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Jiang W, Yang H. Effect of long-term care insurance policy on depression in non-disabled people: evidence from China. BMC Public Health 2024; 24:954. [PMID: 38575900 PMCID: PMC10993433 DOI: 10.1186/s12889-024-18375-3] [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: 10/07/2023] [Accepted: 03/17/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Policy effect might be multidimensional and spill over to non-recipients. It is unclear how the implementation of Long-Term Care Insurance (LTCI) policy affects depression in non-disabled people and how this effect differs in different non-disabled groups. METHODS Using time-varying differences-in-differences method and nationally representative health survey data in wave 2011, wave 2013, wave 2015 and wave 2018 from the China Health and Retirement Longitudinal Study, we assessed the effect of LTCI policy on depression in non-disabled people aged 45 years and older, and discussed the heterogeneity of effect across different population characteristics: retirement, financial support and social participation status. RESULTS We found LTCI policy statistically significant reduced depression by 0.76 units in non-disabled people compared to non-pilot cities. Depression in non-disabled people who unretired, with financial support and without social participation was reduced by 0.8267, 0.7079 and 1.2161 units, respectively. CONCLUSIONS Depression in non-disabled people was statistically significant reduced because of LTCI policy in China, and non-disabled people who unretired, with financial support and without social participation benefited more from LTCI policy. Our findings highlight the depression-reducing effect of LTCI policy in non-recipients and suggest that non-disabled people who unretired, with financial support and without social participation should be concerned during LTCI policy progress.
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Affiliation(s)
- Wenjing Jiang
- Center for Social Security Studies, Wuhan University, 430072, Wuhan, China
- School of Political Science & Public Administration, Wuhan University, 430072, Wuhan, China
| | - Hongyan Yang
- Center for Social Security Studies, Wuhan University, 430072, Wuhan, China.
- School of Political Science & Public Administration, Wuhan University, 430072, Wuhan, China.
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Shi J, Zhang D, Liu X. Intergenerational Caregiving Patterns and Cognitive Health among the Sandwich Generation Within Four-Generation Families. Int J Aging Hum Dev 2024:914150241235088. [PMID: 38436083 DOI: 10.1177/00914150241235088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
This study aims to investigate whether generational differences in intergenerational caregiving patterns (caring for parents only, caring for grandchildren only, and caring for parents and grandchildren simultaneously) are associated with cognitive health disparities among the sandwich generation within four-generation families, drawing upon the theories of intergenerational solidarity and intergenerational stake. Moreover, this study seeks to identify mediators that help explain these disparities. A nationally representative sample of 8,065 respondents was drawn from the 2011 and 2018 waves of the China Health and Retirement Longitudinal Study. The findings reveal that the sandwich generation caring for grandchildren only, as well as those caring for grandchildren and parents simultaneously, exhibit better cognitive health. However, caregiving for parents only is not significantly related to their cognitive health. This study identifies the inability to reduce depressive symptoms as a mediator explaining the insignificant association between caregiving for parents only and the cognitive health of the sandwich generation. The findings underscore the importance of offering support to the sandwich generation within four-generation families to enhance their cognitive health. Moreover, it is imperative to distinguish between different intergenerational caregiving patterns based on generational differences among the sandwich generation, with a specific emphasis on allocating public resources aimed at promoting cognitive health for those engaged in caring for parents.
