Depressive symptoms mediate the longitudinal relationships between sleep quality and cognitive functions among older adults with mild cognitive impairment: A cross-lagged modeling analysis.

Although it is generally recognized that sleep quality, depressive symptoms, and cognitive functions are related respectively, the main ambiguity comes from difficulties in determining their cause-effect relationships. The present study aimed to explore the longitudinal causation relationships among sleep quality, depressive symptoms, and cognitive functions in older people with mild cognitive impairment (MCI). A total of 134 patients from 24 communities in Ningbo City, Zhejiang Province, China with MCI were interviewed at baseline, while 124 of them were re-interviewed 2 months later, and 122 were re-interviewed 4 months later. The Patient Health Questionnaire-9, the Pittsburgh Sleep Quality Index and the Montreal Cognitive Assessment Scale were assessed in the interview. Cross-lagged models were tested to disentangle the relationships among sleep quality, depressive symptoms, and cognitive functions using structural equation modeling with latent variables on the four-mouth longitudinal data. The correlation coefficients between sleep quality and depressive symptoms were significant showing the stability across time points of assessment, while the correlation coefficient of cognitive function was not significant (r = 0.159, p > 0.05). The results of index of model fit indicated that the cross-lagged model was acceptable (CFI = 0.934, TLI = 0.899, RMSEA = 0.075, χ2/df = 1.684). The results of cross-lagged model analysis supported the complete mediating role of depressive symptoms in the association between sleep quality and cognitive functions, where worse sleep quality may lead to more severe depressive symptoms, which in turn leads to more severe cognitive decline. In Conclusion, sleep quality is significantly correlated with cognitive functions in patients with mild cognitive impairment, which association is fully mediated by depressive symptoms. Approaches addressing sleep quality and depressive symptoms are recommended and hold promise for the management of mild cognitive impairment.

Interactions between mild depressive symptoms and amyloid pathology on the trajectory of neurodegeneration, cognitive decline, and risk of Alzheimer's disease.

BACKGROUND: Alzheimer's disease (AD) was driven by the interplay between modifiable environmental factors and ß-amyloid (Aß) pathology. We aimed to investigate the interaction effects of mild depressive symptoms (MDS) with Aß on AD development. METHODS: Longitudinal data of 1746 non-demented adults (mean age = 73 years, female = 53 %, maximum = 10 years) were derived from the Alzheimer's Disease Neuroimaging Initiative cohort. MDS was separately defined by the baseline status, longitudinal latent class, and average intensity during follow-up. Amyloid-positive (A+) status was determined based on cerebrospinal fluid levels of ß-amyloid. Regression models were employed to analyze the interactive effects of MDS with A+ on cognitive decline, neurodegeneration, and AD incidence. RESULTS: Individuals with both A+ status and MDS at baseline experienced the fastest neurodegeneration (p < 0.01), cognitive decline (p < 0.05), and a higher risk of developing AD (HR = 5.23, p < 0.001). Furthermore, A+ participants with the trajectory of increasing depressive symptoms demonstrated more pronounced neurodegeneration (p < 0.001), cognitive decline (p < 0.01), and elevated risk of AD (HR = 10.45, p < 0.001). Finally, A+ status in combination with a higher average intensity of depressive symptoms was associated with faster brain atrophy (p < 0.01) and brain metabolism decline (p < 0.05), cognitive decline (p < 0.05), and higher AD risk (HR = 13.99, p < 0.001). CONCLUSION: These findings emphasized that the MDS-Aß interaction relationship should be considered in risk stratification, prediction, and early management of neurodegeneration and cognitive decline in the pre-dementia stage.

Symptoms and Diabetes among Chinese Middle-Aged and Elderly Adults with Prediabetes: A National Cohort Study.

We aimed to assess the association between depressive symptoms and the risk of transition from prediabetes to diabetes. We included 3,956 adults with prediabetes aged 45 years and above in 2011. Participants with a ten-item Center for Epidemiologic Studies Depression (CES-D) score of 10 or higher were classified as having depressive symptoms. Incident diabetes was defined as a self-reported physician diagnosis of diabetes, or treatment with glucose-lowering medication in 2013, 2015, or 2018. Among 3, 956 participants (mean age was 59.53 years old and 53.29% were female), the proportion of depressive symptoms was 36.50% in 2011. During the 24,831 person-years of follow-up, 458 participants developed diabetes and the incidence rate was 18.44 (95% CI 16.83 to 20.21) per 1000 person-years. Depressive symptoms were significantly associated with a higher risk of incident diabetes (HR, 1.31; 95% CI, 1.07 to 1.59). In addition, the association was in a dose-response fashion (P trend < 0.001). Compared with the CES-D <10 group, the HRs (95% CI) were 1.21 (0.98 to 1.49) in the 10≤ CES-D <21 group, and 1.95 (1.38 to 2.75) in the CES-D ≥ 21 group. Depressive symptoms were shown as an independent risk factor for the progression from prediabetes to diabetes.

