This study aimed (1) to compare walking performance under single (ST) and dual-task (DT) conditions with varying cognitive tasks and degrees of difficulty, (2) to investigate the association of concerns about falling, depressive symptomatology, and psychological and physical well-being with ST and DT walking performance as well as cognitive and motor DT costs (cDTC; mDTC); and (3) to examine whether depressive symptomatology and well-being mediate or moderate the association between concerns about falling and DT performance in a large sample of German nursing home residents.

We analyzed data from a cross-sectional study with 449 ambulatory nursing home residents (mean age 84.1 ± 7.87 years). Performance on three cognitive tasks with different cognitive loads (serial subtraction in one's [SST_1] and three's [SST_3]; verbal fluency [VFT]; number of correctly reproduced responses) and (walking speed) was recorded each under ST and DT conditions (walking plus additional cognitive task). In addition, we assessed concerns about falling, depressive symptomatology, and psychological and physical well-being using the Falls Efficacy Scale - International (FESI), the Center for Epidemiologic Studies Depression Scale (CESD), and the Short-Form-Health Survey (SF-12), respectively.

We observed significant differences in ST walking and walking while performing an additional cognitive task. Walking speed was higher in ST walking than walking during the SST_1, SST_3, and VFT (all p < 0.001). In both the ST walking and the SST_1 DT condition, the concerns about falling (and physical well-being) explained a low proportion of variance in walking speed. Physical well-being had a minor but significant mediating effect on the relationship between concerns about falling and walking speed in the ST walking and SST_1 DT condition.

Concerns about falling and physical well-being seem to exert a small yet statistically significant effect on ST walking under conditions of lower cognitive demand. The effect is diminished by increasing the cognitive load, as compensation becomes impossible. Interventions focusing on decreasing concerns about falling and maintaining physical well-being might compensate for limitations in walking performance of nursing home residents in ST and DT situations. Reducing fall concerns, promoting physical well-being, and adjusting cognitive demands can improve nursing home residents' walking performance.

DRKS00014957 (BfArM - Deutsches Register Klinischer Studien (DRKS)).

Limited research has explored the link between functional dependency, care needs, and depression among older adults. This study aims to explore the association between dependency levels and depression among Chinese older adults, as well as examine the relationship between hygiene environment and these two factors. Data were obtained from the CHARLS 2011-2018. A total of 4871 individuals aged 60 years and older were included. Generalized estimating equations were employed for the analysis. A conceptual framework was established to longitudinally illustrate the pathway from hygiene environment to dependency levels to depression. Findings indicated higher dependency levels and poorer hygiene environments were associated with an increased risk of depression, with dependency serving as a mediator between hygiene environment and depression. Policymakers should prioritize improvements in rural sanitation and long-term care policies, healthcare providers should enhance depression screening and caregiver training, and clinicians should provide personalized interventions to better address mental health challenges.

Examine the association of household ties with diabetes awareness and self-care behaviors among Hispanic/Latinos.

Data from the Hispanic Community Health Study/Study of Latinos were used (Visit 2; 2014-2017; n = 11,071). Household ties (none, extended, and close), sex, and loneliness were used in a cluster analysis to derive the household clusters. Diabetes awareness and diabetes self-care behaviors (among the aware only) were the outcomes.

Clusters that emerged were:(1) Females who rarely feel lonely and who mostly live with close ties; (2) Males who rarely feel lonely and who mostly live with close ties; (3) Males and females who feel lonely despite living with mostly close ties; (4)Males and females who feel lonely and mostly live alone or without familial ties. Cluster 4 had the highest proportion of diagnosed (27%) and undiagnosed diabetes (10%). In regression models, none of the clusters related to diabetes awareness. However, among the aware, glucose monitoring was only significantly higher among cluster 1 relative to cluster 4. Compared to cluster 4, all clusters were significantly more likely to know their HbA1c.

Household tie clusters were related to diabetes self-care behavior but not awareness.

Few digital health interventions for dementia caregivers, especially for racial and ethnic minorities, include long-term follow-ups. This study assessed the feasibility of two-year follow-up of the Wellness Enhancement for Caregivers (WECARE) intervention for Chinese American dementia caregivers, examined the changes in psychosocial health and explored future strategies.

A mixed-method study was conducted two years after the initial WECARE intervention trial. Participants completed an online survey and phone interviews. Quantitative and qualitative data were analyzed complementarily.

Eighteen of 24 participants completed the survey and 15 participated in interviews. Caregivers reported deteriorating conditions of care-recipients and increased caregiving burden, but their depressive symptoms and life satisfaction remained lower compared to baseline. Participants highlighted sustained benefits of WECARE, including stress management, improved communication, and a sense of community through group chats. They expressed a need for ongoing social and information support.

This study demonstrates the feasibility of long-term evaluation for digital interventions like WECARE and emphasizes the need for continuous support. Sustained benefits underscore the potential of culturally tailored digital health interventions for underserved dementia caregivers. Future efforts should integrate ongoing resource access to enhance caregivers' long-term well-being.

Although telomere length is an established marker of biological aging, the impact of religious beliefs on telomere length remains uncertain.

This cross-sectional study investigated the relationship between religiosity and telomere length among senior Brazilians, aged 60 and older. The study examined the association between organizational, non-organizational, and intrinsic religiosity with telomere length, adjusting for sociodemographic, mental, physical health, and medication. Hierarchical linear regression models were used.

821 participants (62.2 % female, mean age 68.9 years, SD = 6.48) were studied. Female gender and younger age were linked to longer telomeres, but no significant associations were found between religious beliefs and telomere length in adjusted or unadjusted models.

This study found no evidence of an association between religiosity and telomere length among older Brazilian adults. While prior research highlights religiosity's positive health effects, its direct influence on telomere length remains unclear, warranting further exploration.

Older adults with insomnia frequently report bothersome pain. Whether insomnia treatment reduces bodily pain in older adults without chronic pain conditions is not known.

This randomized controlled trial aimed to determine whether treatment of insomnia disorder with cognitive behavioral therapy for insomnia (CBT-I), as compared with sleep education therapy (SET), yields durable remission of insomnia and reduces moderate pain symptoms over 36 months in older adults with insomnia disorder.

A community-based sample of 291 adults ages 60 years and older (mean age, 70.1 years; 57.7% female) with insomnia disorder, but no chronic pain condition, were randomized to 2 months of intervention with either CBT-I (n = 156) or SET (n = 135). The primary outcome was change in bodily pain as measured by the short form 36 (SF-36) health survey. Secondary outcome was remission of insomnia continuously sustained over 36 months of follow-up.

Improvements in bodily pain, as indexed by increases in SF-36 scores, were found in CBT-I with insomnia remission (adjusted β = 0.18; 95% CI, 0.004-0.360; P = 0.045) and in SET with insomnia remission (adjusted β = 0.25; 95% CI, 0.035-0.457; P = 0.023) but not in treatment groups without insomnia remission. As compared with those without insomnia remission, insomnia remission was associated with improvements in pain (adjusted β = 0.19; 95% CI, 0.047-0.325; P = 0.009) and with increases in the proportion of participants who achieved a minimal clinically important difference (likelihood ratio χ2 1,16 = 264.04; P < 0.001).

