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Interactions Between Caregiving and Sex and the Antibody Response to COVID-19 Vaccination. 护理和性别与 COVID-19 疫苗接种抗体反应之间的相互作用。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-01 Epub Date: 2024-05-16 DOI: 10.1097/PSY.0000000000001322
Stephen Gallagher, Ruth Ryan, Irene Cassidy, Wenyi Tang, Anna C Whittaker

Objective: Antibody response to vaccination is a powerful paradigm for studying the effects of chronic stress on immune function. In the present study, we used this paradigm to examine the interaction between caregiving (as a type of chronic stress) and sex on the antibody response to a single dose of a COVID-19 vaccination; recent research has called for examination of sex differences on health outcomes among family caregivers. A three-way interaction between caregiving, sex, and psychological distress was also examined.

Methods: COVID-19 antibody data were extracted from 165 caregivers (98 females) and 386 non-caregivers (244 females) from the UK's Understanding Society COVID-19 study. Relevant sociodemographics, health and lifestyle, and distress variables were gathered as potential covariates.

Results: In a 2 × 2 ANOVA, we found that the interaction between caregiving and sex was significant; male caregivers had a lower antibody response to the vaccine compared to female caregivers ( F (1,547), =24.82, p < .001, η2p = 0.043). Following adjustment, male caregivers had the lowest antibody response relative to all other groups. The three-way interaction model, controlling for covariates, was also significant ( R2 = 0.013, p = .049); the conditional effects for the three-way interaction revealed that male caregivers, compared to the other groups, had a lower antibody response at both low and medium levels of psychological distress.

Conclusion: This study found evidence of a three-way interaction between caregiving, sex, and distress on antibody response. Male caregivers had poorer antibody response to a single shot of the COVID-19 vaccination than female caregivers and male and female non-caregivers, and this was evident at low and medium levels of distress. Our findings will be discussed in relation to the caregiver and sex interactions during the pandemic.

目的:接种疫苗后的抗体反应是研究慢性压力对免疫功能影响的一个有力范例。在本研究中,我们利用这一范例研究了护理(慢性压力的一种)和性别对单剂 COVID-19 疫苗接种的抗体反应的交互作用;最近的研究呼吁研究性别差异对家庭护理人员健康结果的影响。此外,还研究了护理、性别和心理压力三者之间的交互作用:从英国 "理解社会 COVID-19 研究 "的 165 名照顾者(98 名女性)和 386 名非照顾者(244 名女性)中提取了 COVID-19 抗体数据。收集了相关的社会人口统计学、健康和生活方式以及痛苦变量作为潜在的协变量:在 2 x 2 方差分析中,我们发现护理与性别之间的交互作用非常显著;与女性护理人员相比,男性护理人员对疫苗的抗体反应较低,F (1,547), =24.82, p < .001, η2 = .043。经调整后,男性护理人员的抗体反应低于所有其他组别。控制协变量的三方交互作用模型也很显著,R2 = .013,p = .049;三方交互作用的条件效应显示,与其他组别相比,男性照顾者在低度和中度心理困扰时的抗体反应都较低:本研究发现,照顾者、性别和心理压力对抗体反应的影响存在三方交互作用。与女性护理人员、男性和女性非护理人员相比,男性护理人员接种一针 COVID-19 疫苗后的抗体反应较差,这在低度和中度心理压力时都很明显。我们将结合大流行期间护理人员与性别之间的相互作用来讨论我们的研究结果。
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引用次数: 0
Evidence-Based Therapist-Supported Digital Mental Health Intervention for Patients Experiencing Medical Multimorbidity: A Retrospective Cohort Intent-to-Treat Study. 对多病症患者进行循证治疗师支持的数字心理健康干预:回顾性队列意向治疗研究》。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-07-01 Epub Date: 2024-05-06 DOI: 10.1097/PSY.0000000000001319
Benjamin W Nelson, Nicholas C Peiper, Kirstin Aschbacher, Valerie L Forman-Hoffman

Objective: Multimorbidity or the co-occurrence of multiple health conditions is increasing globally and is associated with significant psychological complications. It is unclear whether digital mental health (DMH) interventions for patients experiencing multimorbidity are effective, particularly given that this patient population faces more treatment resistance. The goal of the current study was to examine the impact of smartphone-delivered DMH interventions for patients presenting with elevated internalizing symptoms that have reported multiple lifetime medical conditions.

