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He YY, Ding KR, Tan WY, Ke YF, Hou CL, Jia FJ, Wang SB. The Role of Depression and Anxiety in the Relationship Between Arthritis and Cognitive Impairment in Chinese Older Adults. Am J Geriatr Psychiatry 2024:S1064-7481(24)00239-2. [PMID: 38383225 DOI: 10.1016/j.jagp.2024.01.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Mental disorders and cognitive impairment are common in older patients with arthritis. While it is recognized that mental conditions may play a role in the connection between arthritis and cognitive impairment, the precise underlying relationship remains uncertain. METHODS The data was derived from the baseline survey of the Guangdong Mental Health Survey in South China, involving a sample of 3,764 citizens aged 65 and older. An array of aspects were explored, including socio-demographics, lifestyle behaviors, self-reported chronic conditions, depression, anxiety, and cognitive impairment. Logistic regression analyses examined the association between arthritis and cognitive impairment after adjustment for potential confounders. Serial mediation models were used to examine whether depression or anxiety played a mediating role in the arthritis-cognitive impairment linkage. RESULTS The prevalence rates of cognitive impairment and arthritis of the older adults were 28.9% and 12.1%, respectively. Compared to those without arthritis, participants with arthritis were at a higher risk of cognitive impairment (OR = 1.322, 95%CI: 1.022-1.709) after adjustment for socio-demographics, lifestyle behaviors, and mental health conditions. Serial mediation analyses indicated that depressive and anxiety symptoms co-played a serial mediating role in the association between arthritis and cognitive impairment (B1 = 0.025, 95%CI: 0.005-0.052; B2 = 0.050, 95%CI: 0.021-0.086). CONCLUSIONS Arthritis may heighten cognitive impairment risk in Chinese older adults, and the relationship was potentially mediated by depressive and anxiety symptoms. Future interventions should be considered, integrating mental health assessments into arthritis care frameworks and being alert to possible cognitive impairment.
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Affiliation(s)
- Yong-Yi He
- Department of Psychology, School of Public Health (Y-YH, K-RD, F-JJ), Southern Medical University, Guangzhou, China; Guangdong Mental Health Center (Y-YH, K-RD, W-YT, Y-FK, C-LH, F-JJ, S-BW), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Kai-Rong Ding
- Department of Psychology, School of Public Health (Y-YH, K-RD, F-JJ), Southern Medical University, Guangzhou, China; Guangdong Mental Health Center (Y-YH, K-RD, W-YT, Y-FK, C-LH, F-JJ, S-BW), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Wen-Yan Tan
- Guangdong Mental Health Center (Y-YH, K-RD, W-YT, Y-FK, C-LH, F-JJ, S-BW), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Yun-Fei Ke
- Guangdong Mental Health Center (Y-YH, K-RD, W-YT, Y-FK, C-LH, F-JJ, S-BW), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center (Y-YH, K-RD, W-YT, Y-FK, C-LH, F-JJ, S-BW), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Fu-Jun Jia
- Department of Psychology, School of Public Health (Y-YH, K-RD, F-JJ), Southern Medical University, Guangzhou, China; Guangdong Mental Health Center (Y-YH, K-RD, W-YT, Y-FK, C-LH, F-JJ, S-BW), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
| | - Shi-Bin Wang
- Guangdong Mental Health Center (Y-YH, K-RD, W-YT, Y-FK, C-LH, F-JJ, S-BW), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; School of Health, Zhuhai College of Science and Technology (S-BW), Zhuhai, China.