The association between mental status, personality traits, and discrepancy in social isolation and perceived loneliness among community dwellers.

BACKGROUND: Social isolation and loneliness can co-occur; however, they are distinct concepts. There is discrepancy as some people feel lonely in social isolation, while others do not. This study sought to enhance our understanding of this discrepancy between social isolation and loneliness by investigating its related factors, with a specific focus on mental status and personality traits. METHODS: This study adopted a cross-sectional study design and utilized data from the 2016 and 2018 waves of the University of Michigan Health and Retirement Study. The participants were community dwellers aged 50 years and older. The outcome measurement was defined as the discrepancy between social isolation, based on six criteria, and loneliness, assessed using the three-item version of the Revised UCLA Loneliness Scale. Multinomial logistic regression models were conducted to examine the factors associated with the discrepancy. RESULTS: Participants with fewer depressive symptoms and higher extraversion were associated with the only social isolation group and the only loneliness group rather than the group consisting of those who felt lonely with social isolation. In addition, lower neuroticism was associated with the only social isolation group. Participants with fewer depressive symptoms, lower neuroticism, and higher extraversion were more likely not to feel lonely even with social isolation, compared to feeling lonely even in the absence of isolation. CONCLUSIONS: Mental status and personality traits may be closely related to the discrepancy between social isolation and loneliness. This study suggests that incorporating social, mental, and psychological factors may be essential for interventions in social isolation and loneliness.

Age-related differences in the number of chronic diseases in association with trajectories of depressive symptoms: a population-based cohort study.

BACKGROUND: The number of chronic diseases has been associated with changes in depressive symptoms over time among middle-aged and older adults. This study aimed to explore the association between the number of chronic diseases and trajectories of depressive symptoms and the role of age in this association. METHODS: A total of 12,974 middle-aged and older Chinese adults (≥ 45 years) participated in the China Health and Retirement Longitudinal Study (CHARLS) in waves 2011, 2013, 2015, 2018, and 2020. The number of chronic diseases was determined by self-reported hospital diagnosis of hypertension, dyslipidemia, diabetes, cancer, chronic lung diseases, liver disease, heart diseases, stroke, kidney diseases, digestive diseases, emotional, nervous, or psychiatric problems, memory-related disease, arthritis or rheumatism, asthma, and then obtaining the total number of chronic diseases. Depressive symptoms were measured by the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Group-based trajectory modeling (GBTM) was adopted to capture the trajectories of depressive symptoms over time. Multinomial logistic regressions were conducted to examine the association between the number of chronic diseases and trajectories of depressive symptoms and the role of age in this association. RESULTS: Four distinct trajectories of depressive symptoms were observed in 34.68% individuals in mild, 40.76% in moderate, 19.41% in increasing, and 5.15% in severe group. Compared to participants without chronic diseases, those with one, two, three or more chronic diseases had a 1.81, 3, and 7.49-fold higher risk of developing severe depressive symptom trajectory, respectively. Moreover, the association between the number of chronic diseases and severe depressive symptoms trajectory differed by age (45-59 and ≥ 60 years) (P for interaction < 0.05). CONCLUSION: Participants with middle age may play a promoting role in the association between the number of chronic disease and severe depressive symptoms. The severe depressive symptoms intervention may be more beneficial for middle-aged adults.

Effects of Virtual Rehabilitation Training on Post-Stroke Executive and Praxis Skills and Depression Symptoms: A Quasi-Randomised Clinical Trial.