Sustained remission of insomnia disorder leads to improvements in bodily pain, with the potential to prevent chronic pain disorders in older adults with insomnia.

ClinicalTrials.gov NCT01641263.

Model-based clustering is increasingly used to identify multidimensional sleep health profiles. However, generalizability is rarely assessed because of complexities of data sharing and harmonization. Our goal was to evaluate the generalizability of multidimensional sleep health profiles across older adult populations in Western countries and assess whether they predict depressive symptoms over time.

We harmonized five self-reported sleep health indicators (satisfaction, alertness, timing, efficiency, and duration) across six population-based cohorts from the United States and Netherlands (N=614 - 3209 each) and performed identical latent class analysis in each cohort. Novel multivariable similarity metrics, patterns of sleep health and cluster sizes were used to match clusters and assess generalizability across cohorts. We compared cluster characteristics cross-sectionally and used linear mixed-effects modeling to relate sleep health clusters to depressive symptoms over time.

"Average sleep health" (moderate duration; high quality/efficiency; 42.7%-76.7% of sample) and "poor sleep health" (short duration; low quality/efficiency; high daytime sleepiness; 9.4%-20.4% of sample) clusters were generalizable across cohorts. In four cohorts "inefficient sleep" clusters were identified and in two cohorts "long, efficient sleep" clusters were identified. At 3years, those in the poor sleep cluster had depression symptoms that were 1.40-2.79 times greater than in the average sleep cluster, across all cohorts.

We identified two profiles - average sleep health and poor sleep health - that were generalizable across six samples of older adults and predicted depressive symptoms, underscoring the importance of the sleep health paradigm.

Polypharmacy is associated with reduced health-related quality of life (HRQoL). This study explores the association between prescription and non-prescription medication pill burdens, independent of underlying morbidity, on HRQoL in an older adult population.

Data from the final intervention year of the ASPirin in Reducing Events in the Elderly (ASPREE) randomized trial in older adults from Australia and the USA, were analyzed cross-sectionally. Participants reported daily prescription and non-prescription pill counts at the final trial visit. HRQoL was assessed using the 12-Item Short-Form instrument (SF-12) and summarized into the physical component summary (PCS) score and mental component summary (MCS) score, where lower scores reflect poorer HRQoL. Multivariable regression, adjusted for covariates, was used to examine the relationships of categorized prescription and non-prescription pill counts with PCS and MCS separately.

15,165 participants responded to the question about prescription use and 15,727 for non-prescriptions (mean age = 80 years). Compared with non-users of prescription medications, lower mean PCS scores and larger reductions in scores were seen as prescription medication pill burden increased from 1-3, 4-6, 7-9, to ≥ 10 pills (- 1.7, - 4.5, - 7.6, and - 10.9, respectively, p < 0.001). A similar relationship, but of lesser magnitude, was observed with non-prescription medication pill burden, where the mean PCS was lower by - 0.2 for 1-3 pills (p = 0.494), - 1.8 for 4-6 (p < 0.001), and - 1.9 for ≥ 7 pills (p < 0.001), compared with non-users. No significant association was observed between prescription or non-prescription medication pill burdens and MCS.

Prescription and non-prescription medication pill burdens are independently associated with reduced physical, but not mental, HRQoL in older adults.

Understanding the differences between various instruments for assessing depression will help researchers and health practitioners to choose a more appropriate tool and develop a framework to enhance resilience to mental health problems in the older population. The current study aimed to compare the 10-item Center for Epidemiological Studies-Depression (CES-D) scale with the Composite International Diagnostic Interview-Short Form (CIDI-SF) for measuring depressive symptoms in older Indians.

Data came from the first wave of the Longitudinal Aging Study in India (LASI) which was conducted during 2017-19. The final sample included 30,368 older individuals aged 60 years and above (15,824 women and 14,544 men). The level of agreement between the CES-D and CIIDI-SF instruments for depression classification was assessed using Kappa coefficients at various cut-off values. Multivariable logistic regression models were used to examine the associations between background characteristics and depressive symptoms assessed by both instruments.

The prevalence of depressive symptoms based on the CES-D instrument was higher than that of CIDI-SF (30.2% vs. 8.3%). The level of agreement between the CES-D and CIDI-SF for depression classification was 'none' to 'minimal' (κ = 0.04-0.24). Assuming the CIDI-SF scale as the "gold standard", with rising threshold values, sensitivity of the CES-D scale decreased while specificity increased. The CES-D scale yielded a sensitivity of 29-82% and specificity of 39-92% across cut-off values of 3 to 6. The Pearson correlation between the CIDI-SF and CES-D total scores was significant but weak (r =.20). Multivariable analysis showed that depressive symptoms were more prevalent among women, those with higher education, individuals living alone, those with diagnosed psychiatric disorders, and individuals with two or more chronic conditions, compared to men, those who were uneducated, those not living alone and healthier peers, when assessed using both CES-D and CIDI-SF scales. The associations of marital status, religion and wealth quintiles were significant only for depressive symptoms assessed using the CES-D scale.

Depression cases identified by the CES-D showed poor agreement with those identified by the CIDI-SF. Therefore, the prevalence of depressive symptoms measured by the CESD is not interchangeable with that measured by the CIDI-SF. These findings suggest the importance of using both the CES-D and CIDI-SF in large population-based cohorts and surveillance surveys to obtain more accurate and nuanced understanding of depressive disorders across various subgroups of the older population.

Violence and abuse exert extensive health, social, and economic burdens on adolescents in low- and middle-income countries. Digital parenting interventions are promising for mitigating risks at scale. However, their potential for public health impact hinges on meaningful engagement with the digital platform.

The objective of this study was to evaluate the impact of 3 intervention design and implementation factors aimed at increasing engagement with a noncommercialized, offline-first smartphone app for caregivers of adolescents in Tanzania, in partnership with the United Nations Children's Fund, the World Health Organization, and the Tanzanian national government.

Following Multiphase Optimization Strategy (MOST) principles, we conducted a 2×2×2 cluster randomized factorial trial involving caregivers of adolescents aged 10 to 17 years. Caregivers were recruited by community representatives from 16 urban and periurban communities (ie, clusters) in the Mwanza region of Tanzania. Each cluster was randomized to 1 of 2 levels of each factor: guidance (self-guided or guided via facilitator-moderated WhatsApp groups), app design (structured or unstructured), and preprogram digital support (basic or enhanced). Primary outcomes were automatically tracked measures of engagement (app launches, modules completed, and home practice activities reviewed), with secondary outcomes including modules started, time spent in the app, and positive behaviors logged. Generalized linear mixed-effects models assessed the impact of experimental factors on engagement.

