Association between successful aging transitions and depressive symptoms among older Korean adults: findings from the Korean longitudinal study of aging (2006-2018)

Successful aging was negatively associated with depression and anxiety symptoms among adults aged 65 years and older in Ningbo, China

BACKGROUND

Depression and anxiety are the emotional problems most frequently experienced by older adults. We aimed to investigate the associations between successful aging (SA) and depression and anxiety in older adults from Ningbo, China.

METHODS

A cross-sectional study of 6,672 community-dwelling adults aged 65 years or older was performed. SA, depression, and anxiety symptoms were self-reported and measured using the Successful Aging Inventory (SAI), Patient Health Questionnaire-9 item (PHQ-9), and the 7-item Generalized Anxiety Disorder scale (GAD-7), respectively. Linear and logistic regression analyses were used to estimate the associations of SA with depression and anxiety.

RESULTS

After multivariate adjustment, we found that the SAI score was independently associated with the PHQ-9 and GAD-7 scores (β = -0.069 and - 0.048, respectively). Multivariate-adjusted spline regression models showed negative, nonlinear dose-response associations between the SAI score and both depression and anxiety symptoms (Pfor nonlinearity = 0.001 for both). With the highest quartile set as the reference, we determined that the lowest SAI score quartile was independently associated with both depression symptoms (OR = 16.131, 95% CI: 8.423, 30.892) and anxiety symptoms (odds ratio [OR] = 10.926, 95% confidence interval [CI]: 5.268, 22.664). In subgroup analyses, the association between the SAI score and depression symptoms was significantly higher in rural than in urban areas (Pfor interaction = 0.024).

CONCLUSION

Among older adults in Ningbo, China, SA was found to play an important role in depression and anxiety symptoms, suggesting the need for effective and feasible interventions to promote SA in Chinese older adults.

Sociodemographic, lifestyle and psychological factors associated with healthy ageing in a national longitudinal study of middle-aged and older adults in Thailand

The aim of this study was to estimate the longitudinal associations with healthy ageing as well as its association with mortality in a national sample in Thailand. The analytic sample consisted of 2585 participants (≥45 years) in four study assessments in 2015, 2017, 2020, and 2022. The distribution of the healthy ageing components at baseline was 93.7% no major disease, 97.2% no activities of daily living (ADL) disability, 86.3% no depression, 91.8% social engagement and 88.1% high quality of life (QoL); healthy ageing increased from 64.7% in 2015 to 67.1% in 2022. Standardised self-reported measures were used to assess healthy ageing components and covariates. In the adjusted GEE logistic regression analysis, working, high subjective economic status, high physical activity or exercise, and high subjective life expectancy were positively associated, and aged 70 years and older, widowed, past smoking, having underweight, obesity, and low self-rated physical health were negatively associated with healthy ageing. In addition, in adjusted Cox regression, healthy ageing was negatively associated with mortality. Sociodemographic factors, lifestyle indicators, self-rated physical health and subjective life expectancy were associated with healthy ageing. Addressing modifiable factors (e.g. lifestyle factors such as physical activity, smoking or underweight and/or obesity) may contribute to healthy ageing.

Changes in successful aging and its related indicators among community-dwelling older adults: The Korean Frailty and Aging Cohort Study (KFACS)

This study aims to determine the prevalence of successful aging (SA) and examine the association of changes in the indicators of SA and variations in SA status between 2016 and 2020. The study included 548 participants recruited for the Korean Frailty and Aging Cohort Study (KFACS). Compared to participants who achieved SA in 2016 (N = 393, 71.7%), the number of older adults with SA decreased by 7.8% in 2020. Among older adults preserving SA (SA→SA group, 54%), there were relatively small numbers of older adults who successfully maintained indicators, including chronic diseases (no→no, 9.5%), employment (yes→yes, 12.2%), and volunteer activities (yes→yes, 2.9%). Our findings suggest that interventions to strengthen the physical and psychological function of older adults are needed, and social support needs to be guaranteed to improve social engagement for older adults.

Regional differences in the Association of Healthy Aging with the incidence of falls: an analysis based on the China Health and Retirement Longitudinal Study from 2011 to 2020

Background

Falls frequently occur among the older adult population. In this study, we examined the variations in fall incidence across different regions over time, focusing on the disparities between urban and rural areas among older adult Chinese individuals, Healthy aging is comprised of five dimensions: (1) absence of chronic diseases, (2) good physical functioning, (3) normal cognitive function, (4) active social participation, and (5) absence of depression. Additionally, we explored the relationship between healthy aging and the occurrence of falls in middle-aged and older adults. Falls are defined as events that occurred within the past two years.