INTRODUCTION: Apraxia is a neurological disorder that is common after a stroke and impairs the planning and execution of movements. In the rehabilitation field, virtual reality (VR) presents new opportunities and offers advantages to both rehabilitation teams and individuals with neurological conditions. Indeed, VR can stimulate and improve cognitive reserve and abilities, including executive function, and enhance the patient's emotional status. AIM: The objective of this research is to determine the effectiveness of VR in improving praxis skills and behavioural functioning in individuals with severe stroke. METHODS: A total of 20 stroke patients were enrolled from February 2022 to March 2023 and divided by the order of their recruitment into two groups: the experimental group (EG: n = 10) received training to improve their praxis skills using VR whereas the control one (CG: n = 10) received the same amount of standard training. All patients underwent an evaluation using a psychometric battery that consisted of the Hamilton Rating Scale for Depression (HRS-D), Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), Spinnler and Tognoni test, and De Renzi and Faglioni test. Valuations were performed before rehabilitation (T0) and after its completion (T1). RESULTS: Both groups demonstrated significant improvements post-intervention. The EG showed a greater enhancement in their MMSE scores (p = 0.002), and reductions in both ideomotor and constructive apraxia (p = 0.002 for both), compared to the CG. The VR-based training also resulted in significant improvements in their depression symptoms (HRSD scores improved, p = 0.012 in EG vs. p = 0.021 in CG). CONCLUSIONS: This pilot study suggests that VR could help reduce cognitive, constructive apraxia and ideomotor apraxia symptoms caused by stroke injury.

Effects of glycaemic control on memory performance, hippocampal volumes and depressive symptomology.

BACKGROUND: Diabetes and poor glycaemic control have been shown to negatively impact cognitive abilities, while also raising risk of both mood disorders and brain structural atrophy. Sites of atrophy include the hippocampus, which has been implicated in both memory performance and depression. The current study set out to better characterise the associations between poor glycaemic control, memory performance, and depression symptoms, and investigate whether loss of hippocampal volume could represent a neuropathological mechanism underlying these. METHODS: 1331 participants (60.9% female, age range 18-88 (Mean = 44.02), 6.5% with likely diabetes) provided HbA1c data (as an index of glycaemic control), completed a word list learning task, and a validated depression scale. A subsample of 392 participants underwent structural MRI; hippocampal volumes were extracted using FreeSurfer. RESULTS: Partial correlation analyses (controlling for age, gender, and education) showed that, in the full sample, poorer glycaemic control was related to lower word list memory performance. In the MRI sub-sample, poorer glycaemic control was related to higher depressive symptoms, and lower hippocampal volumes. Total hippocampus volume partially mediated the association between HbA1c levels and depressive symptoms. CONCLUSIONS: Results emphasise the impact of glycaemic control on memory, depression and hippocampal volume and suggest hippocampal volume loss could be a pathophysiological mechanism underlying the link between HbA1c and depression risk; inflammatory and stress-hormone related processes might have a role in this.

Association of depressive symptoms with incidence and mortality rates of COVID-19 over 2 years among healthcare workers in 20 countries: multi-country serial cross-sectional study.

BACKGROUND: Long-term deterioration in the mental health of healthcare workers (HCWs) has been reported during and after the COVID-19 pandemic. Determining the impact of COVID-19 incidence and mortality rates on the mental health of HCWs is essential to prepare for potential new pandemics. This study aimed to investigate the association of COVID-19 incidence and mortality rates with depressive symptoms over 2 years among HCWs in 20 countries during and after the COVID-19 pandemic. METHODS: This was a multi-country serial cross-sectional study using data from the first and second survey waves of the COVID-19 HEalth caRe wOrkErS (HEROES) global study. The HEROES study prospectively collected data from HCWs at various health facilities. The target population included HCWs with both clinical and non-clinical roles. In most countries, healthcare centers were recruited based on convenience sampling. As an independent variable, daily COVID-19 incidence and mortality rates were calculated using confirmed cases and deaths reported by Johns Hopkins University. These rates represent the average for the 7 days preceding the participants' response date. The primary outcome was depressive symptoms, assessed by the Patient Health Questionnaire-9. A multilevel linear mixed model (LMM) was conducted to investigate the association of depressive symptoms with the average incidence and mortality rates. RESULTS: A total of 32,223 responses from the participants who responded to all measures used in this study on either the first or second survey, and on both the first and second surveys in 20 countries were included in the analysis. The mean age was 40.1 (SD = 11.1), and 23,619 responses (73.3%) were from females. The 9323 responses (28.9%) were nurses and 9119 (28.3%) were physicians. LMM showed that the incidence rate was significantly and positively associated with depressive symptoms (coefficient = 0.008, standard error 0.003, p = 0.003). The mortality rate was significantly and positively associated with depressive symptoms (coefficient = 0.049, se = 0.020, p = 0.017). CONCLUSIONS: This is the first study to show an association between COVID-19 incidence and mortality rates with depressive symptoms among HCWs during the first 2 years of the outbreak in multiple countries. This study's findings indicate that additional mental health support for HCWs was needed when the COVID-19 incidence and mortality rates increase during and after the early phase of the pandemic, and these findings may apply to future pandemics. TRIAL REGISTRATION: Clinicaltrials.gov, NCT04352634.

