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Reciprocal relationship between pain and depression in elderly Chinese primary care patients
- Authors:
- CHOU Kee-Lee, CHI Iris
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(10), October 2005, pp.945-952.
- Publisher:
- Wiley
This study examines the reciprocal relationship between pain and depression and to identify whether social support, functional disability or social functioning mediated the link between pain and depression among Hong Kong Chinese elderly primary care patients. Three hundred and eighteen patients were assessed by a trained assessor with MDS-HC at baseline and these subjects were randomly selected from attendants of three randomly selected elderly health centers in Hong Kong. These patients were re-assessed one year after baseline evaluation. Multiple regression analyses revealed that pain at baseline significantly predicted depression at 12-month follow-up assessment when age, gender, martial status, education, and depression at baseline were adjusted for, but depression at baseline was not associated with pain at 12-months after baseline measure while controlling for age, gender, martial status, education, and pain at baseline. However, depression did predict the onset of pain. Moreover, social support, physical disability or social functioning did not mediate the impact of pain on depression. These data suggest that pain is an important predictor of depression in elderly primary care patients. Therefore, aged care service practitioners must take this risk factor into consideration in their preventive intervention and treatment for psychological well-being.
Reciprocal relationship between fear of falling and depression in elderly Chinese primary care patients
- Authors:
- CHOU Kee-Lee, CHI Iris
- Journal article citation:
- Aging and Mental Health, 12(5), September 2008, pp.587-594.
- Publisher:
- Taylor and Francis
The objective of the current study is to investigate the link between depression and fear of falling in Hong Kong Chinese older adults in primary are settings. Using longitudinal data collected on 321 Chinese primary care patients 65 years of age and older, the authors investigated the reciprocal relationship between fear of falling and depression and examined whether functional disability and social functioning mediated the link between fear of falling and depression. Participants were recruited from three primary care units in Hong Kong. Subjects were assessed in Cantonese by two trained assessors with Minimum Data Set-Home Care twice over a period of one year. Findings revealed that fear of falling at baseline significantly predicted depression at 12 month follow-up assessment after age, gender, marital status, education and depression at baseline were adjusted, but depression at baseline did not predict fear of falling at 12 months after fear of falling at baseline was adjusted. Moreover, social functioning mediated the impact of fear of falling on depression. The findings presented here indicate that fear of falling potentially increases the risk of depression in Chinese older adults in primary care settings.
Prevalence of depression among elderly Chinese with diabetes
- Author:
- CHOU Kee-Lee
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(6), June 2005, pp.570-575.
- Publisher:
- Wiley
This study aimed to examine the association between diabetes and depression among older Chinese and to determine the extent to which depression is mediated by physical disability and diabetes-related comorbid conditions. The study used a cross-sectional analysis of data from a population-based study composed of a representative sample of 2003 non-institutionalized older adults aged 60 and older living in Hong Kong who agreed to participate in the study. The relation between diabetes and depression (measured with the Geriatric Depression Scale) was examined. Results found 12 percent of the older adults reported physician-diagnosed diabetes and amongst these older persons with diabetes, 26 precent of them reported elated level of depressive symptoms. Logistic regression analyses revealed that diabetes was significantly related to depression even when controlling for age, gender, marital status, and education. More importantly, adjusted for self-reported disability in three domains including self-care, mobility, and higher functioning did not attenuate this association but the association disappeared after adjustment for four diabetes-related complications including heart disease, high blood pressure, stroke, and vision problems had been made.
Combined effect of vision and hearing impairment on depression in elderly Chinese
- Authors:
- CHOU Kee-Lee, CHI Iris
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(9), September 2004, pp.825-832.
- Publisher:
- Wiley
Sensory impairment and depression are common in old age and the relation between depression and vision as well as hearing impairment have been established. However, few studies have directly compared their effects and examined the impact of dual sensory loss. The purpose of this study is to compare impacts of self-reported hearing and vision loss as well as the effect of double sensory impairment on depression. This article analyzes cross-sectional data collected from a representative community sample of 2,003 Chinese elderly people aged 60 or above in Hong Kong. Respondents were interviewed in a face-to-face format and data including vision and hearing impairment, socio-demographic variables, health indicators, family support, and depression were obtained. Logistic regression analyses revealed that visual impairment was significantly related to depression even after age, gender, marital status, education, self-reported health status, the presence of 11 diseases, functional limitation and family support were controlled but hearing loss was not. Hearing impairment did not add to the likelihood of depression where visual impairment was already present. The impact of visual impairment on psychological well-being among elderly Chinese is more robust than hearing loss. Therefore, aged care service practitioners must take this risk factor into consideration in their preventive intervention and treatment for psychological well-being.