Automatically tracked engagement data from 614 caregivers were analyzed, of which 205 (33.4%) were men. Compared to self-guided participants, receiving guidance alongside the app led to significantly more app launches (mean ratio [MR] 2.93, 95% CI 1.84-4.68; P<.001), modules completed (MR 1.29, 95% CI 1.05-1.58; P=.02), modules started (MR 1.20, 95% CI 1.02-1.42; P=.03), time spent in the app (MR 1.45, 95% CI 1.39-1.51; P<.001), and positive behavior logs (MR 2.73, 95% CI 2.07-3.60; P<.001). Compared to the structured design, unstructured design use resulted in significantly more modules completed (MR 1.49, 95% CI 1.26-1.76; P<.001), home practice activity reviews (MR 7.49, 95% CI 5.19-10.82; P<.001), modules started (MR 1.27, 95% CI 1.06-1.52; P=.01), time spent in the app (MR 1.84, 95% CI 1.70-1.99; P<.001), and positive behavior logs (MR 55.68, 95% CI 16.48-188.14; P<.001). While analyses did not detect an effect of enhanced digital support on directly observed engagement, the combination of enhanced digital support and guidance positively influenced engagement across a range of outcomes.

This study is the first to systematically optimize engagement with a digital parenting intervention in a low- and middle-income country. Our findings offer important learnings for developing evidence-based, scalable digital interventions in resource-constrained settings.

Pan-African Clinical Trial Registry PACTR202210657553944; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=24051.

RR2-10.1186/s12889-023-15989-x.

Poor insight is common in persons with psychosis, but treatment can improve insight. Individuals with psychosis who exhibit better insight have better social functioning, reduced negative symptoms, and paradoxically worse depression. There is limited research investigating insight among persons at clinical high risk for psychosis (CHR). Understanding the relationship between insight, social functioning, negative symptoms, and depression might inform treatment. We focused on introspective bias (IB), the overestimation or underestimation of social functioning. Persons with CHR (N = 36), Major Depressive Disorder (MDD; N = 164), and community controls (N = 60) were recruited from the Multisite Assessment of Psychosis-risk Study and completed clinical interviews and self-report instruments. The estimation type was operationalized by whether a person was above or below the standardized mean difference between self-reported and interviewer-rated social functioning. We hypothesized that 1) persons at CHR would have less depressive symptom severity than those with MDD diagnoses, but more depressive symptom severity than control participants accounting for IB within diagnostic groups, 2) CHR and MDD participants would endorse higher levels of negative symptoms, viewed transdiagnostically (e.g., anhedonia, avolition), than controls but not each other, 3) overestimators would endorse higher levels of negative symptoms and depression than underestimators, 4) CHR participants would have the greatest proportions of overestimators, MDD would have the greatest proportion of underestimators, and control participants would have equal proportions of under- and overestimators. Those at CHR had more overestimators, overestimators overall had worse depression and negative symptoms, and diagnostic group membership did not impact the effects of IB on symptoms. This study suggests that IB has clinically relevant correlates but is not a primary treatment target for persons at CHR.

We present a psychometric evaluation of the Center for Epidemiologic Studies Depression Boston Form (CES-D-B) for use with different Latino subgroups as there is inconsistency regarding its performance across subgroups of Latinos, a large and rapidly growing cultural group in the United States.

We evaluated the reliability and structural validity of the scores generated by the CES-D-B using four distinct Latino samples residing in US: Mexicans, Venezuelans, Cubans, and "other Latinos" (total N = 1033). To further explore structural validity of CES-D-B scores, we conducted measurement invariance analyses across different countries of origin, gender groups, educational levels, and languages of assessment (English, Spanish).

For all four samples, CES-D-B scores were highly reliable as indicated with the coefficients ranging from 0.82 to 0.88, and the factor structure provided an adequate fit to the data with the fit indices CFI/TLI ranging from 0.96 to 0.99, RMSEA estimates between 0.02 and 0.07, and SRMR estimates between 0.02 and 0.04. While measurement invariance analyses for different educational levels indicated scalar invariance across all samples, the same level of measurement equivalency was achieved only for Mexicans and Venezuelans with varying gender and languages of assessment.

The findings indicated that CES-D-B scores are internally consistent, possess a strong four-factor structure, and have somewhat equivalent psychometric properties across diverse Latino groups. Findings from this study highlight the importance of considering gender and languages of assessment when assessing depressive symptoms of various Latino subgroups.

The rising rates of adolescent depression have become a critical concern, with family dynamics and interpersonal communication playing a significant role in this mental health issue. However, research on the combined effects of parental warmth and interpersonal trust on adolescent depressive symptoms remains limited. This study aimed to explore the association between parental warmth, interpersonal trust, and depressive symptoms in Chinese adolescents. The sample included 2745 adolescents aged 9 to 18 from the China Family Panel Studies (CFPS). Depressive symptoms were assessed using the CES-D8 scale, which yielded an average score of 4.34. Among participants, 11.3% exhibited symptoms consistent with depression. Multivariate linear regression revealed that both parental warmth (β = -0.296, p < 0.001) and interpersonal trust (β = -0.197, p < 0.001) significantly predicted lower depressive symptoms. Mediation analysis indicated that interpersonal trust partially mediated the relationship between parental warmth and depressive symptoms, explaining 17.68% of the total effect (β = -0.032, 95% CI = -0.060, -0.016). These associations remained significant even after controlling for demographic variables. Our findings suggest that parental warmth protects against depressive symptoms, with interpersonal trust enhancing this protective effect. Interventions focused on fostering parental warmth and enhancing interpersonal trust could improve adolescent mental health.

Depression represents a significant mental health challenge among university students. Previous studies have revealed a relationship between benevolent childhood experiences (BCEs) and depression, but the roles of family relationships and sleep quality in mediating the link between BCEs and depression remain unclear. This study constructed a serial mediating model to examine whether family relationships and sleep quality mediated the relationship between BCEs and depression among Chinese university students.

A total of 1830 university students from 25 universities in three provinces of China got recruited in this study. The assessment utilized the Benevolent Childhood Experiences Scale (BCEs-10) for childhood experiences, the Quality of Family Relationships Scale for family dynamics, the Pittsburgh Sleep Quality Index (PSQI) single-item for sleep quality, and the Center for Epidemiological Survey Depression Scale (CES-D-10) for depression. Correlation analyses and serial mediation modeling were conducted using SPSS 25.0 with PROCESS macro v3.4.1.

BCEs, family relationships, and sleep quality scores were all found to be negatively correlated with depression scores (r = -0.46, -0.32, -0.47, respectively, all p < 0.01). Family relationships, and sleep quality scores were positively correlated with BCEs scores (r = 0.31, 0.27, respectively, both p < 0.01). There was a positive correlation between the family relationships score and sleep quality score (r = 0.22, p < 0.01). Mediating analysis indicated that BCEs had a direct effect on depression (the direct effect accounted for 71.54%). Depression was affected by BCEs partly through three different pathways: the mediating role of family relationships (the mediation effect accounted for 8.50%), the mediating role of sleep quality (the mediation effect accounted for 16.40%), and the serial mediating role of both family relationships and sleep quality (the serial mediation effect accounted for 3.56%).

The findings of this study demonstrated that family relationships and sleep quality partially mediated the association between BCEs and depression by serial mediating effects.Thus, improving sleep quality and family intervention may be effective measures to protect Chinese university students from depression.

Socioeconomic factors play a critical role in influencing mental health outcomes, particularly during periods of crisis such as the COVID-19 pandemic. In Hawai'i, working adults face unique challenges related to employment, food security, and trust in community safety measures, which may exacerbate risks for depression, low self-esteem, and suicidal ideation. Understanding the interplay of these factors is crucial to addressing mental health disparities and informing targeted policy interventions.