Parent-Child Mismatch in Educational Expectations and Depressive Symptoms among Chinese Adolescents.

BACKGROUND: The roles of both parents' and children's educational expectations in shaping adolescent depressive symptoms have increasingly been discussed, yet in a separate manner. To date, few studies have associated parent-child mismatch in educational expectations with depressive symptoms, and less is known about the variation in the association across gender (male vs. female), educational level (primary vs. secondary), and region status (urban vs. rural) in the Chinese educational setting. METHODS: Respondents were from a nationally representative sample of adolescent students in China (sample size: 1844; age range: 10-15 years). Parent-child mismatch in educational expectations included three categories: (1) "match", (2) "mismatch-parent higher", and (3) "mismatch-parent lower". Regression analysis with inverse propensity-score weighting was employed to estimate the effect of parent-child mismatch as to educational expectations on depressive symptoms, and stratified analysis was used to examine the variation of the effect by gender, educational level, and region. RESULTS: Compared with the "match" group, the "mismatch-parent higher" group had significantly higher levels of depressive symptoms. Furthermore, the pattern remained consistent between boys and girls, but differed significantly by adolescents' educational level and region status. Specifically, the pattern was more pronounced in the primary school and urban subsamples. CONCLUSIONS: Findings in this study indicated that educators and policymakers can develop tailored strategies to alleviate depressive symptoms among the "mismatch-parent higher" group, and especially for those children from primary schools and urban areas.

Joint effects of prescription opioid use and physical activity on depressive symptoms.

OBJECTIVES: The possible interaction of prescription opioid use and physical activity with regard to depressive symptoms has not been well studied. This study aimed to investigate the joint effects of prescription opioid use and physical activity on depressive symptoms. STUDY DESIGN: Cross-sectional study. METHODS: This cross-sectional study included 29,542 participants from the National Health and Nutrition Examination Survey (2007 to March 2020). Depressive symptoms were evaluated using the Patient Health Questionnaire-9. Multivariable logistic regression models were used to examine the association. RESULTS: Of the 29,542 adults, 2598 had depressive symptoms (weighted, 7.7%), 1845 used prescription opioids (weighted, 6.0%), and 18,373 (weighted 67.0%) achieved the recommended physical activity. After multivariable adjustment, the odds ratio (OR) of depressive symptoms was 4.06 (95% confidence interval [CI]: 3.28, 5.02) for both prescription opioid use and inactive physical activity compared to those without either condition. No multiplicative interaction was observed for prescription opioid use and inactive physical activity on depressive symptoms (OR = 1.26 [95% CI: 0.87, 1.81]). However, additive interaction was statistically significant between the 2 exposures (relative excess risk due to interaction = 1.34 [95% CI: 0.31, 2.36]; attributable proportion due to interaction = 0.33 [95% CI: 0.12, 0.54]; synergy index = 1.78 [95% CI: 1.12, 2.83]). CONCLUSIONS: Prescription opioid use and inactive physical activity interacted synergistically to affect depressive symptoms.

The impact of internet device diversity on depressive symptoms among middle-aged and older adults in China: A cross-lagged model of social participation as the mediating role.

