Influence of preoperative comprehensive education on anxiety,depression,pain,and sleep in elderly patients operated under general anesthesia

BACKGROUND Owing to the particularities of their physical characteristics,older patients undergoing surgery under general anesthesia experience great surgical traumas.Thus,exploring more refined and individualized nursing approaches is an urgent need to mitigate the negative effects of surgery on such patients.AIM To analyze the influence of preoperative comprehensive education on anxiety,depression,pain,and sleep in older patients who underwent surgery under general anesthesia.METHODS In total,163 older adults who underwent surgery under general anesthesia between June 2022 and November 2023 were selected,77 of them received routine nursing care(control group),and 86 received preoperative comprehensive education(research group).Subsequently,comparative analyses were performed from the following perspectives:Surgical indicators(operation time,time to complete regain of consciousness,and temperature immediately after the procedure and upon recovery from anesthesia)before and after nursing care;negative emotions[self-rating anxiety scale(SAS)/self-rating depression scale(SDS)];pain severity[visual analog scale(VAS)];sleep quality[Pittsburgh sleep quality index(PSQI)];incidence of sleep disturbances(difficulties in falling asleep for the first time,falling asleep again after waking up frequently at night,falling asleep again after waking up early,and falling asleep all night);and incidence of adverse events(airway obstruction,catheter detachment,aspiration,and asphyxia).RESULTS The research group had significantly lower operation time and time to complete regain of consciousness than the control group after nursing care and markedly better recovery of postoperative body temperature and body temperature at awakening.In addition,more notable decreases in SAS,SDS,VAS,and PSQI scores were observed in the research group than in the control group.Furthermore,the incidence rate of sleep disturbance(8.14%vs 29.87%)and adverse events(4.65%vs 19.48%)were lower in the research group than in the control group.CONCLUSION Preoperative comprehensive education in older patients who underwent surgery under general anesthesia can improve postoperative indicators,effectively reduce the occurrence of anxiety and depression,alleviate postoperative pain,and improve sleep quality.

Depression and chronic heart failure in the elderly： an intriguing relationship

Chronic heart failure and depressive disorders have a high prevalence and incidence in the elderly. Several studies have shown how depression tends to exacerbate coexisting chronic heart failure and its clinical outcomes and vice versa, especially in the elderly. The negative synergism between chronic heart failure and depression in the elderly may be approached only taking into account the multifaceted pathophysiological characteristics underlying both these conditions, such as behavioural factors, neurohormonal activation, inflammatory mediators, hypercoagulability and vascular damage. Nevertheless, the pathophysiological link between these two conditions is not well established yet. Despite the high prevalence of depression in chronic heart failure elderly patients and its negative prognostic value, it is often unrecognized especially because of shared symptoms. So the screening of mood disorders, using reliable questionnaires, is recommended in elderly patients with chronic heart failure, even if cannot substitute a diagnostic interview by mental health professionals. In this setting, treatment of depression requires a multidisciplinary approach including： psychotherapy, antidepressants, exercise training and electroconvulsive therapy. Pharmacological therapy with selective serotonin reuptake inhibitors, despite conflicting results, improves quality of life but does not guarantee better outcomes. Exercise training is effective in improving quality of life and prognosis but at the same time cardiac rehabilitation services are vastly underutilized.

The power of informal institutions:The impact of clan culture on the depression of the elderly in rural China

Exploration of ways to improve the subjective welfare of residents is an important area of current academic research.Using data from the China Family Panel Studies survey conducted in 2010,this paper investigated the impact of clan culture on the mental health of elderly people in rural China.The results demonstrated that clan culture can significantly decrease the depression score of the rural elderly.Further,there was no gender difference with respect to the impact of clan culture on the depression score of the elderly.At the same time,the positive effects of clan culture on the depression score of the elderly have gradually weakened with economic development.Exploration of the mechanisms involved indicated that in areas with stronger clan culture,older people receive more social support.This study enriches our understanding of the impact of informal institutions on the welfare of rural residents.At the same time,it can also provide a certain decisionmaking reference for the government to formulate relative poverty relief strategies in a new stage of poverty alleviation.