This study analyzed data from 2,270 adults aged 18 to 65 residing in Hawai'i, collected in 2022. Using probit regression models and conditional inference decision trees, the study assessed the impact of 15 socioeconomic and demographic factors on mental health outcomes, specifically symptoms of depression, low self-esteem, and suicidal ideation. Key variables of interest included food security status, employment, marital status, pre-existing health conditions, and perceptions of COVID-19-related community safety.

The findings revealed significant mental health challenges among the participants, with 39.6% reporting symptoms of depression, 14.7% experiencing low self-esteem, and 4.2% expressing suicidal ideation. Food insecurity emerged as the most significant predictor of poor mental health, particularly for depression and suicidal ideation. Within the food-insecure group, individuals with pre-existing health conditions faced worsened mental health outcomes, while marital status served as a protective factor. Employment reduced the likelihood of depression by 2.8%, and perceptions of community safety during the COVID-19 pandemic were associated with a 9.9% reduction in depression risk.

Food insecurity, particularly when coupled with pre-existing health vulnerabilities, is a critical risk factor for adverse mental health outcomes among working adults in Hawai'i. Employment and positive perceptions of community safety were identified as key protective factors. These findings highlight the urgent need for targeted interventions to improve food security and foster community trust and safety.

The relationship between depression and cognition in middle-aged adults is a topic of interest. Whether poor cognitive function exacerbates depression remains controversial. We clarified the association between cognitive decline and depression based on six nationwide cohorts.

89,056 participants were retrieved from six cohorts in Europe, North America, Asia and Africa. Each two consecutive interviews were collected as a sample set with a total of twenty-eight sample sets to assess changes in depression and cognitive function. Multiple linear regression was conducted within each sample set to evaluate the association between cognitive decline and depression. A two-stage meta-analysis was performed to obtain the average effect within each cohort and the overall effect excluding population and regional heterogeneity. Meta-regression and subgroup analysis were used to explore heterogeneity and potential effect modifiers.

Almost all sample sets indicated negative association between changes in cognitive function and depression scores. The average effects varied across regions: Korea (-0.150 [-0.175, -0.126]), Europe (-0.130 [-0.149, -0.112]), South Africa (-0.090 [-0.129, -0.060]), China (-0.083 [-0.137, -0.030]), Mexico (-0.063 [-0.084, -0.042]), and North America (-0.048 [-0.056, -0.040]). The overall effect excluding population and regional heterogeneity was -0.094 [-0.129, -0.060], and was robust across populations of different age, sex, alcohol consumption, daily living activities and marital status.

The cross-sectional design limited our ability to determine causal relationships.

Cognitive decline was associated with the exacerbation of depression status in middle-aged and older adults worldwide. Country-level factors, rather than individual-level factors, are more likely to modify this effect.

To assess how patient and caregiver factors influence caregiver readiness for hospital discharge in palliative care patients.

This transitional care study uses cross-sectional data from a randomized controlled trial conducted from 2018 to 2023 testing an intervention for caregivers of hospitalized adult patients with a serious or life-limiting illness who received a palliative care consult prior to transitioning out of the hospital.

Caregiver readiness was measured with the Family Readiness for Hospital Discharge Scale (n = 231). Caregiver demographic, intra- and interpersonal factors were self-reported. Patient demographic, comorbidity score, and risk score for complicated discharge planning were extracted from electronic health records. Stepwise regression models estimated variance explained (r2) in caregiver readiness for patient hospital discharge.

Patient demographics and complexity were not statistically associated with caregiver readiness for discharge. Caregiver depressive symptoms, poor caregiver-patient relationship quality, and fewer hours spent caregiving prior to hospitalization explained 29% of the variance in caregiver readiness.

Reliance on patient data may not be sufficient for explaining caregiver readiness for discharge. Assessing caregiver factors may be a better alternative for identifying caregivers at risk for low discharge readiness and those in need of additional support.

ClinicalTrials.gov on November 13, 2017, (No. NCT03339271).

The relationship between pain and falls remains controversial. Therefore, this study explored the associations between pain and fall-related outcomes in 5 340 middle-aged (45-65 years) adults residing in the communities in Korea.

Pain was defined as pain at any location, pain-related activity restriction, and persistent pain. The outcome measures included fall injuries, recurrent falls, injurious falls, and fall-related hip fractures. A multivariate logistic regression model was used to examine the relationship between pain and fall outcome.

Among the study participants, 54.0% reported having experienced pain. During a follow-up period of up to 14 years, those who reported pain and pain-related activity restriction at baseline exhibited a positive association with the occurrence of fall injury (odds ratio [OR] 1.79, 95% confidence interval [CI]: 1.27-2.53) and injurious falls (OR 1.72, 95% CI: 1.20-2.48) but not with recurrent falls (OR 1.90, 95% CI: 0.80-4.54). We also observed a positive association between persistent pain and the risk of fall injury (OR 1.41, 95% CI: 1.13-1.91), whereas no consistent conclusions were drawn regarding the risk of recurrent falls and injurious falls. We also did not identify any correlation between pain and hip fractures resulting from falls.

In conclusion, our findings of the positive correlations of pain and pain-related activity restriction at baseline with fall injuries and injurious falls but not recurrent falls during follow-up suggest that public health initiatives should prioritize pain screening, especially for participants reporting ankle and toe pain, and implement suitable interventions to mitigate the risk of falls and the associated adverse outcomes among middle-aged adults.

This study investigated the association between gait speed, handgrip strength, and their combination, and the risk for developing clinically relevant depressive symptoms in community-dwelling older adults.

A secondary analysis was conducted using data from the ASPirin in Reducing Events in the Elderly study. Participants were community-dwelling older adults in Australia and the United States of America followed for a median (interquartile range) of 3.97 (2.26) years. Baseline handgrip strength and gait speed were used as exposure variables, and their combination categories were also explored. Depression was measured using the modified Center for Epidemiological Studies Depression 10-item scale (CES-D 10). Cox regression was used to estimate Adjusted Hazard Ratios (AHR) with 95 % Confidence Intervals (CI) after adjusting for a range of potential confounders.

A total of 17,231 participants (55.3 % women) were included in the analysis. Slow gait and weak grip at baseline were associated with the risk of depression (AHR: 1.20; CI: 1.11-1.29 and 1.14; 1.06-1.23, respectively). The combination of the two physical performance measures was associated with a 31 % increase in the risk of depression (1.31; 1.16-1.47) and a significant dose-response association was observed for quintiles of gait and grip with depression.

Although the CES-D 10 is a validated scale, it is a self-reported tool rather than a clinical diagnosis of depression.

Low physical function may be a risk factor for depression in older adults. This highlights the inextricable link between the physical and mental health of older adults, which can inform potential clinical and public health prevention strategies for depression in later life.

The estimated glomerular filtration rate based on cystatin C (eGFRcys) and creatinine (eGFRcr) may differ substantially within an individual. The clinical implications of these differences (eGFRdiff) for depressive symptoms risk are unknown and whether it differed by sex are also unknown.

