Yanhui Bian’s research while affiliated with Peking University and other places

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Publications (26)


Schematic model of intervention components as the mediators between intervention and subjective support
Participant flow chart (ITT: Intention-to-treat)
Effectiveness of SS-CBT on intervention components and subjective support. Notes: Model for rumination was adjusted for age, gender, years of schooling, and monthly income; Models for perceived support availability, perceived support adequacy, self-esteem, gratitude, cognitive distortions, and interpersonal competence were adjusted for age, gender, years of schooling, monthly income and baseline rumination; Group: SS-CBT group vs. wail-list control group; Time: post-intervention vs. pre-intervention; ITT: intention-to-treat (n = 50 for the intervention group, n = 50 for the wail-list control group); PP: per-protocol (n = 37 for the intervention group, n = 50 for the wail-list control group); CI: confidence interval
Uncovering mechanisms of subjective support focused cognitive behavioral therapy in improving subjective support among (pre)frail community-dwelling older adults: a randomized controlled trial
  • Article
  • Publisher preview available

January 2025

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11 Reads

Current Psychology

Cuili Wang

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Yanhui Bian

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Yaru Jin

Subjective support-focused cognitive behavioral therapy (SS-CBT) could increase subjective support among (pre)frail community-dwelling older adults, however, the underlying mechanisms remain unclear. We conducted a randomized controlled trial, in which the SS-CBT group (n = 50) received SS-CBT once a week for eight weeks and the wait-list control group (n = 50) received no intervention. The dependent variable was subjective support, and potential mediators included self-esteem, gratitude, cognitive distortions, interpersonal competence and rumination. Measurements took place before and after the intervention. We found that interpersonal competence mediated the effectiveness of SS-CBT on both perceived support availability (β = 2.030, 95%CI = 1.164, 3.081) and perceived support adequacy (β = 6.37, 95%CI = 3.52, 9.74), while self-esteem only mediated the effectiveness of SS-CBT on perceived support availability (β = 1.621, 95%CI = 0.502, 2.843). Gratitude, cognitive distortions, and rumination neither mediated the effectiveness of SS-CBT on perceived support availability nor on perceived support adequacy. These findings highlight self-esteem and interpersonal competence as the mechanisms through which SS-CBT increases subjective support, especially perceived support availability. This implicates that the SS-CBT should exclusively emphasize the apparent active ingredients (self-esteem and interpersonal competence) to promote its efficiency.

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Impacts of Depressive Symptoms on the Effectiveness of a Theory-Driven Exercise Intervention Among Community-Dwelling (Pre)frail Older Adults

December 2024

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5 Reads

Clinical Gerontologist

Objectives: To investigate whether baseline depressive symptoms impacted the effectiveness of an exercise intervention among (pre)frail older adults. Methods: This is a subanalysis of a stepped-wedge cluster randomized trial implementing an exercise intervention, with an application of the integration of the Health Belief Model, Theory of Planned Behavior, and Health Action Process Approach, among 149 community-dwelling (pre)frail older adults. The intervention effectiveness was examined by baseline depressive symptoms (depressive symptoms (n = 40) and non-depressive symptoms (n = 109). Results: Intervention effects were observed among (pre)frail older adults regardless of baseline depressive symptoms on frailty, social function, as well as physical and mental quality of life (QoL). (Pre)frail people with depressive symptoms, compared to those without depressive symptoms, were likely to benefit more in muscle mass, muscle strength, lower extremity function, activities of daily living (ADLs), cognitive function, depressive symptoms, and physical QoL, but less in dynamic balance, instrumental ADLs (IADLs), and mental QoL. Conclusions: These findings implicate that cognitive and psychological strategies should be integrated into exercise interventions among (pre)frail people with depressive symptoms to improve their functional independence and well-being. Clinical implications: Interventions that accommodate depressive symptoms may result in improved outcomes for (pre)frail people with depressive symptoms.




Development and Validation of Prediction Models for Incident Reversible Cognitive Frailty Based on Social-Ecological Predictors Using Generalized Linear Mixed Model and Machine Learning Algorithms: A Prospective Cohort Study

August 2024

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14 Reads

This study aimed to develop and validate prediction models for incident reversible cognitive frailty (RCF) based on social-ecological predictors. Older adults aged ≥60 years from China Health and Retirement Longitudinal Study (CHARLS) 2011–2013 survey were included as training set ( n = 1230). The generalized linear mixed model (GLMM), eXtreme Gradient Boosting, support vector machine, random forest, and Binary Mixed Model forest were used to develop prediction models. All models were evaluated internally with 5-fold cross-validation and evaluated externally via CHARLS 2013–2015 survey ( n = 1631). Only GLMM showed good discrimination (AUC = 0.765, 95% CI = 0.736, 0.795) in training set, and all models showed fair discrimination (AUC = 0.578–0.667, 95% CI = 0.545, 0.725) in internal and external validation. All models showed acceptable calibration, overall prediction performance, and clinical usefulness in training and validation sets. Older adults were divided into three groups using risk score based on GLMM, which could assist healthcare providers to predict incident RCF, facilitating early identification of high-risk population.



