Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990-2019: a systema…

2020

Publisher's version (útgefin grein)

Magnesium and health outcomes: An umbrella review of systematic reviews and meta-analyses of observational and intervention studies

2020

Purpose: To map and grade all health outcomes associated with magnesium (Mg) intake and supplementation using an umbrella review. Methods: Umbrella review of systematic reviews with meta-analyses of observational studies and randomized controlled trials (RCTs) using placebo/no intervention as control group. We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values, 95% prediction intervals, heterogeneity, small-study effects and excess significance. For meta-analyses of RCTs, outcomes with a random-effect p value < 0.005 and a high-GRADE assessment were classified as strong evidence. Results: From 2048 abstracts, 16 meta-analyses an…

The relationship between dietary vitamin k and depressive symptoms in late adulthood: A cross-sectional analysis from a large cohort study

2019

Few studies assessed the associations between dietary vitamin K and depressive symptoms. We aimed to investigate the association between dietary vitamin K and depressive symptoms in a large cohort of North American People. In this cross-sectional analysis, 4,375 participants that were aged 45&ndash

The association between objective vision impairment and mild cognitive impairment among older adults in low- and middle-income countries

2021

Aim: The association between visual impairment and mild cognitive impairment (MCI) has not been investigated to date. Thus, we assessed this association among older adults from six low- and middle-income countries (LMICs) (China, India, Ghana, Mexico, Russia, and South Africa) using nationally representative datasets. Methods: Cross-sectional, community-based data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Visual acuity was measured using the tumbling ElogMAR chart, and vision impairment (at distance and near) was defined as visual acuity worse than 6/18 (0.48 logMAR) in the better-seeing eye. The definition of MCI was based on the National Institute on Aging…

Physical activity and anxiety: A perspective from the World Health Survey

2017

BackgroundDespite the known benefits of physical activity (PA) among people with anxiety, little is known about PA levels in people with anxiety at the population level. This study explored the global prevalence of anxiety and its association with PA.MethodsCross-sectional, community-based data from the World Health Survey was analyzed. Prevalence of anxiety was estimated for 237,964 individuals (47 countries). PA was categorized as low, moderate, and high based on the International Physical Activity Questionnaire (short form). The association between PA and anxiety was assessed by multivariable logistic regression.ResultsThe overall global prevalence of anxiety was 11.4% (47 countries). Ac…

Association of bullying victimization with overweight and obesity among adolescents from 41 low‐ and middle‐income countries

2019

Background: Data on the association between overweight/obesity and bullying victimization among adolescents are scarce from low- and middle-income countries. Objectives: We assessed the associations between overweight/obesity and bullying victimization in 41 low- and middle-income countries. Methods: Cross-sectional data from the Global School-based Student Health Survey were analysed. Data on past 30-day bullying victimization (including type) and body mass index based on measured weight and height were collected. The 2007 WHO Child Growth reference was used to define overweight and obesity. Multivariable logistic regression (multinomial and binary) and meta-analyses based on country-wise …

Sedentary behaviour and sleep problems among 42,489 community-dwelling adults in six low- and middle-income countries

2018

There is a lack of multinational research investigating the association between sleep problems and sedentary behaviour. In this study, we investigated the relationship between the time spent sedentary during waking hours and sleep problems in six low- and middle-income countries. Cross-sectional, community-based data from the Study on Global Ageing and Adult Health survey were analysed. Adjusted logistic regression analyses were undertaken to explore the relationship between self-reported sleep problems (such as difficulties falling asleep, waking up frequently during the night or waking up too early in the morning) in the last 30 days and self-reported sedentary time (categorized as <4,…

Do Older People with Diabetes Meet the Recommended Weekly Physical Activity Targets? an Analysis of Objective Physical Activity Data

2019

Appropriate management of diabetes mellitus (DM) includes following a healthy lifestyle, in which reaching physical activity (PA) recommendations is an important factor. Despite this, it remains unclear whether people with DM meet the recommended PA targets. We therefore aimed to investigate the proportion of older adults with DM (type 1 and 2) engaging in the recommended amount of PA per week in a cross-sectional study. PA levels were objectively measured using the GT1M ActiGraph accelerometer for seven consecutive days, and the cut-off of 150 min of moderate-to-vigorous PA (MVPA) was used. To assess the relationship between not meeting the recommendation for, and the significant factors a…

Association between Food Insecurity and Sarcopenia among Adults Aged ≥65 Years in Low- and Middle-Income Countries

