2) life satisfaction. However, no significant indirect effect was observed between the path from stress (T1) to life satisfaction (T2). Conclusion Mindfulness is a crucial component for improving mental health outcomes. This study underscores the need to prioritize and emphasize mindfulness practices in NBT.
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Affiliation(s)
- Minjung Kang
- School of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
| | - Yeji Yang
- School of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
| | - Hyunjin Kim
- School of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
| | - Songhie Jung
- Gardens and Education Research Division, Korea National Arboretum, Pocheon, Republic of Korea
| | - Hye-Young Jin
- Gardens and Education Research Division, Korea National Arboretum, Pocheon, Republic of Korea
| | - Kee-Hong Choi
- School of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
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Yun J, Yao W, Meng T, Mu Z. Effects of horticultural therapy on health in the elderly: A review and meta-analysis. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-27. [PMID: 37361284 PMCID: PMC10240129 DOI: 10.1007/s10389-023-01938-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/07/2023] [Indexed: 06/28/2023]
Abstract
Aim Given the current aging population, the demand on medical facilities, facilities for elderly care, and even their high prevalence, it is crucial to investigate the advantages of older people. The purpose of our study was to systematically review the existing literature on the health effects of horticultural therapy as a treatment option for the elderly. Subject and methods Article searches were conducted through five databases: Web of science, Science Direct, PubMed, EBSCO, and Google Scholar, according to the standard method of systematic evaluation and meta-analysis. Thirty-two published articles were included, and 27 relevant variables were meta-analyzed to assess the benefits of horticultural therapy in terms of physical and psychological functioning in the elderly. Results Results show that horticultural therapy may be helpful in helping seniors lose weight -0.195 (95% CI -0.507,0.117), reduce their waist circumference -0.327 (95% CI -0.637, -0.017), lower their stress -0.339 (95% CI -0.610, -0.069) and cortisol -0.902 (95% CI -0.728, -0.002) levels, improve their physical flexibility 0.302 (95% CI 0.036, 0.569), social interaction 0.370, (95% CI 0.115, 0.624), and daily vegetables and fruit consumption 0.688 (95% CI: 0.287, 1.089). Conclusion Horticultural therapy may be a useful tool for enhancing the physical, mental and social aspects of the elderly. However, there is substantial heterogeneity and wide variation in the quality of the included studies. Further high-quality studies, rigorous controls and adjustments for significant confounding variables, and larger populations are needed in the future to further our understanding of the link between horticultural therapy and elder health. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-023-01938-w.
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Affiliation(s)
- Jiayue Yun
- Department of Landscape Architecture, College of Architecture and Urban Planning, Qingdao University of Technology, Qingdao, Shandong 266000 People’s Republic of China
| | - Wenfei Yao
- Department of Landscape Architecture, College of Architecture and Urban Planning, Qingdao University of Technology, Qingdao, Shandong 266000 People’s Republic of China
| | - Tian Meng
- Department of Landscape Architecture, College of Architecture and Urban Planning, Qingdao University of Technology, Qingdao, Shandong 266000 People’s Republic of China
| | - Zhiyue Mu
- Department of Landscape Architecture, College of Architecture and Urban Planning, Qingdao University of Technology, Qingdao, Shandong 266000 People’s Republic of China
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Xu M, Lu S, Liu J, Xu F. Effectiveness of horticultural therapy in aged people with depression: A systematic review and meta-analysis. Front Public Health 2023; 11:1142456. [PMID: 36969640 PMCID: PMC10031070 DOI: 10.3389/fpubh.2023.1142456] [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: 01/11/2023] [Accepted: 02/09/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundDepression, an increasing global crisis, has affected many people's daily life, especially for older adults. Horticultural therapy has been widely used in non-pharmacological treatment for patients with depression, with a body of studies demonstrating its therapeutic effects. However, a lack of systematic reviews and meta-analyses makes it difficult to get a holistic picture of this research field.ObjectivesWe aimed to evaluate the reliability of the previous studies and the effectiveness of horticultural therapy (including the intervention of environmental settings, activities, and duration) on older adults with depression.MethodsThis systematic review was conducted under the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines. We searched relevant studies in multiple databases, and the original search was finished on 25 September 2022. We included studies using randomized controlled trials (RCTs) or quasi-experimental designs.ResultsWe yielded a total of 7,366 studies and finally included 13 which involved 698 aged people with depression. Results from meta-analysis indicated significant effects of horticultural therapy on reducing depressive symptoms for the older adults. Besides, we found different outcomes among various horticultural interventions (such as environmental setting, activities, and duration). Depression reduction was more effective in care-providing settings than in community settings; participatory activities were more effective in reducing depression than observational activities; intervention of 4–8 weeks might represent the optimal course of treatment compared to interventions more than 8 weeks in duration.ConclusionWe came up with a comprehensive set of recommendations based on the meta-analysis: aged people in care-providing settings with depression could get the most benefit from horticultural therapy by participating in participatory activities for 4–8 weeks.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022363134, identifier CRD42022363134.
