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Social Psychiatry and Psychiatric Epidemiology

, Volume 51, Issue 10, pp 1449–1455 | Cite as

Poor mental health status and its associations with demographic characteristics and chronic diseases in Chinese elderly

  • Shibin Wang
  • Bo LiEmail author
  • Gabor S. Ungvari
  • Chee H. Ng
  • Helen F. K. Chiu
  • Changgui Kou
  • Yawen Liu
  • Yuchun Tao
  • Yanhua Wu
  • Yingli Fu
  • Yue Qi
  • Yaqin Yu
  • Yu-Tao XiangEmail author
Original Paper

Abstract

Objective

Although poor mental health is associated with significant personal and societal burden, it is rarely reported in older Chinese populations. This study examined the mental health status of a large representative sample of Chinese elderly in relation to socio-demographic characteristics, lifestyle, and chronic diseases.

Methods

Multistage stratified cluster sampling was used in this cross-sectional study. A total of 4115 people aged between 60 and 79 years were selected and interviewed with standardized assessment tools. The 12-item General Health Questionnaire (GHQ-12) was used to measure general mental health with the total score of ≥4 as the threshold for poor mental health status.

Results

The adjusted percentage of poor mental health status in the whole sample was 23.8 %; 18.5 % in men and 28.9 % in women. Multivariate logistic regression analysis revealed that female gender, widowed/separated marital status, rural abode, low income, poor diet, lack of physical exercise, and multi-morbidity were independently associated with poor mental health. The percentage of poor mental health status was significantly higher in patients with anemia, diabetes, hyperlipidemia, cataract/glaucoma, ischemic heart disease, cerebrovascular diseases, nasopharyngitis, chronic gastroenteritis/peptic ulcer, liver diseases, cholecystitis/gallstone, arthritis, or chronic low back pain.

Conclusion

Given the high rate of poor mental health status among older Chinese population, policy makers and health professionals in China should address the mental health burden of its aging population.

Keywords

Mental health Chronic disease Chinese elderly 

Notes

Acknowledgments

This study was funded by the Scientific Research Foundation of the Health Bureau of Jilin Province, China (Grant Number: 2011Z116).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest related to this study.

