Anaemia and physical and mental health in the very old: An individual participant data meta-analysis of four longitudinal studies of ageing

2020 ◽  
Author(s):  
Leah Palapar ◽  
Ngaire Kerse ◽  
Anna Rolleston ◽  
Wendy P J den Elzen ◽  
Jacobijn Gussekloo ◽  
...  

Abstract Objective To determine the physical and mental health of very old people (aged 80+) with anaemia. Methods Individual level meta-analysis from five cohorts of octogenarians (n = 2,392): LiLACS NZ Māori, LiLACS NZ non-Māori, Leiden 85-plus Study, Newcastle 85+ Study, and TOOTH. Mixed models of change in functional ability, cognitive function, depressive symptoms, and self-rated health over time were separately fitted for each cohort. We combined individual cohort estimates of differences according to the presence of anaemia at baseline, adjusting for age at entry, sex, and time elapsed. Combined estimates are presented as differences in standard deviation units (i.e. standardised mean differences–SMDs). Results The combined prevalence of anaemia was 30.2%. Throughout follow-up, participants with anaemia, on average, had: worse functional ability (SMD −0.42 of a standard deviation across cohorts; CI -0.59,-0.25); worse cognitive scores (SMD -0.27; CI -0.39,-0.15); worse depression scores (SMD -0.20; CI -0.31,-0.08); and lower ratings of their own health (SMD -0.36; CI -0.47,-0.25). Differential rates of change observed were: larger declines in functional ability for those with anaemia (SMD −0.12 over five years; CI -0.21,-0.03) and smaller mean difference in depression scores over time between those with and without anaemia (SMD 0.18 over five years; CI 0.05,0.30). Conclusion Anaemia in the very old is a common condition associated with worse functional ability, cognitive function, depressive symptoms, and self-rated health, and a more rapid decline in functional ability over time. The question remains as to whether anaemia itself contributes to worse outcomes or is simply a marker of chronic diseases and nutrient deficiencies.

2019 ◽  
Author(s):  
Hui Feng ◽  
Yinan Zhao ◽  
Mingyue Hu ◽  
Hengyu Hu ◽  
Hui Li ◽  
...  

BACKGROUND Dementia is one of the major cause of disability and dependency among the elderly worldwide, and there are general psychological distresses among caregivers in dementia, such as depression and anxiety symptoms. The physical and mental health of the caregiver is a prerequisite and a promise to help the elderly stay alive and promote health. Web-based interventions can provide for a more convenient and efficient support and education, OBJECTIVE The purpose of this study was to examine the effect of internet-based interventions on mental health outcomes of family caregivers with dementia, and exploring which components of the web-based interventions play an important role.which are likely to reduce caregivers’ negative outcomes associated with care. METHODS A comprehensive literature search was conducted on PubMed, Embase, PsycINFO, Cochrane Database and CINAHL by using relevant terms such as web-based and caregiver as keywords, covering all studies published before June 2018. Two reviewers independently reviewed all published abstracts, according to the established inclusion and exclusion criteria ,we extracted the information about participants, interventions and results, respectively, and reviewed the quality of articles on the methods of randomized trials using the approach recommended by the Cochrane Handbook for systematic review for intervention. RESULTS A total of 815 caregivers participated in 6 articles, and 4 of the studies use depression as an outcome, according to the research after different interventions based on network after the intervention, depression scores average drop of 0.23 (95%CI -0.38 to -0.07, p<0.01), 2 studies show caregivers anxiety symptoms, the average score for anxiety dropped by 0.32 points (95% CI -0.50 to -0.14, p< 0.01), but in terms of coping, pain and stress, the web-based interventions have shown a poor effect. On the whole, the addition of professional psychological support on the basis of education can improve mental health of carers. CONCLUSIONS Internet-based interventions were generally effective in reducing anxiety and depression in dementia carers, although negative results were found in some studies. But in terms of burden and stress, further research is needed.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 414-414
Author(s):  
Anna Huang ◽  
Kristen Wroblewski ◽  
Ashwin Kotwal ◽  
Linda Waite ◽  
Martha McClintock ◽  
...  