BACKGROUND: Depressive symptoms is more prevalent in middle-aged and older populations, and the development of Internet technology has brought new challenges and opportunities for the mental health of this group. This study aims to explore the bidirectional relationship between Internet device diversity and levels of depressive symptoms through longitudinal data analysis, as well as investigate the mediating role of social participation. METHODS: Data for the analysis was retrieved from the China Health and Retirement Longitudinal Survey (CHARLS) in 2015, 2018, and 2020, which included 9259 middle-aged and older adults. The sum of the number of devices mentioned by each participant was calculated to assess the diversity of internet device use, a weighted total score of how frequently and to what extent individuals had participated in various social activities in the past month was calculated to measure the social engagement, and the Center for Epidemiological Studies Depression Scale was used to calculate depressive symptoms. A cross-lagged mediation model and bivariate correlation analysis were employed to examine the longitudinal relationships among depressive symptoms, internet device diversity, and social participation. Age, gender, highest education level, and chronic health conditions were adjusted as covariates. RESULTS: The results from the three waves of longitudinal data revealed mutual predictive relationships among internet device diversity, social participation, and depressive symptoms. The mediating effect was significant (ß = -0.612, 95 % CI -0.796 to -0.429), with significant gender differences observed. Furthermore, our findings indicated that social participation functioned as a protective factor against depressive symptoms, and the association between social participation and depressive symptoms was not a straightforward linear relationship. Older adults exhibiting a high level of social participation exhibited an elevated risk of depressive symptoms compared to those with a lower level of social participation. CONCLUSIONS: This study suggests that there is a relationship between internet device diversity and lower levels of depressive symptoms among middle-aged and older adults in China. Social participation mediates the relationship between internet device diversity and depressive symptoms, and different levels of social engagement have different effects on depressive symptoms. It is recommended to increase support for social participation among middle-aged and older adults, strengthen structural social capital, and better leverage the use of the internet to reduce depressive symptoms levels and promote the physical and mental well-being of this population.

Prediction of depressive symptoms severity based on sleep quality, anxiety, and gray matter volume: a generalizable machine learning approach across three datasets.

BACKGROUND: Depressive symptoms are rising in the general population, but their associated factors are unclear. Although the link between sleep disturbances and depressive symptoms severity (DSS) is reported, the predictive role of sleep on DSS and the impact of anxiety and the brain on their relationship remained obscure. METHODS: Using three population-based datasets (N = 1813), we trained the machine learning models in the primary dataset (N = 1101) to assess the predictive role of sleep quality, anxiety problems, and brain structural (and functional) measurements on DSS, then we tested our models' performance in two independent datasets (N = 378, N = 334) to test the generalizability of our findings. Furthermore, we applied our model to a smaller longitudinal subsample (N = 66). In addition, we performed a mediation analysis to identify the role of anxiety and brain measurements on the sleep quality and DSS association. FINDINGS: Sleep quality could predict individual DSS (r = 0.43, R2 = 0.18, rMSE = 2.73), and adding anxiety, contrary to brain measurements, strengthened its prediction performance (r = 0.67, R2 = 0.45, rMSE = 2.25). Importantly, out-of-cohort validations in other cross-sectional datasets and a longitudinal subsample provided robust similar results. Furthermore, anxiety scores, contrary to brain measurements, mediated the association between sleep quality and DSS. INTERPRETATION: Poor sleep quality could predict DSS at the individual subject level across three datasets. Anxiety scores not only increased the predictive model's performance but also mediated the link between sleep quality and DSS. FUNDING: The study is supported by Helmholtz Imaging Platform grant (NimRLS, ZTI-PF-4-010), the Deutsche Forschungsgemeinschaft (DFG, GE 2835/2-1, GE 2835/4-1), the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)-Project-ID 431549029-SFB 1451, the programme "Profilbildung 2020" (grant no. PROFILNRW-2020-107-A), an initiative of the Ministry of Culture and Science of the State of Northrhine Westphalia.

Depressive symptoms, cognitive functions and daily activities: An extended network analysis in monozygotic and dizygotic twins.

BACKGROUND: The network theory posits that depression emerges as the result of individual symptoms triggering each other. Risk factors for depression can impact these between-symptoms interactions through extended networks. The study aimed to model the extended network of depressive symptoms and known depression risk factors - objective cognitive function, intellectual, physical, and social daily activities, and then, compare the observed networks between monozygotic (MZ) and dizygotic (DZ) co-twins. METHODS: Twin pairs, 722 MZ and 2200 DZ, aged 40-79, were selected from the Dansh Twin Registry for having complete measures of depressive symptoms (e.g., sadness), cognitive functions (e.g., verbal memory), physical (e.g., brisk walk), intellectual (e.g., reading newspapers) and social activities (e.g., phone calls). Gaussian graphical models were used to estimate and compare the networks first between co-twins and then, between MZ to DZ twin pairs separately. RESULTS: Specific intellectual, physical and social activities were central in the extended networks of depressive symptoms and, with the exception of processing speed, more central than cognition. The extended networks' structure was more homogeneous between MZ co-twins relative to DZ co-twins. Cognitive nodes were more central in MZ than DZ co-twins. LIMITATIONS: Cross-sectional design, participants were middle-aged or older, mostly affective (non-somatic) depressive symptoms. CONCLUSIONS: In depression networks, core connecting elements were intellectual, physical and social activities. The interaction between cognition and daily activities seems critical for triggering depressive symptoms. Thus, clinical interventions aimed at preventing depression and associated cognitive deficits should focus on maintenance and/or engagement in stimulating daily activities.