Methods: This preregistered (see https://osf.io/vh2et/ ) retrospective cohort intent-to-treat study with 2819 patients enrolled in a therapist-supported DMH intervention examined the associations between medical multimorbidity (MMB) and mental health outcomes.

Results: Results indicated that more MMB was significantly associated with greater presenting mental health symptom severity. MMB did not have a deleterious influence on depressive symptom trajectories across treatment, although having one medical condition was associated with a steeper decrease in anxiety symptoms compared to patients with no medical conditions. Finally, MMB was not associated with time to dropout, but was associated with higher dropout and was differentially associated with fewer beneficial treatment outcomes, although this is likely attributable to higher presenting symptom severity, rather than lesser symptom reductions during treatment.

Conclusions: Overall, the Meru Health Program was associated with large effect size decreases in depressive and anxiety symptoms regardless of the number of MMB. Future DMH treatments and research might investigate tailored barrier reduction and extended treatment lengths for patients experiencing MMB to allow for greater treatment dose to reduce symptoms below clinical outcome thresholds.

目的:在全球范围内,多病共存或多种健康状况并存的现象日益增多,并且与严重的心理并发症有关。目前尚不清楚针对多病共存患者的数字心理健康(DMH)干预措施是否有效,尤其是考虑到这一患者群体面临更多的治疗阻力。本研究的目的是探讨智能手机提供的 DMH 干预措施对内化症状升高且一生中患有多种疾病的患者的影响:这项预先登记(见 https://osf.io/vh2et/)的回顾性队列意向治疗研究有2819名患者参加,他们接受了治疗师支持的DMH干预,研究了多病医疗(MMB)与心理健康结果之间的关系:结果表明,MMB越多,表现出的心理健康症状越严重。虽然与无病症患者相比,有一种病症会导致焦虑症状的急剧下降,但在整个治疗过程中,多病症并不会对抑郁症状轨迹产生有害影响。最后,MMB与辍学时间无关,但与较高的辍学率有关,并且与较少的有益治疗结果有不同程度的关联,不过这可能是由于出现症状的严重程度较高,而不是在治疗期间症状减轻较少:总体而言,无论MMB的数量如何,MHP都与抑郁症状和焦虑症状的大幅减少有关。未来的DMH治疗和研究可能会为经历MMB的患者量身定制减少障碍和延长治疗时间的方法,以允许更大的治疗剂量将症状减少到临床结果阈值以下。
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引用次数: 0
Affective Responses to Acute Exercise: A Meta-Analysis of the Potential Beneficial Effects of a Single Bout of Exercise on General Mood, Anxiety, and Depressive Symptoms. 急性运动的情绪反应:单次运动对一般情绪、焦虑和抑郁症状的潜在有益影响的荟萃分析。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-07-01 Epub Date: 2024-05-13 DOI: 10.1097/PSY.0000000000001321
Ali A Weinstein, Robbie C M van Aert, Kiersten Donovan, Lotte Muskens, Willem J Kop

Objective: Acute exercise elicits various biobehavioral and psychological responses, but results are mixed with regard to the magnitude of exercise-induced affective reactions. This meta-analysis examines the magnitude of general mood state, anxiety, and depressive symptom responses to acute exercise while exploring exercise protocol characteristics and background health behaviors that may play a role in the affective response.

Methods: A total of 2770 articles were identified from a MEDLINE/PubMed search and an additional 133 articles from reviews of reference sections. Studies had to have measured general mood before the acute exercise bout and within 30 minutes after exercise completion. Effect sizes were estimated using Hedges' g , with larger values indicating improvement in the outcome measure.

Results: A total of 103 studies were included presenting data from 4671 participants. General mood state improved from preexercise to postexercise ( g = 0.336, 95% confidence interval [CI] = 0.234-0.439). Anxiety ( g = 0.497, 95% CI = 0.263-0.730) and depressive symptoms ( g = 0.407, 95% CI = 0.249-0.564) also improved with exercise. There was substantial and statistically significant heterogeneity in each of these meta-analyses. This heterogeneity was not explained by differences in participants' health status. Meta-regression analyses with potential moderators (intensity of exercise, mode of exercise, usual physical activity level, or weight status of participants) also did not reduce the heterogeneity.