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Kemp BR, Ferraro KF, Morton PM, Thomas PA, Mustillo SA, Crimmins EM. Do Early-Life Social, Behavioral, and Health Exposures Increase Later-Life Arthritis Incidence? Res Aging 2021; 44:479-493. [PMID: 34664538 DOI: 10.1177/01640275211044979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES This study investigates direct and indirect influences of childhood social, behavioral, and health exposures on later-life osteoarthritis and rheumatoid arthritis development. METHODS Drawing from cumulative inequality theory and six waves of the Health and Retirement Study (2004-2014), we estimate structural equation modeling-based discrete-time survival analysis of the association between six childhood exposure domains and both osteoarthritis and rheumatoid arthritis incidence for men (n = 2720) and women (n = 2974). Using the delta method to test for mediation, we examine indirect effects via selected health-related risks and resources. RESULTS Risky adolescent behavior is associated with rheumatoid arthritis incidence for women (h.O.R. = 1.883, 95% C.I. [1.016, 3.490]), whereas several types of childhood exposures are associated with later-life osteoarthritis development for both men and women. Experiencing two or more childhood socioeconomic disadvantages is indirectly associated with osteoarthritis (men: coef. = 0.024, 95% C.I. [0.003, 0.045]; women: coef. = 0.111, 95% C.I. [0.071, 0.150]) and rheumatoid arthritis (men: coef. = 0.037, 95% C.I. [0.000, 0.074]; women: coef. = 0.097, 95% C.I. [0.035, 0.159]) development through adult body mass index. DISCUSSION Findings highlight the importance of childhood contexts in understanding the development of later-life osteoarthritis and rheumatoid arthritis.
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Affiliation(s)
- Blakelee R Kemp
- Department of Sociology, 14719University of Nebraska, Lincoln, NE, USA
| | - Kenneth F Ferraro
- Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA.,Department of Sociology, Purdue University, West Lafayette, IN, USA
| | - Patricia M Morton
- Department of Sociology, Wayne State University, Detroit, MI, USA.,Department of Public Health, 2954Wayne State University, Detroit, MI, USA
| | - Patricia A Thomas
- Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA.,Department of Sociology, Purdue University, West Lafayette, IN, USA
| | - Sarah A Mustillo
- Department of Sociology, 6111University of Notre Dame, South Bend, IN, USA
| | - Eileen M Crimmins
- Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA
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Kinkopf KM, Agarwal SC, Goodson C, Beauchesne PD, Trombley TM, Candilio F, Rubini M, Coppa A. Economic access influences degenerative spine disease outcomes at rural Late Medieval Villamagna (Lazio, IT). Am J Phys Anthropol 2020; 174:500-518. [PMID: 33247981 DOI: 10.1002/ajpa.24180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/27/2020] [Accepted: 11/09/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Degenerative joint disease in the spine is heavily influenced by genetic, environmental, and epigenetic factors, as well as exacerbated by physical activity and injury. The objective of this study was to investigate the multivariate relationship between known predictors of degenerative joint disease in the spine, such as age and sex, with mortuary indicators of economic access such as grave inclusions, burial location, and burial type. MATERIALS AND METHODS The presence and severity of vertebral osteophytosis (VO) and vertebral osteoarthritis (VOA) was recorded for the vertebral columns of N = 106 adult individuals from the Late Medieval period at the rural monastery of San Pietro at Villamagna in Lazio, Italy (1300-1450 AD). Multiple skeletal indicators of degenerative joint disease, morphological sex, and age were compared with differences in mortuary treatment across four regions of the spine. RESULTS There are marked differences in severe joint disease outcome between groups with more and less economic access. Relative risk ratios suggest that males and females with less economic access have elevated risk for VO and VOA in specific spine regions, although this effect is reduced among females. DISCUSSION Current research on the consequences of economic and social inequality point to the important role of economic inequality in shaping disease outcomes. Our results suggest that biocultural effects of reduced economic access at the intraclass level may increase vulnerability to the downstream effects of risk exposure (e.g., biomechanical injure, physical activity, biochemical imbalance), and ultimately increase the risk and prevalence for severe degenerative disease outcomes in medieval Italy.