2021

Limited literature has investigated the association between food insecurity and sarcopenia in low- and middle-income countries (LMICs). Therefore, the aim of the present study was to investigate the association between food insecurity and sarcopenia among adults aged ≥65 years in six LMICs. Community-based cross-sectional data of the Study on Global Ageing and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. In the past, 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable logistic reg…

Association between food insecurity and fall-related injury among adults aged ≥65 years in low- and middle-income countries: The role of mental healt…

2021

Purpose:\ud \ud We investigated the association between food insecurity and fall-related injury among older adults from six low- and middle-income countries (LMICs), and the extent to which this association is mediated by mental health.\ud \ud Methods:\ud \ud Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Fall-related injury referred to those that occurred in the past 12 months. Multivariable logistic regression analysis and mediation analysis were conducted to assess association…

Influenza Vaccination and COVID-19 Outcomes in People Older than 50 Years: Data from the Observational Longitudinal SHARE Study

2022

Existing literature on the association between influenza vaccination and COVID-19 infection/outcomes is conflicting. Therefore, we aimed to investigate the association between influenza vaccination and COVID-19 outcomes in a large cohort of adults who participated in the SHARE (Survey of Health, Ageing, and Retirement in Europe). Information regarding influenza vaccination in the previous year, and medical and demographic characteristics, were self-reported. Positivity for COVID-19, symptomatology, and hospitalization were also ascertained using self-reported information. An adjusted logistic regression analysis (including 15 baseline factors or propensity score) was used to assess the asso…

Pain Increases the Risk for Sarcopenia in Community-Dwelling Adults: Results From the English Longitudinal Study of Ageing

2023

AbstractBackgroundPain and sarcopenia are common in older people. Cross-sectional studies have reported a significant association between these two conditions, but cohort studies exploring pain as a potential risk factor for sarcopenia are scarce. Given this background, the aim of the present work was to investigate the association between pain (and its severity) at baseline, and the incidence of sarcopenia over 10 years of follow-up in a large representative sample of the English older adult population.MethodsPain was diagnosed using self-reported information and categorized as mild to severe pain at four sites (low back, hip, knee, and feet). Incident sarcopenia was defined as having low …

Psychotic experiences and subjective cognitive complaints among 224 842 people in 48 low- and middle-income countries.

2018

Abstract Aims Cognitive deficits are an important factor in the pathogenesis of psychosis. Subjective cognitive complaints (SCCs) are often considered to be a precursor of objective cognitive deficits, but there are no studies specifically on SCC and psychotic experiences (PE). Thus, we assessed the association between SCC and PE using data from 48 low- and middle-income countries. Methods Community-based cross-sectional data of the World Health Survey were analysed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 to 10 with higher scores representing more severe SCC. The Composite International Diagnostic Intervi…

Anxiety symptoms and mild cognitive impairment among community-dwelling older adults from low- and middle-income countries.

2021

Abstract Aim Anxiety may be a risk factor for mild cognitive impairment (MCI) but there is a scarcity of data on this association especially from low- and middle-income countries (LMICs). Thus, we investigated the association between anxiety and MCI among older adults residing in six LMICs (China, Ghana, India, Mexico, Russia, South Africa), and the mediational effect of sleep problems in this association. Methods Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer's Association criteria. Multivariable logistic regression analy…

Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17: analysis for th…

2020

Background: Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods: We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuri…

Fried potato consumption is associated with elevated mortality: an 8-y longitudinal cohort study

2017

Background: Few studies have assessed the association between potato consumption and mortality. Objective: We investigated whether potato consumption (including fried and unfried potatoes) is associated with increased premature mortality risk in a North American cohort. Design: A longitudinal analysis included 4440 participants aged 45-79 y at baseline with an 8-y follow-up from the Osteoarthritis Initiative cohort study. Potato consumption (including fried and unfried potatoes) was analyzed by using a Block Brief 2000 food-frequency questionnaire and categorized as ≤1 time/mo, 2-3 times/mo, 1 time/wk, 2 times/wk, or ≥3 times/wk. Mortality was ascertained through validated cases of death. T…

Pain and severe sleep disturbance in the general population: Primary data and meta-analysis from 240,820 people across 45 low- and middle-income coun…