Conclusion: This meta-analysis shows significantly improved general mood, decreased anxiety, and lower depressive symptoms in response to an acute bout of exercise. There was substantial heterogeneity in the magnitude of the effect sizes, indicating that additional research is needed to identify determinants of a positive affective response to acute exercise.

目的:急性运动会引起各种生物行为和心理反应,但关于运动引起的情感反应的程度,结果却不尽相同。本荟萃分析研究了急性运动的一般情绪状态、焦虑和抑郁症状反应的程度,同时探讨了可能对情绪反应起作用的运动方案特征和背景健康行为:方法:通过 MEDLINE/PubMed 搜索共找到 2,770 篇文章,另有 133 篇文章来自参考文献部分的综述。研究必须在急性运动前和运动结束后 30 分钟内测量一般情绪。效应大小采用 Hedges'g 估算,数值越大表明结果测量的改善程度越大:结果:共纳入了 103 项研究,提供了 4671 名参与者的数据。从运动前到运动后,总体情绪状态有所改善(g = 0.336,95%CI = 0.234,0.439)。焦虑(g = 0.497,95%CI = 0.263,0.730)和抑郁症状(g = 0.407,95%CI = 0.249,0.564)也随着运动而改善。在每项荟萃分析中都存在大量统计学意义上的异质性。参与者的健康状况差异无法解释这种异质性。对潜在调节因素(运动强度、运动方式、通常的体力活动水平或参与者的体重状况)进行的荟萃回归分析也没有减少异质性:这项荟萃分析表明,急性运动可显著改善一般情绪、减轻焦虑和抑郁症状。效应大小存在很大的异质性,这表明还需要进行更多的研究,以确定急性运动产生积极情绪反应的决定因素。
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引用次数: 0
Depressive Symptoms, Socioeconomic Position, and Mortality in Older People Living With and Beyond Cancer. 患有癌症及癌症后老年人的抑郁症状、社会经济地位和死亡率。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-07-01 Epub Date: 2024-03-18 DOI: 10.1097/PSY.0000000000001294
Natalie Ella Miller, Abigail Fisher, Philipp Frank, Phillippa Lally, Andrew Steptoe

Objective: Evidence shows that higher depressive symptoms are associated with mortality among people living with and beyond cancer (LWBC). However, prior studies have not accounted for a wider range of potential confounders, and no study has explored whether socioeconomic position (SEP) moderates the association. This study aimed to examine the association between depressive symptoms and mortality among people LWBC, and moderation by SEP.

Methods: Participants from the English Longitudinal Study of Aging, diagnosed with cancer and with a measure of depressive symptoms within 4 years after their diagnosis, were included. Elevated depressive symptoms were indicated by a score of ≥3 on the eight-item Center for Epidemiologic Studies Depression Scale. Cox regression models examined associations with all-cause mortality. Competing risk regression examined associations with cancer mortality.

Results: In 1352 people LWBC (mean age = 69.6 years), elevated depressive symptoms were associated with a 93% increased risk of all-cause mortality (95% confidence interval = 1.52-2.45) within the first 4 years of follow-up and a 48% increased risk within a 4- to 8-year follow-up (95% confidence interval = 1.02-2.13) after multivariable adjustment. Elevated depressive symptoms were associated with a 38% increased risk of cancer mortality, but not after excluding people who died within 1 year after baseline assessments. There were no interactions between depressive symptoms and SEP.

Conclusions: Elevated depressive symptoms are associated with a greater risk of all-cause mortality among people LWBC within an 8-year follow-up period. Associations between depressive symptoms and cancer mortality might be due to reverse causality.

