Valid olfactory impairment tests can help identify mild cognitive impairment: an updated meta-analysis.

Background: Olfactory testing is emerging as a potentially effective screening method for identifying mild cognitive impairment in the elderly population. Objective: Olfactory impairment is comorbid with mild cognitive impairment (MCI) in older adults but is not well-documented in subdomains of either olfactory or subtypes of cognitive impairments in older adults. This meta-analysis was aimed at synthesizing the differentiated relationships with updated studies. Methods: A systematic search was conducted in seven databases from their availability to April 2023. A total of 38 publications were included, including 3,828 MCI patients and 8,160 healthy older adults. Two investigators independently performed the literature review, quality assessment, and data extraction. The meta-analyses were conducted with Stata to estimate the average effects and causes of the heterogeneity. Results: Compared to normal adults, MCI patients had severe impairments in olfactory function and severe deficits in specific domains of odor identification and discrimination. Olfactory impairment was more severe in patients with amnestic mild cognitive impairment than in patients with non-amnestic MCI. Diverse test instruments of olfactory function caused large heterogeneity in effect sizes. Conclusion: Valid olfactory tests can be complementary tools for accurate screening of MCI in older adults.

Higher remnant cholesterol is associated with an increased risk of amnestic mild cognitive impairment: a community-based cross-sectional study.

Background and aims: Amnestic mild cognitive impairment (aMCI) is the most common subtype of MCI, which carries a significantly high risk of transitioning to Alzheimer's disease. Recently, increasing attention has been given to remnant cholesterol (RC), a non-traditional and previously overlooked risk factor. The aim of this study was to explore the association between plasma RC levels and aMCI. Methods: Data were obtained from Brain Health Cognitive Management Team in Wuhan (https://hbtcm.66nao.com/admin/). A total of 1,007 community-dwelling elders were recruited for this project. Based on ten tools including general demographic data, cognitive screening and some exclusion scales, these participants were divided into the aMCI (n = 401) and normal cognitive groups (n = 606). Physical examinations were conducted on all participants, with clinical indicators such as blood pressure, blood sugar, and blood lipids collected. Results: The aMCI group had significantly higher RC levels compared to the normal cognitive group (0.64 ± 0.431 vs. 0.52 ± 0.447 mmol/L, p < 0.05). Binary logistics regression revealed that occupation (P<0.001, OR = 0.533, 95%CI: 0.423-0.673) and RC (p = 0.014, OR = 1.477, 95% CI:1.081-2.018) were associated factors for aMCI. Partial correlation analysis, after controlling for occupation, showed a significant negative correlation between RC levels and MoCA scores (r = 0.059, p = 0.046), as well as Naming scores (r = 0.070, p = 0.026). ROC curve analysis demonstrated that RC levels had an independent predictive efficacy in predicting aMCI (AUC = 0.580, 95%CI: 0.544 ~ 0.615, P < 0.001). Conclusion: Higher RC levels were identified as an independent indicator for aMCI, particularly in the naming cognitive domain among older individuals. Further longitudinal studies are necessary to validate the predictive efficacy of RC.

Transition to healthier lifestyle associated with reduced risk of incident dementia and decreased hippocampal atrophy.

BACKGROUND: Research has estimated the associations of lifestyle at one-time point with the risk of dementia and hippocampal volume, but the impact of lifestyle transition on dementia and hippocampal volume remains unclear. This study aims to examine the associations of lifestyle transition with the risk of dementia and hippocampal volume. METHODS: Based on data from the UK Biobank, a weighted lifestyle score was constructed by incorporating six lifestyle factors. Within each baseline lifestyle group (i.e., healthy, intermediate, and unhealthy), lifestyle transition was classified into decline, maintenance, and improvement. Cox proportional hazard regression was used to estimate the association of lifestyle transition and incident dementia (N = 16,305). A multiple linear regression model was used to estimate the association between lifestyle transition and hippocampal volume (N = 5849). RESULTS: During a median follow-up period of 8.6 years, 120 (0.7 %) dementia events were documented. Among participants with healthy baseline lifestyles, the improvement group had a lower risk of incident dementia (HR: 0.18, 95 % CI: 0.04-0.81) and a larger hippocampal volume (ß = 111.69, P = 0.026) than the decline group. Similar results were observed among participants with intermediate baseline lifestyles regarding dementia risk but not hippocampal volume. No benefits were observed in the improvement group among those with unhealthy baseline lifestyles. LIMITATIONS: A lower incidence of dementia than other cohort study and this may have resulted in an underestimation of the risk of dementia. CONCLUSIONS: Earlier transitions to healthier lifestyle were associated with reduced risk of incident dementia and decreased hippocampal atrophy.