Self-inefficacy's impact on well-being indices in students self-identifying with cluttering characteristics.

INTRODUCTION: Cluttering, a fluency disorder characterized by fast and irregular speech patterns, receives relatively limited research attention. Consequently, the association between cluttering and measures of well-being remains unexplored. In contrast, stuttering, another fluency disorder, has been associated with anxiety and depression. The present study examines whether an individual's experience of cluttering characteristics is related to alterations in both positive and negative measures of well-being. To achieve this, we assessed the relationship between Self-Identified Cluttering Characteristics (SICC) and measures of well-being in a sizeable sample of 1201 university students. Our main objective was to explore the potential impact of self-inefficacy on the association between SICC and well-being. METHODS: Consistent with prior research, participants identified themselves as having cluttering characteristics (SICC) or no-cluttering characteristics (SINCC) based on a verbal and written explanation of the disorder. They also completed questionnaires on psychological well-being indices and self-inefficacy. RESULTS: In total, 276 respondents identified themselves as having cluttering characteristics. In regression models, both SICC and self-inefficacy were predictive of greater negative well-being, increased depressive symptoms, and heightened psychosomatic symptoms. Interestingly, ADHD diagnosis was associated with less negative well-being. Positive well-being indicators (positive future orientation and subjective happiness) were solely predicted by self-inefficacy. Supporting these findings, supplementary regressions including only 56 SICC participants who reported being treated for cluttering yielded similar results. Utilizing Hayes's PROCESS computational procedures to test moderation revealed that self-inefficacy significantly moderated the association between SICC and negative well-being (depressive symptoms) as well as the association between SICC and positive well-being (positive future orientation). CONCLUSIONS: The findings underscore alterations in well-being among individuals who identify themselves as experiencing cluttering characteristics. Primarily, heightened negative well-being was noted in those with SICC, yet individual self-inefficacy reports mitigated this effect. Overall, SICC exacerbates negative well-being rather than diminishing positive well-being. These findings point to the importance of integrating mental health assessment and intervention into clinical practice for individuals with cluttering symptoms and the potential benefits of interventions targeting self-inefficacy to improve overall well-being in this population.

Association between window ventilation frequency and depressive symptoms among older Chinese adults.

OBJECTIVES: Indoor air pollution exposure is harmful to people's physical and mental health, especially in the elderly population. Depressive symptoms are the most common mental health issue among elderly individuals. However, evidence linking the frequency of indoor natural ventilation to depressive symptoms in the elderly population is limited. METHODS: This study included 7887 individuals 65 years and older from 2017 to 2018 the China Longitudinal Healthy Longevity Survey (CLHLS). The frequency of indoor window ventilation was measured as the self-reported times of ventilation of indoor window per week in each season, and the four seasons' scores were added up to calculate the annual ventilation frequency. Depressive symptoms were measured by the 10-item Center for Epidemiologic Studies Short Depression Scale (CESD). Using three models adjusted for demographic, socio-economic, health status, and environmental factors successively, the correlation between indoor window ventilation frequency and depressive symptoms was verified through logistic regression. RESULTS: Among the 7887 elderly people included in this study, 1952 (24.7 %) had depressive symptoms. In the fully adjusted model, compared with the lower indoor annual ventilation frequency group, high indoor annual ventilation frequency group was significantly associated with a 33 % (OR: 0.67, 95%CI: 0.51-0.88) lower probability of depressive symptoms. Subgroup analysis and sensitivity analysis yielded similar results. CONCLUSIONS: High frequency of window ventilation is significantly associated with the lower risk of depressive symptoms in Chinese individuals aged 65 and older. This result provides strong evidence for health intervention and policy formulation.

Prevalence of Depressive Symptoms and Related Factors in Türkiye: Results of the 2016 and 2019 Turkish Health Survey. / Türkiye'de Depresif Belirtilerin Yayginligi ve Iliskili Etmenler: 2016 ve 2019 Türkiye Saglik Arastirmasi Sonuçlari.