2018

Objective:\ud Pain and sleep disturbances are widespread, and are an important cause of a reduced quality of life. Despite this, there is a paucity of multinational population data assessing the association between pain and sleep problems, particularly among low- and middle-income countries (LMICs). Therefore, we investigated the relationship between pain and severe sleep disturbance across 45 LMICs.\ud \ud Method: \ud Community-based data on 240,820 people recruited via the World Health Survey were analyzed. Multivariable logistic regression analyses adjusted for multiple confounders were performed to quantify the association between pain and severe sleep problems in the last 30 days. A me…

Department of Error

2018

Reiner RC Jr, Hay SI. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17: analysis for the Global Burden of Disease Study 2017. Lancet 2020; 395: 1779–801—In this Article, the author byline has been amended to Local Burden of Disease Diarrhoea Collaborators. This correction has been made to the online version as of June 4, 2020, and the printed version is correct. © 2020 Elsevier Ltd

Tea Consumption and Risk of Cancer

2020

Tea is one of the most widely consumed beverages, but its association with cancer risk remains controversial and unclear. We performed an umbrella review to clarify and determine the associations between tea consumption and various types of cancer by summarizing and recalculating the existing meta-analyses. Meta-analyses of observational studies reporting associations between tea consumption and cancer risk were searched on PubMed and Embase. Associations found to be statistically significant were further classified into levels of evidence (convincing, suggestive, or weak), based on P value, between-study heterogeneity, prediction intervals, and small study effects. Sixty-four observational…

Age–sex differences in the global burden of lower respiratory infections and risk factors, 1990–2019: results from the Global Burden of Disease Study…

2022

Funding: Bill & Melinda Gates Foundation. Background: The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories.  Methods: In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466–469, 470.0, 480–4…

Consumption of Fish and ω-3 Fatty Acids and Cancer Risk: An Umbrella Review of Meta-Analyses of Observational Studies

2020

Multiple studies have suggested that ω-3 fatty acid intake may have a protective effect on cancer risk; however, its true association with cancer risk remains controversial. We performed an umbrella review of meta-analyses to summarize and evaluate the evidence for the association between ω-3 fatty acid intake and cancer outcomes. We searched PubMed, Embase, and the Cochrane Database of Systematic Reviews from inception to December 1, 2018. We included meta-analyses of observational studies that examined associations between intake of fish or ω-3 fatty acid and cancer risk (gastrointestinal, liver, breast, gynecologic, prostate, brain, lung, and skin) and determined the level of evidence of…

Multimorbidity and perceived stress: a population-based cross-sectional study among older adults across six low- and middle-income countries

2018

BACKGROUND:\ud Stress in chronic conditions or multimorbidity (≥2 chronic conditions) has been reported to affect clinical outcomes but there are no studies on the association between stress and chronic conditions/multimorbidity among older adults in low- and middle-income countries (LMICs). Thus, we investigated this association among adults aged ≥50 years across six LMICs.\ud \ud METHODS:\ud A cross-sectional analysis using data from the World Health Organization's Study on Global Ageing and Adult Health (China, Ghana, India, Mexico, Russia, South Africa) was conducted. A perceived stress score [range 0 (lowest stress) -100 (highest stress)] was computed based on two questions from the Pe…

Associations between sexual activity and weight status: Findings from the English Longitudinal Study of Ageing.

2019

Objective To investigate the association between weight status and sexual activity in middle-aged and older adults. Methods Cross-sectional analysis on Wave 6 (2012/13) of the English Longitudinal Study of Ageing. Data were from 2,200 men and 2,737 women aged ≥50 years (mean 68.2 years). The explanatory variable was weight status, defined as normal-weight (BMI: ≤24.9), overweight (BMI: 25.0–29.9) or obese (BMI: ≥30) based on objective measurements of height and weight. Outcome variables were any self-reported sexual activity in the last year (yes/no) and, if yes, frequency of sexual intercourse in the last month. Covariates included a range of sociodemographic, lifestyle, and health-related…

Prospective associations of cardiovascular disease with physical performance and disability

2019

Background: Literature regarding cardiovascular disease (CVD) and incident physical performance limitations and disability in older people is equivocal. Aims: This study aimed to investigate whether CVD is longitudinally associated with incident physical performance limitations and disability in a large population-based sample. Methods: This was an 8‑year prospective study using data collected as part of the Osteoarthritis Initiative. Participants were community-dwelling adults with knee osteoarthritis or at high risk for this condition. Diagnosed CVD was self-reported. Physical performance was assessed with measures of chair stand time and gait speed, whereas disability was assessed with t…

Effect of low-dose aspirin on health outcomes: An umbrella review of systematic reviews and meta-analyses.

