Prospective association between social isolation, loneliness and lung function among Chinese middle-aged and older adults.

OBJECTIVE: Previous research has highlighted a heightened occurrence of social isolation and loneliness in older adults diagnosed with chronic lung diseases. Nevertheless, there exists a dearth of studies that have explored the influence of impoverished social relationships on lung function. This study aimed to examine the longitudinal association between social isolation, loneliness and lung function over 4 years among middle-aged and older Chinese adults. METHODS: This study employed two waves (2011 and 2015) of data from the China Health and Retirement Longitudinal Study (CHARLS). The analysis was limited to participants aged 45 years and above and stratified based on gender (3325 men and 3794 women). The measurement of peak expiratory flow (PEF) served as an indicator for assessing lung function. Lagged dependent variable regression models, accounting for covariates, were employed to explore the relationship between baseline social isolation and loneliness and the subsequent PEF. RESULTS: For women, social isolation was significantly associated with the decline in PEF at follow-up (ß = -.06, p < .001) even after adjusting for all covariates; no significant correlation was observed between loneliness and PEF. Among men, there was no significant association found between either social isolation or loneliness and PEF. CONCLUSIONS: Social isolation is prospectively associated with worse lung function in middle-aged and older Chinese women but not men. The results highlight the importance of promoting social relationships in public health initiatives, especially in groups that are more vulnerable.

Association of explicit and implicit social support with psychological adjustment in Chinese women with breast cancer: An interpersonal explanation.

This study aimed to examine the linear and non-linear relationship between explicit and implicit social support and psychological adjustment as well as the underlying interpersonal mechanisms in a sample of Chinese women with breast cancer (n = 202). The results showed that explicit social support was associated with poorer psychological adjustment, while implicit social support exhibited the opposite trend. Moreover, the association between implicit social support and psychological adjustment was stronger at lower levels of implicit social support, but it weakened or disappeared at moderate or higher levels. Furthermore, we found that all the associations between social support and psychological adjustment could be explained by relationship concerns and perceived burdensomeness. These findings emphasize the importance of providing social support and supportive care to patients who have unmet supportive care needs, in line with cultural norms and expectations.

Dyadic effects of cognitive function on depressive symptoms among middle-aged and older Chinese couples.

BACKGROUND: Although cognitive function and depressive symptoms have been suggested to be closely related, less attention has been paid to this association within married couples. This study explored the reciprocal dyadic relationship between cognitive function and depressive symptoms over time. METHODS: This study used four waves of data from the China Health and Retirement Longitudinal Study and analyses were restricted to middle-aged and older couples aged 45 or older. Actor-partner interdependence model adjusted for confounding factors was employed to examine the reciprocal association between cognitive function and depressive symptoms at both the individual and couple levels. Measures of cognitive function consisted of episodic memory and mental status. Depressive symptoms were measured by the Center for Epidemiological Studies Depression scale. RESULTS: For both husbands and wives, cognitive function was reciprocally associated with depressive symptoms at the individual level. Spouses' lower cognitive function was significantly linked to their partners' greater depressive symptoms. However, ones' depressive symptoms were not related to their partners' cognitive function. CONCLUSIONS: These findings expand our knowledge about the dyadic relationship between cognitive function and depressive symptoms in Chinese couples. Effects of interventions for depression in middle-aged and older adults may be enhanced by considering the marital context.

Too depressed to breathe: The longitudinal association between depressive symptoms and lung function among general middle-aged and older adults.

Objective Most previous studies focusing on the association between depressive symptoms and lung function were conducted in patients with chronic lung diseases. This study aims to investigate the association of depressive symptoms with lung function among general Chinese middle-aged and older adults. Participants This study used data from the China Health and Retirement Longitudinal Study (CHARLS). Analyses were conducted with data from three waves (2011, 2013, and 2015) and restricted to those respondents aged 45 and older. Finally, 9487 individuals [mean age (SD) = 58.47 (9.19); female, 53.1%] were included in analysis. Methods Depressive symptoms were measured by the Chinese version of 10-item Center for Epidemiological Studies Depression Scale (CESD-10). Lung function was assessed by peak expiratory flow (PEF). Two-level linear mixed growth models were used to evaluate the longitudinal association between depressive symptoms and PEF. Results Depressive symptoms were significantly associated with PEF among general middle-aged and older adults (b = -1.85, p < 0.001) after adjusting for multiple confounding factors. A significant interaction between depressive symptoms and gender was found (b = 1.29, p < 0.001). The association between depressive symptoms and PEF was greater for men (b = -2.36, p < 0.001) than for women (b = -1.46, p < 0.001). Conclusions This longitudinal study found that increased depressive symptoms were associated with reduced PEF in middle-aged and older adults in China. Compared with women, men with a higher level of depressive symptoms experienced a greater decrement in PEF. Our findings suggest that it is possible to reduce the effects of PEF by improving psychological health among general middle-aged and older populations.