OBJECTIVE: We investigated the prevalence and distribution of depressive symptoms in individuals aged 15 and older, as well as the relationship between depressive symptoms and sociodemographic characteristics, chronic diseases, health status and health behaviors. METHOD: The analysis of data collected from the Türkiye Health Surveys conducted by Turkish Statistical Institute (TURKSAT) in 2016 and 2019 involved using the Chi-Square independence test. Effect sizes were evaluated using Phi or Cramer's V coefficients. Patient Health Questionnaire-8 (PHQ-8) module was used to scan the depressive symptoms. RESULTS: The adult population's point of prevalence of depressive symptoms was 4.7%±0.24 in males and 8%±0.19 in females, with a population total of 6.3%±0.21. The yearly prevalence of depressive symptoms was 6.1%±0.45 in males, 13.2%±0.53 in females and a population total of 10%±0.49. Age, gender, income, education, social support, health status, disability, and chronic illnesses were found to be significant predictors of the incidence of depressive symptoms (p<0,05). The results indicated that the rate of people with depression getting help from psychologists, psychotherapists,and psychiatrists was low. CONCLUSION: Age, gender, income, education, marital status, self-rated health status, social support, number of chronic illnesses, and disability were the most important risk factors for depressive episodes. In addition to such self-reported research completed before the pandemic and Kahramanmaras earthquakes in Türkiye, further studies based on structured diagnostic interviews are required.

Maternal Depressive Symptoms and Children's Behavioral Problems: The Moderating Roles of Emotion Regulation and Teacher-Student Relationship Quality.

The detection rate of children's behavioral problems is on the rise throughout the world, reaching 18.8% in China. Maternal depressive symptoms is one of the main causes of children's behavioral problems. Our study explored the moderating roles and the specific moderating mechanism of children's emotion regulation and teacher-student relationship quality in the association between maternal depressive symptoms and children's behavioral problems based on the resilience framework and the multiple moderating model. A cross-sectional survey on mothers and teachers of Chinese primary school students in grades 1 to 3 in suburban Beijing was conducted to investigate children's behavioral problems, emotion regulation, teacher-student relationship quality, maternal depressive symptoms, and demographic characteristics (n = 300) in this study. Pathway analysis and the Johnson-Neyman method were used to determine the moderating roles and the specific moderating mechanism of emotion regulation and teacher-student relationship quality. Results showed that emotion regulation and teacher-student relationship quality played moderating roles in the association between maternal depressive symptoms and children's behavioral problems and the moderating mechanism was the additive moderating model. To be specific, emotion regulation and teacher-student relationship quality played moderating roles parallelly. Emotion regulation could moderate the negative effect of maternal depressive symptoms on both internalizing and externalizing behavioral problems in children. Meanwhile, teacher-student relationship quality could moderate the negative effect of maternal depressive symptoms on children's externalizing behavioral problems. The study highlighted the value of children's emotion regulation and teacher-student relationship quality against adverse family environments and gave an orientation for intervention.

Analysis of the effect of BMI on depression and anxiety among older adults in China: the mediating role of ADL and IADL.

Background: Anxiety and depression are serious psychological and public health issues among the older adults. Currently, there is a lack of understanding of the relationship between Body Mass Index (BMI) and anxiety or depression symptoms in the older adult population in China. Therefore, the purpose of this study is to investigate the impact of BMI on anxiety and depression through correlation analysis in different subgroups and to examine the potential chain mediating effects of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) between BMI and symptoms of anxiety and depression. Methods: From the CLHLS database conducted in 2017-2018, data regarding height, weight, anxiety symptoms, depression symptoms, as well as demographic, socioeconomic, behavioral, and health-related characteristics were collected. Multivariate logistic regression analysis was used to explore the impact of BMI on anxiety and depression symptoms. Finally, the SPSS macro process was utilized to test the multiple mediating effects of ADL and IADL between BMI and anxiety or depression symptoms. Results: After screening, a final sample of 9,098 Chinese older adult individuals aged 65 and above was selected. Among them, 1,074 cases (11.8%) exhibited anxiety symptoms, 1,458 cases (16.0%) exhibited depressive symptoms. Compared to normal BMI, the adjusted analysis showed that underweight in Chinese older adult individuals was significantly associated with anxiety (OR = 1.316, p = 0.004) and depression (OR = 1.232, p = 0.013). This relationship was found to be more significant in males, individuals aged 80 and above, unmarried individuals, and those residing in town. ADL and IADL played a chain-mediated role between BMI and anxiety symptoms in the older adult. BMI not only had a direct effect on anxiety symptoms in the older adult (effect = -0.0159; SE = 0.0066; 95%CI: LL = -0.0288, UL = -0.0031), but also influenced them indirectly through two pathways: the independent mediating role of IADL (effect = -0.0010; SE = 0.0005; 95%CI: LL = -0.0018, UL = -0.0003) and the chain-mediated role of ADL and IADL (effect = -0.0012; SE = 0.0004; 95%CI: LL = -0.0020, UL = -0.0006). Conclusion: In the older adult individuals in China, underweight is associated with an increased risk of anxiety and depression symptoms. Improving the underweight condition of Chinese older adult individuals can reduce their ADL and IADL limitations, thereby benefiting their mental health.