The prospective cohort study enrolled 3443 participants aged ≥45 years from the 2011-2020 waves of the China Health and Retirement Longitudinal Study. The eGFRdiff was calculated by eGFRcys minus eGFRcr at baseline. Depressive symptoms were measured by the ten-item Center for Epidemiologic Studies Depression Scale. Unadjusted and adjust logistic regression models were used to investigate the relationship between eGFRdiff and depressive symptoms.

1628 (47.3 %) females and 1815 (52.7 %) males were analyzed in the present study. When considering eGFRdiff as a continuous variable, multivariate logistic regression analysis showed that higher eGFRdiff was associated with reduced depressive symptoms in females (OR = 0.985, 95%CI 0.976-0.995, p-value = 0.020), not in males (OR = 0.996, 95%CI 0.988-1.003, p-value = 0.280). The associations remained similar when comparing individuals across different eGFRdiff categories.

In this 9-year follow-up cohort study, baseline eGFRdiff was negatively associated with depressive symptoms among community-dwelling middle-aged and older females, but not males. Monitoring eGFRdiff could have clinical utility in identifying the risk of accelerated depressive symptoms progression in females.

With the continuous advancement of age in China, attention should be paid to the mental well-being of the elderly population. The present study uses a novel machine learning (ML) method on a large representative elderly database in China as a sample to predict the risk factors of depression in the elderly population from both holistic and individual level.

A total of participants met the inclusion criteria from the fourth waves of the China Health and Retirement Longitudinal Study (CHARLS) were analyzed with ML algorithms. The level of depression was assessed by the 10-item Center for Epidemiological Studies Depression Scale (CESD-10).

The current study found top 5 factors that were important for predicting depression in the elderly population in China, including average sleep time, gender, age, social activities and nap time during the day. The results also provide reliable diagnostic likelihood at the individual level to support clinicians identify the most impactful factors contributing to patient depression. Our findings also suggested that activities such as interacting with friends and play ma-Jong, chess or join community clubs may have a positive collaborative effect for elderly's mental health.

Holistic approaches are an effective method of deriving and interpreting sophisticated models of mental health in elderly populations. More detailed information about a patient's demographics, medical history, sleeping patterns and social/leisure activities can help to inform policy and treatment interventions on a population and individual level. Large scale surveys such as CHARLS are effective methods for testing the most accurate models, however, further research using professional clinical input could further advance the field.

Intimate partner violence (IPV) and depression are global health concerns with high prevalence rates and substantial negative impacts on individuals and the wider community. Women are particularly vulnerable to both IPV victimization and depressive disorders, and both are recognized worldwide as priorities for women's health. The aim of this systematic review and meta-analysis was to determine whether recent longitudinal empirical evidence supports exposure to IPV as a contributing factor to the subsequent onset of depression in women.

A search was performed in August 2024 of the Medline, PsychInfo, and EBSCOHost databases for longitudinal studies published after the year 2013, and 1193 studies were identified. Studies were included if they were written in English and measured IPV as an independent variable with depression as a dependent variable. Studies were excluded if depression was not measured separately from other variables or did not report primary quantitative data. Eleven studies with 118,544 female participants met the inclusion criteria for review.

Ten of the 11 reviewed studies reported a statistically significant positive association between exposure to IPV and depression in women. A random effects meta-analysis was used to generate pooled odds ratios from nine estimates, which demonstrated that female IPV survivors have significantly increased odds of developing subsequent depression (OR = 1.92, (95% CI: 1.28, 2.86); although, there was high heterogeneity across studies (I2 = 98.3%, p < 0.001). Ten of the 11 studies were from high-income, industrialized countries, which limits the global application of these findings.

These findings suggest that IPV may be one of many contributing factors for depression in women. However, variability in the definition of IPV and inconsistent adjustment for confounders across studies limits firm conclusions. The findings of this review suggest that strategies to prevent IPV could play a role in reducing the prevalence of depression. They also support the inclusion of depression screening for survivors of IPV in clinical approaches and a review of the effectiveness of IPV-related depression intervention strategies.

This study aimed to investigate the association between global cognitive functioning (GCF) and fear of falling (FOF) in a large population-based sample of adults aged 45 years and older. A total of 2997 and 2012 participants from the original sample were included in the cross-sectional and prospective models, respectively. Participants were re-coded to 'no FOF' and 'FOF' based on their self-reported responses, and those who reported FOF at follow-up were defined as the newly-developed FOF group. GCF was evaluated at baseline and follow-up (2006 and 2020) using the Korean Mini-Mental State Examination (K-MMSE). Multivariable logistic regression models were used to examine the association between GCF at baseline and risk of FOF. In our study, 23.6% (706/2997) of the participants reported FOF at baseline, and 80.3% (1615/2012) reported newly-developed FOF in the follow-up cohort. Importantly, the negative association between GCF and FOF was observed not only in the cross-sectional analyses (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.96-0.99) but also in the prospective analyses (OR 0.93, 95% CI 0.87-0.99). Furthermore, GCF was associated with lower odds of recurrent newly-developed FOF in the stable group than in the original sample (OR 0.87, 95% CI 0.78-0.97 vs OR 0.92, 95% CI 0.86-0.98). Thus, GCF was negatively associated with FOF at baseline and newly-developed FOF in the long-term follow-up cohort, and persistent deficits in GCF may increase the risk of newly-developed FOF. Further research should explore the mechanisms underlying the longitudinal relationship between GCF and newly-developed FOF.

Rural adults and children are at higher risk for overweight and obesity. However, there are relatively few lifestyle modification programs available for these high-risk families, mainly because of the difficulty in reaching them. This mindfulness-based motivational interviewing (MM-based-MI) pilot aimed to improve parents' healthy eating index (HEI), collective family efficacy, family satisfaction, perceived stress, and depressive symptoms as well as parent-child dyads' eating patterns, physical activity (PA), and body mass index (BMI).

This randomized controlled trial (RCT) was conducted in the Midwestern US to examine the feasibility (enrollment, attendance, and attrition), acceptability, and preliminary effects of an MM-based-MI intervention that contained nine sessions of health coaching (1-on-1), while the active-control included nine emailed health handouts sent over an 18-week period.

A total of 46 parents (29 intervention, 17 control; Mage = 38.5 years, 85% female) participated. The enrollment rate, intervention attendance rate, and attrition rate were 12.6%, 79.8%, and 23.9% respectively. Although not statistically significant, compared to the control, the MM-based-MI intervention showed positive effects on improving parents' HEI in terms of increasing total HEI score (Cohen's d = 0.43), vegetable intake (d = 0.41), greens/beans (d = 0.59), protein food (d = 0.82), and self-efficacy in exercise (d = 0.21), as well as decreasing total calories (Kcal, d = -0.58), added sugar (d = -0.50), and depressive symptoms (d = -0.42), while controlling for marital status. Controlling for age, sex, and marital status, intervention children had greater improvement in increasing fiber (d = 0.75) and protein (d = 0.72) intake compared to the active-control group. Moreover, parents in both groups reported improvement (small to large effects) in ↑mindful eating, ↑collective family efficacy, ↑family satisfaction, and ↓perceived stress over time.