目的:有证据表明,抑郁症状越严重,癌症患者和癌症晚期患者(LWBC)的死亡率就越高。然而,之前的研究并没有考虑到更广泛的潜在混杂因素,也没有研究探讨社会经济地位(SEP)是否会调节这种关联。本研究旨在探讨 LWBC 患者中抑郁症状与死亡率之间的关系,以及社会经济地位对两者关系的调节作用:研究对象包括英国老龄化纵向研究(ELSA)中确诊为癌症并在确诊后四年内出现抑郁症状的参与者。8项流行病学研究中心抑郁量表(CES-D)得分≥3分表示抑郁症状加重。Cox 回归模型检验了与全因死亡率的关系。竞争风险回归研究了与癌症死亡率的关系:在 1352 名 LWBC 患者(平均年龄 = 69.6 岁)中,抑郁症状加重与随访前四年内全因死亡风险增加 93% 相关(95% CI:1.52-2.45),经多变量调整后,与随访四至八年内全因死亡风险增加 48% 相关(95% CI:1.02-2.13)。抑郁症状升高与癌症死亡风险增加 38% 有关,但在排除基线评估后一年内死亡的人群后,抑郁症状升高与癌症死亡风险增加不相关。抑郁症状与SEP之间不存在交互作用:结论:在八年的随访期内,抑郁症状的升高与LWBC患者全因死亡风险的增加有关。抑郁症状与癌症死亡率之间的关联可能是由于反向因果关系造成的。
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引用次数: 0
Depression, Inflammation, and the Moderating Role of Metformin: Results From the Midlife in the United States Study and Sacramento Area Latino Study on Aging. 抑郁症、炎症和二甲双胍的调节作用:来自美国中年研究(MIDUS)和萨克拉门托地区拉丁裔老龄化研究(SALSA)的结果。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-06-01 Epub Date: 2023-10-24 DOI: 10.1097/PSY.0000000000001257
Sumaiyah U Syed, Jared I Cortez, Stephanie J Wilson

Objective: Depression can promote inflammation and accelerate aging. Metformin, a widely prescribed antidiabetic, has shown promising preclinical evidence of aging-related health benefits, including decreased inflammation. The current study examined whether metformin usage buffers the association between depressive symptoms and inflammatory markers in two large samples of middle-aged and older, primarily White adults, and older Latino adults.

Methods: Data from the Midlife in the United States Study ( N = 1255) and the Sacramento Area Latino Study on Aging ( N = 1786) included information on medication use, depressive symptoms, and inflammatory markers, namely, interleukin 6 (IL-6), tumor necrosis factor α, and C-reactive protein (CRP). These data were merged into a harmonized sample, and the sample group variable was included in a three-way interaction for analysis.

Results: Specifically, in the Midlife in the United States Study sample, metformin buffered the association between depressive symptoms and CRP ( b = -0.029, standard error [SE] = 0.013, p = .007) and IL-6 ( b = 0.21, SE = 0.010, p = .046), whereas no significant association was found with tumor necrosis factor α. Metformin nonusers displayed higher depressive symptoms associated with elevated CRP ( b = 0.01, SE = 0.003, p < .001) and IL-6 ( b = 0.011, SE = 0.003, p < .001), whereas this association was not present among metformin users ( p values > .068). Conversely, in the Sacramento Area Latino Study on Aging sample, metformin use did not show a significant protective link.

Conclusions: Results from mostly White, highly educated adults supported a mitigating role of metformin in ties between depression, a well-known behavioral risk factor, and inflammation, a key source of biological aging. However, the benefits did not extend to a large sample of older Mexican Americans. The findings reveal a hidden potential benefit of this therapeutic agent and raise important questions around its health equity.

Trial registration: The study was preregistered on OSF ( https://osf.io/c92vw/ ).