Abstract The classical senses (vision, hearing, touch, taste, and smell) play a key role in social function by allowing interaction and communication. We assessed whether sensory impairment across all 5 modalities (global sensory impairment [GSI]) was associated with social function in older adults. Sensory function was measured in 3,005 home-dwelling older U.S. adults at baseline in the National Social Life, Health, and Aging Project and GSI, a validated measure, was calculated. Social network size and kin composition, number of close friends, and social engagement were assessed at baseline and 5- and 10-year follow-up. Ordinal logistic regression and mixed effects ordinal logistic regression analyzed cross-sectional and longitudinal relationships respectively, controlling for demographics, physical/mental health, disability, and cognitive function (at baseline). Adults with worse GSI had smaller networks (β=-0.159, p=0.021), fewer close friends (β=-0.262, p=0.003) and lower engagement (β=-0.252, p=0.006) at baseline, relationships that persisted at 5 and 10 year follow-up. Men, older people, African-Americans, and those with less education, fewer assets, poor mental health, worse cognitive function, and more disability had worse GSI. Men and those with fewer assets, worse cognitive function, and less education had smaller networks and lower engagement. African-American and Hispanic individuals had smaller networks and fewer close friends, but more engagement. Older respondents also had more engagement. In summary, GSI independently predicts smaller social networks, fewer close friends, and lower social engagement over time, suggesting that sensory decline results in decreased social function. Thus, rehabilitating multisensory impairment may be a strategy to enhance social function as people age.


2021 ◽  
Vol 15 (2) ◽  
pp. 155798832110126
Author(s):  
Anika R. Petrella ◽  
Catherine M. Sabiston ◽  
Madison F. Vani ◽  
Andrew Matthew ◽  
Daniel Santa Mina

Exploring tenets of basic psychological needs theory, the objective of this study was to examine the association between psychological needs satisfaction, exercise behavior, and physical and mental health among testicular cancer survivors. The present study investigated whether psychological needs satisfaction was directly associated with increased self-rated health, and if this relationship was mediated by engagement in exercise. Testicular cancer survivors ( N = 135; Mage = 32.45; SD = 7.63) self-reported current psychological needs satisfaction, exercise behavior, and perceived global physical and mental health during routine oncology visits. Associations were examined using path analysis. Psychological needs satisfaction was a positive correlate of both self-rated physical and mental health in this sample, and exercise mediated the association between needs satisfaction and self-rated physical health. This study supports the assumptions underpinning basic psychological needs theory in this unique clinical population. Based on the findings, exercise engagement represents one mechanism associated with perceived health after cancer. Supportive care interventions should aim to enhance satisfaction of psychological needs and investigate exercise as a mechanism underpinning the relationship between needs satisfaction and perceived health in testicular cancer survivors.


2021 ◽  
pp. bjsports-2020-103140
Author(s):  
Rodney K Dishman ◽  
Cillian P McDowell ◽  
Matthew Payton Herring

ObjectiveTo explore whether physical activity is inversely associated with the onset of depression, we quantified the cumulative association of customary physical activity with incident depression and with an increase in subclinical depressive symptoms over time as reported from prospective observational studies.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, PsycINFO, PsycARTICLES and CINAHL Complete databases, supplemented by Google Scholar.Eligibility criteriaProspective cohort studies in adults, published prior to January 2020, reporting associations between physical activity and depression.Study appraisal and synthesisMultilevel random-effects meta-analysis was performed adjusting for study and cohort or region. Mixed-model meta-regression of putative modifiers.ResultsSearches yielded 111 reports including over 3 million adults sampled from 11 nations in five continents. Odds of incident cases of depression or an increase in subclinical depressive symptoms were reduced after exposure to physical activity (OR, 95% CI) in crude (0.69, 0.63 to 0.75; I2=93.7) and adjusted (0.79, 0.75 to 0.82; I2=87.6) analyses. Results were materially the same for incident depression and subclinical symptoms. Odds were lower after moderate or vigorous physical activity that met public health guidelines than after light physical activity. These odds were also lower when exposure to physical activity increased over time during a study period compared with the odds when physical activity was captured as a single baseline measure of exposure.ConclusionCustomary and increasing levels of moderate-to-vigorous physical activity in observational studies are inversely associated with incident depression and the onset of subclinical depressive symptoms among adults regardless of global region, gender, age or follow-up period.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 404-404
Author(s):  
Joseph Kim ◽  
Kyuree Kim