Chain mediations of perceived social support and emotional regulation efficacy between role stress and compassion fatigue: insights from the COVID-19 pandemic.

Background: Nurses at the frontline faced high risks of the COVID-19 infection, undertook heavy workloads of patient care, and experienced tremendous stress that often led to compassion fatigue. Aim: This study was to explore the role of positive psychosocial resources (i.e., perceived social support and emotional regulation efficacy) in the relationship between role stress and compassion fatigue. Methods: A cross-sectional design was conducted in Hubei Province, China between May and September 2021. The Role Stress Questionnaire, the Perceived Social Support Scale, the Emotional Regulation Efficacy Scale, and the Professional Quality of Life Scale were used to measure key variables of interest. Nurse socio-demographic data were also collected. Structural equation modeling was used to explore the relationships, including potential mediating effect, among role stress, perceived social support, emotional regulation efficacy, and compassion fatigue. Results: A total of 542 nurses participated in this investigation, and 500 were eventually enrolled in the analysis. The incidence of compassion fatigue among nurses was 94.2%, including 65.8% of nurses reporting at least moderate compassion fatigue. Univariate analysis showed that educational level, marital status, hospital rank, sleep time were the factors affecting compassion fatigue of the nurses. The structural equation modeling revealed that: Role stress had a direct positive effect on compassion fatigue; Perceived social support and emotional regulation efficacy partially mediated the link between role stress and compassion fatigue respectively; And there was a chain mediating role of perceived social support and emotional regulation efficacy between role stress and compassion fatigue. Conclusion: The incidence of compassion fatigue was high during the COVID-19 pandemic among bedside nurses in China. Improving social support and enhancing the efficacy of emotion regulation may help alleviate compassion fatigue directly and/or via buffering the impact of role stress.

A randomized controlled trial testing the feasibility, acceptability, and preliminary effects of a mental health Screening, Brief Intervention, and Referral to Treatment among refugees in Malaysia.

BACKGROUND: Among refugees residing in countries of first asylum, such as Malaysia, high rates of psychological distress call for creative intervention responses. AIMS: This study examines implementation of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) model promoting emotional well-being and access to services. METHOD: The one-session intervention was implemented in community settings by refugee facilitators during 2017 to 2020. 140 Participants including Afghan (n = 43), Rohingya (n = 41), and Somali (n = 56) refugees were randomized to receive either the intervention at baseline, or to a waitlist control group. At 30 days post-intervention, all participants completed a post-assessment. Additionally, after completing the intervention, participants provided feedback on SBIRT content and process. RESULTS: Findings indicate the intervention was feasible to implement. Among the full sample, Refugee Health Screening-15 emotional distress scores reduced significantly among participants in the intervention group when compared to those in the waitlist control group. Examining findings by nationality, only Afghan and Rohingya participants in the intervention condition experienced significant reductions in distress scores compared to their counterparts in the control condition. Examining intervention effects on service access outcomes, only Somali participants in the intervention condition experienced significant increases in service access compared to the control condition. CONCLUSIONS: Findings indicate the potential value of this SBIRT intervention, warranting further research.

Parenting measurement, normativeness, and associations with child outcomes: Comparing evidence from four non-Western cultures.

