Dataset Information

National context of healthcare, economy and religion, and the association between disability and depressive symptoms in older Europeans: results from the EURODEP concerted action.

ABSTRACT: Associations between disability and depression have been shown to be consistent across cultures among middle-aged adults. In later life the association between disability and depression is much more substantial and may be amenable to influences by health care facilities as well as economic and sociocultural factors. Fourteen community-based studies on depression in later life in 11 western European countries contribute to a total study sample of 22,570 respondents aged 65 years or older. Measures are harmonised for depressive symptoms (EURO-D scale) and disability. Using multilevel modelling to control for the stratified data structure we examined whether the association between disability and depressive symptoms is modified by national health care and mental health care availability, national economic circumstances, demographic characteristics and religious tradition. The association between depressive symptoms and disability is attenuated by health care expenditure and availability of mental health care and also by gross domestic product; it was more pronounced in countries with high levels of orthodox religious beliefs. Higher levels of depressive symptoms are found in countries with a larger gross domestic product (per capita) and higher health care expenses but are interpreted with care because of measurement differences between the centres. The findings from this contextual perspective indicate that general and mental health care should be geared to one another wherever possible.

SUBMITTER: Braam AW

PROVIDER: S-EPMC5547688 | biostudies-other | 2004 Dec

REPOSITORIES: biostudies-other

ACCESS DATA

Similar Datasets

Project description:ObjectiveDisability and social support can impact depressive symptoms of the elderly. Yet, studies infrequently discuss the moderating role of social support when evaluating the association between disability and depressive symptoms. The purpose of this study was to explore the association between disability, social support, and depressive symptoms among the Chinese elderly, and further examine the moderating effect of social support.Materials and methodsUsing the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) data set, we finally selected 9,231 Chinese elderly after screening. The Center for Epidemiologic Studies Depression Scale (CESD-10) was used to evaluate depressive symptoms in the elderly. Disability was measured by basic activities of daily living (B-ADL) and instrumental activities of daily living (I-ADL). Social support included contact with family and friends, sick care, and money received, measured by five self-reported questions. We used multiple linear regression and moderating model to explore the association between disability, social support, and depressive symptoms.ResultsA total of 9,231 patients were included in this study, and approximately 26.75% of the elderly had depressive symptoms. Study found that depressive symptoms were associated with social support (β B-ADL = -0.108, 95% CI: -0.168- -0.047; β I-ADL = -0.098, 95% CI: -0.156- -0.039), β B-ADL (β = 0.296, 95% CI: 0.248-0.343) and I-ADL (β = 0.174, 95% CI: 0.152-0.195). Moreover, the result also showed that social support moderated the effects of B-ADL ( βB-ADL*socialsupport = 0.034, 95% CI: 0.014-0.053, F = 11.57, p = 0.001) and I-ADL ( βI-ADL*socialsupport = 0.025, 95% CI: 0.017-0.033) on depressive symptoms.ConclusionsThe study suggests that disability and social support can affect depressive symptoms, and social support moderates the effect of disability on depressive symptoms. Therefore, taking effective measures to reduce the elderly disability rate of disability and increase their social support are necessary condition for realizing mental health.

Project description:BackgroundThe world population is expected to increase greatly this century, aggravating current problems related to climate, health, food security, biodiversity, energy and other vital resources. Population growth depends strongly on total fertility rate (TFR), but the relative importance of factors that influence fertility needs more study.MethodsWe analyze recent levels of fertility in relation to five factors: education (mean school years for females), economy (Gross Domestic Product, GDP, per capita), religiosity, contraceptive prevalence rate (CPR), and strength of family planning programs. We compare six global regions: E Europe, W Europe and related countries, Latin America and the Caribbean, the Arab States, Sub-Saharan Africa, and Asia. In total, 141 countries are included in the analysis. We estimate the strength of relationships between TFR and the five factors by correlation or regression and present the results graphically.ResultsIn decreasing order of strength, fertility (TFR) correlates negatively with education, CPR, and GDP per capita, and positively with religiosity. Europe deviates from other regions in several ways, e.g. TFR increases with education and decreases with religiosity in W Europe. TFR decreases with increasing strength of family planning programs in three regions, but only weakly so in a fourth, Sub-Saharan Africa (the two European regions lacked such programs). Most factors correlated with TFR are also correlated with each other. In particular, education correlates positively with GDP per capita but negatively with religiosity, which is also negatively related to contraception and GDP per capita.ConclusionsThese results help identify factors of likely importance for TFR in global regions and countries. More work is needed to establish causality and relative importance of the factors. Our novel quantitative analysis of TFR suggests that religiosity may counteract the ongoing decline of fertility in some regions and countries.

Project description:ObjectivesDepressive symptoms can be both a cause and a consequence of functional limitations and medical conditions. Our objectives were to determine the association of depressive symptoms with subsequent total healthcare costs in older women after accounting for functional limitations and multimorbidity.DesignProspective cohort study (Study of Osteoporotic Fractures [SOF]).SettingFour US sites.ParticipantsA total of 2508 community-dwelling women (mean age = 79.4 years) participating in the SOF year 10 (Y10) examination linked with their Medicare claims data.MeasurementsAt Y10, depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS) and functional limitations were assessed by number (range = 0-5) of impairments in performing instrumental activities of daily living. Multimorbidity was ascertained by the Elixhauser method using claims data for the 12 months preceding the Y10 examination. Total direct healthcare costs, outpatient costs, acute hospital stays, and skilled nursing facility during the 12 months following the Y10 examination were ascertained from claims data.ResultsAnnualized mean (SD) total healthcare costs were $4654 ($9075) in those with little or no depressive symptoms (GDS score = 0-1), $7871 ($14 534) in those with mild depressive symptoms (GDS score = 2-5), and $9010 ($15 578) in those with moderate to severe depressive symptoms (GDS score = 6 or more). After adjustment for age, site, self-reported functional limitations, and multimorbidity, the magnitudes of these incremental costs were partially attenuated (cost ratio = 1.34 [95% confidence interval {CI} = 1.14-1.59] for those with mild depressive symptoms, and cost ratio = 1.29 [95% CI = 0.99-1.69] for those with moderate to severe depressive symptoms vs women with little or no depressive symptoms).ConclusionDepressive symptoms were associated with higher subsequent healthcare costs attributable, in part, to greater functional limitations and multimorbidity among those with symptoms. Importantly, even mild depressive symptoms were associated with higher healthcare costs. J Am Geriatr Soc 67:1596-1603, 2019.

Dataset Information

National context of healthcare, economy and religion, and the association between disability and depressive symptoms in older Europeans: results from the EURODEP concerted action.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets