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Aging & Mental Health Jun 2024The first aim of the study is to compare loneliness levels between widowed and non-widowed older adults. The second aim is to identify distinct loneliness patterns among...
OBJECTIVES
The first aim of the study is to compare loneliness levels between widowed and non-widowed older adults. The second aim is to identify distinct loneliness patterns among widowed individuals and explore the impact of pre-spousal loss social support on loneliness during and after bereavement.
METHOD
Data from the Health and Retirement Study were utilized to compare loneliness levels between widowed ( = 137) and non-widowed ( = 2361) older adults ( = 69.01). -tests and latent growth curve models were conducted to compare loneliness levels between the two groups. Growth mixture models were computed to identify distinct loneliness patterns among the widowed individuals. A multinomial logistic regression analysis was conducted to determine how pre-widowhood social support was associated with the obtained classes.
RESULTS
The results revealed that widowed individuals reported significantly higher levels of loneliness at T2. Among widowed individuals, three distinct loneliness patterns were identified: Increased Loneliness (IL) group ( = 32); Low and Stable Loneliness (LSL) group ( = 88); and Decreased Loneliness (DL) group ( = 17). The IL and DL group were less likely to receive social support from spouse, children, and friends compared to the LSL group.
CONCLUSION
This study provides evidence of the protective effect of pre-widowhood social support on the psychological well-being of older adults after spousal loss.
PubMed: 38919075
DOI: 10.1080/13607863.2024.2367045 -
Journal of Affective Disorders Jun 2024Fine particulate matter (PM) has been implicated in various health concerns. However, a comprehensive understanding of the specific PM components affecting depression...
BACKGROUND
Fine particulate matter (PM) has been implicated in various health concerns. However, a comprehensive understanding of the specific PM components affecting depression remains limited.
METHODS
This study conducted a Cox proportional-hazards model to assess the effect of PM components on the incidence of depression based on the China Health and Retirement Longitudinal Study (CHARLS). Participants with Epidemiologic Studies Depression Scale (CESD-10) score of 10 or higher were classified as exhibiting depression.
RESULTS
Our findings demonstrated a significant positive correlation between long-term exposure to black carbon (BC), sulfate (SO), and organic matter (OM) components of PM and the prevalence of depression. Per 1 Interquartile Range (IQR) increment in 3-year average concentrations of BC, OM, and SO were associated with the hazard ratio (HR) of 1.54 (95 % confidence intervals (CI): 1.44, 1.64), 1.24 (95%CI: 1.16, 1.34) and 1.25 (95%CI: 1.16, 1.35). Notably, females, younger individuals, those with lower educational levels, urban residents, individuals who were single, widowed, or divorced, and those living in multi-story houses exhibited heightened vulnerability to the adverse effects of PM components on depression.
LIMITATIONS
Firstly, pollutant data is confined to subjects' fixed addresses, overlooking travel and international residence history. Secondly, the analysis only incorporates five fine particulate components, leaving room for further investigation into the remaining fine particulate components in future studies.
CONCLUSIONS
This study provides robust evidence supporting the detrimental impact of PM components on depression. The identification of specific vulnerable populations contributes to a deeper understanding of the underlying mechanisms involved in the relationship between PM components and depression.
PubMed: 38917887
DOI: 10.1016/j.jad.2024.06.066 -
Journal of Prevention (2022) Jun 2024This study aimed to evaluate the association between Quality of Life (QOL) and independent factors, emphasizing Socio Economic Status (SES) in northwestern Iran. A...
This study aimed to evaluate the association between Quality of Life (QOL) and independent factors, emphasizing Socio Economic Status (SES) in northwestern Iran. A population-based cross-sectional study was performed within the Persian Traffic safety and health Cohort in 2020. Participants were chosen using stratified random sampling method. The majority of participants (69%) were aged between 30 and 65. Around half of the participants were males (54.44%). Most of the female respondents were categorized as very low and medium levels of SES Based on multiple linear regression analysis, the QOL among females was lower compared to males (β: - 0.92, 95% CI - 1.82 to - 0.22). There was a negative association between SES and QOL; individuals with low and very low levels of SES had a lower QOL than those with a medium level of SES (β: - 4.38, 95% CI - 5.9 to - 2.86) (β: - 2.65, 95% CI - 4.08 to - 1.22). The current study highlights that higher SES and educational levels are positively associated with higher QOL. Conversely, older age, females, and widowed individuals are linked with lower QOL.