2020

Aims:\ud \ud This study aimed to use an umbrella review methodology to capture the range of outcomes that were associated with low‐dose aspirin and to systematically assess the credibility of this evidence.\ud \ud Methods:\ud \ud Aspirin is associated with several health outcomes, but the overall benefit/risk balance related to aspirin use is unclear. We searched three major databases up to 15 August 2019 for meta‐analyses of observational studies and randomized controlled trials (RCTs) including low‐dose aspirin compared to placebo or other treatments. Based on random‐effects summary effect sizes, 95% prediction intervals, heterogeneity, small‐study effects and excess significance, signifi…

Association between sarcopenia and quality of life among adults aged ≥ 65 years from low- and middle-income countries

2022

Background Sarcopenia has been associated with a lower quality of life (QoL). However, studies on this association from low- and middle-income countries (LMICs) are scarce. Aims To examine the association between sarcopenia and QoL, in a large nationally representative sample of older adults from six LMICs. Methods Cross-sectional, community-based data from the WHO study on global ageing and adult health (SAGE) were analysed. Non-severe sarcopenia was defined as having low skeletal muscle mass (SMM) and weak handgrip strength but no slow gait speed, while severe sarcopenia was defined as having low SMM, weak handgrip strength, and slow gait speed. QoL was assessed with the 8-item WHO QoL in…

Aspirin and incident depressive symptoms: A longitudinal cohort study over 8 years

2017

Objective: Aspirin exhibits anti-atherosclerotic and anti-inflammatory properties—two potential risk factors for depression. The relationship between aspirin use and depression, however, remains unclear. We investigated whether the aspirin use is associated with a decreased incidence of depressive symptoms in a large North American cohort. Methods: Data from the Osteoarthritis Initiative dataset, a multicenter, longitudinal study on community-dwelling adults was analyzed. Aspirin use was defined through self-report in the past 30 days and confirmed by a trained interviewer. Incident depressive symptoms were defined as a score of ≥16 in the 20-item Center for Epidemiologic Studies-Depression…

Participation in Physical Activity is Associated with Sexual Activity in Older English Adults.

2019

Physical activity (PA) is a potential modifiable correlate of the age-related decline in sexual function, but no studies have explicitly tested this. This study aimed to examine associations between PA, television viewing (TV) time and sexual activity, problems, and concerns. Data were from 7,038 men and women aged &ge

The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990–2019: Findings from the Global Burden of Dis…

2022

Artículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si le hubiere, y los autores pertenecientes a la UAM

Angiotensin-Converting Enzyme Inhibitor Use and Incident Frailty: A Longitudinal Cohort Study

2019

Introduction: Angiotensin-converting enzyme inhibitors (ACEI) may have several pleiotropic effects, but the literature regarding a possible relationship between ACEI use and frailty is limited. We investigated whether ACEI use is associated with lower risk of frailty in a cohort of North American individuals. Methods: Data from the Osteoarthritis Initiative, a cohort study with 8 years of follow-up including community-dwelling adults with knee osteoarthritis or at high risk for this condition, were analyzed. ACEI use was defined through self-reported information and confirmed by a trained interviewer. Frailty was defined using the Study of Osteoporotic Fracture (SOF) index as the presence o…

The association between diabetes and cataract among 42,469 community-dwelling adults in six low- and middle-income countries

2018

Background: Cataract is a major cause of visual impairment in people with diabetes, yet a paucity of data is available in low- and middle-income countries (LMICs) on this comorbidity. Thus we assessed the association between diabetes and cataract in 6 LMICs. Methods: Cross-sectional, community-based data from the Study on Global Ageing and Adult Health (SAGE) was analyzed (n = 42,469 aged ≥18 years). Five years information on self-reported diagnosis of cataract was collected. Three definitions for cataract were used: (a) Self-reported diagnosis and/or past 12-month symptoms; (b) Solely self-reported diagnosis; and (c) Surgical treatment for cataract in the past five years. Diabetes was base…

Food insecurity (hunger) and suicide attempts among 179,771 adolescents attending school from 9 high-income, 31 middle-income, and 4 low-income count…

2019

BACKGROUND: Data on food insecurity and suicide attempts in adolescence are scarce. Thus, the aim of the current study was to assess the association between food insecurity (hunger) and suicide attempts in adolescents from 44 countries. METHODS: Cross-sectional, school-based data from the Global School-based Student Health Survey were analyzed. Data on past 12-month suicide attempts and past 30-day food insecurity (hunger) were collected. Multivariable logistic regression, meta-analysis, and meta-regression were conducted to assess the associations. RESULTS: The final sample consisted of 179,771 adolescents attending school. The prevalence of moderate (rarely/sometimes hungry) and severe (m…

Sociodemographic and behavioural correlates of lifetime number of sexual partners: findings from the English Longitudinal Study of Ageing.

