Browsing by Author "Fuller‑Thomson, Esme"
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- ItemClose relations matter: the association between depression and refugee status in the Canadian Longitudinal Study on Aging (CLSA)(2020) Lin, Shen (Lamson); Kobayashi, Karen M.; Tong, Hongmei; Davison, Karen M.; Arora, Simran R. A.; Fuller‑Thomson, EsmeThis study examined the prevalence and social determinants of depression among refugee and non-refugee adults aged 45–85 in the Canadian Longitudinal Study on Aging. Bivariate analyses and multivariable binary logistic regression analyses were conducted. The prevalence of depression was higher in a sample of 272 refugees (22.1%) and 5059 non-refugee immigrants (16.6%), compared to 24,339 native-born Canadians (15.2%). The adjusted odds ratio (aOR) of depression for refugees were not attenuated when controlling factors such as, (1) socioeconomic status, (2) health conditions and behaviours, (3) social isolation and online social networking (aORs range from 1.61 to 1.70, p’s < 0.05). However, when social support representing close personal relationships was included, the odds of depression for refugees were reduced to non-significance (aOR = 1.30, 95% CI 0.97–1.74, p = 0.08). Refugees’ excess vulnerability to depression is mainly attributable to lower levels of affectionate social support. Targeted interventions in nurturing supportive interpersonal relationships for refugees are warranted.
- ItemDepression in middle and older adulthood: the role of immigration, nutrition, and other determinants of health in the Canadian longitudinal study on aging(2019) Davison, Karen M.; Lung, Yu; Lin, Shen (Lamson); Tong, Hongmei; Kobayashi, Karen M.; Fuller‑Thomson, EsmeBackground: Little is known about depression in middle-aged and older Canadians and how it is affected by health determinants, particularly immigrant status. This study examined depression and socio-economic, health, immigration and nutrition-related factors in older adults. Methods: Using weighted comprehensive cohort data from the baseline Canadian Longitudinal Study on Aging (n = 27,162) of adults aged 45–85, gender-specific binary logistic regression was conducted with the cross-sectional data using the following variables: 1) Depression (outcome) measured using the Center for Epidemiologic Studies Short Depression (CESD-10) rating scale; 2) Immigration status: native-born, recent and mid-term (< 20 years), and long-term immigrants (≥20 years); and 3) covariates: socioeconomic status, physical health (e.g., multi-morbidity), health behavior (e.g., substance use), over-nutrition (e.g., anthropometrics), under-nutrition (e.g., nutrition risk), and dietary intake. Results: The sample respondents were mainly Canadian-born (82.6%), women (50.6%), 56–65 years (58.9%), earning between C$50,000–99,999 (33.2%), and in a relationship (69.4%). When compared to Canadian-born residents, recent, mid-term (< 20 years), and longer-term (≥ 20 years) immigrant women were more likely to report depression and this relationship was robust to adjustments for 32 covariates (adjusted ORs = 1.19, 2.54, respectively, p < 0.001). For women, not completing secondary school (OR = 1.23, p < 0.05), stage 1 hypertension (OR = 1.31, p < 0.001), chronic pain (OR = 1.79, p < 0.001), low fruit/vegetable intakes (OR = 1.33, p < 0.05), and fruit juice (OR = 1.80, p < 0.001), chocolate (ORs = 1.15–1.66, p’s < 0.05), or salty snack (OR = 1.19, p < 0.05) consumption were associated with depression. For all participants, lower grip strength (OR = 1.25, p < 0.001) and high nutritional risk (OR = 2.24, p < 0.001) were associated with depression. For men, being in a relationship (OR = 0.62, p < 0.001), completing postsecondary education (OR = 0.82, p < 0.05), higher fat (ORs = 0.67–83, p’s < 0.05) and omega-3 egg intake (OR = 0.86, p < 0.05) as well as moderate intakes of fruits/vegetables and calcium/high vitamin D sources (ORs = 0.71–0.743, p’s < 0.05) predicted a lower likelihood of depression. For men, chronic conditions (ORs = 1.36–3.65, p’s < 0.001), chronic pain (OR = 1.86, p < 0.001), smoking (OR = 1.17, p < 0.001), or chocolate consumption (ORs = 1.14–1.72, p’s < 0.05) predicted a higher likelihood of depression. Conclusions: The odds of developing depression were highest among immigrant women. Depression in middleaged and older adults is also associated with socioeconomic, physical, and nutritional factors and the relationships differ by sex. These results provide insights for mental health interventions specific to adults aged 45–85.
