The mediating effect of psychological distress on cognitive function and physical frailty among the elderly: Evidence from rural Shandong, China

Jing, Zhengyue; Li, Jie; Wang, Yi; Ding, Lei; Tang, Xiaodong; Feng, Yuejing; Zhou, Chengchao

doi:10.1016/j.jad.2020.03.012

Cited by 43 publications

(40 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The older adults aged 60 years and above accounted for 22.29% of the total population in Shandong in 2018. A multi-stage stratified random sampling method was adopted to select participants, which is explained in detail elsewhere [21]. In this study, 618 respondents who lived alone were selected.…”

Section: Data Sourcementioning

confidence: 99%

Catastrophic health expenditure among single empty-nest elderly with multimorbidity in rural Shandong, China: the effect of co-occurrence of frailty

Jing

et al. 2021

Int J Equity Health

Self Cite

View full text Add to dashboard Cite

Background Previous studies have indicated that older adults with multimorbidity had higher risk of incurring catastrophic health expenditure (CHE). However, the effect of co-occurrence of frailty on CHE among single empty-nest elderly with multimorbidity remains unclear. This study aims to explore the effect of co-occurrence of frailty on CHE among single empty-nest elderly with multimorbidity, and whether this effect is moderated by economic status. Methods A cross-sectional household survey of the older adults in 2019 in Shandong province, China. A total of 606 single empty-nest elderly aged 60 years or older were included in this study. CHE was defined as the out-of-pocket payments for health care that equals or exceeds 40% of the household’ s capacity to pay. Logistic regression models are employed to examine the effect of co-occurrence of frailty on CHE among single empty-nest elderly with multimorbidity. The interaction term is introduced to explore the economic status difference in this effect. Results The CHE incidence for single empty-nest elderly with multimorbidity alone is 64.2%, and the co-occurrence of frailty results in an increase by almost 1.3 times (84.0%) in CHE incidence among single empty-nest elderly with multimorbidity. The co-occurrence of frailty increases the risk of incurring CHE among the single empty-nest elderly with multimorbidity, with the odds of incurring CHE increased by 3.19 times (OR = 3.19; P = 0.005). Furthermore, the interaction analysis shows that the effect of co-occurrence of frailty on CHE among single empty-nest elderly with multimorbidity still exist in lower economic status groups (OR = 4.64; P = 0.027), but not in higher economic status (OR = 2.76; P = 0.062). Conclusions This study demonstrates that there is a positive effect of co-occurrence of frailty on the CHE among the single empty-nest elderly with multimorbidity, and this effect varies by economic status. The health policy-makers should reorganize the healthcare system to make it pro-poor, so as to meet the multiple medical demand and reduce the potential economic burden and inequalities of older adults.

show abstract

Section: Data Sourcementioning

confidence: 99%

Catastrophic health expenditure among single empty-nest elderly with multimorbidity in rural Shandong, China: the effect of co-occurrence of frailty

Jing

et al. 2021

Int J Equity Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…This study used a three-stage stratified cluster method to select the participants, which was explained in detail elsewhere [33]. Finally, 3242 elderly living in the study sites were interviewed, with a respondent rate of 90.05%.…”

Section: Data Source and Samplementioning

confidence: 99%

Physical multimorbidity and lifetime suicidal ideation and plans among rural older adults: the mediating role of psychological distress

Jing

et al. 2021

BMC Psychiatry

Self Cite

View full text Add to dashboard Cite

Background Previous studies have revealed that single physical chronic condition was associated with suicidal ideation/plans, but few studies have examined the relationship between multimorbidity and suicidal ideation/plans, and no studies have explored the underlying potential mechanism on this relationship in China. This study aimed to explore association between physical multimorbidity and suicidal ideation as well as plans, and further examine the mediating role of psychological distress (PD) on this relationship. Methods This study was based on the data from a survey about the health service of rural elderly household in Shandong, China. A total of 3242 adults aged 60 years and older were included in this study. PD was measured by Kessler Psychological Distress Scale (K10). Ordinal and binary logistic regression analyses were employed to explore the association between physical multimorbidity, PD and suicide ideation/plans. Bootstrapping analysis was further used to examine the mediation effect of PD on the association of multimorbidity and suicidal ideations/plans. Results The prevalence of multimorbidity, lifetime suicidal ideation, and suicidal plan in rural older adults was 35.2, 10.6 and 2.2%, respectively. Older adults living in rural areas with two or more chronic physical conditions experienced significantly higher risk of suicidal ideation and suicidal plans. The association between multimorbidity and suicidal ideations/plans was partially mediated by PD, of which, the mediating effect of PD accounted for 31.7 and 25.5% of the total effect, respectively. Conclusion This study demonstrated the associations between physical multimorbidity and suicidal ideation/plans, and the mediating role of PD on this relationship among Chinese rural elderly. Healthcare providers in rural community should provide regular surveillance for the mental health status among the rural elderly with multimorbidity, and carry out various effective intervention measures to improve the mental health status, so as to reduce the risk of suicide.

show abstract

“…A 3-stage stratified cluster sampling method was used to select participants. More information about sample selection has been described in detail in our previous publication [23]. In total, 3,600 questionnaires were distributed, and 3,243 valid questionnaires were included in the study with a response rate of 90.05%.…”

Section: Sample Selectionmentioning

confidence: 99%

“…Physical frailty was assessed by frailty phenotype, which was proposed and validated by Fried et al [25]. It consists of 5 components: shrinking (unintentional weight loss), weakness (grip Gerontology 2020;66:593-602 DOI: 10.1159/000510639 [23]. Individuals with 3-5 criteria are considered to be frail.…”

Section: Cognitive Frailtymentioning

confidence: 99%

What Role Does Activity Engagement Play in the Association between Cognitive Frailty and Falls among Older Adults? Evidence from Rural Shandong, China

Zhao

et al. 2020

Gerontology

Self Cite

View full text Add to dashboard Cite

Introduction: Previous studies have demonstrated the relationship between cognitive frailty and falls among older adults. Activity engagement (AE) is known to be related to falls in older adults but the subject has been limited to empirical study. This study aimed to explore the mediating role of AE between cognitive frailty and falls among older adults in rural Shandong, China. Methods: A total of 3,242 rural seniors (age ≥60 years; 63.6% women) were included in this cross-sectional study. Regression and bootstrap analyses were performed to explore the mediating role of AE between cognitive frailty and falls. Results: The prevalence of falls was 13.1% and the prevalence of cognitive frailty was 6.6% among the participants. AE mediated the association between cognitive frailty and falls (95% CI 0.077–0.223). However, the direct effect was no longer significant after being adjusted for AE (95% CI –0.037 to 0.684; p = 0.078). Conclusion: Cognitive frailty was found to be associated with falls among rural older adults, and AE mediated this association. More attention should be paid to promote AE among Chinese rural older adults with cognitive frailty.

show abstract

The mediating effect of psychological distress on cognitive function and physical frailty among the elderly: Evidence from rural Shandong, China

Cited by 43 publications

References 53 publications

Catastrophic health expenditure among single empty-nest elderly with multimorbidity in rural Shandong, China: the effect of co-occurrence of frailty

Catastrophic health expenditure among single empty-nest elderly with multimorbidity in rural Shandong, China: the effect of co-occurrence of frailty

Physical multimorbidity and lifetime suicidal ideation and plans among rural older adults: the mediating role of psychological distress

What Role Does Activity Engagement Play in the Association between Cognitive Frailty and Falls among Older Adults? Evidence from Rural Shandong, China

Contact Info

Product

Resources

About