The Bidirectional Relationship Between Depressive Symptoms and Homebound Status Among Older Adults

Xiang, Xiaoling; An, Ruopeng; Oh, Hyunsung

doi:10.1093/geronb/gbx180

Cited by 19 publications

(26 citation statements)

References 28 publications

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“…Items included in our mobility difficulty index (eg, walking across a room) are typically combined with other self‐care activities (eg, dressing) to form an indicator of activity of daily living (ADL) disability, which has been linked to unfavorable depression course in previous studies . A population‐based study in the United States has shown that trait‐like (ie, stable traits) outdoor mobility limitation was strongly associated with persistent depressive symptoms over time and that increased limitation in outdoor mobility predicted worsening depressive symptoms 1 year later . In another study that looked at a sample of noninstitutionalized older adults from Montpellier, France, having any mobility limitation that interfered with the ability to do heavy housework, walk half a mile, and climb stairs was associated with a four‐to‐five‐fold increase in the odds of having increasing or chronic depressive symptoms .…”

Section: Discussionmentioning

confidence: 99%

Trajectories of major depression in middle‐aged and older adults: A population‐based study

Xiang

Cheng

2019

Int J Geriat Psychiatry

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Objectives This study aimed to examine depression trajectories and correlates in a nationally representative sample of middle‐aged and older adults in the United States. Methods The study sample consisted of 15 661 participants aged over 50 years from the US Health and Retirement Study. Major depression was assessed using the Composite International Diagnostic Interview (CIDI‐SF). Depression trajectories were identified using a group‐based trajectory modeling enhanced to account for nonrandom attrition. Multinomial logistic regression was conducted to investigate predictors of depression trajectories. Results Four depression trajectory groups were identified: “never” (85.8%), “increasing” (6.3%), “decreasing” (3.2%), and “persistently moderate/high” (4.7%). Baseline depressive symptom severity was a strong predictor of depression trajectories. Older age, male sex, and non‐Hispanic African American race were associated with a lower risk of the three trajectories with small to high depression burden, whereas chronic disease count was associated with a higher risk of these trajectories. The risk of being on the increasing trajectory increased with mobility difficulties. Difficulties in household activities predicted membership in the persistently moderate/high group. Conclusions A small but nonignorable proportion of middle‐aged and older adults have chronic major depression. Initial symptom severity and chronic disease burden are consistent risk factors for unfavorable depression trajectories and potential targets for screening and intervention.

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Section: Discussionmentioning

confidence: 99%

Trajectories of major depression in middle‐aged and older adults: A population‐based study

Xiang

Cheng

2019

Int J Geriat Psychiatry

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“…Table 3 shows studies that present the definition of HB and the applied conceptual framework of HB. Most researchers defined HB as “a condition characterized by an infrequency of going outdoors” [ 6 , 9 , 19 , 20 , 21 , 22 , 26 , 32 , 37 , 38 , 39 ]. Other researchers defined HB as being “confined to one’s home” [ 17 , 18 ], “remaining inside or just around the home [during] daily life” [ 40 ], or “being compelled to stay inside one’s home permanently excluding an accident or temporary illness” [ 9 ].…”

Section: Resultsmentioning

confidence: 99%

“…They explained that the impact of disability is based on the confluence of personal capacity and the ability of social support to compensate for capacity limitations [ 22 ]. Xiang et al explained HB using the International Classification of Functioning, Disability, and Health (ICF) and the concept of autonomy [ 32 ]. They defined HB as a result of interactions between body functions and structures, activities, participation, and environmental factors [ 6 , 41 ].…”

Section: Resultsmentioning

confidence: 99%

“…In other words, HB is defined as one of the states of a continuum of living activities. Xiang et al applied a revised ecological model of aging [ 32 ] to determine the influencing factors that cause HB [ 20 ]. These include demographic (age, gender, race, and ethnicity), socioeconomic (such as education and income), social (such as living arrangements, social networks, and social support), and psychosocial factors (e.g., self-efficacy), health behaviors, health conditions, functioning (physical and cognitive), and environment (built and physical).…”