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Affiliation(s)
- Jiaming Shi
- Department of Social Security, School of Public Administration, Southwestern University of Finance and Economics, Chengdu, China
| | - Denghao Zhang
- School of Marxism, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoting Liu
- School of Public Affairs, Zhejiang University, Hangzhou, China
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Duan A, Zhao H, Zhou C. The Effects of a Healthy Lifestyle on Depressive Symptoms in Older Chinese Adults: The Mediating Role of Psychological Resilience. Cureus 2024; 16:e57258. [PMID: 38686246 PMCID: PMC11057559 DOI: 10.7759/cureus.57258] [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] [Accepted: 03/30/2024] [Indexed: 05/02/2024] Open
Abstract
Objectives This study aimed to validate the interrelationships and potential pathways of influence between healthy lifestyles, psychological resilience, and depressive symptoms in the Chinese elderly population. Methods We utilized data from the Chinese Elderly Health Influential Factors Tracking Survey 2018 and included 9448 samples for the study after screening according to the qualifying conditions. The interrelationships among healthy lifestyles, psychological resilience and depressive symptoms were analyzed using stepwise regression, and the robustness of mediation effects was assessed using Sobel and Bootstrap test. Results Among Chinese older adults, healthy lifestyles were negatively associated with depressive symptoms (β = -0.310, 95% CI: -0.405, -0.215), positively associated with psychological resilience (β = 0.137, 95% CI:0.071, 0.023), and psychological resilience was negatively associated with depressive symptoms (β = -1.014, 95% CI: -1.037, -0.990). Conclusions Psychological resilience partially mediated the association between healthy lifestyles and depressive symptoms, with the mediating effect accounting for 44.8% of the total effect. Our study contributes to the understanding of the relationship between healthy lifestyles and depressive symptoms in the elderly population and emphasizes the important role of psychological resilience. It is recommended that the government and policymakers improve depressive symptoms among older adults through comprehensive measures such as promoting healthy lifestyles and education, providing psychological support services, and creating a favorable environment.
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Affiliation(s)
- Ailing Duan
- Public Health, Chongqing Medical University, Chongqing, CHN
| | - Hang Zhao
- Public Health, Chongqing Medical University, Chongqing, CHN
| | - Chunmin Zhou
- Public Health, Chongqing Medical University, Chonqing, CHN
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Okahashi S, Noguchi T, Ishihara M, Osawa A, Kinoshita F, Ueda I, Kamiya M, Nakagawa T, Kondo I, Sakurai T, Arai H, Saito T. Dyadic Art Appreciation and Self-Expression Program (NCGG-ART) for People with Dementia or Mild Cognitive Impairment and Their Family Caregivers: A Feasibility Study. J Alzheimers Dis 2024; 97:1435-1448. [PMID: 38250777 DOI: 10.3233/jad-231143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
BACKGROUND Non-pharmacological interventions effective for depressive mood and bilateral relationships among persons with cognitive impairment (PwCI) and their family caregivers (FCGs) have not been established. OBJECTIVE To examine the feasibility of a newly developed group-based art appreciation and self-expression program (NCGG-ART) for dyads of PwCI and their FCGs. METHODS This pilot randomized control trial included 34 dyads of PwCI diagnosed with mild to moderate Alzheimer's disease or mild cognitive impairment, and their FCGs, from an outpatient rehabilitation service (Holistic Physio-Cognitive Rehabilitation [HPCR]). Participants were randomly divided equally into the HPCR (control group) or NCGG-ART and HPCR (intervention group) groups. Both included 1-hour weekly, 6-week programs. The primary outcome was depressive symptoms among FCGs assessed using the Patient Health Questionnaire-9 (PHQ-9). Feasibility outcomes included participant satisfaction and motivation. FCGs were interviewed about their experiences and feelings regarding the program, which were analyzed using content analysis. RESULTS Thirty-two dyads (intervention group:16; control group:16) completed the study period. High participation rates, satisfaction, and motivation were demonstrated throughout the intervention. Scores in the PHQ-9 among FCGs did not show positive effects: mean changes in the score were 1.3 for the intervention group and -0.8 for the control group (Cohen d:0.56). However, the qualitative analysis revealed favorable experiences and feelings of the FCGs, such as positive emotions, social interactions, and person-centered attitudes to and positive relationships with PwCI. CONCLUSIONS This program demonstrated high feasibility with FCGs' favorable responses to emotions and relationships with PwCI, ensuring future investigations with a confirmatory study design.
