Chronic Conditions, Persistent Pain, and Psychological Distress Among the Rural Older Adults: A Path Analysis in Shandong, China

Yang, Shijun; Zhao, Dan; Wang, Yi; Li, Wenjuan; Li, Jie; Li, Zhixian; Wei, Zhen; Chen, Yan; Gui, Zhen; Zhou, Chengchao

doi:10.3389/fmed.2021.770914

Cited by 6 publications

(3 citation statements)

References 65 publications

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“…The presence of sleep-disordered breathing in illnesses including chronic lung disease, diabetes, and stroke, as well as symptoms of the chronic disorders themselves, can explain this link between multi-morbidity and sleep problems [ 64 , 65 ]. A potential biological mechanism suggests that some chronic conditions may induce changes in sleep-controlling brain areas and neurotransmitters, and the medicines used to manage chronic conditions have an impact on sleep quality [ 66 ]. Psychological distress and anxiety associated with chronic conditions can also contribute to sleep problems [ 29 , 67 ].…”

Section: Discussionmentioning

confidence: 99%

Mediation of the association between multi-morbidity and sleep problems by pain and depressive symptoms among older adults: Evidence from the Longitudinal Aging Study in India, wave- 1

2023

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Background There could be several possible mechanisms on how chronic conditions relate to sleep problems in older persons; for instance, pain and sleep have a strong link and depressive symptoms are similarly associated with sleep problems. The present study explored whether pain and depressive symptoms are mediators in the relationship between multi-morbidity and sleep problems among older adults. Methods Study utilized data from the Longitudinal Aging Study in India (LASI) with a sample of 31,464 older adults age 60 years and above. Multivariable logistic regression along with mediation analysis using Karlson–Holm–Breen (KHB) method was conducted. Results A proportion of 14.8% of the participants suffered from sleep problems, whereas, 22.5% and 8.7% of older adults had multi-morbidity and had depressive symptoms, respectively. Also, around 10.3% of older adults reported pain and received no medication for the relief of pain, whereas 29.3% of older adults reported pain and received some type of medication for the relief of pain. Older adults with multi-morbidity had higher odds of suffering from sleep problems [adjusted odds ratio (aOR):1.26, confidence interval (CI):1.10–1.45] than those who had no multi-morbidity. Older adults who reported pain but received no medication for the relief of pain [aOR: 1.90, CI: 1.64–2.22] or reported pain and received medication for the relief of pain [aOR: 1.82, CI:1.62–2.04] and those who had depressive symptoms [aOR: 2.21, CI:1.89–2.57%] had higher odds of suffering from sleep problems compared to those who did not report pain and had no depressive symptoms, respectively. Around 11.2% of the association of multi-morbidity with sleep problems was mediated by pain and 4.3% of such association was mediated by depressive symptoms. Conclusion Pain and depressive symptoms were found to mediate the association between multi-morbidity and sleep problems; therefore, reducing pain and depressive symptoms may be considered to improve sleep in older multi-morbid patients.

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Section: Discussionmentioning

confidence: 99%

Mediation of the association between multi-morbidity and sleep problems by pain and depressive symptoms among older adults: Evidence from the Longitudinal Aging Study in India, wave- 1

2023

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“…In addition, GraphPad Prism 8 was used to draw the forest plots. Finally, Structural equation software Mplus 8.3 (Muthén & Muthén, Los Angeles, CA, USA) [ 51 ] was used to test the mediation effect between living alone or not and depressive symptoms with mediating variables. The statistical significance level was P < 0.05.…”

Section: Methodsmentioning

confidence: 99%

The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety

Huang,

Liu,

Liang

et al. 2023

BMC Geriatr

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Background With modernization and ageing in China, the population of older adults living alone is increasing. Living alone may be a potential risk factor for depressive symptoms. However, no parallel mediation model analysis has investigated the mediating factors for living alone or not (living arrangements) and depressive symptoms. Methods This cross-sectional study included a total number of 10,980 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), 1699 of whom lived alone and 9281 of whom did not live alone. Binary logistic regression and parallel mediation effect model were used to explore the relationship between living alone or not and depressive symptoms and possible mediation effects. Bootstrap analysis was used to examine the mediation effect of living alone or not on depressive symptoms. Results Compared to the participants who were not living alone, the living alone group had a higher rate of depressive symptoms. The binary logistic regression showed that after adjusting for other covariates, the risk of depressive symptoms was approximately 0.21 times higher for living alone compared to not living alone (OR = 1.21, 95% CI: 1.06, 1.37). Further, the results of the bootstrap analysis supported the partial mediating role of sleep quality and anxiety. Mediation analysis revealed that sleep quality and anxiety partially mediate the relationship between living alone and depressive symptoms (β = 0.008, 95% CI [0.003, 0.014]; β = 0.015, 95% CI [0.008, 0.024], respectively). Conclusions Sleep quality and anxiety were identified as partially parallel mediators between living alone or not and depressive symptoms. Older adults living alone with poorer sleep quality and more pronounced anxiety were positively associated with higher levels of depressive symptoms. Older adults living alone should be encouraged to engage in social activities that may improve sleep quality, relieve anxiety, and improve feelings of loneliness caused by living alone. Meanwhile, older adults living alone should receive attention and support to alleviate their depressive symptoms.

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“…High psychological distress signals poor mental health and can lead to more severe illnesses such as major depression and post-traumatic stress (Kessler et al, 2003). It has been associated with chronic diseases, pain, self-rated health and frequent hospital visits in aging populations (Asante et al, 2022;Yang et al, 2021). An early diagnosis of these conditions is crucial in developing effective interventions for better mental health.…”

Section: I0 Introduction 11 Background Of the Studymentioning

confidence: 99%

Psychometric properties of a Swahili-translated Kessler Psychological Distress Scale (K6) in sample of aging Kenyans.

Muruthi,

Maina,

Mwega

et al. 2024

ijsshr

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Objective: The prevalence of psychological distress, such as depression and anxiety, is increasing among Kenyans. However, there is a lack of understanding about its prevalence rates among aging people, and we lack culturally standardized and concise tools to measure it. Method: This study utilized a sample of 376 older individuals obtained from three regions in Kenya to investigate the distribution, prevalence, and psychometric properties of a Swahili-translated version of the Kessler Psychological Distress Scale (K6). A significant advantage of the K6 is its capacity to measure various mental health factors despite its conciseness. Results: Distribution assessments reveal that most participants reported high psychological distress scores (13 or above), and women experienced significantly higher rates compared to men. The K6 indicators showed high internal consistency for the sample (alpha =.83). Exploratory factor analysis showed the six items loading to on 1 factor and subsequent confirmatory analysis demonstrated excellent fit (CFI = .95; RMSEA = .03) for the one-factor model. Discussion: The high occurrence of psychological distress among the sample highlights this mental health problem as a potentially urgent area of need in the entire Kenyan population. Factor analysis results suggest that the Swahili-translated K6 is a concise tool with great potential for assessing psychological distress among older Kenyans

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Chronic Conditions, Persistent Pain, and Psychological Distress Among the Rural Older Adults: A Path Analysis in Shandong, China

Cited by 6 publications

References 65 publications

Mediation of the association between multi-morbidity and sleep problems by pain and depressive symptoms among older adults: Evidence from the Longitudinal Aging Study in India, wave- 1

Mediation of the association between multi-morbidity and sleep problems by pain and depressive symptoms among older adults: Evidence from the Longitudinal Aging Study in India, wave- 1

The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety

Psychometric properties of a Swahili-translated Kessler Psychological Distress Scale (K6) in sample of aging Kenyans.

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