Psychological distress in older adults linked to immigrant status, dietary intake, and physical health conditions in the Canadian Longitudinal Study on Aging (CLSA)

J Affect Disord. 2020 Mar 15:265:526-537. doi: 10.1016/j.jad.2020.01.024. Epub 2020 Jan 11.

Abstract

Background: 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 <C$100,000/year (58.2%), and had a post-secondary education (78.4%). For women, psychological distress was associated with being a recent/mid-term immigrant(OR=1.76, 99% CI 1.09-2.83), marital status (widowed/divorced/separated, OR=1.62, 99% CI 1.19-2.20), lower education level (<secondary school; OR = 1.95, 99% CI 1.32-2.88), lower intake of fruit and vegetable (≤ 2/day; OR=1.50, 99% CI 1.05-2.14), higher waist-to-height ratio (>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 strength<cut-off, OR=1.57, 99% CI 1.14-2.16). For men and women, psychological distress was associated with age (>56 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.

Keywords: CLSA; Canadian Longitudinal Study on Aging; Immigrants; Nutrient intake; Older adults; Psychological distress.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aging*
  • Canada / epidemiology
  • Cross-Sectional Studies
  • Eating
  • Emigrants and Immigrants*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Psychological Distress
  • Stress, Psychological / epidemiology

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