Childlessness and psychological well-being in Chinese older adults
- Authors:
- CHOU Kee-Lee, CHI Iris
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(5), May 2004, pp.449-457.
- Publisher:
- Wiley
Childless older adults will increase rapidly in the coming future due to delayed marriage, infertility, and high divorce rate. The authors examined whether childlessness is significantly related to loneliness and depression and whether the effect of childlessness persisted even when other factors including gender, marital status, age, education, self-rated health status and financial strain were controlled for. This article analyzes cross-sectional data collected from a representative community sample of 2003 Chinese elderly people aged 60 or above in Hong Kong. Respondents were interviewed in face-to-face format and data including socio-demographic variables, health indicators, loneliness and depression were obtained. Logistic regression analyses revealed that childlessness was significantly related to loneliness and depression even after marital status, gender, age, education, self-reported health status, and financial strain were controlled for. The impact of childlessness on psychological well-being among elderly Chinese is more robust than that found in older Americans. Moreover, consistent with the findings of previous studies, we found that the effect of childlessness on psychological well-being has to be investigated in the context of marital status. Therefore, aged care service practitioners must take this risk factor into consideration in their preventive intervention and treatment for psychological well-being.
Panic disorder in older adults: evidence from the national epidemiologic survey on alcohol and related conditions
- Author:
- CHOU Kee-Lee
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(8), August 2010, pp.822-832.
- Publisher:
- Wiley
Panic disorder is significantly associated with higher medical and psychiatric comorbidities, yet there is a lack of research in this area. This study investigated the association of panic disorder with childhood parental loss and recent stressful life events; the co-existence of panic disorder with major depressive disorder and alcohol dependence; and the impact of panic disorder on health-related quality of life. Data from 13,420 adults, aged 55 years and older, from the National Epidemiologic Survey on Alcohol and Related Conditions (2001–2002) was used. Panic disorder was assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule. Findings indicated that the current and lifetime prevalence rates of panic disorder were 1.17 and 3.72%, respectively. Panic disorder was more common among low income groups, and those who had reported more recent stressful life events. Major depressive disorder was significantly related to lifetime panic disorder. Panic disorder was also related to a lower health-related quality of life and dual medical conditions. The authors conclude that the correlation between panic disorder and major depressive disorder raised further questions about the nature of panic disorder in the elderly. This study supports the idea that panic disorder has a strong impact on quality of life in old age.
Prevalence and correlates of depression in Chinese oldest-old
- Authors:
- CHOU Kee-Lee, CHI Iris
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(1), January 2005, pp.41-50.
- Publisher:
- Wiley
In Hong Kong, the aged population will be increased rapidly in the coming three decades and the oldest-old (aged 80 and above) is the fastest growing age group. In this paper, we examined the prevalence rate and the correlates of depression for the oldest-old. This article analyzes cross-sectional data collected from a representative community sample of 1 903 Chinese elderly people aged 60 or above in Hong Kong. Respondents were interviewed in face-to-face format with structural questionnaire. Using 8 as the cut-off point for the 15-item Geriatric Depression Scale, we found that the prevalence rate was greater for the oldest-old (31.1% ± 9.7%) than for the young-old (aged between 60 and 69; 19.1% ± 2.8%) and the old-old (aged 70 and 79; 22.4% ± 4.2%) groups. Logistic regression analyses revealed that financial strain, poor self-rated health, loneliness, and heart disease were significantly and positively related to depression in the oldest-old after gender, marital status, education, living arrangement, functional disability, sensory impairment, cognitive ability, and the presence of eight medical conditions were controlled. Interestingly, financial strain, self-rated health, and loneliness were found to be significant correlates of depression in the young-old and the old-old groups, too. Depression is a serious problem for the oldest-old but a number of correlates are consistently identified in the oldest-old, as well as the two other age groups in the elderly population. Therefore, aged care service practitioners must take these correlates into consideration in their prevention and treatment for depression for all different age groups in the aged.