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

Davison KM, Lung Y, Lin S Tong H, Kobayashi KM, Fuller-Thomson E (2020) J Affect Disord. 2020 March, 265, 526-537

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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.