Most cited article - PubMed ID 32379611
Socioeconomic position in childhood and depressive symptoms in later adulthood in the Czech Republic
We examined the relationship between educational attainment (EA) and anxiety symptoms in a sample of 77,792 individuals (median age = 64 years, 55% female) from the Survey of Health, Ageing and Retirement in Europe. Using logistic regression, we estimated odds ratio (OR) with 95% confidence interval (CI) for the association between EA (7 educational levels based on International Standard Classification of Education) and anxiety symptoms (12 or more points from the shortened 5-item version of the Beck Anxiety Inventory), adjusting for sociodemographic and health-related factors. We further explored whether the relationship varied by region, sex and age group. Independent of sociodemographic and health-related factors, higher levels of EA were associated with lower odds of anxiety symptoms. The magnitude of this association plateaued at first stage of tertiary education (OR 0.40; 95% CI 0.35-0.47, p < 0.001). The association was stronger in females, middle-aged individuals and in Central and Eastern Europe while not apparent in Northern Europe. Our findings suggest that individuals with higher education might be protected against anxiety throughout life. The protective effect of education against anxiety symptoms is more pronounced in less egalitarian regions and in females.
- MeSH
- European People MeSH
- Middle Aged MeSH
- Humans MeSH
- Aged MeSH
- Educational Status * MeSH
- Anxiety * epidemiology MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Research Support, N.I.H., Extramural MeSH
BACKGROUND: Experience of early-life socioeconomic deprivation (ELSD) may increase the risk of mental disorders in young adulthood. This association may be mediated by structural and functional alterations of the hippocampus. METHODS: We conducted a prospective cohort study on 122 participants of the European Longitudinal Study of Pregnancy and Childhood. Information about ELSD was collected via questionnaire from mothers during the first 18 months of participants' lives. At age 23-24, participants underwent examination by structural magnetic resonance imaging, resting-state functional connectivity and assessment of depressive symptoms (Mood and Feelings Questionnaire) and anxiety (Spielberger State-Trait Anxiety Inventory). The association of ELSD with brain outcomes in young adulthood was assessed with correlations, linear regression (adjusting for sex, socioeconomic position and mother's mental health) and moderated mediation analysis. RESULTS: Higher ELSD was associated with greater depressive symptoms (B = 0.22; p = 0.001), trait anxiety (B = 0.07; p = 0.02) and lower global connectivity of the right hippocampus (B = -0.01; p = 0.02). These associations persisted when adjusted for covariates. In women, lower global connectivity of the right hippocampus was associated with stronger trait anxiety (B = -4.14; p = 0.01). Global connectivity of the right hippocampus as well as connectivity between the right hippocampus and the left middle temporal gyrus mediated the association between ELSD and trait anxiety in women. Higher ELSD correlated with a lower volume of the right hippocampus in men, but the volume of the right hippocampus was not related to mental health. CONCLUSIONS: Early preventive strategies targeted at children from socioeconomically deprived families may yield long-lasting benefits for the mental health of the population.
- Keywords
- anxiety, depression, fMRI, sex differences,
- MeSH
- Depression * MeSH
- Child MeSH
- Adult MeSH
- Hippocampus MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Magnetic Resonance Imaging MeSH
- Young Adult MeSH
- Prospective Studies MeSH
- Socioeconomic Factors MeSH
- Pregnancy MeSH
- Anxiety * MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
In 54 participants (41% women) from the Czech arm of the European Longitudinal Study of Pregnancy and Childhood, a national birth cohort with prospectively collected data from their birth until young adulthood, we aimed to study the association between early-life socioeconomic deprivation (ELSD), cognitive ability in adolescence, trait anxiety and resting state functional connectivity of the lateral prefrontal cortex (LPFC) in young adulthood. We found that ELSD was associated with lower cognitive ability in adolescence (at age 13) as well as higher trait anxiety in young adulthood (at age 23/24). Higher cognitive ability in adolescence predicted lower trait anxiety in young adulthood. Resting state functional connectivity between the right LPFC and a cluster of voxels including left precentral gyrus, left postcentral gyrus and superior frontal gyrus mediated the relationship between lower cognitive ability in adolescence and higher trait anxiety in young adulthood. These findings indicate that lower cognitive ability and higher trait anxiety may be both consequences of socioeconomic deprivation in early life. The recruitment of the right LPFC may be the underlying mechanism, through which higher cognitive ability may ameliorate trait anxiety.