目的:抑郁症能促进炎症,加速衰老。二甲双胍是一种广泛使用的抗糖尿病药物,已显示出与衰老相关的健康益处的有希望的临床前证据,包括减少炎症。目前的研究考察了二甲双胍的使用是否能缓冲两个大样本中老年人(主要是白人成年人和拉丁裔老年人)的抑郁症状和炎症标志物之间的关联。方法:来自美国中年研究(MIDUS;N=1255)和萨克拉门托地区拉丁裔老龄化研究(SALSA;N=1786)的数据包括药物使用、抑郁症状和炎症标志物,即IL-6、TNF-α和CRP的信息。将这些数据合并到一个统一的样本中,并将样本组变量纳入三方交互作用中进行分析。结果:具体而言,在MIDUS样本中,二甲双胍缓冲了抑郁症状与CRP(b=0.029,SE=0.013,p=0.007)和IL-6(b=0.21,SE=0.010,p=0.046)之间的相关性,而与TNF-α没有发现显著相关性。非二甲双胍使用者表现出较高的抑郁症状,与CRP(b=0.01,SE=0.003,p<.001)和IL-6(b=0.011,SE=0.0003,p<0.001)升高相关,而二甲双胍使用者中不存在这种相关性(p>.068)。相反,在SALSA样本中,二甲双胍的使用没有显示出显著的保护作用。结论:大多数受过高等教育的白人成年人的研究结果支持二甲双胍在抑郁症(一种众所周知的行为风险因素)和炎症(生物衰老的关键来源)之间的关系中的缓解作用。然而,这些福利并没有扩大到大量墨西哥裔老年美国人。研究结果揭示了这种治疗剂隐藏的潜在益处,并围绕其健康公平性提出了重要问题。试验注册:该研究已在OSF上预先注册(https://osf.io/c92vw/)。
{"title":"Depression, Inflammation, and the Moderating Role of Metformin: Results From the Midlife in the United States Study and Sacramento Area Latino Study on Aging.","authors":"Sumaiyah U Syed, Jared I Cortez, Stephanie J Wilson","doi":"10.1097/PSY.0000000000001257","DOIUrl":"10.1097/PSY.0000000000001257","url":null,"abstract":"<p><strong>Objective: </strong>Depression can promote inflammation and accelerate aging. Metformin, a widely prescribed antidiabetic, has shown promising preclinical evidence of aging-related health benefits, including decreased inflammation. The current study examined whether metformin usage buffers the association between depressive symptoms and inflammatory markers in two large samples of middle-aged and older, primarily White adults, and older Latino adults.</p><p><strong>Methods: </strong>Data from the Midlife in the United States Study ( N = 1255) and the Sacramento Area Latino Study on Aging ( N = 1786) included information on medication use, depressive symptoms, and inflammatory markers, namely, interleukin 6 (IL-6), tumor necrosis factor α, and C-reactive protein (CRP). These data were merged into a harmonized sample, and the sample group variable was included in a three-way interaction for analysis.</p><p><strong>Results: </strong>Specifically, in the Midlife in the United States Study sample, metformin buffered the association between depressive symptoms and CRP ( b = -0.029, standard error [SE] = 0.013, p = .007) and IL-6 ( b = 0.21, SE = 0.010, p = .046), whereas no significant association was found with tumor necrosis factor α. Metformin nonusers displayed higher depressive symptoms associated with elevated CRP ( b = 0.01, SE = 0.003, p < .001) and IL-6 ( b = 0.011, SE = 0.003, p < .001), whereas this association was not present among metformin users ( p values > .068). Conversely, in the Sacramento Area Latino Study on Aging sample, metformin use did not show a significant protective link.</p><p><strong>Conclusions: </strong>Results from mostly White, highly educated adults supported a mitigating role of metformin in ties between depression, a well-known behavioral risk factor, and inflammation, a key source of biological aging. However, the benefits did not extend to a large sample of older Mexican Americans. The findings reveal a hidden potential benefit of this therapeutic agent and raise important questions around its health equity.</p><p><strong>Trial registration: </strong>The study was preregistered on OSF ( https://osf.io/c92vw/ ).</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"473-483"},"PeriodicalIF":2.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11039570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71426354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fulfilled Mind, Healthy Gut? Relationships of Eudaimonic Psychological Well-Being With the Gut Microbiome in Postmenopausal Women. 充实的心灵,健康的肠道?绝经后妇女的快乐心理与肠道微生物组的关系。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-06-01 Epub Date: 2024-01-15 DOI: 10.1097/PSY.0000000000001278
Anne-Josee Guimond, Shanlin Ke, Shelley S Tworoger, Tianyi Huang, Andrew T Chan, Laura D Kubzansky, Yang-Yu Liu

Objective: Eudaimonic facets of psychological well-being (PWB), like purpose in life and sense of mastery, are associated with healthy aging. Variation in the gut microbiome may be one pathway by which mental health influences age-related health outcomes. However, associations between eudaimonic PWB and the gut microbiome are understudied. We examined whether purpose in life and sense of mastery, separately, were associated with features of the gut microbiome in older women.

Methods: Participants were from the Mind-Body Study ( N = 206, mean age = 61 years), a substudy of the Nurses' Health Study II cohort. In 2013, participants completed the Life Engagement Test and the Pearlin Mastery Scale. Three months later, up to two pairs of stool samples were collected, 6 months apart. Covariates included sociodemographics, depression, health status, and health behaviors. Analyses examined associations of PWB with gut microbiome taxonomic diversity, overall community structure, and specific species/pathways. To account for multiple testing, statistical significance was established using Benjamini-Hochberg adjusted p values (i.e., q values ≤0.25).