PubMed: 38916839
DOI: 10.1007/s10935-024-00786-y -
Health Science Reports Jun 2024Marital status has been shown to be associated with mortality, but evidence in critically ill elder intensive care unit (ICU) patients with cerebrovascular diseases...
BACKGROUND AND AIMS
Marital status has been shown to be associated with mortality, but evidence in critically ill elder intensive care unit (ICU) patients with cerebrovascular diseases (CeVD) is limited. This study was to explore the correlation between marital status and the prognosis of patients with CeVD aged 65 years and over in the ICU.
METHODS
In the present study, 3564 patients were enrolled in the Medical Information Mart for Intensive Care IV database (version 2.2). Patients were divided into four groups based on marital status: married, single, divorced, and widowed. The primary outcome was all-cause mortality as patients were followed up for 3-, 6-, 9-, and 12-month. All-cause mortality risk for patients with different marital status was compared. Univariate and multivariable logistic regression analyses, survival curves and stratified analyses were performed to determine the correlation between marital status and mortality in critically ill patients with CeVD aged ≥65 years.
RESULTS
Of the patients, 51.2% (1825/3564) were married, followed by 23.8% (847/3564) were widowed, 18.2% (647/3564) were single, and 6.9% (245/3567) were divorced. Compared with the married, the unmarried had a higher proportion of female ( < 0.001), older ( < 0.001), and less proportion of mechanical ventilation ( = 0.045). Multivariate analyses showed that no differences were observed for mortality risk among different marital statuses ( > 0.05), while at late follow-up, widowed had a significance higher mortality risk than the married (9-month: odds ratio [OR]: 1.30, 95% confidence interval [CI]: 1.05-1.61, = 0.02; 12-month: OR: 1.38, 95% CI: 1.12-1.71, = 0.003). Stratified analyses indicated a stable correlation between marital status and 12-month mortality rate in sub-analysis for gender ( = 0.46) and age ( = 0.35).
CONCLUSION
Marital status is associated with long-term prognosis in older patients with CeVD admitted to ICU. Widowed people should receive more societal attention irrespective of sex or age.
PubMed: 38915359
DOI: 10.1002/hsr2.2177 -
Rivista Di Psichiatria 2024Mental health disorders and chronic health diseases are highly prevalent and impactful consequences of distressful experiences among refugees, yet a comprehensive...
INTRODUCTION
Mental health disorders and chronic health diseases are highly prevalent and impactful consequences of distressful experiences among refugees, yet a comprehensive conceptual model encompassing biopsychosocial factors is lacking. This study aims to assess the relevance of widowhood to PTSD and major depression maintenance as well as to adverse health outcomes in a cohort of Bosnian refugees.
METHODS
This longitudinal study included 526 subjects followed up for 3 years. The interviews were conducted in refugee camps in Varaždin, Croatia, in the Bosnian language. Data were collected using the Harvard Trauma Questionnaire and Hopkins Checklist-25, respectively. Physical health disorders were self-reported.
RESULTS
Both at baseline and endpoint female gender and marital loss are associated with a statistically significant higher burden of psychological and physical health outcomes. This group showed higher rates of PTSD and major depression disorders, as high comorbidity with hypertension, cardiovascular diseases, asthma and arthritis.
DISCUSSION
The results of the present study align with a wealth of literature studies linking marital loss to shifts in mental health and impaired physical health. A conceptual framework is provided for understanding how both mental health and physical health outcomes are highly dependent on social phenomena.