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Affiliation(s)
- Meijing Xu
- College of Horticulture, China Agricultural University, Beijing, China
| | - Shan Lu
- College of Horticulture, China Agricultural University, Beijing, China
| | - Jianjiao Liu
- Faculty of Architecture, Building and Planning, University of Melbourne, Melbourne, VIC, Australia
| | - Feng Xu
- College of Horticulture, China Agricultural University, Beijing, China
- *Correspondence: Feng Xu
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Chan HS, Chu HY, Chen MF. Effect of horticultural activities on quality of life, perceived stress, and working memory of community-dwelling older adults. Geriatr Nurs 2022; 48:303-314. [PMID: 36347114 DOI: 10.1016/j.gerinurse.2022.10.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
This study sampled 86 community-dwelling older adults to investigate the effect of horticultural activities on their quality of life, perceived stress, and working memory. The results demonstrated that after 8 weeks of horticultural activities, the effect sizes (Cohen's d) of their quality of life, perceived stress, and working memory were 0.92, -1.32, and 0.62, respectively. Among the four domains of quality of life, the social relationships domain improved the most. For perceived stress, the score of the experimental group decreased from 1.70 (0.48) to 1.29 (0.58). For working memory, the score increased from 3.43 (1.13) to 4.14 (1.27), whereas the score of the control group did not change substantially. Statistical analysis conducted using a generalized estimating equation revealed a significant interaction effect between group and time (P < 0.001). This study provides a reference for improving the quality of life, perceived stress, and working memory in older people.
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Affiliation(s)
- Hui-Shan Chan
- Department of Applied Cosmetology, National Tainan Junior College of Nursing, 78, Sec. 2, Minzu Rd., Tainan City 70007, Taiwan
| | - Hui-Ying Chu
- Department of Living Services Industry, Tainan University of Technology, 529, Zhong-Zheng Rd., Yongkang District, Tainan City 71002, Taiwan.
| | - Mei-Fang Chen
- Department of Nursing, National Tainan Junior College of Nursing, 78, Sec. 2, Minzu Rd., Tainan City 70007, Taiwan
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Briggs R, Morris PG, Rees K. The effectiveness of group-based gardening interventions for improving wellbeing and reducing symptoms of mental ill-health in adults: a systematic review and meta-analysis. J Ment Health 2022:1-18. [PMID: 36151719 DOI: 10.1080/09638237.2022.2118687] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND There is increasing interest in the association between nature, health and wellbeing. Gardening is a popular way in which interaction with nature occurs and numerous gardening projects aim to facilitate wellbeing among participants. More research is needed to determine their effectiveness. AIM To systematically evaluate the effectiveness of group-based gardening interventions for increasing wellbeing and reducing symptoms of mental ill-health in adults. METHODS A systematic review of Randomised Controlled Trials was conducted following the protocol submitted to PROSPERO (CRD42020162187). Studies reporting quantitative validated health and wellbeing outcomes of the community residing, adult populations (18+) were eligible for inclusion. RESULTS 24 studies met inclusion criteria: 20 completed and four ongoing trials. Meta-analyses suggest these interventions may increase wellbeing and may reduce symptoms of depression, however, there was uncertainty in the pooled effects due to heterogeneity and unclear risk of bias for many studies. There were mixed results for other outcomes. RESEARCH LIMITATIONS/IMPLICATIONS Heterogeneity and small sample sizes limited the results. Poor reporting precluded meta-analysis for some studies. Initial findings for wellbeing and depression are promising and should be corroborated in further studies. The research area is active, and the results of the ongoing trials identified will add to the evidence base.
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Affiliation(s)
- Rebecca Briggs
- School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland.,Warwick Medical School, The University of Warwick, Coventry, England
| | - Paul Graham Morris
- School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland
| | - Karen Rees
- Warwick Medical School, Health Sciences, The University of Warwick, Coventry, England
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Electroencephalography (EEG)-Based Neural Emotional Response to Flower Arrangements (FAs) on Normal Elderly (NE) and Cognitively Impaired Elderly (CIE). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073971. [PMID: 35409655 PMCID: PMC8997455 DOI: 10.3390/ijerph19073971] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 02/01/2023]
Abstract
Background: The purpose of this study is to explore the differences and similarities of EEG -based neural emotional response toward flower arrangements (FAs) between the normal elderly (NE) and cognitively impaired elderly (CIE) in arranging flowers. Methods: The study participants included 16 elderly individuals: eight elderly people with normal cognitive function and eight elderly people with cognitive dysfunction. They were divided into two groups to arrange flowers, and six mood indicators (Engagement, Excitation, Focus, Interest, Relaxation and Stress) were measured with EEG before and after the experiment. Results: The similarities were that there was no significant difference in Excitement, Relaxation and Stress between pre-test and post-test for NE and CIE. The differences were that there was a significant difference on Engagement and Interest in CIE, and they both increased, but there was no difference with respect to them in NE. While there was a significant difference on the Focus of NE, it was decreased, but there was no difference for it with respect to CIE. Conclusions: A similarity on EEG-Based Neural Emotional Responses to flower arrangements between NE and CIE was that they both felt relaxation. The differences were that the Focus of NE decreased and the Interest and Engagement of CIE increased. CIEs were more interested and engaged in FAs.