Results: We found no evidence of an association between PWB and gut microbiome alpha diversity. In multivariate analysis, higher purpose levels were significantly associated with lower abundance of species previously linked with poorer health outcomes, notably Blautia hydrogenotrophica and Eubacterium ventriosum ( q values ≤0.25). No significant associations were found between PWB and metabolic pathways.

Conclusions: These findings offer early evidence suggesting that eudaimonic PWB is linked with variation in the gut microbiome, and this might be one pathway by which PWB promotes healthy aging.

目的:心理幸福感(PWB)的优美方面,如生活目标和主人翁感,与健康老龄化有关。肠道微生物组的变化可能是心理健康影响与年龄相关的健康结果的途径之一。然而,人们对美满生活目标和肠道微生物组之间的关系研究不足。我们研究了生活目标和主人翁感是否分别与老年女性肠道微生物组的特征有关:参与者来自身心研究(N = 206,平均年龄 = 61),这是护士健康研究 II 队列的一项子研究。2013年,参与者完成了 "生活参与测试 "和 "皮尔林掌握量表"。三个月后,他们采集了多达两对粪便样本,间隔时间为 6 个月。协变量包括社会人口统计学、抑郁症、健康状况和健康行为。分析检验了PWB与肠道微生物组分类多样性、整体群落结构和特定物种/途径之间的关联。为了考虑多重检验,使用本杰明-霍奇伯格调整后的 p 值(即 q 值≤0.25)来确定统计显著性:结果:我们没有发现任何证据表明肺结核与肠道微生物组阿尔法多样性之间存在关联。在多变量分析中,目的水平越高,以前与较差健康结果相关的物种丰度就越低,尤其是嗜氢布劳氏菌(Blautia hydrogenotrophica)和通风杆菌(Eubacterium ventriosum)(q值≤0.25)。在脉搏波和代谢途径之间没有发现明显的关联:这些研究结果提供了早期证据,表明愉悦性脉搏波速度与肠道微生物组的变化有关,这可能是脉搏波速度促进健康老龄化的途径之一。
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引用次数: 0
Mindfulness-Based Stress Reduction Reduces Proinflammatory Gene Regulation But Not Systemic Inflammation Among Older Adults: A Randomized Controlled Trial. 一项随机对照试验:正念减压可减少老年人的促炎基因调节,但不能减少全身性炎症。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-06-01 Epub Date: 2023-11-17 DOI: 10.1097/PSY.0000000000001264
Emily K Lindsay, Anna L Marsland, Steven W Cole, Janine M Dutcher, Carol M Greco, Aidan G C Wright, Kirk Warren Brown, John David Creswell

Objective: Aging is associated with increased proinflammatory gene expression and systemic inflammation, and psychosocial stress may accelerate these changes. Mindfulness interventions show promise for reducing psychosocial stress and extending healthspan. Inflammatory pathways may play a role. In a sample of lonely older adults, we tested whether mindfulness training reduces proinflammatory gene expression and protein markers of systemic inflammation.

Methods: Lonely older adults (65-85 years; N = 190) were randomly assigned to an 8-week Mindfulness-Based Stress Reduction (MBSR) or matched Health Enhancement Program (HEP). Blood was drawn before and after the intervention and at 3-month follow-up. In peripheral blood mononuclear cells, RNA profiling was used to assess transcriptional regulation by proinflammatory nuclear factor κB (NF-κB) as well as β-adrenergic cAMP response element-binding protein (CREB), antiviral interferon regulatory factor (IRF), and glucocorticoid receptor (GR) transcription factors. Plasma was assayed for proinflammatory markers interleukin 6 (IL-6) and C-reactive protein (CRP). Analyses tested time (pre, post, follow-up) by condition (MBSR versus HEP) effects.

Results: MBSR reduced NF-κB ( d = 0.17, p = .028) but did not alter CREB ( d = 0.10, p = .20), IRF ( d = 0.13, p = .086), or GR activity ( d = 0.14, p = .063) relative to HEP over time. Contrary to predictions, there were no time by condition effects of MBSR compared with HEP on reducing circulating IL-6 or CRP.