- Keywords
- birth cohort, cognition, epidemiology, trait anxiety,
- MeSH
- Child MeSH
- Adult MeSH
- Cognition MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Magnetic Resonance Imaging * MeSH
- Adolescent MeSH
- Young Adult MeSH
- Brain * MeSH
- Socioeconomic Factors MeSH
- Anxiety MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
The aim was to investigate the pattern and rate of cognitive decline across distinctive trajectories of depressive symptoms in older adults. In this prospective multinational cohort study on 69,066 participants (on average 64 years at baseline, 55% women), assessments of cognitive functions (immediate recall, delayed recall, verbal fluency) and depressive symptoms (EURO-D scale) were conducted at 2-year intervals. The trajectories of depressive symptoms were obtained using latent growth mixture modelling, cognitive decline was assessed using smoothing splines and linear mixed effects models. Four distinct trajectories of depressive symptoms were identified: constantly low (n = 49,660), constantly high (n = 2999), increasing (n = 6828) and decreasing (n = 9579). Individuals with increasing and constantly high depressive symptoms showed linear cognitive decline, while those with constantly low and decreasing depressive symptoms had fluctuating cognition. Participants with increasing depressive symptoms had the fastest decline, while those with decreasing symptoms were spared from decline in cognition. This study suggests that the pattern as well as the rate of cognitive decline co-occurs with specific patterns of changes in depressive symptoms over time. The most pronounced cognitive decline is present in individuals, in whom depressive symptoms increase late in life. Unique mechanisms of cognitive decline may exist for subgroups of the population, and are associated with the trajectory of depressive symptoms.
- MeSH
- Depression physiopathology psychology MeSH
- Depressive Disorder physiopathology MeSH
- Cognition physiology MeSH
- Cognitive Dysfunction physiopathology MeSH
- Middle Aged MeSH
- Humans MeSH
- Prospective Studies MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Research Support, N.I.H., Extramural MeSH
BACKGROUND: Increasing educational attainment (EA) could decrease the occurrence of depression. We investigated the relationship between EA and depressive symptoms in older individuals across four European regions. METHODS: We studied 108,315 Europeans (54% women, median age 63 years old) from the Survey on Health, Ageing and Retirement in Europe assessing EA (seven educational levels based on International Standard Classification of Education [ISCED] classification) and depressive symptoms (≥4 points on EURO-D scale). Logistic regression estimated the association between EA and depressive symptoms, adjusting for sociodemographic and health-related factors, testing for sex/age/region and education interactions. RESULTS: Higher EA was associated with lower odds of depressive symptoms, independent of sociodemographic and health-related factors. A threshold of the lowest odds of depressive symptoms was detected at the first stage of tertiary education (OR 0.60; 95% confidence interval [CI] 0.55-0.65; p < 0.001; relative to no education). Central and Eastern Europe showed the strongest association (OR for high vs. low education 0.37; 95% CI 0.33-0.40; p < 0.001) and Scandinavia the weakest (OR for high vs. low education 0.69; 95% CI 0.60-0.80; p < 0.001). The association was strongest among younger individuals. There was a sex and education interaction only within Central and Eastern Europe. CONCLUSIONS: Level of EA is reflected in later-life depressive symptoms, suggesting that supporting individuals in achieving EA, and considering those with lower EA at increased risk for depression, could lead to decreased burden of depression across the life course. Further educational support in Central and Eastern Europe may decrease the higher burden of depressive symptoms in women.
- Keywords
- Depression, Europe, education, epidemiology,
- MeSH
- Depression epidemiology MeSH
- Retirement MeSH
- Middle Aged MeSH
- Humans MeSH
- Logistic Models MeSH
- Aged MeSH
- Social Determinants of Health statistics & numerical data MeSH
- Aging MeSH
- Educational Status * MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Research Support, N.I.H., Extramural MeSH
- Geographicals
- Europe epidemiology MeSH
- Europe, Eastern MeSH