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Effect of Coriander Plants on Human Emotions, Brain Electrophysiology, and Salivary Secretion. BIOLOGY 2021; 10:biology10121283. [PMID: 34943198 PMCID: PMC8698652 DOI: 10.3390/biology10121283] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/24/2021] [Accepted: 12/02/2021] [Indexed: 12/03/2022]
Abstract
Simple Summary This research aims to investigate the effects of coriander plants on human emotions and physiological activities. The results showed coriander plants could significantly reduce the angry sub-scores, alpha amylase and amino acids (arginine, proline, histidine, and taurine) concentrations in saliva. Theta (4–8 Hz) band activity of the cerebral cortex was significantly enhanced. Moreover, taurine significantly positively correlated with anger and negatively correlated with vigor. All the results signified that coriander plant could influence the activity of brain electrophysiological and salivary secretion through its VOCs to improve people’s negative emotions. This study will provide a theoretical basis for the living coriander plants have some therapeutic effect on the human psychological state. Abstract Coriander is a popular herb with versatile applications. However, the current research about coriander medicinal values have been mainly focusing on its extracts while lacking in the relationship between living coriander plants and emotion. Therefore, this study aims to investigate the effects of coriander plants on human emotions and physiological activities. The results showed that the main Volatile organic compounds (VOCs) of coriander plants were 2-ethyl-1-hexanol, d-limonene, eucalyptol, benzyl alcohol, Isophorone, dimethyl glutarate, α-terpineol, styrene, methyl methacrylate, α-pinene. Coriander plants could significantly reduce the angry sub-scores, alpha amylase and amino acids (arginine, proline, histidine, and taurine) concentrations in saliva. Theta (4–8 Hz) band activity of the cerebral cortex was significantly enhanced. Moreover, taurine significantly positively correlated with anger and negatively correlated with vigor. All the results signified that coriander plant could influence the activity of brain electrophysiological and salivary secretion through its VOCs to improve people’s negative emotions.
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Increased plasma brain-derived neurotrophic factor (BDNF) as a potential biomarker for and compensatory mechanism in mild cognitive impairment: a case-control study. Aging (Albany NY) 2021; 13:22666-22689. [PMID: 34607976 PMCID: PMC8544315 DOI: 10.18632/aging.203598] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/18/2021] [Indexed: 12/12/2022]
Abstract
Background: Previous meta-analyses examining the continuum of Alzheimer’s disease (AD) concluded significantly decreased peripheral brain-derived neurotrophic factor (BDNF) in AD. However, across different meta-analyses, there remain inconsistent findings on peripheral BDNF levels in individuals with mild cognitive impairment (MCI). This issue has been attributed to the highly heterogenous clinical and laboratory factors. Thus, BDNF’s level, discriminative accuracy for identifying all-cause MCI and its subtypes, and its associations with other biomarkers and neurocognitive domains, remain largely unknown. Methods: To address this heterogeneity, we compared a healthy control cohort (n=56, 45 female) to an MCI cohort (n=40, 28 female), to determine whether plasma BDNF, hs-CRP, and DHEA-S can differentiate healthy from MCI individuals, including two MCI subtypes (amnestic [aMCI] and non-amnestic [non-aMCI]). The associations between BDNF with other biomarkers and neurocognitive tests were examined. Adults with cerebral palsy were included as sensitivity analyses. Results: Compared to healthy controls, BDNF was significantly higher in all-cause MCI, aMCI, and non-aMCI. Furthermore, BDNF had good (AUC=0.84, 95% CI=0.74 to 0.95, p<0.001) and excellent discriminative accuracies (AUC=0.92, 95% CI=0.84 to 1.00, p<0.001) for all-cause MCI and non-amnestic MCI, respectively. BDNF was significantly and positively associated with plasma hs-CRP (β=0.26, 95% CI=0.02 to 0.50, p=0.038), despite attenuated association upon controlling for BMI (β=0.15, 95% CI=-0.08 to 0.38, p=0.186). Multiple inverse associations between BDNF and detailed neurocognitive tests were also detected. Conclusions: These findings suggest BDNF is increased as a compensatory mechanism in preclinical dementia, supporting the neurotrophic and partially the inflammatory hypotheses of cognitive impairment.
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Ng TKS, Matchar DB, Pyrkov TV, Fedichev PO, Chan AWM, Kennedy B. Association between housing type and accelerated biological aging in different sexes: moderating effects of health behaviors. Aging (Albany NY) 2021; 13:20029-20049. [PMID: 34456185 PMCID: PMC8436907 DOI: 10.18632/aging.203447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/10/2021] [Indexed: 11/25/2022]
Abstract
Introduction: Despite associated with multiple geriatric disorders, whether housing type, an indicator of socioeconomic status (SES) and environmental factors, is associated with accelerated biological aging is unknown. Furthermore, although individuals with low-SES have higher body mass index (BMI) and are more likely to smoke, whether BMI and smoking status moderate the association between SES and biological aging is unclear. We examined these questions in urbanized low-SES older community-dwelling adults. Methods: First, we analyzed complete blood count data using the cox proportional hazards model and derived measures for biological age (BA) and biological age acceleration (BAA, the higher the more accelerated aging) (N = 376). Subsequently, BAA was regressed on housing type, controlling for covariates, including four other SES indicators. Interaction terms between housing type and BMI/smoking status were separately added to examine their moderating effects. Total sample and sex-stratified analyses were performed. Results: There were significant differences between men and women in housing type and BAA. Compared to residents in ≥3 room public or private housing, older adults resided in 1–2 room public housing had a higher BAA. Furthermore, BMI attenuated the association between housing type and BAA. In sex-stratified analyses, the main and interaction effects were only significant in women. In men, smoking status instead aggravated the association between housing type and BAA. Conclusion: Controlling for other SES indicators, housing type is an independent socio-environmental determinant of BA and BAA in a low-SES urbanized population. There were also sex differences in the moderating effects of health behaviors on biological aging.