Conclusions: In lonely older adults, MBSR reduced cellular proinflammatory gene regulation in ways that would predict reduced disease risk. However, no similar effect was observed for circulating protein markers of inflammation. These results provide specificity about how mindfulness interventions may impact distinct inflammatory markers among aging adults in ways that may have important implications for healthspan.

Trial registration: Clinical Trials identifier NCT02888600.

目的:衰老与促炎基因表达增加和全身性炎症有关,而心理社会压力可能加速这些变化。正念干预显示出减少心理社会压力和延长健康寿命的希望。炎症途径可能起作用。在一个孤独的老年人样本中,我们测试了正念训练是否会减少促炎基因表达和全身性炎症的蛋白质标志物。方法:65 ~ 85岁孤独老年人;N = 190)被随机分配到8周的正念减压(MBSR)或匹配的健康增强计划(HEP)。在干预前后和随访3个月时抽血。在外周血单核细胞(PBMCs)中,RNA谱分析用于评估促炎NF-kB、β-肾上腺素能CREB、抗病毒IRF和糖皮质激素受体(GR)转录因子的转录调节。检测血浆促炎标志物IL-6和CRP。分析测试时间(前,后,随访)的条件(MBSR与HEP)的影响。结果:随着时间的推移,MBSR降低了NF-kB (d = 0.17, p = 0.028),但没有改变相对于HEP的CREB (d = 0.10, p = 0.20)、IRF (d = 0.13, p = 0.086)或GR活性(d = 0.14, p = 0.063)。与预测相反,与HEP相比,MBSR在降低循环IL-6或CRP方面没有时间×条件效应。结论:在孤独的老年人中,正念减压可以降低细胞促炎基因的调节,从而预测疾病风险的降低。然而,在循环炎症蛋白标记物中没有观察到类似的效果。这些结果提供了正念干预如何影响老年人不同炎症标志物的特异性,这可能对健康寿命有重要影响。试验注册:临床试验标识符NCT02888600。
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引用次数: 0
Article Summaries for June 2024 Psychosomatic Medicine, Volume 86, Issue 5. 2024 年 6 月文章摘要 《心身医学》第 86 卷第 5 期。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-06-01 DOI: 10.1097/PSY.0000000000001325
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引用次数: 0
Older Adults' Social Profiles and Links to Functional and Biological Aging in the United States and Mexico. 美国和墨西哥老年人的社会概况及其与功能性和生物性衰老的联系。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-06-01 Epub Date: 2023-09-06 DOI: 10.1097/PSY.0000000000001248
Stephanie J Wilson, Christina M Marini

Objective: Social stress-loneliness, isolation, and low relationship quality-increase risks of aging-related diseases. However, the ways in which they intersect to undermine healthy aging remain poorly understood. We used latent class analysis to identify groups of older adults based on their social stress in both the United States and Mexico. Thereafter, we examined their cross-sectional associations with markers of functional and biological aging.

Method: Participants in the Health and Retirement Study (HRS; N = 8316) and Mexican Health and Aging Study (MHAS; N = 15,001) reported their loneliness, isolation (i.e., living alone), and relationship quality with spouse, children, and friends. Outcomes included C-reactive protein, functional limitations, self-rated health, comorbidities, gait speed, and grip strength. Models controlled for demographics, health behaviors, and body mass index.

Results: In both countries, five classes emerged, a supported group and four with elevated social stress: a) strained, b) isolated, c) spousal ambivalence, and d) unhappily married. Compared with the others, strained participants in both samples had greater functional limitations, poorer self-rated health, and more comorbidities, as well as slower gait in HRS and weaker grip in MHAS. Generally, supported participants fared better than the other groups. In HRS, C-reactive protein levels differed between the strained group and others, but these associations were explained by health behaviors and body mass index.

Conclusions: Older adults in both countries with strained relationships fared worst in their aging-related outcomes, revealing new insights about the links between toxic social stress and unhealthy aging.