- ItemNutrition, immigration and health determinants are linked to verbal fluency among Anglophone adults in the Canadian Longitudinal Study on Aging (CLSA)(2020) Fuller‑Thomson, Esme; Saab, Zahraa; Davison, Karen M.; Lin, Shen (Lamson); Taler, Vanessa; Kobayashi, Karen M.; Tong, HongmeiLater-life cognitive impairment is an important health issue; however, little is known about the condition among diverse groups such as immigrants. This study aims to examine whether the healthy immigrant effect exists for verbal fluency, an indicator of cognitive functioning, among anglophone middleaged and older adults in Canada. Methods: Using from the baseline data of the Canadian Longitudinal Study on Aging (CLSA), multiple linear regression was employed to compare associations among immigrants (recent and long-term) and Canadian-born residents without dementia for two verbal fluency tests, the Controlled Oral Word Association Test (COWAT) and the Animal Fluency (AF) task. Covariates included socioeconomic, physical health, and dietary intake. Results: Of 8,574 anglophone participants (85.7% Canada-born, 74.8% aged 45-65 years, 81.8% married, 81.9% with a post-secondary degree), long-term immigrants (settled in Canada >20 years) performed significantly better than Canadian-born residents for the COWAT (42.8 vs 40.9) but not the AF task (22.4 vs 22.4). Results of the multivariable adjusted regression analyses showed that long-term immigrants performed better than Canadian-born peers in both the COWAT (B=1.57, 95% CI: 0.80-2.34) and the AF test (B=0.57, 95% CI: 0.19-0.95), but this advantage was not observed among recent immigrants. Other factors associated with low verbal fluency performance included being single, socioeconomically disadvantaged, having hypertension, excess body fat, and consuming low amounts of pulses/nuts or fruit/vegetables. Conclusions: Long-term immigrants had higher verbal fluency test scores than their Canadian-born counterparts. Immigration status, social, health and nutritional factors are important considerations for possible intervention and prevention strategies for cognitive impairment.
- ItemNutritional factors, physical health and immigrant status are associated with anxiety disorders among middle-aged and older adults: findings from baseline data of the Canadian longitudinal study on aging (CLSA)(2020) Davison, Karen M.; Lin, Shen (Lamson); Tong, Hongmei; Kobayashi, Karen M.; Mora-Almanza, Jose G.; Fuller‑Thomson, EsmeThe main purpose of this study was to compare the lifetime prevalence of anxiety disorders among foreign-born and Canadian-born adults in middle and later life. Using baseline data of the Canadian Longitudinal Study on Aging (2010–2015), multivariable binary logistic regression was conducted to investigate anxiety diagnosis and immigrant status, while controlling for socio-economic, health-related, and nutrition covariates. Of 26,991 participants (49.3% men, 82.5% Canadian born, 58.5% aged 45–65 years), the overall prevalence of self-reported physician diagnosis of anxiety disorders was 8.5%, with immigrants being lower than Canadian-born respondents (6.4% vs. 9.3%, p < 0.001). After accounting for all covariates, the adjusted odds ratio (aOR) for anxiety disorders was lower among immigrants (aOR = 0.77, 95% CI: 0.67–0.88) compared to those who were Canadian born. Identified risk factors included: younger age (aORs = 1.79–3.52), being a woman (aOR = 1.25, 95% CI: 1.07–1.46), single status (aOR = 1.27, 95% CI: 1.09–1.48), lower income (aORs = 1.28–2.68), multi-morbidities (aORs = 2.73–5.13), chronic pain (aOR = 1.31, 95% CI: 1.18–1.44), lifetime smoking ≥ 100 cigarettes (aOR = 1.35, 95% CI: 1.23–1.48), BMI < 18.5 (aOR = 1.87, 95% CI: 1.20–2.92), body fat ≥ 26% (aORs = 1.28–1.79), fruit and vegetable intake (<3/day; aORs = 1.24–1.26), and pastry consumption (>1/day; aOR = 1.55, 95% CI: 1.12–1.15) (p < 0.05). Targeting socio-economic and nutritional risk factors may reduce the burden of anxiety disorders in middle and late adulthood.