Results

Among 9,918 participants, 33.8% lived in urban areas and 23.0% achieved healthy aging. In contrast, 66.2% resided in rural areas with 16.5% achieving healthy aging. In 2011, rural residents had a higher fall incidence rate (17% in rural vs. 13.5% in urban); by 2020, the fall rate remained higher in rural areas (19.5% in rural vs. 17.3% in urban). Unhealthy aging (HR = 1.08, 95%CI: 1.00-1.16) were risk factors for falls. Subgroup analysis revealed that in rural areas, unhealthy aging increased the risk of falls. In urban areas, the increased risk of falls associated with unhealthy aging was not significant (Rural HR = 1.11, 95%CI:1.01-1.22; Urban HR = 1.05, 95%CI: 0.93-1.18).

Conclusion

Healthy aging may be more strongly associated with a lower risk of falls in rural areas, while this association might be less pronounced in urban areas due to different environmental and social factors. This highlights the need for environment-specific fall prevention strategies and targeted measures for the older adult.

Regional differences in the effects of healthy aging on depressive symptoms: a Korean longitudinal study of aging (2006-2020)

Background

Depression is a widely prevalent, often recurrent condition. To analyze the regional differences in depressive symptoms over time, we investigated urban-rural differences in change in depression over time in South Korea and the association between healthy aging and depressive symptoms among middle-aged and older adults.

Methods

Data collected in the Korean Longitudinal Study of Aging, from 2006 to 2020, of adult participants aged ≥45 years without depressive symptoms were analyzed. Healthy aging was defined under five principal components: absence of chronic disease, good physical function, normal cognitive function, active social engagement, and good psychological adaptation. Depressive symptoms were measured using the short version of the Center for Epidemiologic Studies Depression Scale. Using the Andersen-Gill model for recurrent time-to-event, we examined the effect of healthy aging on depressive symptoms, with a subgroup analysis based on the residential area.

Results

Of the 7,708 participants, 78.2% lived in urban areas and 39.4% achieved healthy aging. In 2008, rural residents had a higher incidence of depressive symptoms (rural 11.8%; urban 8.9%); however, after 2016, the depressive symptoms of urban residents gradually increased (rural 6.4%; urban 12.1%). Unhealthy aging (adjusted hazard ratio = 3.04, 95% confidence interval: 2.72-3.39) and urban residence (adjusted hazard ratio = 1.15, 95% confidence interval: 1.06-1.24) were risk factors for depressive symptoms. The subgroup analysis revealed that individuals who did not achieve healthy aging had an increased risk of depressive symptoms, regardless of their residential area (hazard ratio [95% confidence interval]: urban, 3.13 [2.75-3.55]; rural 2.59 [2.05-3.28]).

Conclusion

As urbanization accelerates, urban residents have a higher risk of depressive symptoms than rural residents. Healthy aging is an essential factor in reducing depressive symptoms. To achieve healthy aging, appropriate interventions and policies that target the middle-aged adults and gradually extend to older adults are needed, considering individual and regional factors.

Individual and environmental factors associated with successful aging among Korean older adults: Multilevel analysis of cross-sectional nationwide survey data

PURPOSE

The importance of environmental influences on successful aging has recently been emphasized. However, existing studies that investigated environmental factors related to successful aging in older adults did not apply multi-level analysis while simultaneously examining individual and environmental factors related to successful aging. Therefore, this study aimed to determine the level of successful aging in older adults and the individual and environmental factors related to successful aging.

MATERIALS AND METHODS

Data from a nationwide survey were used. The study comprised a cross-sectional sample of 73,942 community-dwelling adults aged ≥65 years with individual-level data drawn from the 2019 Korea Community Health Survey. Community-level data of 255 local administrative districts (cities or counties) were extracted from the Community Health Determinant Database from 2017 to 2019. These data were merged and used in multi-level logistic regression analyses.

RESULTS

Generally, 27.1% of the participants achieved successful aging. Individual factors including sex, age, marital status, education level, job, monthly household income, smoking, physical activity, and body mass index were significantly associated with successful aging. Four environmental factors, urban residential area, social network, satisfaction with living environment, and air quality, were positively associated with successful aging at the community level; among them, high satisfaction with living environment (OR = 6.06, 95% CI: 2.43-15.12) was the most strongly associated factor with successful aging.

CONCLUSIONS

The findings suggest that environmental factors are essential for successful aging among older adults in addition to individual factors. Therefore, multiple strategies considering individual and environmental factors are needed to improve successful aging.

Depression and oral health-related quality of life: A longitudinal study

Objectives

Geriatric oral health-related quality of life is a relatively new but rapidly growing concept as it is directly related to the general wellbeing and self-esteem of older adults. This study assessed the impact of worsening depression symptoms on oral health-related quality of life using representative nationwide data of Korean older adults.

Methods

This study comprised a longitudinal sample of older adults aged ≥60 from the Korean Longitudinal Study of Aging (2016-2020). After applying the exclusion criteria, 3,286 participants were included in the study. Depression status was determined through the biennial assessment of the short-form Center for Epidemiologic Studies Depression Scale (CESD-10); oral health was measured using the Geriatric Oral Health Assessment Index (GOHAI). We employed the lagged general estimating equations to assess the temporal effect of the CESD-10 score change on the GOHAI score.