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Affiliation(s)
- Ted Kheng Siang Ng
- Arizona State University, Edson College of Nursing and Health Innovation, Phoenix, AZ 85004, USA.,National Cheng Kung University, Institute of Behavioral Medicine, College of Medicine, Taiwan
| | - David Bruce Matchar
- Duke-National University of Singapore Medical School, Program in Health Services and Systems Research, Singapore.,Duke University School of Medicine, Department of Medicine (General Internal Medicine), Durham, NC 27710, USA
| | | | - Peter O Fedichev
- GERO PTE. LTD., Singapore.,Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region 141700, Russia
| | - Angelique Wei-Ming Chan
- Duke-National University of Singapore Medical School, Program in Health Services and Systems Research, Singapore.,Duke-National University of Singapore Medical School, Center for Aging, Research and Education, Singapore.,National University of Singapore, Department of Sociology, Faculty of Arts and Social Sciences, Singapore
| | - Brian Kennedy
- National University of Singapore, Center for Healthy Longevity, Healthy Longevity Program and Department of Biochemistry, Yong Loo Lin School of Medicine, Singapore.,Singapore Institute of Clinical Sciences, A*STAR, Singapore
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Ng TKS, Gan DRY, Mahendran R, Kua EH, Ho RCM. Social connectedness as a mediator for horticultural therapy's biological effect on community-dwelling older adults: Secondary analyses of a randomized controlled trial. Soc Sci Med 2021; 284:114191. [PMID: 34271401 DOI: 10.1016/j.socscimed.2021.114191] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/21/2021] [Accepted: 06/28/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Elevated levels of inflammatory marker and a lack of social connectedness are two prominent risk factors for developing dementia and depression. Horticultural therapy (HT) has been shown to improve social connectedness and inflammatory markers. However, the underpinning mechanisms of HT remained unknown. Within this study, we hypothesized that improved social connectedness mediates the effects of HT on IL-6 levels. METHODS The present study is a secondary analysis of a randomized controlled trial investigating the bio-psycho-social effects of HT. Social connectedness was operationalized as positive relationships with others (PRWO), a sub-scale of the Ryff's scale of psychological well-being. IL-6 was quantified using a commercial ELISA kit. Outcomes were assessed at baseline, 3-month and 6-month post-intervention. Mediation analyses with bootstrapping were run to investigate our primary hypothesis. All analyses were controlled for covariates. RESULTS We recruited 59 participants (78% women; 67.10 ± 4.31 years). 29 participants partook in HT and 30 participants were included in the waitlist control group. At baseline, social connectedness was significantly correlated with IL-6 levels (β = -0.12, 95% CI = -0.21 to -0.03, p = 0.008). Furthermore, social connectedness at 3-month significantly mediated the effects of HT on IL-6 levels at 6-month (β = 0.32, 95% CI = 0.09 to 0.54, p = 0.005; β = -0.25, 95% CI = -0.45 to -0.05, p = 0.016). CONCLUSIONS These findings highlight the critical roles of social connectedness as a social determinant of health in eliciting HT's biological effects. When administering HT, interventionalists should consider social connectedness as a modifiable factor for ameliorating increased inflammation in older adults.
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Affiliation(s)
- Ted Kheng Siang Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore.
| | - Daniel R Y Gan
- Real Estate Foundation Postdoctoral Fellow at the Gerontology Research Centre, Simon Fraser University, #2800-515 West Hastings St, Vancouver, B.C, V6B 5K3, Canada
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore; Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore; Academic Development Department, Duke-NUS Medical School, 8 College Road, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore; Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore
| | - Roger C-M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore; Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore
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Chu HY, Chan HS, Chen MF. Effects of Horticultural Activities on Attitudes toward Aging, Sense of Hope and Hand-Eye Coordination in Older Adults in Residential Care Facilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6555. [PMID: 34207071 PMCID: PMC8296344 DOI: 10.3390/ijerph18126555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 11/24/2022]
Abstract
This study investigated the effects of an 8-week horticultural activity intervention on attitudes toward aging, sense of hope, and hand-eye coordination in 88 older adults in residential care facilities. In the experimental group, the mean score for "attitudes toward aging" increased from 3.81 before the intervention to 4.74 points after the intervention (standard deviation SD = 0.24 and 0.27, respectively), and the control group dropped from 3.75 to 3.70 (standard deviations, respectively SD = 0.27 and 0.28). The mean score for "sense of hope" increased from 3.28 before the intervention to 3.81 points after the intervention (SD = 0.49 and 0.26, respectively). In contrast to the control group, the mean score gradually declined from 3.26 to 3.16 points (standard deviation SD = 0.54 and 0.48, respectively). In the test of hand-eye coordination, the time required to complete the cup stacking test significantly decreased from 33.56 to 25.38 s in the experimental group but did not significantly change in the control group. Generalized estimating equation analysis revealed a significant interaction between group and time (p < 0.001). The data trends revealed significant differences in outcomes between the experimental group and the control group. At 3 months after the end of the study, the effect size in the experimental group remained higher than that in the control group.