This study compared parenting across four non-Western cultures to test cross-cultural commonality and specificity principles in three aspects: measurement properties, parenting normativeness, and their associations with child outcomes. Both mothers and fathers (N = 1509 dyads) with preschool-aged children (M = 5.00 years; 48% girls) from urban areas of four countries (Malaysia, N = 372; China, N = 441; Turkey, N = 402; and Japan, N = 294) reported on four parenting constructs (authoritative, authoritarian, group harmony socialization, and intrusive control) and their sub-dimensions using modified culturally relevant measures. Teachers reported on children's internalizing, externalizing, and prosocial behaviors. The commonality principle was supported by two sets of findings: (1) full measurement invariance was established for most parenting constructs and sub-dimensions, except that intrusive control only reached partial scalar invariance, and (2) no variations were found in associations between parenting and any child outcomes across cultures or parent gender at the construct level for all four parenting constructs and at the sub-dimensional level for authoritarian and intrusive control sub-dimensions. The specificity principle was supported by the other two sets of findings: (1) cross-cultural differences in parenting normativeness did not follow the pattern of economic development but yielded culture-specific patterns, and (2) at the sub-dimensional level, the authoritative parenting and group harmony socialization sub-dimensions were differently associated with child outcomes across cultures and/or parent gender. The findings suggested that examining specific dimensions rather than broad parenting constructs is necessary to reflect cultural specificities and nuances. Our study provided a culturally-invariant instrument and a three-step guide for future parenting research to examine cross-cultural commonalities/specificities. RESEARCH HIGHLIGHTS: This is the first study to use an instrument with measurement invariance across multiple non-Western cultures to examine the commonality and specificity principles in parenting. Measurement invariance was achieved across cultures for authoritative and authoritarian parenting, group harmony socialization, intrusive control, and their sub-dimensions, supporting the commonality principle. Cross-cultural differences in parenting normativeness did not follow the pattern of economic development but yielded culture-specific patterns, supporting the specificity principle. Both commonalities and specificities were manifested in associations between parenting and child outcomes across cultures.

Longitudinal associations between emotion regulation strategies and subjective well-being in migrant and non-migrant adolescents in urban China.

This study examined the long-term reciprocal impact of two key emotion regulation strategies, cognitive reappraisal and expressive suppression, on the subjective well-being of migrant and non-migrant adolescents in urban China. A total of 2397 middle school students from urban China (864 migrant, Mage  = 13.05 years, SD = 0.62, 41.7% girls; 1533 non-migrant, Mage  = 13.01 years, SD = 0.47, 50.1% girls) were followed from 2016 to 2017. Data on the two emotion regulation strategies (measured using the Chinese version of the Emotion Regulation Questionnaire) and subjective well-being (measured using the Subjective Well-Being Inventory) were collected. Although no differences were found in the use of cognitive reappraisal, migrant adolescents reported greater use of expressive suppression than non-migrant adolescents. Furthermore, a two-group cross-lagged panel analysis showed that cognitive reappraisal positively predicted subjective well-being among both migrant and non-migrant adolescents, whereas expressive suppression was positively related to subjective well-being in only migrant adolescents. Migrant adolescents with higher levels of subjective well-being jointly used cognitive reappraisal and expressive suppression, while non-migrant adolescents were prone to only using cognitive reappraisal. These findings indicate that group-level context influences both the utilisation and functionality of emotion regulation strategies among migrant and non-migrant adolescents in urban China.

Corrigendum: Chain mediations of perceived social support and emotional regulation efficacy between role stress and compassion fatigue: insights from the COVID-19 pandemic.

[This corrects the article DOI: 10.3389/fpubh.2023.1269594.].

Social media usage of chinese nursing students: Attitudes, motivations, mental health problems, and self-disclosure.