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Affiliation(s)
- Sayaka Okahashi
- Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Taiji Noguchi
- Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Behavioural Science and Health, University College London, London, UK
- Japan Society for the Promotion of Science, Chiyoda, Japan
| | - Masumi Ishihara
- Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Aiko Osawa
- Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- Hospital, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Fumie Kinoshita
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Ikue Ueda
- Hospital, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masaki Kamiya
- Hospital, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takeshi Nakagawa
- Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Izumi Kondo
- Hospital, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takashi Sakurai
- Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Cognition and Behavior Science, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Tami Saito
- Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
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Wang Y, Xu J, Yang S, Jiang J, Gao J. Exploratory graph analysis on the Connor-Davidson Resilience Scale (CD-RISC) among older adults in China. Sci Rep 2023; 13:19971. [PMID: 37968334 PMCID: PMC10651855 DOI: 10.1038/s41598-023-46854-x] [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: 07/16/2023] [Accepted: 11/06/2023] [Indexed: 11/17/2023] Open
Abstract
It is important for healthy aging to understand resilience in depth. This study aims to examine the dimensional structure underlying the Connor-Davidson Resilience Scale (CD-RISC) among Chinese older adults. Exploratory Graph Analysis (EGA) was used to evaluate the dimensional structure of CD-RISC in two large samples: training sample (n = 11,493) and cross-validation sample (n = 7662). Then, Confirmatory Factor Analysis (CFA) was used to compare the fit of the theoretical dimensions with the EGA dimensions. Finially, Generalized Linear Model was used to examine the association between resilience scores and self-rated health (SRH) after controlling other covariates in order to evaluate the predictive value of the EGA dimensions. The EGA indicated two demensions(named foresight and self-adjustment) of the 25-item CD-RISC. The CFA comparison found that the two-demension structure of CD-RISC fit significantly better than the theoretical three-demension structure. After controlling for sociodemographic characteristics, generalized linear model showed that the EGA dimensions has better protective value with SRH. Compared with older adults with lowest quartile of foresight, those with second (odds ratio, OR = 0.68, 95% CI = 0.62 ~ 0.75), third (OR = 0.50, 95% CI = 0.45 ~ 0.56) and fourth quartile (OR = 0.42, 95% CI = 0.37 ~ 0.48) of foresight had lower odds ratio of poor SRH. Similarly, older adults with the second (OR = 1.11, 95% CI = 1.01 ~ 1.23) and fourth (OR = 0.79, 95% CI = 0.69 ~ 0.90) quartile of self-adjustment also had lower OR of poor SRH than those with lowest quartile of self-adjustment. These findings show that EGA outperforms the traditional methods, which may be helpful to understand resilience deeply. CD-RISC should be interpreted into two aspects among community-dwelling older adults in China, highlighting the significance of the practical value and cultural context of resilience.
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Affiliation(s)
- Yujie Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Jixiang Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Shitong Yang
- School of Public Health, Fudan University, Shanghai, China
| | - Junjia Jiang
- School of Public Health, Fudan University, Shanghai, China
| | - Junling Gao
- School of Public Health, Fudan University, Shanghai, China.
- Collaborative Innovation Cooperative Unit of National Clinical Research Center for Geriatric Diseases, Shanghai, China.
- Core Unit of Shanghai Clinical Research Center for Geriatric Diseases, Shanghai, China.
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Jin X, Liu H, Niyomsilp E. The Impact of Physical Activity on Depressive Symptoms among Urban and Rural Older Adults: Empirical Study Based on the 2018 CHARLS Database. Behav Sci (Basel) 2023; 13:864. [PMID: 37887514 PMCID: PMC10604260 DOI: 10.3390/bs13100864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/14/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023] Open
Abstract
Using data from the China Health and Retirement Longitudinal Study 2018, we employed the propensity score matching method to examine the effect of physical activity on depressive symptoms among older adults across rural and urban areas. The study sample consisted of 5055 participants, with urban and rural populations representing 31.3% and 68.7%, respectively. This study found that rural older adult individuals exhibited a greater incidence of depressive symptoms and lower physical activity levels when compared to their urban counterparts. Engagement in high-intensity physical activity was identified as an effective method for mitigating depressive symptoms among older adults. However, the moderating effects of physical activity were only observed among urban older adult individuals. Our findings revealed a cross-sectional correlation between physical activity and depressive symptoms among older adult Chinese individuals, and this link differed between urban and rural areas. Although high-intensity physical activity has a positive effect on depressive symptoms among older adults, physical activity interventions should sufficiently consider the variations in older adults' living conditions and environments due to urban-rural differences so that interventions can be customized to improve the mental health of older adults.
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Affiliation(s)
- Xueyu Jin
- Taiyuan Institute of Technology, Taiyuan 030008, China;
| | - Huasen Liu
- School of Sports and Leisure, Xi’an Physical Education University, Xi’an 710068, China;
| | - Eksiri Niyomsilp
- School of Management, Shinawatra University, Pathum Thani 12160, Thailand
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