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Affiliation(s)
- Hui-Ying Chu
- Department of Living Services Industry, Tainan University of Technology, No. 529, Zhongzheng Rd., Yongkang District, Tainan City 71002, Taiwan
| | - Hui-Shan Chan
- Department of Applied Cosmetology, National Tainan Junior College of Nursing, 78 Sec. 2, Minzu Rd., Tainan City 70043, Taiwan;
| | - Mei-Fang Chen
- Department of Nursing, National Tainan Junior College of Nursing, 78 Sec. 2, Minzu Rd., Tainan City 70043, Taiwan;
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Meore A, Sun S, Byma L, Alter S, Vitale A, Podolak E, Gibbard B, Adams T, Boyer J, Galfalvy H, Yehuda R, Feder A, Haghighi F. Pilot evaluation of horticultural therapy in improving overall wellness in veterans with history of suicidality. Complement Ther Med 2021; 59:102728. [PMID: 33965561 DOI: 10.1016/j.ctim.2021.102728] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/02/2021] [Accepted: 05/03/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Novel approaches to mental health and suicide prevention are lacking. Converging evidence has shown the effectiveness of horticultural therapy (HT) in improving mental health symptoms, but whether it would reduce suicide risk and contributing risk factors is unknown. DESIGN Using a cohort model, HT was delivered 3.5 h over four weekly, sessions administered by a registered horticultural therapist to veterans with history of suicide ideation or attempt who felt isolated and experienced ongoing environmental stressors with interest in learning new coping strategies. SETTING HT delivery occurred in an urban garden, through a community partnership between the VA (Veterans Administration) and the New York Botanical Garden. Guided by principles of biophilia, participating veterans took part in nature walks, self-reflection and journaling, and planting activities. OUTCOME MEASURES Stress, mood, pain, and social isolation levels were measured weekly pre-post HT sessions using thermometer scales, with concordant validity to validated clinical instruments. RESULTS Of the 20 men and women with a history of suicide attempts/ideation, HT demonstrated immediate improvements after each session across all symptom domains in magnitude of reduction in stress, pain, mood, and loneliness. The effect sizes were in medium to large range (Cohen's d>.5). Additionally, a single HT session showed a sustained effect over subsequent 2-to-4 weeks as observed by the significantly decreased pre-session thermometer scores in subsequent weeks. Reductions in mood symptoms correlated with decline in suicidal ideation (rs = 0.63). CONCLUSION HT intervention maybe a promising therapeutic modality for improving overall wellness in suicide prevention in at-risk veteran populations.
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Affiliation(s)
- Anne Meore
- New York Botanical Garden, Bronx, NY, United States
| | - Shengnan Sun
- James J. Peters VA Medical Center, Bronx, NY, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Lauren Byma
- James J. Peters VA Medical Center, Bronx, NY, United States
| | - Sharon Alter
- James J. Peters VA Medical Center, Bronx, NY, United States
| | - Amanda Vitale
- James J. Peters VA Medical Center, Bronx, NY, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Evan Podolak
- James J. Peters VA Medical Center, Bronx, NY, United States
| | | | - Toby Adams
- New York Botanical Garden, Bronx, NY, United States
| | - James Boyer
- New York Botanical Garden, Bronx, NY, United States
| | | | - Rachel Yehuda
- James J. Peters VA Medical Center, Bronx, NY, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ann Feder
- James J. Peters VA Medical Center, Bronx, NY, United States
| | - Fatemeh Haghighi
- James J. Peters VA Medical Center, Bronx, NY, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States.
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Community Garden Initiatives Addressing Health and Well-Being Outcomes: A Systematic Review of Infodemiology Aspects, Outcomes, and Target Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041943. [PMID: 33671320 PMCID: PMC7922762 DOI: 10.3390/ijerph18041943] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 11/17/2022]
Abstract
Previous research has suggested that activities such as community gardens could offer a wide range of health benefits. The aim of the article is to systematically review the available literature to analyse the magnitude of the phenomenon, the geographical distribution, and the main characteristics in terms of health outcomes and target populations. The search addresses the question whether the activity in community gardens improves health and well-being outcomes of individuals. From the total amount of 7226, 84 selected articles showed that:(1) up to 50% are published by U.S. universities or institutions; (2) up to 44% of the studies considered “community gardens” as the main activity of the research focus; (3) one-third of the studies included adults; (4) almost 25% of the studies used “general health” as the main outcome when investigating the benefits of community gardens; (5) the percentage of studies that achieved their outcomes was heterogeneous among the different health dimensions. In conclusion, while a certain degree of heterogeneity in the used definition and outcome still exist, community gardens may be a viable strategy for well-being promotion in terms of psychological, social, and physical health and may be considered as an innovative urban strategy to promote urban public health.
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Wong GCL, Ng TKS, Lee JL, Lim PY, Chua SKJ, Tan C, Chua M, Tan J, Lee S, Sia A, Ng MKW, Mahendran R, Kua EH, Ho RCM, Larbi A. Horticultural Therapy Reduces Biomarkers of Immunosenescence and Inflammaging in Community-Dwelling Older Adults: A Feasibility Pilot Randomized Controlled Trial. J Gerontol A Biol Sci Med Sci 2021; 76:307-317. [PMID: 33070170 PMCID: PMC7812436 DOI: 10.1093/gerona/glaa271] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND With the challenges that aging populations pose to health care, interventions that facilitate alleviation of age-related morbidities are imperative. A prominent risk factor for developing age-related morbidities is immunosenescence, characterized by increased chronic low-grade inflammation, resulting in T-cell exhaustion and senescence. Contact with nature and associated physical activities have been shown to boost immunity in older adults and may be promoted in the form of horticultural therapy (HT). We aimed to examine the effects of HT on immunosenescence. METHOD We conducted a randomized controlled trial with 59 older adults assigned to either the HT intervention or waitlist control group. Older adults in the HT intervention group underwent HT intervention program over 6 months. Venous blood was drawn at baseline and at the third and sixth month from the commencement of this study. For participants who attended all 3 blood collection time points (HT: n = 22; waitlist: n = 24), flow cytometry analysis was performed on whole blood samples to evaluate the kinetics of lymphocyte subsets over the intervention period, revealing the composition of CD4+ and CD8+ subsets expressing exhaustion markers-CD57, CTLA4, and KLRG1. Enzyme-linked immunosorbent assays were employed to measure changes in plasma IL-6 levels. RESULTS HT is associated with increased numbers of naive CD8+ T cells and fewer CTLA4-expressing terminally differentiated effector CD4+ and CD8+ memory T cells re-expressing CD45RA (TEMRA). Furthermore, IL-6 levels were reduced during HT, and the frequencies of naive and TEMRA CD8+ T cells were found to be associated with IL-6 levels. CONCLUSION HT is associated with a reduction in the levels of biomarkers that measure the extent of T-cell exhaustion and inflammaging in older adults. The positive effects of HT on T-cell exhaustion were associated with the reduction of IL-6 levels.