2018

BackgroundNo current data are available on correlates of lifetime sexual partners at older ages. This study aimed to explore correlates of the lifetime number of sexual partners in a sample of older adults.MethodData were from 3054 men and 3867 women aged ≥50 years participating in the English Longitudinal Study of Ageing. Participants reported their lifetime number of sexual partners and a range of sociodemographic characteristics and health behaviours. Multivariable multinomial logistic regression was used to examine correlates of lifetime number of sexual partners, with analyses performed separately for men and women and weighted for non-response.ResultsYounger age, being separated/divor…

Objectively measured far vision impairment and sarcopenia among adults aged ≥ 65 years from six low- and middle-income countries

2021

Background:\ud \ud There are currently no studies on visual impairment and sarcopenia. We investigated the cross-sectional association between objectively measured far vision impairment and sarcopenia in a nationally representative sample of older adults aged 65 years and over from six low- and middle-income countries (LMICs).\ud \ud Methods:\ud \ud Cross-sectional, community-based data from the study on global ageing and adult health (SAGE) were analyzed. Far vision acuity was measured using the tumbling E LogMAR chart and classified as: no vision impairment (6/12 or better); mild vision impairment (6/18 or better but worse than 6/12); moderate vision impairment (6/60 or better but worse t…

Pro-inflammatory dietary pattern is associated with fractures in women: an eight-year longitudinal cohort study

2017

Summary: In this study, during 8 years of follow-up, we reported that higher dietary inflammatory index values were associated with a higher risk of incident fractures in women, but not in men, after adjusting for potential confounders. Introduction: Inflammation is a key risk factor for many adverse outcomes in older people. While diet is a potential source of inflammation, little is known about the impact of inflammatory diet on fractures. Thus, we investigated whether higher Dietary Inflammatory Index (DII)™ ® scores are associated with fractures in a cohort of North American people. Methods: This longitudinal study with a follow-up of 8 years included 3648 participants (1577 males and 2…

Multimorbidity and anxiety symptoms among adults aged 50 years and over from six low- and middle-income countries

2021

Currently, there are limited data on the association between multimorbidity (i.e., ≥ 2 chronic conditions) and anxiety, especially among the older population in low- and middle-income countries (LMICs). Thus, the aim of the present study was to examine the association between multimorbidity and anxiety symptoms in a large sample of adults aged ≥ 50 years from six LMICs (China, India, Ghana, Mexico, Russia, South Africa). Cross-sectional, nationally representative, community-based data from the Study on Global Ageing and Adult Health (SAGE) were analysed. A total of 11 chronic physical conditions were assessed. Anxiety symptoms referred to extreme/severe problems with worry or anxiety in the…

Fruit and vegetable consumption and sarcopenia among older adults in low- and middle-income countries

2020

Fruit and vegetable consumption may protect against sarcopenia but there are no studies on this topic from low- and middle-income countries (LMICs). Thus, we assessed this association among older adults from six LMICs. Community-based cross-sectional data of the Study on Global Aging and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. Quintiles of vegetable and fruit consumption were created based on the number of servings consumed on a typical day. Multivariable logistic regression analysis was conducted. The sample consisted of 14,585 individuals aged &ge

Correlates of physical activity among depressed older people in six low-income and middle-income countries: A community-based cross-sectional study

2018

Objective Despite the benefits of physical activity (PA) in older people with depression, many do not comply with the International PA guidelines. Thus, we investigated what factors influence PA participation among 915 community-dwelling older adults (aged ≥65 years) with depression in 6 low-income and middle-income countries (LMICs). Methods Cross-sectional data were analyzed from the World Health Organization's Study on Global Ageing and Adult Health. The sample was restricted to those with DSM-IV depression or receiving depression treatment in the last 12 months. PA was assessed by the Global Physical Activity Questionnaire. Participants were dichotomized into low (ie, not meeting 150 mi…

