title: The association of perceived stress with depressive symptoms in older Taiwanese-Result of a longitudinal national cohort study.
abstract: OBJECTIVE
  To determine the impact of perceived-stress over one's own health, financial condition, job, and conflict with family members, and family members' problems on depressive symptoms in older adults.
  
  
  METHODS
  We analyzed datasets of the Taiwan Longitudinal Survey on Aging, and used self-reported stress in 2003 and 2007 to represent long-term stress conditions in 4854 ≥ 50-year old persons. The impact of long-term stress on depressive status (evaluated with CES-D10, score range 0-30) was determined with multivariate logistic regression analysis. Persons with proxy interviews, incomplete CES-D data, or cognitive impairment were excluded.
  
  
  RESULTS
  Perceived-health stress had stronger impacts on depressive symptoms than most other stress situations. Job-related stress showed no impact. Other stress situations showed modest associations in the middle-aged and young-olds. Ongoing stress had stronger impacts than past stress. Excluding health and job stresses, the impact generally decreased with aging. The association with clinically relevant depression generally followed that with depressive symptoms.
  
  
  CONCLUSIONS
  All perceived stresses are not equal in their impacts on subsequent depressive symptoms. Perceived-health stress has stronger impacts under most conditions. Better understanding of the associations of various stressors with depressive symptoms could enhance planning of effective strategies to reduce the risk of depression in older persons.
authors.affiliation: Department of Healthcare Administration, Asia University, Wu-feng, Taichung, Taiwan; Center for Health Policy and Management Research, Asia University, Wu-feng, Taichung, Taiwan; Department of Health Services Management, School of Public Health, China Medical University, Taichung, Taiwan. Electronic address: atsai@umich.edu.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Tsai
authors.forename: Shu-Huang
authors.initials: SH
authors.lastname: Chi
authors.forename: Jiun-Yi
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003469:Culture; D003866:Depressive Disorder / Q000523:psychology*; D054541:Family Conflict / Q000523:psychology; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007406:Interview, Psychological; D007588:Job Satisfaction; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011157:Population Dynamics; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology*; D013624:Taiwan
keywords: CES-D; Center for Epidemiologic Studies Depression Rating Scale; Depressive symptoms; Health stress; Older adults; Perceived stress; SPMSQ; Simple Portable Mental Status Questionnaire; TLSA; Taiwan; Taiwan Longitudinal Survey on Aging