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Mental health problems are highly prevalent in China; however, China's mental health services lack resources to deliver high-quality care to people in need. Digital mental health is a promising solution to this short-fall in view of the population's digital literacy. In this review, we aim to: (i) investigate the effectiveness, acceptability, usability, and safety of digital health technologies (DHTs) for people with mental health problems in China; (ii) critically appraise the literature; and (iii) make recommendations for future research directions. The databases MEDLINE, PsycINFO, EMBASE, Web of Science, CNKI, WANFANG, and VIP were systemically searched for English and Chinese language articles evaluating DHTs for people with mental health problems in mainland China. Eligible studies were systematically reviewed. The heterogeneity of studies included precluded a meta-analysis. In total, 39 articles were retrieved, reporting on 32 DHTs for various mental health problems. Compared with the digital mental health field in the West, the Chinese studies targeted schizophrenia and substance use disorder more often and investigated social anxiety mediated by shame and culturally specific variants, DHTs were rarely developed in a co-production approach, and methodology quality was less rigorous. To our knowledge, this is the first systematic review focused on digital mental health in the Chinese context including studies published in both English and the Chinese language. DHTs were acceptable and usable among Chinese people with mental health problems in general, similar to findings from the West. Due to heterogeneity across studies and a paucity of robust control trial research, conclusions about the efficacy of DHTs are lacking. [ABSTRACT FROM AUTHOR]

Introduction: Handgrip strength is a simple and inexpensive marker of health and mortality risk. It presents an ideal risk-stratifying method for use in low and middle-income countries (LMICs). There are, however, no population-based studies investigating the associations between handgrip strength and depression in LMICs. We aimed to assess these associations among community-dwelling middle-aged and older adults using nationally representative data from six LMICs.Method: Cross-sectional data on individuals aged ≥ 50 years from the World Health Organization's Study on Global Ageing and Adult Health were analyzed. Depression was based on the Composite International Diagnostic Interview. Weak handgrip strength was defined as < 30 kg for men and < 20 kg for women using the average value of two handgrip measurements of the dominant hand. Multivariable logistic regression analysis was conducted.Results: The sample included 34,129 individuals (62.4 ± 16.0 years; 52.1% female). The prevalence of weak handgrip strength and depression were 47.4% and 6.2%, respectively. Individuals with weak handgrip strength had a higher prevalence of depression than those without this condition (8.8% vs. 3.8%; p < 0.001). Across all countries, after adjustment for potential confounders, weak handgrip strength was associated with a 1.45 (95%CI = 1.12-1.88) times higher odds for depression, although some between-country differences were noted.Discussion: Weaker handgrip strength is associated with higher odds for depression in LMICs. Future research should seek to establish the predictive value of this inexpensive measure for clinical use. Furthermore, interventional studies should examine if muscular strength can be a target of resistance-training interventions to address depressive symptoms in low-resourced settings. [ABSTRACT FROM AUTHOR]

Objective: Sedentary behaviour (SB) is harmful for health and well-being and may be associated with depression. However, little is known about the correlates of SB in people with depression. Thus, we investigated SB correlates among community-dwelling adults with depression in six low- and middle-income countries.Methods: Cross-sectional data from the World Health Organization's Study on Global Ageing and Adult Health were analyzed. The analysis was restricted to those with DSM-IV Depression or receiving depression treatment in the last 12 months. Self-reported time spent sedentary per day was the outcome. High SB was defined as ≥8 hours of SB per day. The correlates (sociodemographic and health-related) of SB were estimated by multivariable linear and logistic regression analyses.Results: In 2375 individuals with depression (mean age=48.0 years; 60.7% female), the prevalence of high SB was 11.1% (95%CI=8.2%-14.9%), while the mean (±SD) time spent sedentary was 215 (±192) minutes per day. Socio-demographic factors significantly associated with high SB were older age and being unmarried, being male and being unemployed. In other domains, no alcohol consumption, current smoking, mild cognitive impairment, bodily pain, arthritis, stroke, disability, and lower levels of social cohesion, COPD, visual impairment, and poor self-rated health was associated with greater time spent sedentary.Conclusion: Our data suggest that future interventions seeking to reduce SB among individuals with depression may target at risk groups based on identified sociodemographic correlates while the promotion of social cohesion may have the potential to increase the efficacy of future public health initiatives. From a clinical perspective, bodily pain and somatic co-morbidities need to be taken into account. [ABSTRACT FROM AUTHOR]

Prevalence of multimorbidity (i.e., ≥2 chronic conditions), chronic diseases, and obesity is increasing in low- and middle-income countries (LMICs), posing a potential threat to the health of older adults living in these areas. This study hence investigates the unexplored association between obesity and multimorbidity among older adults from LMICs. Cross-sectional, community-based data from the WHO Study on global Ageing and adult health (SAGE) were analysed. The sample consisted of 20,198 individuals aged ≥60 years [Mean age (SD) = 69.3 (13.1) years; 54.1% female] from China, India, Ghana, Mexico, Russia, South Africa. Twelve chronic conditions were assessed. Multivariable logistic regression was conducted to assess the association between BMI ≥ 30 kg/m2, high waist circumference (WC, cut-points > 102 cm for males and > 88 cm for females) and multimorbidity. After adjusting for potential confounders, overall, BMI ≥ 30 kg/m2 was associated with 1.43 (95%CI = 1.21-1.69) times higher odds for multimorbidity, while this estimate for high WC was 1.50 (95%CI = 1.21-1.86). Significant associations emerged between obesity measures and five out of twelve chronic conditions. Results from this study underline the need to reduce obesity among older adults in areas where its prevalence is increasing, as it is associated with increased odds for multimorbidity. Future longitudinal research in this setting is required to assess the impact of obesity reduction on multimorbidity incidence. [ABSTRACT FROM AUTHOR]

Objectives: A number of small-scale, single-country studies have suggested that muscular weakness may be a biomarker for cognitive health, mild cognitive impairment (MCI), and dementia. However, multinational, representative studies are lacking, particularly from low- and middle-income countries (LMICs). Thus, we assessed the association between muscular strength (measured by maximal handgrip) and MCI in six LMICs (China, Ghana, India, Mexico, Russia, and South Africa), using nationally representative data., Methods: Cross-sectional, community-based data on individuals aged 50 years or older from the World Health Organization's Study on Global Ageing and Adult Health were analyzed. MCI was defined according to the National Institute on Aging-Alzheimer's Association criteria. Weak handgrip strength was defined as less than 30 kg for men and less than 20 kg for women using the average value of two handgrip measurements of the dominant hand. Multivariable logistic regression analysis was conducted to assess the association between muscular strength and MCI., Results: A total of 32 715 participants were included (mean age 62 ± SD 15.6 y and 51.7% female). The prevalence of MCI and weak handgrip strength was 15.3% (95% CI, 14.4%-16.3%) and 46.5% (95% CI, 43.6%-49.5%), respectively. After adjustment for potential confounders, weak handgrip strength was associated with 1.41 (95% CI, 1.23-1.61) times higher odds for MCI. The corresponding figures for those aged 50 to 64 years and 65 years or older were 1.35 (95% CI, 1.14-1.60) and 1.54 (95% CI, 1.27-1.86), respectively., Conclusions: Muscular weakness may provide a clinically useful indicator of MCI risk. Increasing our understanding of the connection between muscular and cognitive function could ultimately lead to the development and broader implementation of resistance training interventions targeting both physical and cognitive health., (© 2019 John Wiley & Sons, Ltd.)