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Affiliation(s)
- Katherine M Kinkopf
- Department of Geography and Anthropology, California State Polytechnic University, Pomona, Pomona, California, USA
| | - Sabrina C Agarwal
- Department of Anthropology, University of California Berkeley, Berkeley, California, USA.,Archaeological Research Facility, University of California Berkeley, Berkeley, California, USA
| | | | - Patrick D Beauchesne
- Department of Behavioral Sciences, University of Michigan, Dearborn, Dearborn, Michigan, USA
| | - Trent M Trombley
- Department of Anthropology, University of California Berkeley, Berkeley, California, USA.,Archaeological Research Facility, University of California Berkeley, Berkeley, California, USA
| | - Francesca Candilio
- Soprintendenza Archeologia, Belle Arti e Paesaggio per la città metropolitana di Cagliari ele province di Oristano e Sud Sardegna, Cagliari, Italy
| | - Mauro Rubini
- Department of Archaeology, Foggia University, Foggia, Italy.,Anthropological Service, S.A.B.A.P.-RM-MET, S.A.B.A.P.-LAZ, Rome, Italy
| | - Alfredo Coppa
- Department of Environmental Biology, Sapienza University of Rome, Rome, Italy
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Abstract
There is relatively little published on the socioeconomic distribution of chronic disease burden in older people. This study aims to quantify income-related inequalities in chronic disease situation among ≥45-year-old people in China. Data were collected from the 2015 China Health and Retirement Longitudinal Study. Self-reported chronic conditions included 14 diseases (ie, heart problem, diabetes). Multivariate Generalized Quasi-Poisson Regression was used to evaluate associations between prevalence and personal income. Prevalence of hypertension was highest among people above ≥ 75 (male participants 44.41%, female participants 47.53%). Heart problem prevalence increased with age. Chronic disease prevalence among population aged 45 to 59 years was greatly affected by income. Prevalence ratios (PRs) were highest for heart problems in 45 to 59 middle-income male participants and for memory-related diseases in 45 to 59 middle-income female participants. Significant inequalities in chronic conditions prevalence persist into old age, particularly among 45- to 59-year-old people. Opposite to developed countries, the prevalence of some chronic disease (ie, heart problem) is higher in richer populations in China. These findings pose the policy challenge of needing to prevent such inequalities in older years.
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Affiliation(s)
| | | | - Ding Ye
- 2 Hangzhou Medical College, China
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Blaney C, Sommer J, El-Gabalawy R, Bernstein C, Walld R, Hitchon C, Bolton J, Sareen J, Patten S, Singer A, Lix L, Katz A, Fisk J, Marrie RA; CIHR Team in Defining the Burden and Managing the Impact of Psychiatric Comorbidity in Immune-Mediated Inflammatory Disease. Incidence and temporal trends of co-occurring personality disorder diagnoses in immune-mediated inflammatory diseases. Epidemiol Psychiatr Sci 2020; 29:e84. [PMID: 31915099 DOI: 10.1017/S2045796019000854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AIMS Although immune-mediated inflammatory diseases (IMID) are associated with multiple mental health conditions, there is a paucity of literature assessing personality disorders (PDs) in these populations. We aimed to estimate and compare the incidence of any PD in IMID and matched cohorts over time, and identify sociodemographic characteristics associated with the incidence of PD. METHODS We used population-based administrative data from Manitoba, Canada to identify persons with incident inflammatory bowel disease (IBD), multiple sclerosis (MS) and rheumatoid arthritis (RA) using validated case definitions. Unaffected controls were matched 5:1 on sex, age and region of residence. PDs were identified using hospitalisation or physician claims. We used unadjusted and covariate-adjusted negative binomial regression to compare the incidence of PDs between the IMID and matched cohorts. RESULTS We identified 19 572 incident cases of IMID (IBD n = 6,119, MS n = 3,514, RA n = 10 206) and 97 727 matches overall. After covariate adjustment, the IMID cohort had an increased incidence of PDs (incidence rate ratio [IRR] 1.72; 95%CI: 1.47-2.01) as compared to the matched cohort, which remained consistent over time. The incidence of PDs was similarly elevated in IBD (IRR 2.19; 95%CI: 1.69-2.84), MS (IRR 1.79; 95%CI: 1.29-2.50) and RA (IRR 1.61; 95%CI: 1.29-1.99). Lower socioeconomic status and urban residence were associated with an increased incidence of PDs, whereas mid to older adulthood (age 45-64) was associated with overall decreased incidence. In a restricted sample with 5 years of data before and after IMID diagnosis, the incidence of PDs was also elevated before IMID diagnosis among all IMID groups relative to matched controls. CONCLUSIONS IMID are associated with an increased incidence of PDs both before and after an IMID diagnosis. These results support the relevance of shared risk factors in the co-occurrence of PDs and IMID conditions.
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