Logistic Regression Analysis on the Correlation between Physical Diseases and Life Events and Depression in the Elderly

[Objectives]This study was conducted to explore the effects of physical diseases and life events on depression among urban elderly people.[Methods]Five hundred urban elderly people in Shiyan City were selected using a convenient sampling method to investigate and diagnose depression using the Geriatric Mental State Schedule and its accompanying computer diagnostic system.The Minimum Data Set(MDS)and related factor survey form were used to investigate physical diseases and life events,and statistical analysis was conducted using methods such as logistic regression analysis and factor analysis.[Results]The prevalence rates of angina,stroke,or partial paralysis,migraine,vision problems,hyperthyroidism or hypothyroidism,as well as the number of physical diseases were significantly higher in elderly depression patients than in objects free of depression.Stroke or partial paralysis[OR(95%CI)=6.389(1.684,24.237)],emotional trauma events[OR(95%CI)=1.438(1.069,1.934)]and adverse health and economic events[OR(95%CI)=1.652(1.099,2.483)]were risk factors for late life depression(LLD).[Conclusions]Some physical diseases and life events may affect the onset process of depression in urban elderly people,and various measures need to be taken to reduce the risk of physical diseases and life events on depression.

An Interpretable Depression Prediction Model for the Elderly Based on ISSA Optimized LightGBM

Depression is one of the most severe mental health illnesses among senior citizens.Aiming at the low accuracy and poor interpretability of traditional prediction models,a novel interpretable depression predictive model for the elderly based on the improved sparrow search algorithm(ISSA)optimized light gradient boosting machine(LightGBM)and Shapley Additive exPlainations(SHAP)is proposed.First of all,to achieve better optimization ability and convergence speed,various strategies are used to improve SSA,including initialization population by Halton sequence,generating elite population by reverse learning and multi-sample learning strategy with linear control of step size.Then,the ISSA is applied to optimize the hyper-parameters of light gradient boosting machine(LightGBM)to improve the prediction accuracy when facing massive high-dimensional data.Finally,SHAP is used to provide global and local interpretation of the prediction model.The effectiveness of the proposed method is validated by a series of comparative experiments based on a real-world dataset.

The prevalence of depression among the empty-nest elderly in China:a meta-analysis of cross-sectional studies

Empty-nest elderly are those who have no children or whose children are away from home,and they have to live alone or with their spouses.The prevalence of depression in the elderly is worrying,especially in the empty-nest elderly.This study aimed to examine the prevalence of depression among the empty-nest elderly in China and explore the factors that influence depression among the empty-nest elderly.Methods:We searched both international(PubMed,Cochrane Library,Embase,and Web of Science)and Chinese(CNKI,WanFang,SinoMed,and VIP)databases from their inception date until 12 April,2020,and collected cross-sectional studies on the prevalence of depression among the empty-nest elderly in China.Two reviewers independently screened the literature,extracted the data,and evaluated the risk of bias included in the study.Meta-analysis was performed using Stata12.0 software.Results:Twenty-seven cross-sectional studies were included in the meta-analysis.The pooled prevalence of depression among the empty-nest elderly in China was 41%(95%CI:32%–50%).Subgroup analysis revealed that the Geriatric Depression Scale versions,sampling methods,living areas,gender,age,chronic diseases,and living arrangements were associated with the prevalence of depression among the empty-nest elderly in China.Conclusions:The prevalence of depression among the empty-nest elderly in China was relatively high.Researchers could explore more reasons for the differences in the prevalence of depression among the empty-nest elderly from multiple perspectives in the future.Relevant departments should identify and routinely evaluate the negative emotions of the empty-nest elderly.Meanwhile,community nurses should care for the emotional needs of the empty-nest elderly,carry out targeted mental health education,and promote the realization of healthy aging.

Relationships between Chronic Diseases and Depression among Middleaged and Elderly People in China: A Prospective Study from CHARLS

Given the rapid increase in the prevalence of chronic diseases in aging populations,this prospective study including 17707 adults aged≥45 years from China Health and Retirement Longitudinal Study was used to estimate the associations between chronic discase,multimorbidity,and depression among middle-aged and elderly adults in China,and explore the mediating factors.Depressive symptoms were assessed using the 10-item Centre for Epidemiological Studies Depression Scale(CES-D-10)questionnaire.Twelve chronic physical conditions,including hypertension,diabetes,dyslipidemia,cancer,chronic lung disease,liver disease,heart failure,stroke,kidney disease,arthritis or rheumatism,asthma,digestive disease were assessed.The prevalence rates for physical multimorbidity and depression(CES-D-10≥10)were 43.23%and 36.62%,respectively.Through multivariable logistic models and generalized estimating equation(GEE)models,we found all 12 chronic physical conditions,and multimorbidity were significantly associated with depression.Both mobility problems and chronic pain explained more than 30%of the association for all chronic conditions,with particularly high percentages for stroke(51.56%)and cancer(51.06%)in mobility problems and cancer(53.35%)in chronic pain.Limited activities of daily living(ADL)explained 34.60%of the stroke-cancer relationship,while sleep problems explained between 10.15%(stroke)and 14.89%(chronic lung disease)of the association.Individuals with chronic diseases or multimorbidity are significantly more likely to be depressed.Functional symptoms involving limitations of ADL and mobility difficulties mediated much of the association between chronic diseases and incident depression.These symptoms could be targeted for interventions to ameliorate the incidence of depression among individuals with chronic conditions.