Relationship between multidimensional prognostic index and incident depressive symptoms in older people: Findings from the Irish Longitudinal Study o…

2020

Objectives: The multidimensional prognostic index (MPI) is a useful prognostic tool for evaluating adverse health outcomes in older individuals. However, the association between MPI and depressive symptoms has never been explored, despite depression being a common condition in older people. We therefore aimed to evaluate whether MPI may predict incident depressive symptoms. Methods: Longitudinal, cohort study, with 2 years of follow-up (W1: October 2009-February 2011; W2: April 2012-January 2013), including people aged ≥65 years without depressive symptoms at baseline. A comprehensive geriatric assessment including information on functional, nutritional, cognitive status, mobility, comorbid…

Association of food insecurity with suicidal ideation and suicide attempts in adults aged ≥50 years from low- and middle-income countries

2022

Background-\ud \ud The aim of the present study was to investigate associations between food insecurity with suicidal ideation and suicide attempts in adults aged ≥50 years from six low- and middle-income countries (LMICs).\ud \ud Methods-\ud \ud Cross-sectional, community-based data from the World Health Organisation's Study on Global Aging and Adult Health were analyzed. Self-reported information on past 12-month suicidal ideation and suicide attempts was collected. Past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable logistic regression analysis was conducted to assess the association between food insecuri…

Syndemic effects of HIV risk behaviours: results from the NHANES study

2019

Abstract The aim of the present study is to use the syndemic framework to investigate the risk of contracting HIV in the US population. Cross-sectional analyses are from The National Health and Nutrition Examination Survey. We extracted and aggregated data on HIV antibody test, socio-demographic characteristics, alcohol use, drug use, depression, sexual behaviours and sexually transmitted diseases from cycle 2009–2010 to 2015–2016. We carried out weighted regression among young adults (20–39 years) and adults (40–59 years) separately. In total, 5230 men and 5794 women aged 20–59 years were included in the present analyses. In total, 0.8% men and 0.2% women were tested HIV-positive. Each inc…

Associations in physical activity and sedentary behaviour among the immigrant and non-immigrant US population

2020

BackgroundImmigrants are at a higher risk of poor mental and physical health. Regular participation in physical activity (PA) and low levels of sedentary time are beneficial for both these aspects of health. The aim was to investigate levels and trends in domain-specific PA and sedentary behaviour in the US. immigrant compared with non-immigrant populations.MethodsFrom the 2007–2016 National Health and Nutrition Examination Survey (NHANES), a total of 25 142 adults (≥18 years) were included in this analysis. PA and sedentary behaviour time were assessed by a questionnaire.ResultsTransit-related PA showed downward linear trends in young immigrant adults (ptrend=0.006) and middle-aged non-imm…

Cross-sectional associations between angiotensin-converting enzyme inhibitor use and cancer diagnosis in US adults

2020

The objective of the present study was to investigate the association between angiotensin-converting enzyme (ACE) inhibitor use and cancer incidence (overall, and breast, prostate, and colorectal cancers specifically) in a large representative sample of US adults. Cross-sectional data on cancer diagnosis, timing of cancer diagnosis, ACE inhibitor use, and other characteristics were extracted from 49 512 adults aged ≥ 20 years participating in the National Health and Nutrition Examination Survey (1999–2016). Multivariable-logistic and propensity score matching (PSM) regressions examined the relationship between pre-diagnosis use of ACE inhibitors and diagnosis of all cancers, and breast, pro…

Mitochondrial genetic haplogroups and cardiovascular diseases: Data from the Osteoarthritis Initiative

2019

Background Some case-control studies reported that mitochondrial haplogroups could be associated with the onset of cardiovascular diseases (CVD), but the literature regarding this topic is limited. We aimed to investigate whether any mitochondrial haplogroup carried a higher or lower risk of CVD in a large cohort of North American people affected by knee osteoarthritis or at high risk for this condition. Materials and methods A longitudinal cohort study including individuals from the Osteoarthritis Initiative was done. Haplogroups were assigned through a combination of sequencing and PCR-RFLP techniques. All the mitochondrial haplogroups have been named following this nomenclature: HV, JT, …

Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000-17

2020

Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage o…

Statin Use and Knee Osteoarthritis Outcomes: A Longitudinal Cohort Study

2018

Objective: Statins have several pleiotropic effects, but the literature regarding the possible relationship between use of statins and outcomes in knee osteoarthritis (OA) is limited. The aim of this study was to investigate whether statin use is associated with a lower risk of radiographic OA (ROA), radiographic symptomatic knee OA, and pain in North American individuals. Methods: A total of 4,448 community-dwelling adults from the Osteoarthritis Initiative were followed for 4 years. Statin use (including the time from baseline and the type of statin) was defined through self-report information and confirmed by a trained interviewer. Knee OA outcomes included incident ROA, symptomatic knee…

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study …

2020

Publisher's version (útgefin grein)

Multidimensional frailty increases cardiovascular risk in older people: An 8-year longitudinal cohort study in the Osteoarthritis Initiative.

2021

Background:\ud \ud Cardiovascular diseases (CVDs) are the most important cause of mortality and an important cause of disability. Frailty seems to be associated with higher cardiovascular risk, but limited research has been done using a multidimensional approach to frailty. Thus, the present study aimed to investigate whether the multidimensional prognostic index (MPI), based on comprehensive geriatric assessment (CGA), is associated with CVD risk in the Osteoarthritis Initiative (OAI) study.\ud \ud Methods:\ud \ud Community-dwellers affected by knee OA or at high risk for this condition were followed for 8 years. A standardized CGA including information on functional, nutritional, mood, co…

Is chocolate consumption associated with health outcomes? An umbrella review of systematic reviews and meta-analyses.

2019

Background & aims: The literature regarding the potential health benefits of chocolate consumption are unclear and the epidemiological credibility has not been systematically scrutinized, while the strength of the evidence is undetermined. We therefore aimed to map and grade the diverse health outcomes associated with chocolate consumption using an umbrella review of systematic reviews. Methods: Umbrella review of systematic reviews of observational and intervention studies (randomized placebo-controlled trials, RCTs). For each association, random-effects summary effect size, 95% confidence interval, and 95% prediction interval were estimated. We also assessed heterogeneity, evidence fo…

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

2020

Publisher's version (útgefin grein)

Relationship between sedentary behavior and depression: a mediation analysis of influential factors across the lifespan among 42,469 people in low- a…

2018

Abstract Background Sedentary behavior (SB) is associated with diabetes, cardiovascular disease and low mood. There is a paucity of multi-national research investigating SB and depression, particularly among low- and middle-income countries. This study investigated the association between SB and depression, and factors which influence this. Methods Cross-sectional data were analyzed from the World Health Organization's Study on Global Ageing and Adult Health. Depression was based on the Composite International Diagnostic Interview. The association between depression and SB (self-report) was estimated by multivariable linear and logistic regression analyses. Mediation analysis was used to id…

Lifetime self-reported arthritis is associated with elevated levels of mental health burden: A multi-national cross sectional study across 46 low- an…

2017

Population-based studies investigating the relationship of arthritis with mental health outcomes are lacking, particularly among low- and middle-income countries (LMICs). We investigated the relationship between arthritis and mental health (depression spectrum, psychosis spectrum, anxiety, sleep disturbances and stress) across community-dwelling adults aged ≥18 years across 46 countries from the World Health Survey. Symptoms of psychosis and depression were established using questions from the Mental Health Composite International Diagnostic Interview. Severity of anxiety, sleep problems, and stress sensitivity over the preceding 30 days were self-reported. Self-report lifetime history of a…

Mediterranean diet and knee osteoarthritis outcomes: A longitudinal cohort study.

2018

Objectives: Mediterranean diet has several beneficial effects on health, but data regarding the association between Mediterranean diet and knee osteoarthritis (OA) are limited mainly to cross-sectional studies. We investigated whether higher Mediterranean diet adherence is prospectively associated with lower risk of radiographic OA (ROA), radiographic symptomatic knee OA (SxOA) and pain worsening in North American people at high risk or having knee OA. Methods: Adherence to the Mediterranean diet was evaluated using a validated Mediterranean diet score (aMED), categorized in five categories (Q1 to Q5, higher values reflecting higher adherence to Mediterranean diet). Knee OA outcomes include…

Risk of Hospitalized Falls and Hip Fractures in 22,103 Older Adults Receiving Mental Health Care vs 161,603 Controls: A Large Cohort Study.

