Dataset Information

Mediating Effects of Social Support on Depression and Suicidal Ideation in Older Korean Adults With Hypertension Who Live Alone.

ABSTRACT: BACKGROUND:Older adults who live alone are less physically and emotionally healthy and report higher levels of depression relative to those who do not live alone. Suicide is the most problematic health issue reported by older adults who live alone. In particular, vulnerable older adults who live alone experience difficulty obtaining self-care and medical services; therefore, early detection of depression is difficult, and there are few opportunities to implement suicide prevention strategies in this population. In addition, social support for depression is an important factor affecting illness and economic vulnerability in older adults who live alone. PURPOSE:This study aimed to examine the relationship between depression and suicidal ideation in vulnerable older Korean adults with hypertension and to explore the mediating effect of social support on this relationship. METHODS:The study used a cross-sectional design. Vulnerable older adults who were 65 years old or older with hypertension and who received home visit services from a public health center were invited to participate. The participants completed structured questionnaires, including the 15-item Short-Form Geriatric Depression Scale, 12-item Multidimensional Scale of Perceived Social Support, and 19-item Scale for Suicidal Ideation, and provided information regarding their demographic characteristics, health status, and economic status. Descriptive and correlation analyses were performed to examine the correlations among these variables. The three-step regression analysis method proposed by Baron and Kenny was used to examine the mediating effect of social support. RESULTS:The mean depression, social support, and suicidal ideation scores of participants were 23.64 (± 2.04), 35.94 (± 15.40), and 7.80 (± 7.73), respectively. In addition, depression was negatively correlated with social support (r = -.27) and positively correlated with suicidal ideation (r = .21), whereas social support was negatively correlated with suicidal ideation (r = -.35). Social support mediated the relationship between depression and suicidal ideation (Z = 2.69). CONCLUSIONS:Social support was identified as an important variable for older adults with chronic illness who lived alone. Interventions that include social support hold the potential to reduce depression and suicidal ideation in this population.

SUBMITTER: Nam EJ

PROVIDER: S-EPMC6553967 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Mediating Effects of Social Support on Depression and Suicidal Ideation in Older Korean Adults With Hypertension Who Live Alone.

Nam Eun Jeong EJ Lee Jong-Eun JE

The journal of nursing research : JNR 20190601 3

<h4>Background</h4>Older adults who live alone are less physically and emotionally healthy and report higher levels of depression relative to those who do not live alone. Suicide is the most problematic health issue reported by older adults who live alone. In particular, vulnerable older adults who live alone experience difficulty obtaining self-care and medical services; therefore, early detection of depression is difficult, and there are few opportunities to implement suicide prevention strate ...[more]

PMID: 30694222

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Project description:ImportanceMental health problems are common during the transition from adolescence to young adulthood. Although perceived social support and mental health problems have been shown to be concurrently associated, longitudinal studies are lacking to document the directionality of this association, especially in emerging adulthood (late teens to late 20s).ObjectiveTo test whether social support in emerging adulthood protects against later depression, anxiety, and suicidal ideation and suicide attempts after adjusting for a range of confounders, including prior mental health problems and family characteristics.Design, setting, and participantsThis population-based cohort study included 1174 participants from the Quebec Longitudinal Study of Child Development. Participants underwent yearly or biennial assessment (starting from age 5 months to age 20 years). Data were collected from March 16, 1998, through June 1, 2018.Main outcomes and measuresSelf-reported perceived social support was measured at age 19 years using the 10-item Social Provision Scale. Mental health problems, including depressive and anxiety symptoms as well as suicidal ideation and attempts, were measured at age 20 years. Social support and mental health problem raw scores were converted to z-scores to ease interpretation. Depressive and anxiety symptoms were categorized using validated cutoffs to determine clinical significance.ResultsThe study consisted of 1174 participants (574 female [48.89%] and 600 male [51.11%] individuals). Emerging adults with higher levels of perceived social support at age 19 years reported fewer mental health problems 1 year later, even after adjusting for a range of mental health problems in adolescence at ages 15 and 17 years (eg, depressive and anxiety symptoms and suicidal ideation and attempts) and family characteristics (eg, socioeconomic status and family functioning and structure). Higher perceived social support was associated with fewer symptoms of depression (β = -0.23; 95% CI, -0.26 to -0.18; P = <.001 and odds ratio [OR], 0.53; 95% CI, 0.42-0.66 for severe depression) and anxiety (β = -0.10; 95% CI, -0.15 to -0.04; P < .001 and OR, 0.78; 95% CI, 0.62-0.98 for severe anxiety). Higher perceived social support was associated with a lower risk for suicide-related outcomes (OR, 0.59 [95% CI, 0.50-0.70] for suicidal ideation and OR, 0.60 [95% CI, 0.46-0.79] for suicide attempts).Conclusions and relevanceIn this cohort study, emerging adults who perceived higher levels of social support reported experiencing fewer mental health problems 1 year later. These findings suggest that perceived social support may protect against mental health problems during the transition into adulthood, even in those who experience mental health problems in adolescence. Leveraging social support in prevention and treatment options may protect against mental health symptoms during this transition period.