Effects of group reminiscence on elderly depression: A meta-analysis

Background/purpose:The present meta-analysis was performed to evaluate the effectiveness of group reminiscence on depression in elderly patients.Methods:Published and unpublished randomised controlled trials that assessed the effects of group reminiscence on depression in elderly patients were systematically reviewed using multiple electronic databases.Relative risks for dichotomous data and weighted mean differences for continuous data were calculated with 95%confidence intervals.Results:Ten trials were evaluated.Group reminiscence provided significantly greater relief of depressive symptoms than did the control intervention immediately after and 3 months after the intervention(p<0.00001).However,this advantage disappeared 6 months after the intervention(p?0.14).Group reminiscence significantly improved self-esteem and life satisfaction(p<0.01).Conclusion:Group reminiscence was associated with short-term depression relief among elderly patients with depression and effectively improved self-esteem and life satisfaction.Higher-quality large-scale randomised controlled trials are needed to confirm these findings.

Depression among elderly living in Briddashram (old age home)

Introduction: Depression is a common public health issue with the increasing life expectancy worldwide and depression is associated with morbidity as well as disability among the elderly. There are very few studies related with depression among elderly from developing countries. Objective: The purpose of this study was to assess the prevalence of depression and its correlates among the elderly living in Briddashram (old age home). Methods: This is a cross-sectional study carried out in 2012. Data were collected by face-to-face interview using short version of Geriatric Depression Scale. The data were analyzed using percentage, mean, simple correlation and regression. Results: The subjects (N = 185) were elderly aged 60 years and above living in Devghat area, Nepal. Mean age of the subjects was 73.67 (±3.23) years old and 51% were male. 94% elderly belong to Khas ethnicity. Nearly one third (31%) elderly were from nuclear family back ground, 25% were married, and only 18% elderly were literate. Majority of the elderly (93%) had health problems and self reported health shows 86% elderly reported their health fair. This study shows mean functional disability score was 2.53 (±2.05). Finding shows the prevalence of depression was 57.8%. Among them 46.7% had mild, 8.9% had moderate and 2.2% had severe depression. A statistically significant correlation was found between feelings of depression and age, sex, previous family type, ethnicity, feeling of loneliness and instrumental activities of daily living. Regression analysis shows that being women, feeling of loneliness and higher the dependency in IADL were predictors of depression. Conclusion: This study indicates that many elderly living in the Briddashram are suffering from depression. There should be some interruption from the concerned authorities so that depression can be reduced which will support to the well-being and quality of life of elderly.

Unpacking the Associations between Traumatic Events and Depression among Chinese Elderly: Two Dimensions of Aging Attitudes as Mediators and Moderators

Traumatic events have been considered significant risk factors for older adults’mental health,but the mediating mechanism and moderating effect of aging attitudes that underlie this relationship have yet been completely investigated.The attitudes of the elderly toward aging can be divided into two closely related but conceptually different dimensions,including positive and negative.Positive aging attitudes refer to optimistic feelings and experiences about aging,whereas negative attitudes toward aging are related to detrimental thoughts and sensa-tions experienced about the increasing age.The purpose of this study is to explore the mediating and moderating roles of these two dimensions of aging attitudes between traumatic events and depression of the elderly in China.Data for this research come from the China Longitudinal Aging Social Survey(CLASS)of 2014.A nationally representative sample consisting of 11,511 Chinese older adults aged 60 and above was obtained through a stra-tified,multi-stage probability sampling method.The results revealed that the association between traumatic events and depression was mediated and moderated by positive and negative aging attitudes,controlling for gen-der,age,spouse,educational level,and ethnicity.Significance,implications,and limitations were discussed.

Correlation between social support and depression in elderly stroke patients in the sequelae stage from five communities of Shanghai, China

Using a convenience sampling method, 81 aged patients who were between 6 and 24 months post-stroke were selected from five communities of Shanghai, China. The correlations between social support and depression, as well as other influential factors, were investigated. Results revealed that 46% （37/81） of the stroke patients suffered from depression. Depression was correlated with social support total scores and the two domains of subjective support and utilization. Older age, male gender, low income, absence of spouse and cerebral hemorrhage were risk factors for depression and identify more vulnerable groups.