Abstract The purpose of this study was to identify the profiles of older adults according to lifestyle. Data for the study were from the 2017 Consumption and Activities Mail Survey (CAMS). CAMS 2017 is a questionnaire mailed to a sub-sample of respondents from the Health and Retirement Study. Participants were limited to older adults 65 and older, and the final sample consisted of 1136 older adults. The sample included 443 men and 693 women. Caucasians comprised 82.0% of the participants. Lifestyle was measured through items assessing the amount of time spent on activities. Due to high skewness, the items were dichotomized, 0=no time spent on activity and 1=time spent on the activity. Latent class analysis (LCA) was performed to identify groups based on lifestyle. LCA is a person-centered approach for identifying unobserved subgroups based on similarity in responses to items. Three lifestyle groups were identified. Group 1 was “Outgoing” with 471 individuals. Group 2 was “Adequate” with 229 individuals. Group 3 was “Inactive” with 436 individuals. An ANOVA was then conducted to assess mean differences in self-rated health, cognition, depressive symptoms, and loneliness for the three lifestyle groups. The “Outgoing” and “Adequate” groups had significantly higher scores on self-rated health and cognition, and in addition, significantly lower scores on depressive symptoms and loneliness compared to the “Inactive” group. No significant differences were observed between the “Outgoing” and “Adequate” groups. An implication from this study is the importance of maintaining an active lifestyle in later life for better mental health and cognition.


2021 ◽  
Author(s):  
Maria Thomson ◽  
Maureen Wilson-Genderson ◽  
Laura A Siminoff

Abstract Background Informal caregivers play a fundamental role in the care of hematological cancer patients, but less is known about how secondary caregivers are involved. We assessed the presence or absence of a secondary caregiver, the types of caregiving activities performed by primary and secondary caregivers and examined whether the presence of a secondary caregiver was associated with primary caregiver characteristics and wellbeing over time. Methods A case series of hematological cancer patient-caregiver dyads (n = 171) were recruited from oncology clinics in Virginia and Pennsylvania and followed for 2 years. Multi-level models were developed to examine the associations between presence of a secondary caregiver and the primary caregivers’ well-being. Results Most (64.9%) primary caregivers reported having secondary caregivers. Multilevel models showed primary caregivers without help had higher baseline mental and physical health, but experienced deteriorating physical health overtime, compared to supported primary caregivers. Supported primary caregivers reported improvements in mental health over time that was associated with improvements in physical health. Conclusions Primary caregivers in good physical and mental health at the beginning of their caregiving journey but who have the least assistance from others may be at greatest risk for detrimental physical health effects long term. Attention to the arrangement of caregiving roles (i.e., who provides what care) overtime is needed to ensure that caregivers remain healthy and well supported.


2021 ◽  
Author(s):  
Michiyo Okada ◽  
Yoshihiro Nakadoi ◽  
Ai Fujikawa

Abstract Background Japan is facing a markedly high incidence of adolescent suicide. This study examines the relationship between depression and self-rated health, which is a significant factor driving people toward suicide, highlighting the importance of children’s assessments of their health. Methods In this cross-sectional study, an original questionnaire combining text and illustrations was administered to 6,421 elementary, junior, and senior high school students. To assess children’s self-rated health, we classified the survey questions into two domains: physical and mental health. We further classified the questions based on symptom duration. Depression assessment was based on the Depression Self-Rating Scale for Children. To provide a basis for the effective use of the self-rated health assessment tool, we classified the respondents into three groups based on physical/mental conditions together with the duration of those conditions and made comparisons. The groups were Favorable Health, Temporarily Poor Health, and Persistently Poor Health, and the results were analyzed using an ANOVA. Results Self-rated health levels decreased, and depressive conditions worsened with age. Although most children led physically and mentally healthy school lives, the mean Depression Self-Rating Scale score was significantly higher for the Persistently Poor Health group than the other two, and the Temporarily Poor Health group scored significantly higher than the Favorable Health group for both physical and mental health (all p < 0.001). Conclusions As the Temporarily and Persistently Poor Health groups in the domains of physical and mental health are more likely to be depressed, timely cooperation between schools and medical institutions is imperative to prevent depression.


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