Results

A decrease in CESD-10 score over a 2-year period was significantly associated with a decrease in GOHAI score in men and women: β = -1.810 and β = -1.278, respectively (p-values < 0.0001). Furthermore, compared to the same or improved CESD-10 score, worsening of the score on 1-2 points detected the β = -1.793 in men and β = -1.356 in women, and worsening on ≥3 points: β = -3.614 in men and β = -2.533 in women.

Conclusions

This study found that depression exacerbation is negatively associated with oral health-related quality of life in later life. Further, a more significant worsening of depression symptoms was correlated with lower scores for oral health-related quality of life in our study population.

Marital transition and cognitive function among older adults: the korean Longitudinal Study of Aging (2006-2020)

BACKGROUND

Marital status has been suggested as an associated factor for cognitive impairment. The consequences of marital transitions are still understudied. This study evaluated the influence of marital transitions on cognitive function using longitudinal, nationwide data of Korean older adults.

METHODS

This research comprised a longitudinal sample of older adults aged ≥ 45 years old, drawn from the Korean Longitudinal Study of Aging (2006-2020). Marital transition was determined through the biennial assessment of change in marital status; cognitive function was measured using the Korean version of the Mini-Mental State Examination. We employed general estimating equations to assess the temporal effect of marital transition on cognitive function.

RESULTS

Compared to married individuals, the odds ratios (ORs) of cognitive decline were higher in not married and transitioned out of marriage participants: men (OR 1.32, 95% confidence interval (CI) 0.96-1.82; OR 1.42, 95% CI 0.90-2.24), women (OR 1.21, 95% CI 1.03-1.42; OR 1.20, 95% CI 1.01-1.52), respectively, despite the findings being not statistically significant in men. The participants who transitioned out of marriage over time also showed greater ORs for mild cognitive impairment: men (OR 1.39, 95% CI 0.79-1.87), women (OR 1.33, 95% CI 1.05-1.80), and dementia: men (OR 1.60, 95% CI 0.85-1.99), women: (OR 1.49, 95% CI 1.20-2.19).

CONCLUSION

Marital transition is found to be associated with cognitive function decline. Not-married individuals and those who became divorced or widowed were associated with the risk of cognitive function decline. Particular attention should be paid to these marital transitioned groups.

Living Arrangement of Older Adults and its Effect on Five-Year Survival

INTRODUCTION

Given the impact of living alone on health outcomes, this study was conducted to assess the living arrangement of senior adults and its effect on the mortality.

MATERIAL AND METHODS

This cohort study carried out on elderly people aged 60 years and over. Demographic characteristics, the number of comorbid disorders and living condition-as being alone or living with other people-were collected. The mini-mental state examination questionnaire, the geriatric depression scale, the Katz index of activities of daily living, the Lawton instrumental activities of daily living scale, and a modified version of Duke social support index were used for data collection. The participants were followed for five years, and their survival was assessed.

RESULTS

Out of the 500 examined individuals, 100 (20.0%) were living alone. During 5 years of follow-up, sixteen (19.8%) of the people who died were living alone. The adjusted effect of age (P<0.001), male gender (P=0.004), the number of comorbidities (P=0.031), the person's social support (P=0.028) and dependence to others to do complex daily activities (P=0.020) on the mortality of the participants was significant, however, other factors including living alone, illiteracy, cognitive impairment and depression did not show such a statistically significant effect (P>0.05).

CONCLUSION

Living arrangement, itself, did not show a significant effect on the mortality of older adults.

The Influence of Pension Mode on the Mental Health of Older Adults-Evidence from Older Adults in China

Successful aging is achieved throughout the life course, and successful aging groups tend to have good psychosocial and physical conditions and are active in social activities. With increasing age, the mental health problems of older adults have become increasingly prominent, and the choice of pension mode is closely related to the mental health of older adults. Starting from the psychological level of the older adult, this paper used data from the 2018 Chinese Longitudinal Healthy Longevity Survey to study the impact of three pension methods on the mental health of older adults. The study found that, at present, there are three types of pension modes in China: living alone, family pension, and institutional care, and family pensions are still the mainstream pension mode. Older adults with deeper negative feelings are more inclined to family pensions than to live alone, but the spiritual comfort provided by family members does not improve the negative feelings of older adults. Institutional care deepens the negative feeling and reduces the positive feeling of older adults. In addition, retirement or pension and medical insurance, as life security in old age, can effectively reduce the negative feelings of old age and promote positive feelings. In view of the present situation of China's pension mode and the psychological characteristics of the older adults, we should further build a perfect family pension security system, promote the personalized service construction of older adult care institutions, promote applicable aging renovation of existing residential areas, and encourage older adults to engage in healthy exercise.