The role of depression and anxiety in the relationship between poor sleep quality and subjective cognitive decline in Chinese elderly: Exploring parallel, serial, and moderated mediation

Xu, Wen‐Qi; Lin, Li‐Hua; Ding, Kai‐Rong; Ke, Yun-Fei; Huang, Jiahao; Hou, Cai‐Lan; Jia, Fu‐Jun; Wang, Shibin

doi:10.1016/j.jad.2021.07.063

Cited by 37 publications

(29 citation statements)

References 64 publications

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“…The present study provides further evidence in support of these risk factors. The results showed that depression is associated with the high prevalence of MCI in the Chinese elderly population, consistent with previous findings ( 14 , 23 ). Jia et al ( 6 ) showed high prevalence of cognitive impairment in the Chinese elderly population with hypertension (odds ratio: dementia = 1.86; MCI = 1.62), hyperlipidemia (dementia = 1.87; MCI = 1.29), diabetes (dementia = 2.14; MCI = 1.44), heart disease (dementia = 1.98; MCI = 1.17), and cerebrovascular disease (dementia = 5.44; MCI = 1.49), but the above risk factors were not found in the present study.…”

Section: Discussionsupporting

confidence: 92%

“…With regard to aging, the global elderly population is growing rapidly, especially in mainland China. According to China's Seventh National Population Census in 2020, the number of elderly people over 60 years has reached 264.02 million, accounting for 18.7% of the total population ( 23 ). Rapid growth in the elderly population has stimulated interest in elucidating the causes of cognitive impairments and strategies for preventing them.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and associated factors of cognitive impairment among the elderly population: A nationwide cross-sectional study in China

Qin

Luo

Xiong

et al. 2022

Front. Public Health

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BackgroundCognitive impairments are associated with increased risk for progression to dementia. In China, limited surveys have been conducted to estimate the national prevalence and risk factors associated with cognitive impairment in China. This study aims to assess the national prevalence and modifiable risk factors for cognitive impairments in the Chinese elderly population.MethodsThis cross-sectional study was based on the 2018 China Health and Retirement Longitudinal Study. The Mini Mental State Examination (MMSE) is recommended to test for cognitive impairment. Univariate and multivariate logistic regression models were used in assessing risk factors for cognitive impairments in the Chinese elderly population.ResultsA total of 3768 participants aged 60 years or older were enrolled in this study. The national prevalence of cognitive impairments was 22.24% in China, and the prevalence of cognitive impairment was higher in the south-west region than in the north region (29.94 vs. 16.53%, p < 0.05). The risk for cognitive impairments was higher in the following participants: not married or not living with spouse relative to married with spouse present (OR = 1.39, 95% CI, 1.15–1.70; p = 0.001), nap duration of ≥ 90 min relative to 30–60 min (OR = 1.54, 95% CI, 1.20–1.98; p = 0.001), sleep duration of ≥ 8 h relative to 6–8 h (OR = 1.73, 95% CI, 1.29–2.31; p < 0.001), and depression relative to no depression (OR = 1.67, 95% CI, 1.41–1.97; p < 0.001). The risk of cognitive impairment was lower in participants living in the urban areas relative to the rural areas (OR = 0.57, 95% CI, 0.47–0.69; p < 0.001) and consuming alcohol once a month relative to never consuming alcohol (OR = 0.69, 95% CI, 0.51–0.94; p = 0.02).ConclusionCognitive impairment prevalence was high in the Chinese elderly population. The potentially modifiable risk factors for cognitive impairment should be further assessed in the development of interventions for the elderly Chinese population.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Prevalence and associated factors of cognitive impairment among the elderly population: A nationwide cross-sectional study in China

Qin

Luo

Xiong

et al. 2022

Front. Public Health

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“…Higher scores indicate higher risks to suffer depression. The Chinese version has been widely used and demonstrated a high reliability and validity among elderly people ( 52 , 53 ). Cronbach's α for the present sample was 0.806.…”