[Interaction of hypertensive comorbidity patterns and social participation on depressive symptoms].

OBJECTIVE: To explore the relationship between hypertensive comorbidity patterns and social participation and depressive symptoms in middle-aged and elderly hypertensive patients. METHODS: Using the data from the 2015, 2018 and 2020 of the China Health and Retirement Longitudinal Study, 2786 middle and elderly adults aged 45 and above with hypertension were included. Data analysis was performed in Stata 17.0 statistical software, using frequency and percentage to describe baseline characteristics. The generalized estimation equation(GEE) was used to to analyze the data, and GEE was constructed with the depressive symptoms of middle and elderly people as the dependent variable. The unifactorial and multifactorial analysis of the effects of hypertensive comorbidity patterns and social participation on depressive symptoms, and the influence of the interaction between hypertensive comorbidity patterns and social participation on depressive symptoms were analyzed. RESULTS: Among the baseline characteristics of 2786 middle and older adults with hypertension, 2319(83.24%) had hypertensive comorbidity and 1558(55.92%) had social participant. The result of unifactorial GEE analysis of depressive symptoms in middle and older adults showed that the risk of depressive symptoms was higher in hypertensive comorbidity than in hypertension without comorbidity(OR=2.31, 95%CI 1.97-2.71, P<0.01), and lower in middle and older adults with social participation than in those without social participation(OR=0.71, 95%CI 0.64-0.78, P<0.01). The result of multifactorial GEE analysis of depressive symptoms in middle and older adults showed that the risk of depressive symptoms was higher in hypertensive comorbidity than in hypertension without comorbidity(OR=2.06, 95%CI 1.75-2.41, P<0.01), and lower in middle and older adults with social participation than in those without social participation(OR=0.78, 95%CI 0.70-0.87, P<0.01). Analysis of the interaction of hypertensive comorbidity and social participation on depressive symptoms in middle and older adults showed that middle and older adults with hypertensive comorbidity and no social participation had a 2.20 times higher risk of depressive symptoms than those with hypertension without comorbidity and no social participation(OR=2.20, 95%CI 1.78-2.72, P<0.01). CONCLUSION: Comorbidity is severe in the hypertensive population, and social participation in the hypertensive comorbidity population may reduce the risk of developing depressive symptoms.

Association Between Sickness Presenteeism and Depressive Symptoms by Occupation and Employment Type During the COVID-19 Pandemic.

Background: Sickness presenteeism (SP) has gained attention in occupational health. This study aimed to analyze the relationship between SP and depressive symptoms by occupation and employment type during the COVID-19 pandemic in Korea. Methods: Community Health Survey data (August 16 to October 31, 2020-2021) were used to assess depressive symptoms and SP among workers (n = 221,241; mean age 46.0; 53.5% male). Depressive symptoms were measured using the Patient Health Questionnaire-9, and SP was defined by the ability to rest at home when exhibiting COVID-19 symptoms. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of depressive symptoms were estimated using multiple logistic regression analyses for each sex and year stratum. The interaction between SP and occupation on depressive symptoms was assessed using relative excess risk due to interaction (RERI). Results: The prevalence of depressive symptoms was higher in individuals with SP than in those without SP (4.22% [n = 696] vs. 1.89% [n = 3861], respectively). After adjusting for demographic and occupational variables, the association between SP and depressive symptoms was significant in both sexes in 2020 and 2021 (OR [95% CI]: 2.18 [1.82-2.62], 2.41 [1.97-2.93], 2.05 [1.77-2.38], 2.47 [2.11-2.88] for male-2020, male-2021, female-2020, and female-2021, respectively). A marginally significant interaction between service workers and SP on depressive symptoms was observed among male workers in 2021 (RERI = 2.37, 95% CI = [-0.04-4.78]) but not in other strata. Conclusion: SP is significantly associated with depressive symptoms in Korean workers across employment and occupational types, with a prominent association in service workers.