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      Social participation reduces depressive symptoms among older adults: An 18-year longitudinal analysis in Taiwan

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          Abstract

          Background

          Relatively little empirical attention has focused on the association between social participation and depressive symptoms amongst older adults in Asian nations, where persons over the age of 65 represent a rapidly growing segment of the population. This study explores the dynamic relationship between participation in social activities and trajectories of depressive symptomatology among older Taiwanese adults surveyed over 18 years.

          Methods

          Data are from a nationally representative sample of 1,388 adults aged 60-64 first surveyed in 1989 and followed over an 18-year time period for a total of six waves. Individual involvement in social activities was categorized into continuous participation, ceased participation before age 70, initiating participation in older adulthood, never participated, and dropped out before age 70. Two domains of depressive symptoms--negative affect and lack of positive affect--were measured using a 10-item version of the Center for Epidemiologic Studies-Depression Scale.

          Results

          Analyses using growth curve modeling showed that continuously participating or initiating participation in social activities later life is significantly associated with fewer depressive symptoms among older Taiwanese adults, even after controlling for the confounding effects of aging, individual demographic differences, and health status.

          Conclusions

          These findings suggest that maintaining or initiating social participation in later life benefits the mental health of older adults. Facilitating social activities among older adults is a promising direction for programs intended to promote mental health and successful aging among older adults in Taiwan.

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          Most cited references34

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          Cross-validation of a short form of the CES-D in Chinese elderly.

          To establish the reliability and validity of a 10-item short form of the CES-D (CESD-10). Cross-sectional and longitudinal follow-up over 3 years. Standardized questionnaire and face-to-face interview were conducted. Community and psychogeriatric assessment clinic of a voluntary organization. Five hundred and fifty-four elderly in the general community, 30 elderly from a community centre and 31 elderly patients with depressive symptoms. Instruments other than the CESD-10 included Activities of Daily Living (ADL), the Life Satisfaction Scale (LSS), the Lubben Social Network Scale, a single-item measure of self-rated health. Reliability of the CESD-10 in terms of internal consistency was satisfactory (Cronbach alpha = 0.78-0.79). Moderate consistency over a period of 3 years was also found to be significant (r = 0.44, p < 0.01). The CESD-10 showed comparable accuracy to the original CES-D in classifying cases with depressive symptoms (kappa = 0.84, p < 0.01). Significant relationships of the CESD-10 with impairments of daily functioning, life satisfaction, social support, and self-rated health were established. The CESD-10 also differentiated significantly between groups of 'normal' and clinically depressed elderly. The CESD-10 attained satisfactory content and temporal reliability. Its construct and concurrent validity were established. With its brevity, it should prove a useful mental health measure for the elderly.
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            Stress, health, and the life course: some conceptual perspectives.

            This article proposes several conceptual perspectives designed to advance our understanding of the material and experiential conditions contributing to persistent disparities in rates of morbidity and mortality among groups unequal in their social and economic statuses. An underlying assumption is that these disparities, which are in clear evidence at mid- and late life, may be anchored to earlier circumstances of the life course. Of particular interest are those circumstances resulting in people with the least privileged statuses having the greatest chances of exposure to health-related stressors. Among the stressors closely linked to status and status attainment are those that continue or are repeated across the life course, such as enduring economic strain and discriminatory experiences. Also taking a long-range toll on health are circumstances of stress proliferation, a process that places people exposed to a serious adversity at risk for later exposure to additional adversities. We suggest that this process can be observed in instances of trauma, in early out-of-sequence transitions, and in the case of undesired changes that disrupt behaviors and relationships in established roles. Effective effort to close the systemic health gaps must recognize their structural underpinnings.
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              Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey.

              General population survey data are presented on the lifetime prevalence of suicide attempts as well as transition probabilities to onset of ideation, plans among ideators, and attempts among ideators either with or without a plan. Risk factors for these transitions are also studied. Data are from part II of the National Comorbidity Survey, a nationally representative survey carried out from 1990 to 1992 in a sample of 5877 respondents aged 15 to 54 years to study prevalences and correlates of DSM-III-R disorders. Transitions are estimated using life-table analysis. Risk factors are examined using survival analysis. Of the respondents, 13.5% reported lifetime ideation, 3.9% a plan, and 4.6% an attempt. Cumulative probabilities were 34% for the transition from ideation to a plan, 72% from a plan to an attempt, and 26% from ideation to an unplanned attempt. About 90% of unplanned and 60% of planned first attempts occurred within 1 year of the onset of ideation. All significant risk factors (female, previously married, age less than 25 years, in a recent cohort, poorly educated, and having 1 or more of the DSM-III-R disorders assessed in the survey) were more strongly related to ideation than to progression from ideation to a plan or an attempt. Prevention efforts should focus on planned attempts because of the rapid onset and unpredictability of unplanned attempts. More research is needed on the determinants of unplanned attempts.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2011
                10 May 2011
                : 11
                : 292
                Affiliations
                [1 ]Insitute of Health and Welfare Policy, Research Center for Health and Welfare Policy, School of Medicine, National Yang-Ming University, Taipei, Taiwan, China
                [2 ]Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan, China
                [3 ]Kessler Foundation Research Center & Department of Physical Medicine & Rehabilitation, UMDNJ-New Jersey Medical School, USA
                Article
                1471-2458-11-292
                10.1186/1471-2458-11-292
                3103460
                21569285
                a3772fb4-b6f7-401e-ae54-9c466f4b10c3
                Copyright ©2011 Chiao et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 October 2010
                : 10 May 2011
                Categories
                Research Article

                Public health
                social participation,growth curve modeling,depressive symptoms,older adults,taiwan
                Public health
                social participation, growth curve modeling, depressive symptoms, older adults, taiwan

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