BACKGROUND: Excessive self-disclosure online may risk the reputations, mental health problems, and professional lives of nursing students. This study investigated nursing students' usage of social media, their attitudes towards social media, mental health problems and self-disclosures, and the relationships of these variables. METHODS: A cross-sectional study was conducted online (n = 1054) with questionnaires of Fear of Missing Out (FoMO), Social Media Fatigue (SMF), Students' Uses and Views of Social Media (SUVSM) and self-disclosure in social media which included self-information shown on social media and information viewed by others. RESULTS: Although most of them held positive attitudes towards social media, 17.4% of the participants acknowledged that they had posted inappropriate contents online and 37.6% witnessed improper posts from schoolmates or teachers online. SMF was affected by familiar with relevant regulations on the social media usage (ß = -.10, p < .001), FoMO (ß = .41, p < .001), and SUVSM (ß = .17, p < .001). Additionally, nearly 1/3 participants reported their net-friends could view following information: gender, age, occupation, education level and location. Self- disclosure in social media was positively influenced by education (ß = .10, p < .001), sharing moments or Weibo, etc. (ß = .009, P = 0.009), time spent on social media daily (ß = .11, p < .001), accepting stranger's "friend request" (ß = .06, P = 0.047), FoMO (ß = .14, p < .001) and SMF (ß = .19, p < .001). Furthermore, effect of SUVSM on self-disclosure in social media was mediated by FoMO and SMF. CONCLUSION: Inappropriate contents are posted and witnessed by appreciable proportions of nursing students. Positive attitude towards social media may strengthen FoMO and SMF, which may increase self-disclosure in social media in turn.

Development of mother-infant co-regulation: The role of infant vagal tone and temperament at 6, 9, and 12 months of age.

Using Porges' (2011) Polyvagal Theory as a backdrop, this study examined whether changes in parasympathetic functioning, as indexed by baseline measures of cardiac vagal tone at 6, 9, and 12 months of age, were linked to changes in infants' (N = 101) dyadic co-regulation over these same time points. Mothers and infants were observed at each time point during a 15-minute unstructured free-play and co-regulated patterns of interactions were coded using the Revised Relational Coding System (Fogel et al., 2003). Analyses were carried out using multi-process growth curve modeling to examine baseline measurements (intercepts) and changes (slopes) in vagal tone, co-regulation as well as mothers' report of infant temperament. Findings demonstrate links between infants' vagal tone and changes in mother-infant co-regulation. Specifically, increasing levels of cardiac vagal tone was related to increases in symmetrical but decreases in unilateral patterns of co-regulation over time. These findings suggest that changes in the autonomic nervous system likely undergird infants' improving capacity to engage in more mutually sustained patterns of co-regulation.

Prevalence of depression in older adults: A systematic review and meta-analysis.

Depression is a prevalent mental disorder in older adults, but the prevalence in older adults varies largely across studies due to differences in regional cultures and screening tools. The objective of this review is to systematically evaluate the global prevalence of depression in older adults. PubMed, Embase, Web of Science and Cochran Library databases were searched independently from 2000 to 2021. Subgroups, sensitivity, and meta-regression analyses were performed to address heterogeneity. Publication bias was evaluated using Egger's test. Forty-eight eligible studies were included in this review. The global prevalence of depression in older adults was 28.4%, with high between-study heterogeneity. The meta-analysis showed that the prevalence of depression in older adults is high although it varied with geographic regions, screening tools, sample sizes and representativeness, and study quality. Therefore, it is necessary to carefully consider appropriate screening tools to estimate the prevalence in different regions of a population.

Montreal Cognitive Assessment: Seeking a Single Cutoff Score May Not Be Optimal.

BACKGROUND: Cutoff scores of the Montreal cognitive assessment (MoCA) for screening mild cognitive impairment in older adults differ across the world and within the Chinese culture. It is argued that to seek a cutoff score is essential to classify test participants. It was unknown how taking a classifying approach might reveal the cutoff score for identifying mildly cognitively impaired older adults. METHODS: Participants, selected from 13 communities in Wuhan, China, were tested with the Chinese version of MoCA and rated with the Activities of Daily Living and the Clinical Dementia Rating scales. Mixture modeling was applied to the data with certain covariates and MoCA sum scores as the outcome of the latent class. Models with different numbers of classes were compared in terms of information criteria, likelihood ratio test, entropy, and interpretability. RESULTS: A 3-class model (normal, mildly impaired, and severely impaired) was found to fit the data best. The normal class averaged a MoCA score of 24, while the severely impaired class averaged a score below 18. For those cases with MoCA scores above 18 and below 24, it is not certain if they are in the normal or the severely impaired classes. CONCLUSION: Latent variable classification modeling provides another option to identify MCI in older adults. Some categorically different cases of MCI cannot be captured with any single MoCA sum score. A range of 18-24 MoCA scores might serve as a better screening criterion of MCI. Older adults who scored within this gray zone should be monitored for potential interventions.