目的:社会压力--孤独、孤立和低关系质量--会增加与衰老相关的疾病风险。然而,人们对这些因素如何交织在一起破坏健康老龄化仍然知之甚少。我们使用潜类分析法,根据美国和墨西哥老年人的社会压力来识别他们的群体。之后,我们研究了他们与功能性和生物性衰老标志物之间的横截面关联:健康与退休研究(HRS;N = 8316)和墨西哥健康与老龄化研究(MHAS;N = 15001)的参与者报告了他们的孤独感、孤立感(即独居)以及与配偶、子女和朋友的关系质量。研究结果包括 C 反应蛋白、功能限制、自评健康状况、合并症、步速和握力。模型对人口统计学、健康行为和体重指数进行了控制:在这两个国家中,出现了五个等级,一个是得到支持的组别,四个是社会压力较大的组别:a) 紧张型、b) 孤立型、c) 配偶矛盾型和 d) 婚姻不幸福型。与其他参与者相比,两个样本中的紧张参与者都有更大的功能限制、更差的自我健康评价和更多的合并症,在 HRS 中步态更慢,在 MHAS 中握力更弱。一般来说,得到支持的参与者的情况要好于其他组别。在HRS中,劳损组与其他组的C反应蛋白水平不同,但这些关联可通过健康行为和体重指数来解释:结论:人际关系紧张的两国老年人在衰老相关的结果中表现最差,揭示了有毒社会压力与不健康衰老之间联系的新见解。
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引用次数: 0
New Directions in Geroscience: Integrating Social and Behavioral Drivers of Biological Aging. 老年科学的新方向:整合生物衰老的社会和行为驱动因素。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-06-01 Epub Date: 2024-05-09 DOI: 10.1097/PSY.0000000000001320
Lisbeth Nielsen, Anna L Marsland, Elissa J Hamlat, Elissa S Epel

Abstract: The "geroscience hypothesis" posits that slowing the physiological processes of aging would lead to delayed disease onset and longer healthspan and lifespan. This shift from a focus on solely treating existing disease to slowing the aging process is a shift toward prevention, including a focus on risk factors found in the social environment. Although geroscience traditionally has focused on the molecular and cellular drivers of biological aging, more fundamental causes of aging may be found in the social exposome-the complex array of human social environmental exposures that shape health and disease. The social exposome may interact with physiological processes to accelerate aging biology. In this commentary, we review the potential of these insights to shape the emerging field of translational geroscience. The articles in this special issue highlight how social stress and social determinants of health are associated with biomarkers of aging such as inflammation, epigenetic clocks, and telomeres, and spotlight promising interventions to mitigate stress-related inflammation. For geroscience to incorporate the social exposome into its translational agenda, studies are needed that elucidate and quantify the effects of social exposures on aging and that consider social exposures as intervention targets. The life course perspective allows us to measure both exposures and aging biology over time including sensitive periods of development and major social transitions. In addition, given rapid changes in the measurement of aging biology, which include machine learning techniques, multisystem phenotypes of aging are being developed to better reflect whole body aging, replacing reliance on single system biomarkers. In this expanded and more integrated field of translational geroscience, strategies targeting factors in the social exposome hold promise for achieving aging health equity and extending healthy longevity.

摘要:"地球科学假说 "认为,减缓衰老的生理过程将导致疾病的延迟发生,并延长健康和寿命。这种从单纯治疗现有疾病到延缓衰老过程的转变是向预防的转变,包括关注社会环境中的风险因素。虽然地球科学传统上一直关注生物衰老的分子和细胞驱动因素,但衰老的更根本原因可能存在于社会暴露体中,即影响健康和疾病的一系列复杂的人类社会环境暴露。社会暴露组可能会与生理过程相互作用,加速生物衰老。在这篇评论中,我们回顾了这些见解在塑造新兴的转化地球科学领域方面的潜力。本特刊中的文章强调了社会压力和健康的社会决定因素如何与炎症、表观遗传时钟和端粒等衰老生物标志物相关联,并重点介绍了缓解压力相关炎症的有前景的干预措施。要想让地球科学将社会暴露组纳入其转化议程,就需要开展研究,阐明和量化社会暴露对衰老的影响,并将社会暴露视为干预目标。从生命过程的角度来看,我们可以测量一段时间内的暴露和衰老生物学,包括敏感的发展期和重大的社会转型。此外,由于衰老生物学测量方法(包括机器学习技术)的快速变化,正在开发多系统衰老表型,以更好地反映全身衰老,取代对单一系统生物标志物的依赖。在这一扩展和更加综合的转化地球科学领域,针对社会暴露组因素的战略有望实现老龄化健康公平和延长健康长寿。
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Psychosomatic Medicine
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