Social isolation and cognitive decline among older adults with depressive symptoms: prospective findings from the China Health and Retirement Longitudinal Study.

OBJECTIVES: Identifying potentially modifiable risk factors of cognitive decline among people with depressive symptoms could provide insight into strategies for improving treatment effect of depression and prevention of dementia. Quite a few studies have examined the association between social isolation and cognitive function directly among depressed older adults and the results are still mixed. The aim is to examine the association of social isolation and cognitive decline among older adults with depressive symptoms in a non-Western country. METHODS: This study used data from the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were measured by the Chinese version of the 10-item Center for Epidemiological Studies Depression Scale (CESD-10) (elevated depressive symptom cutoff≥10). Social isolation was assessed based on responses to four items: marital status, residence, contact with children, and social activity. Lagged dependent variable regressions adjusted for confounding factors were used to evaluate the association between baseline social isolation and follow-up cognitive function. RESULTS: A number of 2,507 participants [mean age (SD)=61.37 (7.26); male, 41.0%] with increased depressive symptoms were available for the present study. Baseline social isolation was significantly associated with 4-year episodic memory (ß=-0.08, p<0.001) in depressed women, but not men (ß=-0.03, p=0.350). No significant association between baseline social isolation and follow-up mental status was found for women (ß=-0.04, p=0.097) or men (ß=0.01, p=0.741). DISCUSSION: This longitudinal study found that social isolation was significantly associated with memory decline over 4 years among depressed women (but not men) in China.

Social isolation and depression onset among middle-aged and older adults in China: Moderating effects of education and gender differences.

BACKGROUND: Most studies exploring the association between social isolation and depression tend to focus on Western countries. The primary aim of this longitudinal study was to examine the association between social isolation and depression onset among middle-aged and older adults in China. METHODS: Data on 6,817 participants (mean age = 57.91, SD = 8.77; men, 52.1%) from the first and fourth waves of the China Health and Retirement Longitudinal Study (CHARLS) were analyzed. Binary logistic regressions were used to evaluate the association between social isolation and depression onset. The moderating effects of socioeconomic status (education) and gender differences were also examined. RESULTS: Social isolation was significantly associated with depression onset (OR = 1.24, 95% CI = 1.10-1.41). Compared to men with lower education (OR = 0.97, 95% CI = 0.77-1.23), those with higher education (OR = 1.91, 95% CI = 1.40-2.60) exhibited a greater association between social isolation and depression onset. Moderating effect of education was not found for women. LIMITATIONS: Depression were self-reported, which might be less reliable than clinical interview. CONCLUSIONS: Our results suggested that high level of social isolation was significantly associated with a higher incidence of depression among middle-aged and older adults in China. Education played a moderating role in this association for men rather than women.

Social isolation, loneliness and functional disability in Chinese older women and men: a longitudinal study.

OBJECTIVE: This study investigated whether loneliness or social isolation is associated with the onset of functional disability over 4 years among Chinese older populations. SETTING AND SUBJECTS: This study used data from the China Health and Retirement Longitudinal Study (CHARLS). Functional status was assessed by activities of daily living (ADL) and instrumental activities of daily living (IADL). Analyses were conducted with data from two waves (2011 and 2015) and were restricted to those respondents aged 50 and older and free of functional disability at baseline [n = 5,154, mean age (SD) = 60.72 (7.51); male, 52.3%]. METHOD: Social isolation, loneliness and covariates were measured at baseline. Follow-up measures of new-onset ADL and IADL disability were obtained 4 years later. We stratified the sample by gender, and then used binary logistic regressions to evaluate the associations between baseline isolation, loneliness and new-onset ADL and IADL disability. RESULTS: For women, baseline social isolation was significantly associated with new-onset ADL (OR = 1.18, 95% CI = 1.07-1.30) and IADL (OR = 1.11, 95% CI = 1.01-1.21) disability; no significant association between loneliness and ADL or IADL disability was found. For men, neither social isolation nor loneliness was found to be significantly associated with ADL or IADL disability. CONCLUSION: This longitudinal study found that social isolation, rather than loneliness, was significantly associated with functional disability over 4 years among women (but not men) in China. These findings expand our knowledge about the association between social relationships and functional status among non-Western populations.