CONCLUSIONS
This investigation reinforces the hypothesis of the role of social bonds and marital support in recovery from trauma experiences. Further studies are, however, needed for a better understanding of the consequences of adverse events on trauma-exposed subjects from a holistic bio-psycho-social point of view.
Topics: Humans; Female; Refugees; Male; Stress Disorders, Post-Traumatic; Longitudinal Studies; Adult; Middle Aged; Bosnia and Herzegovina; Depressive Disorder, Major; Mental Health; Health Status; Croatia; Sex Factors; Widowhood
PubMed: 38912760
DOI: 10.1708/4288.42699 -
Cureus May 2024Loneliness is often associated with behavioral, psychological, social, and mental and physical health aspects, while the relationship between trust and loneliness is...
INTRODUCTION
Loneliness is often associated with behavioral, psychological, social, and mental and physical health aspects, while the relationship between trust and loneliness is still challenging in terms of research. The present study aimed to investigate to what extent loneliness and trust interact and if there is any association between loneliness and routine events or behaviors that affect overall well-being.
METHODS
This cross-sectional sample of 120 participants, aged between 40 and 75 years, was collected from an urban Primary Health Care Unit, between May and July 2023, in a consecutive manner, after criteria application. The University of California, Los Angeles (UCLA) Loneliness Scale (Version 3) and the Personal Trust and Connections Scale (PerTC) were completed. Hierarchical multiple linear regression analysis in steps and multiple logistic regression analysis were performed.
RESULTS
The mean age of the participants was 59.8 years and the majority were females (73.3%). Only 10.8% were found to have no Behavioral Risk Factors (BRFs). A higher sense of loneliness was associated with being widowed/unmarried/divorced (unstandardized β=-4.10, p=0.045), not having children (β=-2.80, p=0.038), having more BRFs (β=2.03, p=0.032), or being in contact with fewer friends (β=-0.56, p<0.001). A higher sense of loneliness was related to lower levels of trust (β=-1.29, p=0.032). Lower odds of demonstrating high levels of loneliness were found among married individuals (odds ratio (OR): 0.38; 95% confidence interval (CI) 0.15, 0.95; p=0.039) and those who reported six or more routine contacts or meetings with friends (OR: 0.31; 95% CI 0.13, 0.74; p=0.008). A lower score on the total PerTC scale was related to higher odds of increased loneliness (OR: 2.78; 95%CI 1.01, 7.62; p=0.048).
CONCLUSION
Being married and coming in contact or meeting with more friends was associated with lower odds of reporting high feelings of loneliness, while lower trust was correlated with increased odds of loneliness. Also, persons with more BRFs were found to have a higher loneliness score. Given their inverse correlation, tools that measure levels of loneliness and trust, like the UCLA and PerTC scales, may be used within primary care consultation to offer new insights on health risk behaviors and their possible synergistic influences.
PubMed: 38910642
DOI: 10.7759/cureus.61019 -
Global Health Action Dec 2024Mauritius has implemented a range of stringent policies to control smoking and promote public health. Regular monitoring focuses on the prevalence of tobacco use, yet...
BACKGROUND
Mauritius has implemented a range of stringent policies to control smoking and promote public health. Regular monitoring focuses on the prevalence of tobacco use, yet there is a gap in understanding its socio-economic patterns.
OBJECTIVE
The aim of this study was to estimate the prevalence of tobacco smoking and to identify the social determinants associated with smoking among men in Mauritius in 2021.
METHODS
This is a cross-sectional population-based study conducted by the Ministry of Health and Wellness during 2021. In total, 3622 individuals participated (response rate of 84.1%), of which 1663 were men (45.9%). The study mainly focused on men given the low prevalence of smoking among women. Daily smoking was the outcome and a series of sociodemographic and socioeconomic factors were included as independent variables. Prevalence ratios (PR) and their 95% confidence intervals (95% CI) were estimated to fulfill the study objective.