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Affiliation(s)
| | - Ted Kheng Siang Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore
| | - Jia Le Lee
- Singapore Immunology Network, Agency for Science, Technology and Research
| | - Pei Yi Lim
- Department of Biological Sciences, Singapore Polytechnic
| | | | - Crystal Tan
- Singapore Immunology Network, Agency for Science, Technology and Research
| | - Michelle Chua
- Singapore Immunology Network, Agency for Science, Technology and Research
| | - Janice Tan
- Singapore Immunology Network, Agency for Science, Technology and Research
| | - Samantha Lee
- Department of Biological Sciences, Singapore Polytechnic
| | - Angelia Sia
- Centre for Urban Greenery and Ecology Research, National Parks Board, Singapore
| | - Maxel K W Ng
- Horticulture & Community Gardening Division, National Parks Board, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Anis Larbi
- Singapore Immunology Network, Agency for Science, Technology and Research
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Lin TY, Huang CM, Hsu HP, Liao JY, Cheng VYW, Wang SW, Guo JL. Effects of a Combination of Three-Dimensional Virtual Reality and Hands-on Horticultural Therapy on Institutionalized Older Adults' Physical and Mental Health: Quasi-Experimental Design. J Med Internet Res 2020; 22:e19002. [PMID: 33135666 PMCID: PMC7669444 DOI: 10.2196/19002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/05/2020] [Accepted: 08/10/2020] [Indexed: 12/21/2022] Open
Abstract
Background Institutionalized older adults have limited ability to engage in horticultural activities that can improve their physical and mental health. Objective This study explored the effects of a combination of 3D virtual reality and horticultural therapy on institutionalized older adults’ physical and mental health. Methods The study used a quasi-experimental design. A total of 106 older adults from 2 long-term care facilities were recruited and assigned to the experimental (n=59) or control (n=47) group. The experimental participants received a 9-week intervention. Both groups completed 3 assessments: at baseline, after the intervention, and 2 months later. The outcome variables included health status, meaning in life, perceived mattering, loneliness, and depression. Results The experimental group demonstrated significantly improved health status (P<.001), meaning in life (P<.001), and perceived mattering (P<.001) as well as significantly reduced depression (P<.001) and loneliness (P<.001) compared to the control group immediately after the intervention; these effects persisted for up to 2 months. Conclusions This study verified the beneficial effects of a combination of 3D virtual reality and hands-on horticultural therapy on older adults’ health. These results could support the future successful implementation of similar programs for institutionalized older adults on a larger scale.
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Affiliation(s)
- Tsung-Yi Lin
- Department of Marketing and Distribution Management, Hsing Wu University, Taipei, Taiwan
| | - Chiu-Mieh Huang
- Institute of Clinical Nursing, School of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Hsiao-Pei Hsu
- Institute of Clinical Nursing, School of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Jung-Yu Liao
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | | | - Shih-Wen Wang
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan
| | - Jong-Long Guo
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan
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Meta-analysis of controlled trials testing horticultural therapy for the improvement of cognitive function. Sci Rep 2020; 10:14637. [PMID: 32884098 PMCID: PMC7471303 DOI: 10.1038/s41598-020-71621-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 08/12/2020] [Indexed: 11/08/2022] Open
Abstract
Improving cognitive function is one of the most challenging global issues in cognitive impairment population. Horticultural therapy involves the expertise of a horticultural therapist who establishes a treatment plan for horticultural activities that aim to achieve cognitive changes, and thereby improve health-related quality of life. However, more convincing evidence demonstrating the effect of horticultural therapy on cognitive function is essential. The purpose of this study was to conduct a meta-analysis of controlled trials testing the effect of horticultural therapy on cognitive function and the findings indicate that horticultural therapy programs significantly improved cognitive function. The effect size of the horticultural therapy program was large. Findings of this meta-analysis have important implications for practice and policies. Contemporary healthcare systems should consider horticultural therapy as an important intervention for improving patients’ cognitive function. Governments and policy-makers should consider horticultural therapy as an important tool to prevent the decline of cognitive function in cognitive impairment population.