Project description:BackgroundRecent analyses have described metabolomic markers for depression and suicidal ideation in non-pregnant adults. We examined the metabolomic profile of antepartum depression and suicidal ideation during mid-pregnancy, a time of high susceptibility to mood disorders.MethodsWe collected fasting blood from 100 pregnant Peruvian women and profiled 307 plasma metabolites using liquid chromatography-mass spectrometry. We used the Patient Health Questionnaire 9 to define antepartum depression (score  ≥ 10) and suicidal ideation (having thoughts that you would be better off dead, or of hurting yourself). Logistic regression was used to calculate odds ratios (ORs).ResultsThree triacylglycerol metabolites (C48:5 triacylglycerol [OR = =1.89; 95% confidence interval (CI): 1.14-3.14], C50:6 triacylglycerol [OR = =1.88; 95%CI: 1.13-3.14], C46:4 triacylglycerol [OR = =1.89; 95%CI: 1.11-3.21]) were associated with higher odds of antepartum depression and 4 metabolites (betaine [OR = =0.56; 95%CI:0.33-0.95], citrulline [OR = =0.58; 95%CI: 0.34-0.98], C5 carnitine [OR = =0.59; 95%CI: 0.36-0.99], C5:1 carnitine [OR = =0.59; 95%CI: 0.35-1.00]) with lower odds of antepartum depression. Twenty-six metabolites, including 5-hydroxytryptophan (OR = =0.52; 95%CI: 0.30-0.92), phenylalanine (OR = =0.41; 95%CI: 0.19-0.91), and betaine (OR = =0.53; 95%CI: 0.28-0.99) were associated with lower odds of suicidal ideation.LimitationsOur cross-sectional study could not determine whether metabolites prospectively predict outcomes. No metabolites remained significant after multiple testing correction; these novel findings should be replicated in a larger sample.ConclusionsAntepartum suicidal ideation metabolomic markers are similar to markers of depression among non-pregnant adults, and distinct from markers of antepartum depression. Findings suggest that mood disorder in pregnancy shares metabolomic similarities to mood disorder at other times and may further understanding of these conditions' pathophysiology.

Project description:ImportanceOlder adults who live alone are at risk for poor health outcomes. Whether social support mitigates the risk of living alone, particularly when facing a sudden change in health, has not been adequately reported.ObjectiveTo assess if identifiable support buffers the vulnerability of a health shock while living alone.Design, setting, and participantsIn this longitudinal, prospective, nationally representative cohort study from the Health and Retirement Study (enrollment March 2006 to April 2015), 4772 community-dwelling older adults 65 years or older who lived alone in the community and could complete activities of daily living (ADLs) and instrumental ADLs independently were followed up biennially through April 2018. Statistical analysis was completed from May 2020 to March 2021.ExposuresIdentifiable support (ie, can the participant identify a relative/friend who could help with personal care if needed), health shock (ie, hospitalization, new diagnosis of cancer, stroke, heart attack), and interaction (multiplicative and additive) between the 2 exposures.Main outcomes and measuresThe primary outcomes were incident ADL dependency, prolonged nursing home stay (≥30 days), and death.ResultsOf 4772 older adults (median [IQR] age, 73 [68-81] years; 3398 [71%] women) who lived alone, at baseline, 1813 (38%) could not identify support, and 3013 (63%) experienced a health shock during the study. Support was associated with a lower risk of a prolonged nursing home stay at 2 years (predicted probability, 6.7% vs 5.2%; P = .002). Absent a health shock, support was not associated with a prolonged nursing home stay (predicted probability over 2 years, 1.9% vs 1.4%; P = .21). However, in the presence of a health shock, support was associated with a lower risk of a prolonged nursing home stay (predicted probability over 2 years, 14.2% vs 10.9%; P = .002). Support was not associated with incident ADL dependence or death.Conclusions and relevanceIn this longitudinal cohort study among older adults who live alone, identifiable support was associated with a lower risk of a prolonged nursing home stay in the setting of a health shock.

Dataset Information

Mediating Effects of Social Support on Depression and Suicidal Ideation in Older Korean Adults With Hypertension Who Live Alone.

Publications

Mediating Effects of Social Support on Depression and Suicidal Ideation in Older Korean Adults With Hypertension Who Live Alone.

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