Correlation of Depression with the Functional Profile of Elderly People Living in Homes for the Aged

Introduction: Due to the growth of the elderly population, there is a notable lack of preparation among family members and society to face the challenges of this new reality, resulting in an increasing demand for homes for the aged (HA). It is necessary to understand how the impairment of physical health, mental health and the level of depression can affect the functional capacity of the institutionalized elderly who live in homes for the aged. Objective: To describe the correlation between depression and functionality of elderly people who live in homes for the aged. Method: A cross-sectional, descriptive study with 70 elderly people of both sexes, aged 60 years or older, who live in HA in the state of Rio de Janeiro. Result: It was verified that the female gender was predominant in the HA consulted. The majority of elderly live in HA voluntarily 48.6% and that 41.43% did not complete elementary school. The majority of the elderly 81.43% had the ability to perform basic activities of daily living and the elderly 52.86% had normal psychological pictures. The worsening of the depressive picture is associated with the worse functioning of elderly who live in HA (p < 0.02). Conclusion: Depression is a factor that is associated with the functional capacity of the institutionalized elderly. The worse the functional level of the institutionalized elderly, the greater the chances of presenting a depressive state.

Comparison between Elderly Persons of the Urban Community, According to the Indicative of Depression

Objectives: To compare the sociodemographic and economic profile, functional capacity, number of self-referred morbidities and level of physical activity among the elderly with and without indicative of depression. Methods: Cross-sectional and analytical study, with 980 elderly persons (250 with and 730 without indicative of depression) residing in the city of Uberaba, in the State of Minas Gerais, Brazil, between August 2012 and May 2013. We used the BOMFAQ Questionnaire, GDS 15, Katz Index, Lawton and Brody Scale and IPAQ. For data analysis, descriptive statistics and the Chi-square test (p Results: In the comparison between the groups, there were significant differences regarding the female gender (p = 0.009), education (p = 0.008), individual income (p Conclusion: The comparison of the existence or not of depressive symptoms among the elderly enables a more effective planning of public policies aimed at health promotion and adequate treatment in cases of disease already present and the subsidization of preventive strategies, using data such as risk factors and associated factors and ways to research depression.

Application of Chinese five-tone melodies combined with acupoint massage in reducing anxiety and depression levels of elderly

Background:To investigate the clinical efficacy of Chinese five-tone melodies combined with acupoint massage on anxiety and depression in elderly in Nursing home.Methods:The intervention music for 22 elderly participants was selected according to the different traditional Chinese medicine evidence types,and the music therapy combined with acupoint massage therapy.The clinical intervention lasted for a total of 8 weeks.Participants were assessed with the Self-Assessment Scale for Anxiety and the Geriatric Depression Scale in pre and post-intervention.Results:The Self-Assessment Scale for Anxiety and Geriatric Depression Scale scores of the elderly were significantly lower after the intervention compared to the pre-intervention period(P<0.01).Conclusion:The five-element music combined with acupoint massage therapy has a significant clinical effect in reducing the level of anxiety and depression in the elderly in Nursing homes.

Depression of the elderly revealing a primary hypothyroidism

Introduction Psychiatric manifestations are exceptional during hypothyroidism and are not always easy to diagnose, especially since the clinical signs of hypothyroidism can be confused with those of the depressive syndrome. We report an original observation of depression of the elderly revealing an isolated primary hypothyroidism. Observation A 78-year-old patient, followed for essential hypertension, well-balanced under monotherapy with calcium channel blockers, and without degenerative complications, was referred by her family doctor for depressive syndrome not improved by the specific treatment prescribed and correctly taken for six months. The clinical examination noted in particular macroglossia with dental impressions and dry and cracked skin. The biological assessment showed hypothyroidism with TSH at 28μmol/l. Thyroid ultrasound showed atrophy of the thyroid gland. The thyroid autoimmunity (anti-thyroglobulin and anti-thyroperoxidase antibodies) was negative. The rest of the biological tests were in the normal range. The diagnosis of Riedel’s thyroiditis was retained and the patient was treated with levothyroxine in progressive doses until TSH normalization was achieved. The evolution on the psychiatric level was also favorable with disappearance of the signs of the depression and the anti-depressive treatment was discontinued. Conclusion Depression is rare, complicating only 4% of overt hypothyroidism and its diagnosis is not always easy, especially in the elderly. Hormone replacement therapy significantly improves the depressive syndrome and protects against cognitive decline. Thus, hypothyroidism screening seems appropriate for any depressive syndrome in the elderly.