Development and validation of a risk scoring tool for predicting incident reversible cognitive frailty among community‐dwelling older adults: A prospective cohort study

July 2024

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2 Reads

Geriatrics and Gerontology International

Aim Reversible cognitive frailty (RCF) is an ideal target to prevent asymptomatic cognitive impairment and dependency. This study aimed to develop and validate prediction models for incident RCF. Methods A total of 1230 older adults aged ≥60 years from China Health and Retirement Longitudinal Study 2011–2013 survey were included as the training set. The modified Poisson regression and three machine learning algorithms including eXtreme Gradient Boosting, support vector machine and random forest were used to develop prediction models. All models were evaluated internally with fivefold cross‐validation, and evaluated externally using a temporal validation method through the China Health and Retirement Longitudinal Study 2013–2015 survey. Results The incidence of RCF was 27.4% in the training set and 27.5% in the external validation set. A total of 13 important predictors were selected to develop the model, including age, education, contact with their children, medical insurance, vision impairment, heart diseases, medication types, self‐rated health, pain locations, loneliness, self‐medication, night‐time sleep and having running water. All models showed acceptable or approximately acceptable discrimination (AUC 0.683–0.809) for the training set, but fair discrimination (AUC 0.568–0.666) for the internal and external validation. For calibration, only modified Poisson regression and eXtreme Gradient Boosting were acceptable in the training set. All models had acceptable overall prediction performance and clinical usefulness. Older adults were divided into three groups by the risk scoring tool constructed based on modified Poisson regression: low risk (≤24), median risk (24–29) and high risk (>29). Conclusions This risk tool could assist healthcare providers to predict incident RCF among older adults in the next 2 years, facilitating early identification of a high‐risk population of RCF. Geriatr Gerontol Int 2024; 24: 874–882 .


Flow chart of the selection process of studies. *Studies of the same project were combined as one.
Forest plots for (a) caregiver burden, (b) depression, (c) anxiety, (d) caregiving time and (e) quality of life. Edu, education; Multi, multicomponent intervention.
Effectiveness of interventions for informal caregivers of community‐dwelling frail older adults: A systematic review and meta‐analysis

July 2024

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37 Reads

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3 Citations

Journal of Advanced Nursing

Aim Systematic reviews on interventions for informal caregivers of community‐dwelling frail older adults were published over a decade ago and they mistook frailty for other severe age‐related conditions like disability and dementia. Therefore, this study aimed to systematically synthesize these interventions supporting these caregivers identified by an acknowledged frailty assessment instrument and to examine their effectiveness on caregiver‐related outcomes. Design Systematic review and meta‐analysis. Data Sources Fourteen electronic databases, grey literature and reference lists were systematically searched for randomized controlled trials (RCTs) and non‐randomized controlled trials (NRCTs) from inception to November 3, 2023. Methods Methodology quality and risk of bias were assessed. Data were meta‐analysed using the Comprehensive Meta‐Analysis, version 3.0. Studies and outcomes unsuitable for meta‐analysis were summarized by narrative syntheses. Results Four studies consisting of three RCTs and one NRCT were included involving 350 participants. Interventions for caregivers of frail older adults included multicomponent interventions (n = 3) and education intervention (n = 1). Interventions had a moderate effect on reducing depression and showed nonsignificant effects on caregiver burden, caregiving time or quality of life (QoL). The PEDro scores for RCTs ranged from 6 to 8, indicating good methodologic quality, but were all judged as high risk of bias. The NRCT reported all methodologic aspects and was at low risk of bias. Conclusions Few studies focus on interventions targeting caregivers of frail older adults, and their effectiveness may vary by outcomes. This review suggested the potential benefits of these interventions in reducing caregivers' depression. Impact The differential effectiveness by outcomes and high risk of bias of studies implicate that more rigorous studies are warranted.




Citations (15)


... significantly improve caregivers' knowledge, skills, and quality of life (QoL). 17,18 The SimB-PSYED program, which incorporates RAM principles, addresses focal stimuli by providing targeted information and skills training for caregivers. A previous study demonstrated that instructor-guided simulation (e.g., a program on tracheotomy care education with low-cost fidelity) can improve tracheostomy care knowledge and experiences for inpatient providers. ...