Princess Power: Longitudinal Associations Between Engagement With Princess Culture in Preschool and Gender Stereotypical Behavior, Body Esteem, and Hegemonic Masculinity in Early Adolescence.

Princess culture is criticized for contributing to gender stereotypes and poor body esteem, however, there is little longitudinal research examining these claims. This study examines associations between engagement with princess culture during early childhood and gender stereotypes, body esteem, and adherence to hegemonic masculinity in early adolescence. Participants included 307 children (51% female, Mage = 4.83 years, 87% White) who completed questionnaires at two time points, 5 years apart. The results indicated that early engagement with princess culture was not associated with later adherence to female gender stereotypes. However, princess engagement was associated with lower adherence to norms of hegemonic masculinity and higher body esteem. Socioeconomic status and gender moderated the results. Effect sizes were small to moderate. The changing nature of Disney princesses is discussed in the context of gender development across childhood.

Social support and coping style of Tongqi in China: A cross-sectional study.

Tongqi (gays' wives) in China were under tremendous distress and social pressure due to their special identities and were not clearly known. A sample of 179 Chinese Tongqi were recruited through online social media groups in 2017-2018. Their hidden lives, social support, and coping styles were analyzed. The results showed that the majority of Tongqi concealed their identities, had negative responses to cope with their tremendous distress, and did not have sufficient social support. Their social support was mainly from family members. Hidden identities obstructed Tongqi's access to extrafamilial social support that could alleviate their distress. Tongqi need more social support and protection.

Hindrances of peripherally inserted central catheter care of leukemia patients: a qualitative study.

OBJECTIVE: A peripherally inserted central catheter (PICC) needs regular care. However, clinical observations found that some discharged leukemia patients in mainland China had not complied with the requirement of regular care. Our study aims to explore the facilitators and hindrances of regular cares of PICC in leukemia patients with the Colaizzi phenomenon analysis. METHODS: This qualitative report used the descriptive phenomenological method to collect information and was conducted in accordance with the COREQ checklist. By purposive sampling, 11 leukemia patients with PICC were selected and interviewed in the Department of Hematology of a first-class hospital in Wuhan (central China). The interviews were conducted from March 2016 to May 2017. RESULTS: Two facilitators for PICC care were extracted through interviews, including fear of nosocomial infection and convenience for treatment. Eleven hindrances were summarized, including high costs, unavailability of local services, worries about affecting family members, a lack of health awareness, inconvenient transportations, fluke minds, physical discomfort, fears of leukemia and chemotherapy, short chemotherapy intervals, damage to appearance, and no insurance coverage of costs. CONCLUSION: Leukemia patients' compliance with PICC care was hindered by several factors. The improvement of PICC care may need joint efforts of patients, nursing professionals, hospitals' managerial staff, and governments.

The direct and indirect effects of family and school-related factors on Latino adolescent substance use.

Latino adolescents continue to have high usages of alcohol and other harmful substances when compared with other ethnic groups (Centers for Disease Control & Prevention, 2005; Telzer, Gonzales, & Fuligni, 2014). This study focuses on the direct and indirect effects of family and school-related factors that impact Latino adolescent substance use comparing male and female groups. Structural equation modeling (SEM) was used to analyze the relationship between maternal monitoring knowledge, the adolescent-teacher relationship, family stress and substance use through academic achievement and school engagement mediators using data from 359 Latino boys and 480 Latina girls from a West Texas area school district. Results indicated that maternal monitoring knowledge was negatively associated with substance use while family stress was positively associated with substance use. Gender differences were found between the influence of maternal monitoring knowledge and academic achievement and among other indirect paths to substance use. Academic achievement completely mediated the relationship between the adolescent-teacher relationship and substance use for both genders while school engagement was also found to be a significant mediator for girls and not boys. Implications are discussed.