References

  1. 1.
    Agborsangaya CB, Lau D, Lahtinen M, Cooke T, Johnson JA (2013) Health-related quality of life and healthcare utilization in multimorbidity: results of a cross-sectional survey. Qual Life Res Intern J Qual Life Asp Treat Care Rehabil 22:791–799CrossRefGoogle Scholar
  2. 2.
    Boey KW, Chiu HFK (2005) Life strain and psychological distress of older women and older men in Hong Kong. Aging Mental Health 9:555–562CrossRefPubMedGoogle Scholar
  3. 3.
    Bowling A (2007) Gender-specific and gender-sensitive associations with psychological health and morbidity in older age. Baseline findings from a British population survey of ageing. Aging Mental Health 11:301–309CrossRefPubMedGoogle Scholar
  4. 4.
    Chiu HF, Yip PS, Chi I, Chan S, Tsoh J, Kwan CW, Li SF, Conwell Y, Caine E (2004) Elderly suicide in Hong Kong—a case-controlled psychological autopsy study. Acta Psychiatr Scand 109:299–305CrossRefPubMedGoogle Scholar
  5. 5.
    Consultation WE (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363:157–163CrossRefGoogle Scholar
  6. 6.
    Cornah D (2006) Cheers? Understanding the relationship between alcohol and mental health. Mental Health Foundation, UKGoogle Scholar
  7. 7.
    do Nascimento KK, Pereira KS, Firmo JO, Lima-Costa MF, Diniz BS, Castro-Costa E (2015) Predictors of incidence of clinically significant depressive symptoms in the elderly: 10-year follow-up study of the Bambui cohort study of aging. Intern J Geriatr Psychiatry 30:1171–1176CrossRefGoogle Scholar
  8. 8.
    Edmans J, Bradshaw L, Gladman JR, Franklin M, Berdunov V, Elliott R, Conroy SP (2013) The Identification of Seniors at Risk (ISAR) score to predict clinical outcomes and health service costs in older people discharged from UK acute medical units. Age Ageing 42:747–753CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Feng Z, Liu C, Guan X, Mor V (2012) China’s rapidly aging population creates policy challenges in shaping a viable long-term care system. Health Aff 31:2764–2773CrossRefGoogle Scholar
  10. 10.
    Fone DL, Dunstan F (2006) Mental health, places and people: a multilevel analysis of economic inactivity and social deprivation. Health Place 12:332–344CrossRefPubMedGoogle Scholar
  11. 11.
    Forsman AK, Nyqvist F, Wahlbeck K (2011) Cognitive components of social capital and mental health status among older adults: a population-based cross-sectional study. Scand J Public Health 39:757–765CrossRefPubMedGoogle Scholar
  12. 12.
    Fortin M, Stewart M, Poitras ME, Almirall J, Maddocks H (2012) A systematic review of prevalence studies on multimorbidity: toward a more uniform methodology. Ann Fam Med 10:142–151CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Fu R, Noguchi H (2016) Does marriage make us healthier? Inter-country comparative evidence from China, Japan, and Korea. PLoS One 11:e0148990CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Gale CR, Harris A, Deary IJ (2016) Reaction time and onset of psychological distress: the UK Health and Lifestyle Survey. J Epidemiol Commun Health 70:813–817. doi: 10.1136/jech-2015-206479 CrossRefGoogle Scholar
  15. 15.
    Gomez-Pinilla F (2008) Brain foods: the effects of nutrients on brain function. Nat Rev Neurosci 9:568–578CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Gorstein J, Sullivan K, Parvanta I, Begin F (2007) Indicators and methods for cross-sectional surveys of vitamin and mineral status of populations. The Micronutrient Initiative (Ottawa) and the Centers for Disease Control and Prevention (Atlanta)Google Scholar
  17. 17.
    Hassanzadeh J, Asadi-Lari M, Ghaem H, Kassani A, Niazi M, Menati R (2016) The Association of Poor Mental Health Status and Sociocultural Factors in Men: A Population-Based Study in Tehran, Iran. Am J Men Health. doi: 10.1177/1557988316630720
  18. 18.
    Jokela M, Batty GD, Kivimaki M (2013) Ageing and the prevalence and treatment of mental health problems. Psychol Med 43:2037–2045CrossRefPubMedGoogle Scholar
  19. 19.
    Katon W, von Korff M, Lin E, Bush T, Ormel J (1992) Adequacy and duration of antidepressant treatment in primary care. Med Care 30:67–76CrossRefPubMedGoogle Scholar
  20. 20.
    Keqing L, Ze C, Lijun C, Qinpu J, Guang S, Haoran W, Jing H, Wuwen Z, Jianguo X, Yanping Z, Ben Z, Jianxun J, Xueyi W, Jun T, Yufu Z, Haishan H, Jianping G, Enyi Z (2008) Epidemiological survey of mental disorders in the people aged 18 and older in Hebei Province. Asian J Psychiatry 1:51–55CrossRefGoogle Scholar
  21. 21.
    Lopresti AL, Hood SD, Drummond PD (2013) A review of lifestyle factors that contribute to important pathways associated with major depression: diet, sleep and exercise. J Affect Disord 148:12–27CrossRefPubMedGoogle Scholar
  22. 22.
    Ma X, Xiang YT, Li SR, Xiang YQ, Guo HL, Hou YZ, Cai ZJ, Li ZB, Li ZJ, Tao YF, Dang WM, Wu XM, Deng J, Ungvari GS, Chiu HF (2008) Prevalence and sociodemographic correlates of depression in an elderly population living with family members in Beijing, China. Psychol Med 38:1723–1730CrossRefPubMedGoogle Scholar
  23. 23.
    Mui AC (2010) Productive ageing in China: a human capital perspective. China J Soc Work 3:111–123CrossRefGoogle Scholar
  24. 24.