Reference:

Effectiveness of Simulation-Based Psychoeducational Intervention for Family Caregivers of Older Adults with Disability and Chronic Illnesses: A Quasi-Experimental Study
Effectiveness of interventions for informal caregivers of community‐dwelling frail older adults: A systematic review and meta‐analysis

Journal of Advanced Nursing

... As the research on this topic deepens, researchers continue to find close connections between the two. Frailty and cognitive impairment have similar pathophysiology [9] and may promote each other's development [10]. On this basis, the concept of cognitive frailty (CF) was proposed. ...

Effects of cognitive reserve on cognitive frailty among older adults: A population-based prospective cohort study
  • Citing Article
  • March 2024

Geriatrics and Gerontology International

... Correlation and path analyses consistently revealed that IHMT was associated with lower levels of loneliness among older adults with disabilities. IHMT may be associated with enhanced functional and intrinsic capacities among older adults with disabilities, which, in turn is associated with lower levels of loneliness (Stara et al., 2023;Yu et al., 2024). This study builds on earlier work by examining how improvements in functional ability may be linked to loneliness among older adults with disabilities in the digital age. ...

Relationship between intrinsic capacity and health-related quality of life among community-dwelling older adults: the moderating role of social support

Quality of Life Research

... US and European HIV care guidelines suggest assessment for frailty using a validated metric among PWH starting at age 50 years, although differing assessments are often used. 52 Despite increased characterization of frailty in PWH, knowledge gaps persist. While geriatric-HIV programs have begun to emerge to meet the unique clinical needs of older PWH, including frailty assessments, such clinics are limited, and many HIV clinicians do not assess frailty in routine care. ...

Clinical practice guidelines for frailty vary in quality but guide primary health care: a systematic review
  • Citing Article
  • July 2023

Journal of Clinical Epidemiology

... Five machine learning methods, namely Logistic Regression, ExtraTrees classifier, Bagging classifier, XGBoost, and RF, were applied to develop the risk models based on the training set. Further, a Grid Search with 5-fold cross validation was employed to find all possible combinations of hyperparameters for each ML model [24]. Then, each model's performance was conducted by confusion matrix, AUC, accuracy, precision, specificity, Recall and F1 scores. ...

Development and validation of a preliminary clinical support system for measuring the probability of incident 2-year (pre)frailty among community-dwelling older adults: A prospective cohort study
  • Citing Article
  • June 2023

International Journal of Medical Informatics

... Yu at al, 2022 47 Yu at al, 2023 46 Beard at al, 2022 21 Yu at al, 2021 48 Yu at al, 2021 49 Tay at al, 2023 44 Beard at al, 2019 20 ...

How does social support interact with intrinsic capacity to affect the trajectory of functional ability among older adults? Findings of a population-based longitudinal study
  • Citing Article
  • March 2023

Maturitas

... Loneliness was evaluated based on individuals' subjective perception of feeling alone in the past 3 months. Depression was assessed using the Geriatric Depression Scales-5, with a score of 2 or less indicating a normal range [31]. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE) [32], which provides insights into cognitive abilities and impairments. ...

Validation and Comparison of Three Short Depression Screening Tools Among Chinese Community-Dwelling Older Adults
  • Citing Article
  • October 2022

Research in Gerontological Nursing

... However, there's been a lack of attention to intervention effects on senior fitness, sleep quality, and mental health (Yoon et al., 2018;Kwan et al., 2020). Researchers are encouraged to explore the effectiveness of exercise interventions from a broad perspective for comprehensive effectiveness evaluation, considering exercise interventions have been proven to offer a wide range of health benefits (Qiao et al., 2022). ...

A theory‐driven exercise intervention among community‐dwelling (pre)frail older adults: Protocol for a stepped‐wedge cluster‐randomized trial

Journal of Advanced Nursing

... For example, a longitudinal aging study analysis has indicated that higher IC is associated with reduced risk of falls [9]. Other studies have found that a decrease in IC is associated with a decrease in quality of life, an increased risk of disability [10], an increased risk of hospitalization [11], an increased incidence of frailty [12], and an increased mortality rate [13], consistent with cohort studies from Hong Kong [14]. It can be seen that improving IC is crucial for the health and life of the older adults, and how to maintain and improve IC in the older adults has become an increasingly important factor in nursing practices. ...

Patterns of intrinsic capacity among community-dwelling older adults: Identification by latent class analysis and association with one-year adverse outcomes
  • Citing Article
  • May 2022

Geriatric Nursing

... The psychological burden of frailty, combined with reduced social interactions and support, exacerbates the challenges faced by these patients. Psychological support can alleviate the symptoms of FS and should therefore be strongly recommended in this group of patients [42]. It is worth emphasizing here that good control of blood pressure and lipid profile can reduce the risk of dementia, which can significantly worsen social aspects of QoL [43]. ...

Effects of social support on frailty trajectory classes among community-dwelling older adults: The mediating role of depressive symptoms and physical activity
  • Citing Article
  • May 2022

Geriatric Nursing