Despite some limitations (small sample size, virtual at home measurement), our results support the feasibility, acceptability, and preliminary effects of this Mindful Healthy Family program on potentially mitigating some obesogenic behaviors among rural parent-child dyads.

Trial registration: ClinicalTrials.gov identifier: NCT05324969.

This study investigates the association between frailty and mortality in Eastern European populations, which remains largely unexplored compared with Western Europe. The aim is to assess the risk of all-cause and cardiovascular mortality associated with varying levels of frailty.

A prospective multicentre cohort study was conducted, involving random population samples from the Czech Republic, Poland and Lithuania. The baseline survey (2002-2005) included 26 746 individuals aged 45-69 years, with an average follow-up of 13 years. Frailty was measured using a Comprehensive Geriatric Assessment (CGA)-based Frailty Index (FI), calculating the number of deficits in each domain. Cox proportional regression models and inverse probability weighting (IPW) were employed to account for risk factor differences among the frailty groups: robust, prefrail, mild, moderate and severe.

The study included 14 287 people, among whom 891 were frail, with a total of 2402 deaths.Compared with non-frail persons, those with mild (IPW HR 2.06, 95% CI 1.60 to 2.66) and severe (IPW HR 2.71, 95% CI 1.45 to 5.07) frailty had more than twofold elevated risk of all-cause mortality. For cardiovascular mortality, the corresponding HRs were (IPW HR 3.05, 95% CI 2.14 to 4.35) and (IPW HR 3.88, 95% CI 1.95 to 7.74). Men exhibited a higher mortality risk at all frailty levels only in unweighted analysis. Country-specific differences were not significant.

A CGA-based FI is an independent predictor of all-cause and cardiovascular mortality, with even mild frailty increasing the risk. Implementing frailty assessments can improve health risk prediction in older adults from Eastern Europe.

Assessing liver health and its determinants in the elderly is crucial. Lifestyle factors, including nutrition and exercise, may influence liver function. This study aimed to investigate the association between macronutrients and energy intake with serum levels of aminotransferases in elderly Iranian athletes and non-athletes.

A cross-sectional study involving 811 elderly participants (369 athletes, 442 non-athletes) from the Neyshabur Longitudinal Study on Aging (NeLSA) was conducted. Dietary intake was assessed using a food frequency questionnaire. Serum Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured. Regression analyses were employed to evaluate the associations between macronutrient intake and liver enzymes, adjusting for potential confounding variables.

In elderly athletes, higher calorie, protein, and carbohydrate intake were significantly associated with elevated ALT levels (p < 0.01 for all). Additionally, higher carbohydrate and calorie intake were linked to increased AST levels in athletes (p < 0.05 for both). For elderly non-athletes, only higher protein intake was significantly associated with increased ALT levels (p < 0.05), while no nutritional factors were associated with changes in AST levels.

This study revealed that higher calorie, protein, and carbohydrate intake were associated with elevated ALT and AST levels in elderly individuals, particularly athletes. For athletes, all three nutrients were linked to elevated ALT, while only carbohydrates and calories impacted AST. For non-athletes, only protein affected ALT. These findings suggest that tailored nutritional strategies may be necessary to preserve liver health in active aging populations.

The associations between insomnia symptoms and oral health have not been studied. We examined the relationships between insomnia symptoms and oral health in a large representative sample of the middle-aged and older adult Indian population.

59,370 Indian adults aged ≥ 45 years were included in this study. Multivariable logistic regression was conducted to evaluate the associations of insomnia symptoms with tooth loss, dental cavities, and periodontal disease in the whole sample and within different age subgroups.

Individuals reporting insomnia symptoms were more likely to show higher prevalence rates of tooth loss (8.4%), dental cavities (22.6%), and periodontal disease (20.9%) than those without insomnia symptoms. Multivariable logistic regression analyses revealed that there were significant associations of insomnia symptoms with tooth loss (OR: 1.20, CI: 1.12-1.29), dental cavity (OR: 1.15, CI: 1.10-1.21), and periodontal disease (OR: 1.70, CI: 1.61-1.78) independent of potential cofounders. A significant moderation effect by age was observed between insomnia symptoms and oral health conditions.

Insomnia symptoms were associated with higher prevalence rates of tooth loss, dental cavities, and periodontal disease among middle-aged and elderly adults in India. These associations varied across different age groups. In the management of oral health, the potential adverse impact of insomnia symptoms should be closely monitored.

This study aimed to determine the impact of job fitness on depression and depressive symptoms in Korean middle-aged and older population.

We collected data from the Korean Longitudinal Study of Aging (KLoSA), and performed a longitudinal analysis on 3,185 individuals with jobs at baseline. The dependent variable, depressive symptoms was measured by CES-D10 score, and the main variable of interest, job fitness was classified into nine groups according to job satisfaction and education level. To determine whether the estimate of depressive symptoms over the past week and depression changed over time, we applied the Generalized Estimating Equation (GEE) model.

In the fully adjusted model, the impact of job fitness on depression and depressive symptoms was statistically significant. Compared to those with a suitable job level and a medium educational level, those with a large gap between job and educational levels were more likely to develop depression and depressive symptoms. It was also found that satisfaction with job content was a crucial factor affecting depression in the middle-aged and older adults.

Our findings demonstrated that job fitness significantly influenced depression, even after accounting for the effect of job satisfaction caused by a mismatch in job-education fitness. Since work demands and responsibility are difficult to quantify or qualify, job-education fitness could serve as a valuable tool to predict the extent of depression deterioration in individuals.

Through a longitudinal study, we explored the relationship between sensory impairments and depression in the elderly, and examined the mediating roles of daily activity capability and social participation within this relationship.

Based on data from the China Health and Retirement Longitudinal Study (CHARLS) collected in 2015 and 2018, a total of 4,419 individuals aged 60 and above were selected as research participants. Sensory impairments (predictor variables) were assessed in 2015 through self-rated visual and hearing capabilities. Daily activity capability and social participation (mediator variables) were also assessed in 2015, with daily activities assessed using the Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL), and social participation assessed by the quantity of social activity participation. Depression status (outcome variable) was assessed in 2018 using the Center for Epidemiologic Studies Depression Scale (CESD-10). Statistical analysis was conducted using logistic regression and SPSS Macro PROCESS.

First, there is a significant correlation between sensory impairments and an increased risk of depression among the elderly, including visual impairment (VI), hearing impairment (HI), and dual sensory impairment (DSI), all of which increase the likelihood of depression. Second, DSI indirectly affect depression through the cascading mediating effects of daily activity capability and social participation. Finally, in contrast to DSI, when there is only a single sensory impairment, either VI or HI, the cascading mediating effects of daily activity capability and social participation on depression are not statistically significant.

The elderly population with dual sensory impairments requires continued attention to help these individuals adopt preventive measures to halt the onset and worsening of depression.