    Naimi TS, Stockwell T, Zhao J, Xuan Z, Dangardt F, Saitz R (2016) Selection biases in observational studies affect associations between ‘moderate’ alcohol consumption and mortality. doi: 10.1111/add.13451
  25. 25.
    National Bureau of Statistics of China (2013) China statistical abstract. Beijing, ChinaGoogle Scholar
  26. 26.
    Paul C, Ayis S, Ebrahim S (2006) Psychological distress, loneliness and disability in old age. Psychol Health Med 11:221–232CrossRefPubMedGoogle Scholar
  27. 27.
    Phillips MR, Zhang J, Shi Q, Song Z, Ding Z, Pang S, Li X, Zhang Y, Wang Z (2009) Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey. Lancet 373:2041–2053CrossRefPubMedGoogle Scholar
  28. 28.
    Qu B, Li X, Liu J, Mao J (2012) Analysis of the current situation regarding the aging rural population in China and proposed countermeasures. Popul Health Manag 15:181–185CrossRefPubMedGoogle Scholar
  29. 29.
    Resnick B, Perry D, Applebaum G, Armstrong L, Cotterman M, Dillman S, Elliott S, McCarthy M, Narrett M, Parrish S, Parrish JH (2003) The impact of alcohol use in community-dwelling older adults. J Community Health Nurs 20:135–145CrossRefPubMedGoogle Scholar
  30. 30.
    Schneiderman N, Ironson G, Siegel SD (2005) Stress and health: psychological, behavioral, and biological determinants. Annu Rev Clin Psychol 1:607–628CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Schoenborn CA, Adams PE (2010) Health behaviors of adults: United States, 2005–2007. Vital and health statistics. Series 10, Data from the National Health Survey:1–132Google Scholar
  32. 32.
    Schuckit MA (2009) Alcohol-use disorders. Lancet 373:492–501CrossRefPubMedGoogle Scholar
  33. 33.
    Su D, Wu XN, Zhang YX, Li HP, Wang WL, Zhang JP, Zhou LS (2012) Depression and social support between China’ rural and urban empty-nest elderly. Arch Gerontol Geriatr 55:564–569CrossRefPubMedGoogle Scholar
  34. 34.
    Tian T, Chen Y, Zhu J, Liu P (2015) Effect of air pollution and rural-urban difference on mental health of the elderly in China. Iran J Public Health 44:1084–1094PubMedPubMedCentralGoogle Scholar
  35. 35.
    Unutzer J, Patrick DL, Simon G, Grembowski D, Walker E, Rutter C, Katon W (1997) Depressive symptoms and the cost of health services in HMO patients aged 65 years and older. A 4-year prospective study. JAMA 277:1618–1623CrossRefPubMedGoogle Scholar
  36. 36.
    Walsh R (2011) Lifestyle and mental health. Am Psychol 66:579–592CrossRefPubMedGoogle Scholar
  37. 37.
    Wang S, Kou C, Liu Y, Li B, Tao Y, D’Arcy C, Shi J, Wu Y, Liu J, Zhu Y, Yu Y (2015) Rural-urban differences in the prevalence of chronic disease in northeast China. Asia Pac J Public Health Asia Pac Acad Consort Public Health 27:394–406CrossRefGoogle Scholar
  38. 38.
    Wang SB, D’Arcy C, Yu YQ, Li B, Liu YW, Tao YC, Wu YH, Zhang QQ, Xu ZQ, Fu YL, Kou CG (2015) Prevalence and patterns of multimorbidity in northeastern China: a cross-sectional study. Public health 129:1539–1546CrossRefPubMedGoogle Scholar
  39. 39.
    Wong TS, Xiang YT, Tsoh J, Ungvari GS, Ko FW, Hui DS, Chiu HF (2014) Depressive disorders in older patients with chronic obstructive pulmonary disease (COPD) in Hong Kong: a controlled study. Aging Mental Health 18:588–592CrossRefPubMedGoogle Scholar
  40. 40.
    Xiang Y-T, Yu X, Sartorius N, Ungvari GS, Chiu HFK (2012) Mental health in China: challenges and progress. Lancet 380:1715–1716CrossRefPubMedGoogle Scholar
  41. 41.
    Xiang YT, Ma X, Lu JY, Cai ZJ, Li SR, Xiang YQ, Guo HL, Hou YZ, Li ZB, Li ZJ, Tao YF, Dang WM, Wu XM, Deng J, Lai KY, Ungvari GS (2009) Alcohol-related disorders in Beijing, China: prevalence, socio-demographic correlates, and unmet need for treatment. Alcohol Clin Exp Res 33:1111–1118CrossRefPubMedGoogle Scholar
  42. 42.
    Yamamoto N, Abe Y, Arima K, Nishimura T, Akahoshi E, Oishi K, Aoyagi K (2014) Mental health problems and influencing factors in Japanese women 4 months after delivery. J Physiol Anthropol 33:32CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Yang TZ, Huang L, Wu ZY (2003) The application of Chinese health questionnaire for mental disorder screening in community settings in mainland China. Chin J Epidemio 24:769–773Google Scholar
  44. 44.
    Zhu H, Gu D (2010) The protective effect of marriage on health and survival: does it persist at oldest-old ages? J Popul Aging 3:161–182CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Shibin Wang
    • 1
    • 2
  • Bo Li
    • 1
    Email author
  • Gabor S. Ungvari
    • 3
    • 4
  • Chee H. Ng
    • 5
  • Helen F. K. Chiu
    • 6
  • Changgui Kou
    • 1
  • Yawen Liu
    • 1
  • Yuchun Tao
    • 1
  • Yanhua Wu
    • 1
  • Yingli Fu
    • 1
  • Yue Qi
    • 1
  • Yaqin Yu
    • 1
  • Yu-Tao Xiang
    • 2
    Email author
  1. 1.Department of Epidemiology and Biostatistics, School of Public HealthJilin UniversityChangchunChina
  2. 2.Unit of Psychiatry, Faculty of Health SciencesUniversity of Macau, Avenida da UniversidadeTaipaChina
  3. 3.University of Notre Dame Australia/Marian CentrePerthAustralia
  4. 4.School of Psychiatry and Clinical NeurosciencesUniversity of Western AustraliaPerthAustralia
  5. 5.Department of PsychiatryUniversity of MelbourneMelbourneAustralia
  6. 6.Department of PsychiatryChinese University of Hong KongHong Kong SARChina

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