RESULTS
The prevalence of smoking among men was 30.4%. People in the 25-34 age group (PR = 1.65; 95% CI: 1.12-2.41), those separated, divorced or widowed (PR = 1.57; 95% CI: 1.16-2.11), the ethnic groups Muslim-Mauritians (PR = 1.70; 95% CI: 1.00-2.89) and Creoles (PR = 1.97; 95% CI: 1.16-3.35), and those with secondary (PR = 1.29; 95% CI: 1.00-1.67) and primary education (PR = 1.47; 95% CI: 1.10-1.98) were statistically significantly associated with daily smoking.
CONCLUSIONS
Although a gradual decline in smoking prevalence was observed compared with the previous 2015 survey, the Ministry of Health and Wellness should persist in fortifying its anti-smoking measures and concentrate on crafting tailored interventions aimed at the vulnerable groups identified in this study.
Topics: Humans; Cross-Sectional Studies; Male; Adult; Mauritius; Prevalence; Middle Aged; Social Determinants of Health; Young Adult; Smoking; Socioeconomic Factors; Female; Adolescent; Sociodemographic Factors
PubMed: 38899339
DOI: 10.1080/16549716.2024.2367415 -
International Journal of Nursing... Jun 2024To identify the risk factors for the nursing diagnosis of fall risk in adults (00303) in elderly people in the community-dwelling.
PURPOSE
To identify the risk factors for the nursing diagnosis of fall risk in adults (00303) in elderly people in the community-dwelling.
METHOD
This is a methodological study, with a quantitative approach, carried out with elderly people living in the city of Ribeirão Preto, SP, Brazil, from February to December 2018. For data collection, the demographic profile, Mini-Mental State Examination, diseases self-reported, functional independence measure, Lawton and Brody scale, geriatric depression scale, and self-perception of gait instruments were used. Tests of accuracy and association of risk factors with p ≤ 0.05 were performed.
FINDINGS
A total of 262 elderly people, aged over 80 years (55.7%), 71% of which were female and 42.7% were widowed, were included in the sample. A total of 82.1% had vascular diseases, 72.1% had diabetes, and 20.6% had depression. The predominant risk factors were difficulty performing instrumental activities of daily living (58.8%), cognitive dysfunction (43.5%), and depressive symptoms (26.3%). Difficulty performing instrumental activities of daily living had a sensitivity greater than 60%. The positive and negative predictive values were mostly greater than 50%. In the regression analysis, it was found that the elderly have a higher risk of suffering a fall if they present anxiety (p = 0.05), impaired physical mobility (p = 0.02), and difficulty to perform instrumental activities of daily living as risk factors (p = 0.03).
CONCLUSION
It was possible to identify the presence of risk factors for the diagnosis fall risk in adults (00303) in the clinical context of the elderly in home settings and contribute to the clinical validation of the taxonomy, increase the evidence and importance of the diagnosis, and generate new knowledge for gerontological nursing.
IMPLICATIONS FOR NURSING PRACTICE
To help nurses identify risk factors that lead elderly people to suffer falls at home and to implement preventive actions in their community with the support of their families.
PubMed: 38898669
DOI: 10.1111/2047-3095.12479 -
BioRxiv : the Preprint Server For... Jun 2024While there is extensive information about sperm nuclear basic proteins (SNBP) in vertebrates, there is very little information about Arthropoda by comparison. This...
While there is extensive information about sperm nuclear basic proteins (SNBP) in vertebrates, there is very little information about Arthropoda by comparison. This paper aims to contribute to filling this gap by analyzing these proteins in the sperm of the noble false widow spider (Order Araneae, Family Theridiidae). To this end, we have developed a protein extraction method that allows the extraction of cysteine-containing protamines suitable for the preparation and analysis of SNBPs from samples where the amount of starting tissue material is limited. We carried out top-down mass spectrometry sequencing and molecular phylogenetic analyses to characterize the protamines of and other spiders. We also used electron microscopy to analyze the chromatin organization of the sperm, and we found it to exhibit liquid-liquid phase spinodal decomposition during the late stages of spermiogenesis. These studies further our knowledge of the distribution of SNBPs within the animal kingdom and provide additional support for a proposed evolutionary origin of many protamines from a histone H1 (H5) replication-independent precursor.