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18
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Tu PC, Cheng WC, Hou PC, Chang YS. Effects of Types of Horticultural Activity on the Physical and Mental State of Elderly Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145225. [PMID: 32698351 PMCID: PMC7400358 DOI: 10.3390/ijerph17145225] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/12/2020] [Accepted: 07/15/2020] [Indexed: 02/03/2023]
Abstract
This study aimed to evaluate the effect of types of horticultural activities among elderly individuals in a senior citizen learning camp. We arranged four horticultural activities: Grass Doll, Kokedama, Rocky Leaf Prints, and Herb Tasting and Smelling. Twenty-seven senior citizens (60 to 76 years) were recruited to participate. We assessed their physiological and mental state before and after the activities by measuring heart rate variability (HRV), pulse rate, blood pressure, salivary amylase activity (SAA), and Profile of Mood States (POMS). Results showed that SAA was significantly lower after the Rocky Leaf Prints, Herb Tasting and Smelling, and Kokedama. Pulse rate had a downward trend after the four horticultural activities. The ratio of low frequency (LF) over high frequency (HF) results showed that the Rocky Leaf Prints had a larger downward trend, followed by Herb Tasting and Smelling. POMS scores indicated significant improvement for Rocky Leaf Prints and Herb Tasting and Smelling. The types including artistic creation and food tasting were promising methods for psychological relaxation, stress reduction, and vigor enhancement for elderly persons. Findings showed that the impact of activities involving contact with plants was more significant in short-term activities. We hope this study can help plan the horticultural activities of the elderly in the future.
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Affiliation(s)
- Pei-Chun Tu
- Department of Horticulture and Landscape Architecture, National Taiwan University, Taipei 106, Taiwan; (P.-C.T.); (P.-C.H.)
| | - Wen-Chen Cheng
- School of Nursing, Fooyin University, Kaohsiung 831, Taiwan;
| | - Ping-Cheng Hou
- Department of Horticulture and Landscape Architecture, National Taiwan University, Taipei 106, Taiwan; (P.-C.T.); (P.-C.H.)
| | - Yu-Sen Chang
- Department of Horticulture and Landscape Architecture, National Taiwan University, Taipei 106, Taiwan; (P.-C.T.); (P.-C.H.)
- Correspondence: ; Tel.: +886-2-3366-4856
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Zu X, Zhang Z, Wu Y, Zheng J. The Spillover Effects of Supportive Neighboring Behavior on Mental Health and Career Satisfaction: A Longitudinal Research on Chinese Low-Income Employees. Psychol Res Behav Manag 2020; 13:507-515. [PMID: 32607020 PMCID: PMC7304670 DOI: 10.2147/prbm.s239435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 05/23/2020] [Indexed: 11/23/2022] Open
Abstract
Background We examined the effects of supportive neighboring behavior on mental health and career satisfaction among Chinese low-income employees. We further examined the mediating roles of work interference with family (WIF) and of family interference with work (FIW) in this relationship. Methods A total of 220 Chinese low-income employees were selected via two-wave longitudinal survey in China; the time distance was five weeks. They completed questionnaires on their self-reported supportive neighboring behavior, work-family conflict, general mental health and career satisfaction. Afterwards, we adopted a structural equation modeling (SEM) to examine our hypotheses by R (Version 3.5.3) and Lavaan Package (Version 0.6-3). Results Supportive neighboring behavior (Time 1) improved good mental health (Time 2) and career satisfaction (Time 2). Work interference with family (Time 1) mediated the effect of neighboring behavior on mental health while family interference with work (Time 1) mediated the effect of neighboring behavior on mental health and career satisfaction. Conclusion Our findings suggest that supportive neighboring behavior is vital in mitigating mental health problems and enhancing career satisfaction by decreasing work interference with family and family interference with work. Our research expands the scope of current literature on community support by incorporating bi-directional supportive neighboring behavior. By adopting family interference with work and work interference with family as mediators, our research examines the spillover mechanisms through which career satisfaction and mental health are influenced by supportive neighboring behavior.
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Affiliation(s)
- Xiaoqian Zu
- School of Management, Harbin Institute of Technology, Harbin, People's Republic of China
| | - Zhenduo Zhang
- School of Management, Harbin Institute of Technology, Harbin, People's Republic of China
| | - Yongxiang Wu
- School of Management, Harbin Institute of Technology, Harbin, People's Republic of China
| | - Junwei Zheng
- Department of Construction Management, Kunming University of Science and Technology, Kunming, People's Republic of China
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Lee RZY, Yu J, Rawtaer I, Allen PF, Bao Z, Feng L, Feng Q, Lee JK, Lim CT, Ling LH, Thang LL, Naing T, Wang DY, Yap KZ, Kua EH, Mahendran R. CHI study: protocol for an observational cohort study on ageing and mental health in community-dwelling older adults. BMJ Open 2020; 10:e035003. [PMID: 32371513 PMCID: PMC7229981 DOI: 10.1136/bmjopen-2019-035003] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Ageing is associated with a multitude of healthcare issues including dementia, depression, frailty, morbidity associated with chronic disease and high healthcare utilisation. With Singapore's population projected to age significantly over the next two decades, it has become increasingly important to understand the disease burden and etiological process among older adults. The Community Health and Intergenerational study aims to holistically examine ageing in place by investigating the resilience and vulnerability factors of the ageing process in the biological, psychological and social domains within the environment. METHODS AND ANALYSIS Using a cohort multiple randomised controlled trial design, comprehensive health profiles of community-dwelling older adults will be collected. The objective is to recruit 1000 participants (aged 60-99 years) living in the western region of Singapore within a period of 3 years (2018-2020). Assessments include basic sociodemographic, physical health and function (cardiac, oral and blood profiles and visual function), cognitive functioning, daily functioning, physical fitness, emotional state, free-flowing speech, sleep quality, social connectedness, caregiver burden, intergenerational communication, quality of life, life satisfaction, attitudes to ageing and gratitude and compassion. Results from the cohort will enable future studies to identify at-risk groups and develop interventions to improve the physical and mental health and quality of life of older adults. ETHICS AND DISSEMINATION Approval of the cohort study by the National University of Singapore Institutional Review Board (NUS-IRB Reference code: H-17-047) was obtained on 12 October 2017. Written consent will be obtained from all participants. Findings from the cohort study will be disseminated by publication of peer-reviewed manuscripts, presentations at scientific meetings and conferences with local stakeholders.