Section: Resultsmentioning

confidence: 99%

“…Previous studies have investigated factors affecting HB in various ways, such as personal [ 19 , 23 , 27 , 28 , 29 , 30 ], social [ 2 , 31 ], and environmental factors [ 32 ]. Along with the changes in the definition of HB, it is expected that the view of HB’s influencing factors will also have changed; however, few studies have reviewed the factors affecting HB in older adults.…”

Section: Introductionmentioning

confidence: 99%

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A Scoping Review of Homebound Older People: Definition, Measurement and Determinants

Noh

2021

IJERPH

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Being homebound (HB) can affect people’s physical and mental health by decreasing movement, which can itself be exacerbated by the deterioration of people’s health. To break this vicious cycle of HB and being in poor health, it is necessary to identify and address the factors influencing HB status. Thus, we used a scoping review to identify an HB trend, focusing on the definition, measurements, and determinants of HB status. We analyzed 47 studies according to the five-stage methodological framework for scoping reviews. The common attribute of definitions of HB status was that the boundaries of daily life are limited to the home. However, this varied according to duration and causes of becoming HB; thus, the understanding of HB shifted from the presence or absence of being HB to the continuum of daily activity. Various definitions and measurements have been used to date. Many studies have focused on individual factors to analyze the effect of HB. In the future, it will be necessary to develop a standardized measurement that reflects the multidimensional HB state. In addition, it is necessary to utilize a theoretical framework to explore the social and environmental factors affecting HB.

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Physical isolation and mental health among older US adults during the COVID-19 pandemic: longitudinal findings from the COVID-19 Coping Study

Joseph

O'Shea

Eastman

et al. 2022

Soc Psychiatry Psychiatr Epidemiol

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Purpose We investigated the relationships between physical isolation at home during the period when many US states had shelter-in-place orders and subsequent longitudinal trajectories of depression, anxiety, and loneliness in older adults over a 6 month follow-up. Methods Data were from monthly online questionnaires with US adults aged ≥ 55 in the nation-wide COVID-19 Coping Study (April through October 2020, N = 3978). Physical isolation was defined as not leaving home except for essential purposes (0, 1-3, 4-6, and 7 days in the past week), measured at baseline (April-May). Outcomes were depressive symptoms (8-item Center for Epidemiological Studies Depression Scale), anxiety symptoms (5-item Beck Anxiety Inventory), and loneliness (3-item UCLA loneliness scale), measured monthly (April-October). Multivariable, population-and attritionweighted linear mixed-effects models assessed the relationships between baseline physical isolation with mental health symptoms at baseline and over time. Results Physical isolation (7 days versus 0 days in the past week) was associated with elevated depressive symptoms (adjusted β = 0.85; 95% CI 0.10-1.60), anxiety symptoms (adjusted β = 1.22; 95% CI 0.45-1.98), and loneliness (adjusted β = 1.06; 95% CI 0.51-1.61) at baseline, but not with meaningful rate of change in these mental health outcomes over time. The symptom burden of each mental health outcome increased with increasing past-week frequency of physical isolation. Conclusion During the early COVID-19 pandemic, physical isolation was associated with elevated depressive symptoms, anxiety symptoms, and loneliness, which persisted over time. These findings highlight the unique and persistent mental health risks of physical isolation at home under pandemic control measures.

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The Bidirectional Relationship Between Depressive Symptoms and Homebound Status Among Older Adults

Abstract: Homebound status and depressive symptoms form a feedback loop to influence each other. Improving the outdoor mobility of older adults may have immediate benefits for reducing depressive symptoms.

Cited by 19 publications

References 28 publications

Trajectories of major depression in middle‐aged and older adults: A population‐based study

Trajectories of major depression in middle‐aged and older adults: A population‐based study

A Scoping Review of Homebound Older People: Definition, Measurement and Determinants

Physical isolation and mental health among older US adults during the COVID-19 pandemic: longitudinal findings from the COVID-19 Coping Study

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