Section: Methodsmentioning

confidence: 99%

Chinese elderly migrants' loneliness, anxiety and depressive symptoms: The mediation effect of perceived stress and resilience

Wang

Hou

Zhang

et al. 2022

Front. Public Health

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Elderly migrants who face the dual challenges of aging and migration are more likely to suffer psychological disorders. Existing research has demonstrated a link between loneliness and psychological disorders in the general elderly population. However, we know little about the relationships among elderly migrants, and the psychological mechanisms linking them. This study aims to examine the effects of loneliness on anxiety and depressive symptoms among Chinese elderly migrants, and explore the mediating roles of perceived stress and resilience. All 654 participants were recruited in Nanjing, Jiangsu Province, China. Results showed that loneliness was significantly correlated with anxiety and depressive symptoms (p < 0.001). Perceived stress and resilience mediated the relationship between loneliness and anxiety symptoms. The mediating effect of perceived stress was 0.128 (Bootstrap 95% CI: 0.092–0.168, Ratio = 37.4%). Resilience was 0.026 (Bootstrap 95% CI: 0.005–0.049, Ratio = 7.6%). Furthermore, perceived stress and resilience also mediated the relationship between loneliness and depressive symptoms. The mediating effects were 0.111 and 0.043, respectively (Bootstrap 95% CI: 0.073–0.151, Ratio = 27.9%; Bootstrap 95% CI: 0.020–0.069, Ratio = 10.8%). All the mediating effects were significant because the bootstrap 95% CIs did not contain zero. Overall, our findings suggested that loneliness not only can directly influence elderly migrants' anxiety and depressive symptoms but also by increasing perceived stress or decreasing resilience.

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“…Anxiety is ubiquitous in elderly individuals, from the perspective of population aging, the pressure caused by anxiety includes the increasing global burden of disease, a greater needs for health services and increased mortality ( 5 , 18 , 19 ). For individuals, the negative outcomes of anxiety include diminished quality of life and well-being, disability, and even more severe physical and mental disorders ( 20 ). To prevent anxiety among the elderly, as well as provide meaningful support for subsequent therapeutic interventions, it is necessary to investigate and assess the contributing factors of anxiety adequately.…”

Section: Introductionmentioning

confidence: 99%

The prevalence of anxiety and its key influencing factors among the elderly in China

Liu

Xu²,

Yang³

et al. 2023

Front. Psychiatry

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IntroductionWith the rapid aging population, the mental health of older adults is paid more and more attention. Anxiety is a common mental health illness in older adults. Therefore, the study aimed to explore the current situation of anxiety and its factors among the elderly in China.MethodsBased on the data from 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), a total of 10,982 respondents aged 60 and above were selected. Generalized Anxiety Disorder (GAD-7) scale was used to assess the anxiety. Univariate and multivariate analysis were used to analyze the influencing factors of anxiety. Random forest was established to rank the importance of each influencing factors.ResultsThe results showed that the prevalence of anxiety among the elderly was 11.24%. Anxiety was mainly associated with 14 factors from five aspects: sociodemographic characteristics, health status, psychological state, social trust and social participation, among which loneliness related to psychological status was the most important factor.DiscussionThe revelation of this study is that the present situation of anxiety among the elderly cannot be ignored, and it is necessary to take measures to prevent and control it from many aspects.

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The role of depression and anxiety in the relationship between poor sleep quality and subjective cognitive decline in Chinese elderly: Exploring parallel, serial, and moderated mediation

Cited by 37 publications

References 64 publications

Prevalence and associated factors of cognitive impairment among the elderly population: A nationwide cross-sectional study in China

Prevalence and associated factors of cognitive impairment among the elderly population: A nationwide cross-sectional study in China

Chinese elderly migrants' loneliness, anxiety and depressive symptoms: The mediation effect of perceived stress and resilience

The prevalence of anxiety and its key influencing factors among the elderly in China

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