Loneliness is one critical risk factor for cognitive health. Combining data from ongoing aging studies and the published literature, we provided the largest meta-analysis on the association between loneliness and dementia (k = 21 samples, N = 608,561) and cognitive impairment (k = 16, N = 103,387). Loneliness increased risk for all-cause dementia (HR = 1.306, 95% CI [1.197,1.426]), Alzheimer's disease (HR = 1.393, 95% CI [1.290,1.504]; k = 5), vascular dementia (HR = 1.735, 95% CI [1.483,2.029]; k = 3), and cognitive impairment (HR = 1.150, 95% CI [1.113,1.189]). The associations persisted when models controlled for depression, social isolation, and/or other modifiable risk factors for dementia. The large heterogeneity across studies was partly due to differences in loneliness measures and ascertainment of cognitive status. Results underscored the importance to further examine type/sources of loneliness and cognitive symptoms to develop effective interventions that reduce the risk of dementia.

Arthritis often results in unmet healthcare needs for older adults with cognitive decline, who may struggle to communicate pain or recall symptoms. However, the risk factors for arthritis in this group remain underexplored. We addressed this gap by identifying and comparing arthritis risk factors among older adults with varying cognitive statuses. Data from 334 participants with cognitive decline and 808 participants with normal cognition were analysed using the Korean Longitudinal Study of Aging, tracking arthritis diagnoses over 12 years with Kaplan-Meier curves and Cox proportional hazards regression. Results showed 47.6% of older adults with cognitive decline developed arthritis, compared with 30.1% with normal cognition. Key risk factors for the cognitive decline group included depressive symptoms (hazard ratio [HR]: 1.87), living alone (HR: 1.66), infrequent social interactions (HR: 1.42), and greater dependency in daily activities (HR: 1.41). In the normal cognition group, additional chronic illnesses (HR: 1.41) and higher body mass index (HR: 1.09) were significant risk factors. Understanding these distinct risk factors is crucial for preventing and managing arthritis among at risk groups. Moreover, these findings can assist in developing comprehensive public health strategies integrating mental health and social support to improve health outcomes for older adults with cognitive decline.

Musculoskeletal pain frequently accompanies the development of mobility disability and falls in old age. To better understand this, we aimed to quantify the impact of different pain measures-recalled pain and movement-evoked pain-on 400-meter walk and stair climb time in older adults participating in the Study of Muscle, Mobility and Aging (SOMMA).

In SOMMA (N=879, age=76.3 ± 5.0 years, 59% women, 84% Non-Hispanic White), participants completed usual pace 400m walk (avg=6.6 ± 1.2 min.) and repeat stair climb tests (avg=26.6 ± 7.2 sec.). Assessments of recalled pain included the Brief Pain Inventory short form (BPI-sf), total lower body pain (lower back, hips, knees, feet/ankles), stiffness (hip or knee), and Neuropathy Total Symptom Score (NTSS-6). Movement-evoked pain was assessed separately before and after the 400m walk and repeat stair climb tasks. Multivariable linear regression modeled the associations of pain with time to complete the tasks, reported as β[95%CI] expressed per SD increment of pain measure or β[95%CI] per pain categories, adjusted for age, sex, race, ethnicity, body mass index, prescription medications, and depressive symptoms.

Greater degree of any pain measure was associated with longer physical performance time, though intercorrelations between recalled pain measures varied (r=0.13-0.57, p<0.05 for all). For each SD increment in lower body pain, participants had longer walk time (by 10.5 sec [6.1, 14.8]) and stair climb (by 0.6 sec [0.1, 1.1]). Compared to participants with no change in pain upon movement, walk time was longer in those with more pain upon movement (19.5 sec [10.3, 28.7]) (p<0.001) but not those with less pain upon movement; stair climb showed similar patterns.

Recalled and movement-evoked pain measures were weakly correlated with one another but similarly associated with time to complete 400m walk and stair climb tests. Different pain assessments capture different functional domains of pain but have similar associations with physical performance in these older adults.

This study was designed to investigate the implications of perceived social support from adult children (SSAC) on the incidence of later-life depression (LLD) among rural older adults in China. A total of 1762 participants without depressive symptoms and aged ≥60 years at baseline were recruited from three waves (2011, 2013, and 2015) of the China Health and Retirement Longitudinal Study (CHARLS) and followed up until 2018. After following-up for 2-7 years (average 4.6 years), a total of 746 participants (43.2%) were identified with LLD and the overall incidence of LLD was 128.5 per 1000 person-years. Univariate and multiple Cox regression analysis consistently indicated that receiving living care support was the sole form of SSAC that may significantly reduce the risk of LLD in rural older adults in China (HR: 0.81, 95% CI: 0.70-0.95, p = .008). These results may be of assistance in comprehensively understanding the role of SSAC in the mental health of older adults.

Empirical evidence shows that many family carers, especially immigrants, experience considerable health disadvantages and poorer quality of life. Australia has a rapidly increasing multicultural population, officially referred to as Culturally and Linguistically Diverse (CALD) people. This paper explores similarities and differences in the carer profile and physical and mental health of CALD and non-CALD family carers.

A cross-sectional anonymous survey was conducted of self-reported family carers aged 18 years and older. Identical paper and online survey modes were provided to enable choice. Key variables included demographic and carer profile, diagnosed chronic physical health conditions, and validated scales such as CESD-12 and MOS-SF12, including derivative composite Physical and Mental Component Summary (PCS and MCS, respectively) scores. The sample comprised 649 participants (CALD = 347, non-CALD = 302). The analyses included univariate, bivariate, and multivariable linear regression analyses for three outcome variables: PCS, MCS, and CESD-12.

CALD carers were comparatively younger and married, and 54% had university-level education (29% in the gfvnon-CALD group). Women were primary carers in both groups (67.4% versus 72.2%). The weekly care hours were higher for non-CALD carers. Both groups had below population-referenced scores for mean PCS and MCS values. For CESD-12, non-CALD respondents had higher scores (17.5 vs. 11.2, p < 0.022). Regression analyses showed significant differences for demographic, carer, and physical health variables across the three outcome variables.

Women have a higher domestic workload, which, when combined with high care hours, adversely impacts physical and mental health. The need for improved and culturally aligned care support systems is required.

Neighborhood safety is crucial for the well-being of residents; however, longitudinal evidence is scarce. This study explored the association between neighborhood safety concerns and depressive symptoms among women. A nationally representative sample of 10,008 women was surveyed in 2016. Six dimensions of neighborhood safety concerns were assessed: crime, food, safety at night, traffic accidents, building and facility, and general safety. The total score for neighborhood safety concerns ranged from 6 to 24, with higher scores indicating greater concerns. Depressive symptoms were assessed using the 10-item version of the Center for Epidemiologic Studies Depression. For cross-sectional analyses, we explored how neighborhood safety concerns were associated with concurrent depressive symptoms at baseline. For the longitudinal analyses, we explored how they were associated with depressive symptom onset at the 2-year follow-up (2018) among women without depressive symptoms at baseline (n = 7,643). Logistic regressions were employed. The mean (standard deviation [SD]) of the neighborhood safety concern score was 12.7 (3.3). In the cross-sectional analysis, a 1-SD increase in neighborhood safety concern score was associated with 1.23-fold (95% CI: 1.13-1.35) increase in the odds of concurrent depressive symptoms at the baseline year. In the longitudinal analysis, a 1-SD increase in neighborhood safety concern score was associated with 1.15-fold (95% CI: 1.03-1.29) increase in the odds of experiencing the onset of depressive symptoms at the follow-up year. This study suggests that neighborhood safety concerns are risk factors for the development of depressive symptoms of female residents. Policy efforts are necessary to ensure community safety.