PubMed: 38895387
DOI: 10.1101/2024.06.04.597381 -
JAMA Network Open Jun 2024Older adults are particularly vulnerable to loneliness and its physical and psychosocial sequelae, but scalable interventions are lacking, especially during disasters... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Older adults are particularly vulnerable to loneliness and its physical and psychosocial sequelae, but scalable interventions are lacking, especially during disasters such as pandemics.
OBJECTIVE
To compare the effects of layperson-delivered, telephone-based behavioral activation and mindfulness interventions vs telephone-based befriending on loneliness among at-risk older adults.
DESIGN, SETTING, AND PARTICIPANTS
This assessor-blinded, 3-arm randomized clinical trial screened Chinese older adults through household visits and community referrals from April 1, 2021, to April 30, 2023, in Hong Kong. Eligible participants (≥65 years of age) who were lonely, digitally excluded, living alone, and living below the poverty line and provided consent to participate were randomized into behavioral activation, mindfulness, and befriending groups. Assessments were conducted at baseline, 1 month, and 3 months.
INTERVENTION
As part of the Helping Alleviate Loneliness in Hong Kong Older Adults (HEAL-HOA) dual randomized clinical trial, 148 older laypersons were trained to deliver a twice-weekly 30-minute intervention via telephone for 4 weeks.
MAIN OUTCOMES AND MEASURES
The primary outcome was loneliness measured by the UCLA Loneliness Scale (range, 20-80) and the De Jong Gierveld Loneliness Scale (range, 0-6), with higher scores on both scales indicating greater loneliness. Secondary outcomes were depression, perceived stress, life satisfaction, psychological well-being, sleep quality, perceived social support, and social network.
RESULTS
A total of 1151 participants (mean [SD] age, 76.6 [7.8] years; 843 [73.2%] female) were randomized to the behavioral activation (n = 335), mindfulness (n = 460) or befriending (n = 356) group. Most were widowed or divorced (932 [81.0%]), had primary education or below (782 [67.9%]), and had 3 or more chronic diseases (505 [43.9%]). Following intention-to-treat principles, linear mixed-effects regression model analyses showed that loneliness measured by the UCLA Loneliness Scale was significantly reduced in the behavioral activation group (mean difference [MD], -1.96 [95% CI, -3.16 to -0.77] points; P < .001]) and in the mindfulness group (MD, -1.49 [95% CI, -2.60 to -0.37] points; P = .004) at 3 months compared with befriending. Loneliness measured by the De Jong Gierveld Loneliness Scale was not significantly reduced at 3 months in the behavioral activation group (MD, -0.06 [95% CI, -0.26 to 0.13] points; P > .99]) but was in the mindfulness group (MD, 0.22 [95% CI, 0.03 to 0.40] points; P = .01) at 3 months compared with befriending. In the behavioral activation and mindfulness groups, sleep quality improved compared with befriending, but perceived stress increased. Psychological well-being and perceived social support improved in the behavioral activation group. No statistically significant between-group differences were observed in depression, life satisfaction, or social network.
CONCLUSION AND RELEVANCE
In this randomized clinical trial, scalable psychosocial interventions delivered remotely by older laypersons appeared promising in reducing later life loneliness and addressing the pressing mental health challenges faced by aging populations and professional geriatric mental health workforce shortages. Further research should explore ways to maximize the clinical relevance and cost-effectiveness of these interventions.
TRIAL REGISTRATION
Chinese Clinical Trial Registry Identifier: ChiCTR2300072909.
Topics: Humans; COVID-19; Female; Aged; Male; Loneliness; Hong Kong; Telephone; Poverty; Mindfulness; SARS-CoV-2; Pandemics; Aged, 80 and over
PubMed: 38888923
DOI: 10.1001/jamanetworkopen.2024.16767