- ItemPost‑traumatic stress disorder (PTSD) in mid‑age and older adults difers by immigrant status and ethnicity, nutrition, and other determinants of health in the Canadian Longitudinal Study on Aging (CLSA)(2021) Davison, Karen M.; Hyland, Christina E.; West, Meghan L.; Lin, Shen (Lamson); Tong, Hongmei; Kobayashi, Karen M.; Fuller‑Thomson, EsmeThis study aimed to address knowledge gaps about post-traumatic stress disorder (PTSD) in mid-age and older adults, with particular attention to the relationship of PTSD with nutrition and with ethnicity and immigrant status.
- ItemPsychological distress in older adults linked to immigrant status, dietary intake, and physical health conditions in the Canadian Longitudinal Study on Aging (CLSA)(2020) Davison, Karen M.; Lung, Yu; Lin, Shen (Lamson); Tong, Hongmei; Kobayashi, Karen M.; Fuller‑Thomson, EsmeBackground Psychological distress increases mortality risk; there is little knowledge about its prevelance and contributory factors in older populations. Methods Canadian Longitudinal Study on Aging baseline data (2010–2015) were analyzed to examine the relationship between Kessler's Psychological Distress Scale-K10 and immigrant status (recent/mid-term,<20 years; long-term, ≥20 years; Canadian-born). Covariates included socioeconomic and health-related variables. Stratified by sex, two series of multinomial logistic regression were used to calculate the likelihood of having mild distress (20 < K10 score ≤24) and moderate/severe distress (K10 score >24). Results Respondents (n = 25,700) were mainly Canadian-born (82.8%), 45–65 years (59.3%), earning cut-off; OR=1.32, 99% CI 1.02–1.70), and higher nutritional risk (ORs = 2.16–3.31, p's <0.001). For men, psychological distress was associated with under-nutrition (grip strength56 years, ORs=0.19–0.79, p's<0.01), lower income (≤C$149,000, ORs = 1.68–7.79, p's<0.01), multi-morbidities (ORs = 1.67–4.70, p's<0.01), chronic pain (ORs = 1.67–3.09, p's<0.001) and higher intake of chocolate (≥ 0.6 bar/week, ORs=1.61–2.23, p's<0.001). Limitations Cross-sectional design prohibits causal inferences. Conclusions Nutritional factors, immigration status, social, and health-related problems are strongly associated with psychological distress among midlife and older adults.
- ItemRefugee status is associated with double the odds of psychological distress in mid-to-late life: findings from the Canadian longitudinal study on aging(2020) Tong, Hongmei; Lung, Yu; Lin, Shen (Lamson); Kobayashi, Karen M.; Davison, Karen M.; Agbeyaka, Senyo; Fuller‑Thomson, EsmePsychological distress is associated with a range of negative outcomes including lower quality of life and an increased risk of premature all-cause mortality. The prevalence of, and factors associated with, psychological distress among middle-aged and older Canadians are understudied. Using the Canadian Longitudinal Study on Aging (CLSA) baseline data, this study examined factors associated with psychological distress among adults between 45 and 85 years, including refugee status and a wide range of sociodemographic, health-related and social support characteristics. Psychological distress was measured by Kessler’s Psychological Distress Scale-K10 scores. Bivariate and multivariable binary logistic regression analyses were conducted. The prevalence of psychological distress was significantly higher among the 244 refugees (23.8%), compared to 23,149 Canadian-born Canadians (12.8%) and 4,765 non-refugee immigrants (12.6%), despite the fact that the average time the refugees had lived in Canada was more than four decades. The results of the binary logistic regression analysis indicated refugees had twice the age-sex adjusted odds of psychological distress (OR = 2.31, 95% CI: 1.74, 3.07). Even after further adjustment for 16 potential risk factors, a significant relationship remained between refugee status and psychological distress (OR = 1.56; 95% CI = 1.12, 2.17). Other significant factors associated with psychological distress included younger age, female gender, visible minority status, lower household income, not having an undergraduate degree, multimorbidities, chronic pain, and lack of social support. Policies and interventions addressing psychological distress among Canadians in mid- to later life should target refugees and other vulnerable groups.