Persons who have experienced homelessness have higher lifetime risks of violent victimization relative to the general population. However, the long-term impacts of violent victimization on various facets of well-being are poorly understood among ever-homeless persons, particularly when violence is experienced in early adulthood. Here, using data from the National Longitudinal Study of Adolescent to Adult Health, we focus on a subsample of emerging adults who reported ever suffering homelessness (N = 481). Drawing primarily from Waves III and IV of the data, a series of regression models are specified to determine whether violent victimization in emerging adulthood is related to a range of negative outcomes later in life among ever-homeless persons (economic hardship, binge drinking, drug use, depression, offending, and victimization). Results indicate that victimization in emerging adulthood increases the risks for subsequent victimization for ever-homeless persons, but that it has no robust associations with any other outcomes examined. We explain these findings through processes of disadvantage saturation, in which the consequences of victimization may be more subdued among individuals who experience an array of hardships and disadvantages in their lives. The implications of these findings for policy are future research are discussed, and we emphasize the need for a context-contingent approach to the study of victimization and its life course consequences.

A number of studies based on young to middle aged adult and child samples have found that exposure to greenspace and bluespace can have a positive impact on mental health and well-being. However, there is limited research among older adults and the extant studies have provided mixed results. The present study was designed to examine how the association between these forms of exposure and depressive symptoms among older adults varies as a function of different spatially and temporally resolved exposure metrics.

The sample consisted of 617 individuals (46.19% female) aged ≥ 60 years of age. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Individuals' greenspace exposure was quantified using spatially and temporally resolved metrics, including monthly and annual averaged satellite-derived normalized difference vegetation index (NDVI) across multiple buffer distances (250 m to 2,000 m) centered at participants' home address. We also quantified exposure to blue-greenspace from a highly detailed land use and land cover dataset. A multivariable logistic regression model assessed the association between greenspace and blue-greenspace exposure and depressive symptoms, adjusting for age, sex, income, education, marital status, current smoking, alcohol status, medical conditions, temperature, crime rate, population density, and per capita park area.

We found a significant association between exposures to greenspace and blue-greenspace and depressive symptoms (CES-D cutoff ≥ 4) among older adults. After adjusting for confounding variables, the odds of depressive symptoms were significantly decreased by an IQR increment in residential exposure to greenspace [odds ratio (OR) = 0.67; 95% confidence interval (95% CI), 0.49 ~ 0.91] and blue-greenspace (OR = 0.59; 95% CI, 0.41 ~ 0.84) measured nearby their home address (i.e., as close as 250 m). When stratified by household income level, the association was only significant among low-income individuals. We also found temporal variation in the association between depressive symptoms and monthly NDVI-based greenspace exposure, in which the odds of depressive symptoms were the lowest for greenspace in cold months (i.e., January, February, and March).

Our findings suggest that neighborhood greenspace may serve as a protective factor against depression among older adults, but the benefits may depend on the spatial and temporal context. More investigation is needed to replicate our findings on the spatial and temporal variations of greenspace exposure metrics and their effects on depressive symptoms.

Oral health influences the quality of life of older adults. Further, depression is negatively associated with oral health. However, little is known about this relationship among older adults with chronic health conditions. Additionally, since oral health and depression differ between genders, this study aimed to investigate the effect of transitions in depressive symptoms on oral health among older adults with chronic health conditions by gender.

We used data from the Korean Longitudinal Study of Aging (2020-2022). The study sample comprised 2836 older adults (1104 men; 1732 women). We adopted multiple linear regression to examine the association between depressive symptom transitions and oral health by gender.

The new onset depression symptoms were significantly associated with the deterioration of oral health in men (β = -5.4308) and women (β = -4.8328). Our study showed a gender-specific association between new onset depressive symptoms and particular domains of oral health. For men, the association was slightly more negative in psychosocial function (β = -2.1177) while women presented lower GOHAI scores in both the physical function domain (β = -1.8800) and the psychosocial function domain (β = -1.8801).

The data used in this study were self-reported via a survey; thus, self-report bias may be a relevant concern.

To prevent deterioration in oral health, depressive symptoms must be detected and addressed early among older adults with chronic conditions. This study underscores the importance of interventions that consider gender differences in the association between depressive symptoms and psychosocial and physical functioning.

Internet exclusion and depressive symptoms are prevalent phenomena among older adults; however, the association between internet exclusion and depressive symptoms remains limited. This study aims to investigate the association between internet exclusion and depressive symptoms among older adults from high-income countries (HICs) and low- and middle-income countries (LMICs).

We conducted a comprehensive longitudinal, cross-cultural analysis, and the participants were adults aged 60 years and older from 32 countries participating in five nationally representative longitudinal cohort studies: the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing and Retirement in Europe (SHARE), the China Health and Retirement Longitudinal Study (CHARLS), and the Mexican Health and Ageing Study (MHAS). Internet exclusion was defined as the self-reported absence from internet use. Depressive symptoms were evaluated using the Centre for Epidemiologic Studies of Depression scale (CES-D) or the Euro-Depression scale (Euro-D). These five cohorts, being heterogeneous, were respectively conducted with panel data analysis. Logistic regression, implemented within the generalized estimating equations framework, was used to examine the association between internet exclusion and the likelihood of experiencing depressive symptoms, adjusting for the causal-directed-acyclic-graph (DAG) minimal sufficient adjustment set (MSAS), including gender, age, education, labour force status, household wealth level, marital status, co-residence with children, residence status, cognitive impairment, and functional ability.

Our study included a total of 129,847 older adults during the period from 2010 to 2020, with a median follow-up of 5 (2, 7) years. The pooled proportion of internet exclusion was 46.0% in HRS, 32.6% in ELSA, 54.8% in SHARE, 92.3% in CHARLS, and 65.3% in MHAS. Internet exclusion was significantly associated with depressive symptoms across all cohort studies: HRS (OR = 1.13, 95% CI 1.07-1.20), ELSA (OR = 1.22, 95% CI 1.11-1.34), SHARE (OR = 1.55, 95% CI 1.47-1.62), CHARLS (OR = 1.49, 95% CI 1.26-1.77), and MHAS (OR = 1.48, 95% CI 1.39-1.58). Moreover, internet exclusion was found to be associated with all dimensions of depression in the SHARE, MHAS, and ELSA cohorts (except for sleep and felt sad) cohorts.

A considerable proportion of older adults experienced internet exclusion, particularly those in LMICs. Internet exclusion among older adults, irrespective of their geographic location in HICs or LMICs, was associated with a higher likelihood of experiencing depressive symptoms, which demonstrated the importance of addressing barriers to internet access and promoting active participation in the internet society among older adults.

National Key R&D Program of China (grant number 2022ZD0160704), the Scientific Research and Innovation Team of The First Affiliated Hospital of Zhengzhou University (grant number ZYCXTD2023005), the Collaborative Innovation Major Project of Zhengzhou (grant number 20XTZX08017), the Joint Project of Medical Science and Technology of Henan Province (grant number LHGJ20220428), and National Natural Science Foundation of China (grant number 82373341).