Pathological video game symptoms from adolescence to emerging adulthood: A 6-year longitudinal study of trajectories, predictors, and outcomes.

The aim of this study was to examine trajectories of pathological video game symptoms over a 6-year period from adolescence to emerging adulthood. We also examined a number of predictors and outcomes for different trajectories. Participants included 385 adolescents (M age = 15.01 at the initial time point) who completed multiple questionnaires once a year over a 6-year period. Analyses showed there were 3 distinct trajectories. Approximately 10% of adolescents (called "increasing symptoms") showed moderate levels of pathological gaming symptoms at the initial time point and then increases in symptoms over time. Conversely, 18% of adolescents (called "moderate symptoms") started with moderate symptoms that did not change over time. Finally, 72% of adolescents (called "nonpathological") were relatively low in symptoms across the 6 years of data collection. Being male predicted both the increasing and moderate groups. The increasing group tended to show the worst outcomes over time, with higher levels of depression, aggression, shyness, problematic cell phone use, and anxiety than the nonpathological group, even when controlling for initial levels of many of these variables. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

CD4+ T Cell Count, Sleep, Depression, and Anxiety in People Living With HIV: A Growth Curve Mixture Modeling.

We investigated changes in CD T cell counts related to sleep quality, depression, anxiety, and sociodemographic variables in heterogeneous groups of people living with HIV in a 6-month prospective study. Our longitudinal study involved 247 ambulatory patients living with HIV and using antiretroviral therapy. Sleep quality, anxiety, depression, and CD T cell counts were assessed three times at 3-month intervals. Growth curve mixture modeling was conducted to explore changes over time. A two-class mixture model with logarithmic change pattern fit the data best. For the majority of the sample (89.1%), anxiety, depression, and sleep quality did not change when CD T cells increased. For a small proportion of the sample (11.9%), sleep quality, anxiety, and depression deteriorated when CD T cells decreased. Marital status and alcohol use affected the classification significantly. Health care professionals should provide relevant services to people living with HIV with decreasing CD T cell counts.

The Impact on Mental Health of Losing an Only Child and the Influence of Social Support and Resilience.

The number of parents who have lost their only child (PLOCs) has increased annually with the implementation of the birth control policy in mainland China. This study aimed to investigate the mental health status of PLOCs and the influence of social support and resilience. Study 1 recruited 100 PLOCs and 88 nonbereaved parents, and compared differences in depression, anxiety, and loneliness. Study 2 investigated the influence of social support and resilience on the mental health of PLOCs via a mediating model. Results indicate that PLOCs reported more anxiety and depression symptoms than nonbereaved counterparts. Perceived close family support, objective support, and resilience negatively predicted anxiety and depression. In addition, perceived close family support was found to influence mental health via resilience. The current findings reveal that losing an only child has long-term negative impacts on the mental health of PLOCs. However, perceived close family support and objective support can protect their mental health either directly or indirectly via resilience.

Longitudinal effects of maternal love withdrawal and guilt induction on Chinese American preschoolers' bullying aggressive behavior.

Bullying has been understudied among preschool children, especially those from Chinese American families. Previous research has also neglected the dimensional effects of psychological control on child bullying development. This study examined two psychological control dimensions, love withdrawal and guilt induction, and their effects on children's bullying aggressive behavior using a longitudinal design. Participants were first-generation Chinese American mothers (N = 133; mean age [Mage] = 37.82) and their preschool children (Mage = 4.48). Chinese immigrant mothers reported their psychologically controlling parenting and teachers rated children's bullying aggressive behaviors in the school setting. Confirmatory factor analyses were conducted to establish the psychometric properties and cross-wave measurement equivalence of the study constructs. Cross-lagged structural equation modeling analysis indicated that maternal love withdrawal prospectively predicted more bullying aggressive behavior, whereas guilt induction predicted less bullying aggressive behavior in children 6 months later. These results held after controlling for the initial level of children's problem behaviors and demographic variables (child age, gender, and maternal education). For child effects, child bullying aggressive behavior predicted more maternal guilt induction over time but not love withdrawal. Our findings highlight the importance of construct specificity and cultural context in understanding associations between parenting and child development.