Dual trajectories of loneliness and depression and their baseline correlates over a 14-year follow-up period in older adults: Results from a nationally representative sample in Taiwan.

AIMS: To explore the codevelopment between loneliness and depression in older adults, and to identify its potential baseline individual, family and extrafamilial correlates. BACKGROUND: The number of older adults around the world has steadily increased over the last decades. Later life is a particularly vulnerable life stage due to multiple unfavourable conditions, and mental health in this stage appears to become an inescapable issue. Previous research has found the cross-sectional association between loneliness and depression, but their codevelopment has been understudied. Therefore, exploring the codevelopment and its correlates has significant implications for prevention and healthcare professionals. DESIGN: A longitudinal follow-up study. METHODS: The study used nationally representative data over a 14-year follow-up period from the Taiwan Longitudinal Study on Ageing focused on Taiwanese aged 60 years and above (n = 4049). Group-based trajectory modelling, group-based dual-trajectory modelling and multinomial logistic regression were the primary analytical methods. RESULTS: We identified three distinct dual trajectories of loneliness and depression: longitudinal low-frequency lonely depressed (29.3%), longitudinal moderate-frequency lonely depressed (59.4%) and longitudinal high-frequency lonely depressed (11.3%). After considering several demographic and background characteristics, difficulty in physical functioning, number of physical symptoms and diseases, sleep quality and number of child deaths were found to be significantly associated. CONCLUSION: Across the three identified dual-trajectory groups, they all showed a stable loneliness frequency pattern over time; however, the moderate-frequency group and high-frequency group both had a trajectory of increasing depression. It seems that depression tends to change over time in a worsening direction, especially for those with a certain frequency of loneliness. Furthermore, differences in individual and family correlates were found across the groups. IMPLICATIONS FOR PRACTICE: Interventions focusing on the specific factors may help hinder coexisting loneliness and depression, and have implications for developing health promotion strategies and chronic disease care plans.

A longitudinal, cross-lagged panel analysis of loneliness and depression among community-based older adults.

In the present study, we intended to examine the temporal association between loneliness and depression among community-based older adults. We analyzed data on 3,920 persons with a mean age of 67.6 years at baseline from the Taiwan Longitudinal Study on Aging. Structural equation modeling was used to investigate the temporal association between loneliness and depression over a period of 14 years. The results showed that the temporal association between loneliness and depression was bidirectional but stronger and more robust for depression as the initial symptom. Loneliness at Time 1 and 3, respectively, significantly predicted depression at Time 2 and 4. Depression at each time point had a significant effect on subsequent loneliness, even considering covariates. Future prevention programs for older adults with depression should also target at dealing with their loneliness, and vice versa. This study also highlights the need to assess and to manage the two symptoms simultaneously.

Exploring Individual, Family, and Extrafamilial Factors Associated With Depression Among Elderly Residents of Care Settings.

This study investigated simultaneously the associations among individual, family, and extrafamilial factors and depression among elderly residents of care settings in Taiwan. The data for this study were obtained from the Vulnerability and Social Exclusion among Different Groups of Disadvantaged Elderly in an Aging Society: Phenomena and Strategies (1/2) project, which was conducted in Taipei City and Taipei County in 2007. We applied multiple regression procedures to a sample of 327 residents of care settings (48.3% women) who were mild physical impairment or physically independent and cognitively clear for determining factors associated with depression and their cumulative effects. We discovered that 24.5% of the residents were depressed. Physical mobility, number of chronic diseases, and self-assessed health status were significantly associated factors in all models. In the final model, we determined that one third of extrafamilial factors were significantly associated with depression, after controlling for all other variables. In addition, we observed an overall trend of increased mean scores of depression with an increase in the number of risk factors. The results imply that interventions aimed at preventing depression in elderly persons living in care settings, particularly persons with multiple risk conditions such as impaired physical mobility and medical comorbidities, should be designed to include extrafamilial elements. Establishing strong connections between elderly care setting residents and the institutional and neighborhood environments can help prevent depression.

Dual trajectories of breakfast eating and fruit and vegetable intake over a 5-year follow-up period among economically disadvantaged children: Gender differences.

Breakfast eating (BE) seems to be cross-sectionally associated with fruit and vegetable intake (FVI). To date, gender differences in any codevelopment between BE and FVI, as well as their associated factors, have not been examined. The objectives of this study were (1) to identify dual trajectories of BE and FVI among economically disadvantaged boys and girls; and (2) to examine potential associated factors of identified dual trajectories by gender. Children from economically disadvantaged families were enrolled in this prospective multicity study of the Taiwan Database of Children and Youth in Poverty between July 6 and October 31, 2009 and followed up biannually (2009, 2011, and 2013). One thousand one children (50.2% girls, mean ages at each time point being 9.1, 11.2 and 13.1 years, respectively; 49.8% boys, 9.0, 11.0 and 13.0 years) who completed at least two of the three assessments were included. Dual trajectories of BE and FVI over a 5-year follow-up period were identified as the outcome variables of interest by using mainly group-based dual trajectory modeling. Nine potential associated factors were then examined using logistic regression models. Two distinct dual trajectories of BE and FVI were identified among the girls: longitudinally irregular (68.8%) and shift to irregular (31.2%). Two distinct dual trajectories of BE and FVI were identified among the boys: longitudinally irregular (90.2%) and consistently regular (9.8%). Age was the significantly associated factor for boys. The findings confirmed a heterogeneous codevelopment between BE and FVI that may indicate different underlying mechanisms. Most children with a longitudinally irregular BE pattern had a similar pattern of FVI. Future research should comprehensively explore the gender differences in the determinants of codevelopment between BE and FVI.

Nickel complexes incorporating an amido phosphine chelate with a pendant amine arm: synthesis, structure, and catalytic Kumada coupling.

A series of organonickel(II) complexes incorporating an amido phosphine ligand tethered with an amino pendant have been prepared and characterized. Deprotonation of N-(dimethylaminoethyl)-2-diphenylphosphinoaniline (H[PNN]) with one equivalent of n-BuLi in ethereal or hydrocarbon solutions at -35 °C generates cleanly dimeric {Li[PNN]}(2) as yellow crystals. The reaction of NiCl(2)(DME) with {Li[PNN]}(2) in THF at -35 °C affords green crystalline [PNN]NiCl. Treating [PNN]NiCl with NaX in acetone solutions gives [PNN]NiX (X = Br, I). Alkylation or arylation of [PNN]NiCl with appropriate Grignard reagents in THF at -35 °C produces red crystalline [PNN]NiR (R = Me, Et, i-Bu, n-hexyl, CH(2)Ph, Ph). The chloride complex [PNN]NiCl was found to be an active catalyst precursor for Kumada coupling reactions of PhX (X = I, Br, Cl) with aryl or alkyl Grignard reagents, including those containing ß-hydrogen atoms. The X-ray structures of {Li[PNN]}(2) and [PNN]NiX (X = Cl, Br, Me, Et, n-hexyl) are reported.