Effects of Band Therapy Using Music on Grasping Power, Depression, and Personal Relationships in Nursing-Home-Dwelling Elderly Individuals

The current study examined the effects of band therapy using music on grasping power, depression, and personal relationships among residents of a nursing home. Thirty subjects participated in the study. The band therapy included greetings, warm-up exercises with music, singing with dance, playing instruments, closing speech, and stretching with background music. Band therapy was held for 40 minutes once per week, for a total of four sessions, in the activity room of the nursing home. Findings showed that grasping power, depression, and personal relationships were improved at posttest, but the differences were not statistically significant. A better study design to compare the effects of band therapy with the other group, and a more simple and repeated intervention for the elderly to follow without stress might be necessary.

A Clinical Study on the Effect of Group Nostalgia Therapy on Quality of Life and Cognitive Function in Elderly Patients with Depression

Background:Elderly people with depression require special care and attention.However,nostalgia is a complex emotional situation for a person who recalls the missing past.To improve mental health,quality of life,and attitudes toward aging in institutional care,group nostalgia therapy can be a nursing intermediary for the elderly.This study aimed to analyze the effect of group nostalgia therapy on quality of life cognitive function in elderly patients with depression.Methods:A total of 89 participants were enrolled in this study,which was further categorized into a control(n=40)and a nostalgia therapy group(n=49).A standard questionnaire was used to compare the QoL,MMSE and GDS scores between the control and the nostalgia therapy groups.Results:Neither the nostalgia group nor the control group showed any statistical difference based on the patient characteristics,and both groups had a homogeneous distribution with p<0.05.However,in the intervention with nostalgia therapy,the therapy group showed improvements in almost all four domains of quality of life:physical health,psychological,environmental and social well-being.Moreover,the standard regression residual plot observed that both the post-test scores of MMSE and GDS showed favorable scores with respect to WHO-QoL.Conclusion:The study observed that group nostalgia therapy helps improve the quality of life and cognitive function in elderly patients with depression.The study also concludes that reducing depressive symptoms through nostalgia therapy could improve all four domains of the WHOQoL BREF.

DISCRIMINATIVE ANALYSIS OF FUNCTIONAL NEAR-INFRARED SPECTROSCOPY SIGNALS FOR DEVELOPMENT OF NEUROIMAGING BIOMARKERS OF ELDERLY DEPRESSION

Functional near-infrared spectroscopy(fNIRS)is a neuroimaging technology which is suitable for psychiatric patients.Several fNIRS studies have found abnormal brain activations during cognitive tasks in elderly depression.In this paper,we proposed a discriminative model of multivariate pattern classification based on fNIRS signals to distinguish elderly depressed patients from healthy controls.This model used the brain activation patterns during a verbal fluency task as features of classification.Then Pseudo-Fisher Linear Discriminant Analysis was performed on the feature space to generate discriminative model.Using leave-one-out(LOO)cross-validation,our results showed a correct classification rate of 88%.The discriminative model showed its ability to identify people with elderly depression and suggested that fNIRS may be an efficient clinical tool for diagnosis of depression.This study may provide the first step for the development of neuroimaging biomarkers based on fNIRS in psychiatric disorders.

Negative efficacy of antidepressants in pharmacotherapy of child and adolescent depression

Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines still recommend the use of antidepressants,especially specific serotonin re-uptake inhibitors.Previous studies have suggested that antidepressants have little therapeutic effect but many side effects,such as switching to mania,suicide,and non-suicidal self injury(NSSI),in the treatment of child and adolescent depression.In the process of developing guidelines,drug recommendations should not only focus on impro-ving symptoms,but they should also consider potential side effects.This review discusses the serious side effects of antidepressants,including switching to mania,suicide,and NSSI.

Gut-brain axis as a bridge in obesity and depression:Mechanistic exploration and therapeutic prospects

A recent study by Wang et al,published in the World Journal of Psychiatry,provided preventative and therapeutic strategies for the comorbidity of obesity and depression.The gut-brain axis,which acts as a two-way communication system between the gastrointestinal tract and the central nervous system,plays a pivotal role in the pathogenesis of these conditions.Evidence suggests that metabolic byproducts,such as short-chain fatty acids,lipopolysaccharide and bile acids,which are generated by the gut microbiota,along with neurotransmitters and inflammatory mediators within the gut-brain axis,modulate the host's metabolic processes,neuronal regulation,and immune responses through diverse mechanisms.The interaction between obesity and depression via the gut-brain axis involves disruptions in the gut microbiota balance,inflammatory immune responses,and alterations in the neuroendocrine system.Modulating the gut-brain axis,for example,through a ketogenic diet,the use of probiotics,and the supplementation of antioxidants,offers new remedial approaches for obesity and depression.Future research that explores the mechanisms of the gut-brain axis is needed to provide more evidence for clinical treatment.