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Affiliation(s)
- Rachael Zhi Yi Lee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Junhong Yu
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Iris Rawtaer
- Department of Psychiatry, Sengkang General Hospital, Singapore
| | - Patrick Finbarr Allen
- Dean, Faculty of Dentistry, National University of Singapore, Singapore
- Centre for Oral Health, National University Health System, Singapore
| | - Zhiming Bao
- Department of English Language and Literature, Faculty of Arts and Social Science, National University of Singapore, Singapore
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Qiushi Feng
- Department of Sociology, National University of Singapore, Singapore
- Centre for Family and Population Research, National University of Singapore, Singapore
| | - Jeong Kyu Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Chin Tat Lim
- Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lieng Hsi Ling
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Heart Centre, Singapore
| | - Leng Leng Thang
- Centre for Family and Population Research, National University of Singapore, Singapore
- Department of Japanese Studies, National University of Singapore, Singapore
| | - Thet Naing
- Department of Ophthalmology, National University Health System, Singapore
| | - D Y Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kai Zhen Yap
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
| | - E H Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Academic Development Department, Duke-NUS Medical School, Singapore
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Hassan A, Qibing C, Yinggao L, Tao J, Li G, Jiang M, Nian L, Bing-Yang L. Psychological and physiological effects of viewing a money plant by older adults. Brain Behav 2019; 9:e01359. [PMID: 31305032 PMCID: PMC6710203 DOI: 10.1002/brb3.1359] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/24/2019] [Accepted: 06/24/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Observing plants can induce neurophysiological responses that can alleviate stress and reduce anxiety. However, few studies have examined such effects in older adults. METHODS The physiological and psychological effects of observing nature (visual observation of a money plant) on 50 older Chinese women (age range: 58-90 years, SD: 8.5 years) were investigated. The participants observed a healthy money plant in a planter for 5 min; the lack of presence of a plant was used as a control. Physiological measurements were assessed using electroencephalography, and the STAI was used as a psychological assessment. RESULTS After a 5-min observation of a money plant as compared with the control condition, systolic blood pressure significantly decreased, variations in both high alpha and high beta brainwaves were found, and psychological measurements revealed lower anxiety scores. CONCLUSIONS Our findings indicate that viewing a money plant for 5 min may enhance both psychological and physiological relaxation in older adults.
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Affiliation(s)
- Ahmad Hassan
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Chen Qibing
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Liu Yinggao
- College of Forestry, Sichuan Agricultural University, Chengdu, China
| | - Jiang Tao
- College of Forestry, Guizhou University, Guizhou, China
| | - Guo Li
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Mingyan Jiang
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Li Nian
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Lv Bing-Yang
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
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Ng KST, Sia A, Ng MKW, Tan CTY, Chan HY, Tan CH, Rawtaer I, Feng L, Mahendran R, Larbi A, Kua EH, Ho RCM. Effects of Horticultural Therapy on Asian Older Adults: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081705. [PMID: 30096932 PMCID: PMC6121514 DOI: 10.3390/ijerph15081705] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 08/01/2018] [Accepted: 08/07/2018] [Indexed: 01/17/2023]
Abstract
The effect of horticultural therapy (HT) on immune and endocrine biomarkers remains largely unknown. We designed a waitlist-control randomized controlled trial to investigate the effectiveness of HT in improving mental well-being and modulating biomarker levels. A total of 59 older adults was recruited, with 29 randomly assigned to the HT intervention and 30 to the waitlist control group. The participants attended weekly intervention sessions for the first 3 months and monthly sessions for the subsequent 3 months. Biological and psychosocial data were collected. Biomarkers included IL-1β, IL-6, sgp-130, CXCL12/SDF-1α, CCL-5/RANTES, BDNF (brain-derived neurotrophic factor), hs-CRP, cortisol and DHEA (dehydroepiandrosterone). Psychosocial measures examined cognitive functions, depression, anxiety, psychological well-being, social connectedness and satisfaction with life. A significant reduction in plasma IL-6 level (p = 0.02) was observed in the HT intervention group. For the waitlist control group, significant reductions in plasma CXCL12 (SDF-1α) (p = 0.003), CXCL5 (RANTES) (p = 0.05) and BDNF (p = 0.003) were observed. A significant improvement in social connectedness was also observed in the HT group (p = 0.01). Conclusion: HT, in reducing plasma IL-6, may prevent inflammatory disorders and through maintaining plasma CXCL12 (SDF-1α), may maintain hematopoietic support to the brain. HT may be applied in communal gardening to enhance the well-being of older adults.
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Affiliation(s)
- Kheng Siang Ted Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Angelia Sia
- Centre for Urban Greenery and Ecology Research, National Parks Board, Singapore 259569, Singapore.
| | - Maxel K W Ng
- Horticulture and Community Gardening Division, National Parks Board, Singapore 259569, Singapore.
| | - Crystal T Y Tan
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore 138648, Singapore.
| | - Hui Yu Chan
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Chay Hoon Tan
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore.
| | - Iris Rawtaer
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore.
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore.
| | - Anis Larbi
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore 138648, Singapore.
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore.
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore.
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