2020

Abstract: Objectives: To investigate the risk of hospitalized fall or hip fracture among older adults using mental health services. Design: Retrospective cohort study. Setting and Participants: Residents of a South London catchment aged >60 years receiving specialist mental health care between 2008 and 2016. Measures: Falls and/or a hip fracture leading to hospitalization were ascertained from linked national records. Incidence rates and incidence rate ratios (IRRs) were age- and gender-standardized to the catchment population. Multivariable survival analyses were applied investigating falls and/or hip fractures as outcomes. Results: In 22,103 older adults, incidence rates were 60.1 per 100…

Chronic physical conditions, physical multimorbidity, and quality of life among adults aged ≥ 50 years from six low- and middle-income countries

2022

Abstract Purpose Multimorbidity (i.e., ≥ 2 chronic conditions) poses a challenge for health systems and governments, globally. Several studies have found inverse associations between multimorbidity and quality of life (QoL). However, there is a paucity of studies from low- and middle-income countries (LMICs), especially among the older population, as well as studies examining mediating factors in this association. Thus, the present study aimed to explore the associations, and mediating factors, between multimorbidity and QoL among older adults in LMICs. Methods Cross-sectional nationally representative data from the Study on Global Ageing and Adult Health were analyzed. A total of 11 chroni…

Anxiety symptoms among informal caregivers in 47 low- and middle-income countries: A cross-sectional analysis of community-based surveys.

2022

Background-\ud \ud There are no multi-country studies on the association between informal caregiving and anxiety from low- and middle-income countries (LMICs). Therefore, we investigated this relationship in a large predominantly nationally representative sample from 47 LMICs.\ud \ud Methods-\ud \ud Cross sectional data from the World Health Survey were analyzed. Anxiety symptoms referred to severe or extreme problems with worries or anxiety in the past 30 days.\ud \ud Information on caregiving in the past 12 months was obtained. Multivariable logistic regression analysis adjusting for age, sex, marital status, education, household size, employment, disability, and country was conducted. Da…

Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015 : a systematic analysi…

2016

BACKGROUND: Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time. METHODS: Drawing from ana…

Multimorbidity increases the risk of dementia: a 15 year follow-up of the SHARE study.

2023

Abstract Aims the literature regarding the association between multimorbidity and dementia is still unclear. Therefore, we aimed to explore the potential association between multimorbidity at the baseline and the risk of future dementia in the SHARE (Survey of Health, Ageing and Retirement in Europe) study, a large European research survey, with a follow-up of 15 years. Methods in this longitudinal study, multimorbidity was defined as the presence of two or more chronic medical conditions, among 14 self-reported at the baseline evaluation. Incident dementia was ascertained using self-reported information. Cox regression analysis, adjusted for potential confounders, was run and hazard ratios…

Prospective associations between alcohol use, binge drinking and sexual activity in older adults: The English Longitudinal Study of Ageing

2021

The present study aimed to investigate associations between alcohol consumption, including binge drinking, and sexual activity. Data were from 1,622 men and 2,195 women aged ≥50 years participating in the English Longitudinal Study of Ageing. Multivariable logistic regression was used to prospectively assess sex-specific associations between baseline frequency of alcohol use in the last year or binge drinking in the last week (self-reported in 2004/05) and sexual activity at 8-year follow-up (2012/13). Covariates included partner status, age, ethnicity, wealth, limiting long-standing illness, smoking status, physical activity, and depressive symptoms. After adjustment, regular alcohol consu…

Association between food insecurity and depression among older adults from low- and middle-income countries.

2021

Background:\ud \ud To examine the association between self‐reported food insecurity and depression in 34,129 individuals aged ≥50 years from six low‐ and middle‐income countries (LMICs) (China, Ghana, India, Mexico, Russia, and South Africa).\ud \ud Methods:\ud \ud Cross‐sectional, community‐based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Self‐reported past 12‐month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview were used for the endorsement of past 12‐month …

Handgrip strength and depression among 34,129 adults aged 50 years and older in six low- and middle-income countries

2019

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…

Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

2020

Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the…

The global burden of cancer attributable to risk factors, 2010–19 : A systematic analysis for the Global Burden of Disease Study 2019

2022

Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 20…

Ejaculation Disorders in Male Patients with Cancer: A Systematic Review and Meta-Analysis of Prevalence

2021

PURPOSE: Ejaculatory dysfunction (EjD) and erectile dysfunction after cancer treatment are clinically important complications, but their exact prevalence by various kinds of cancer site and type of treatment is unknown. The aim of this systematic review and meta-analysis was to examine the available evidence and provide pooled estimates for prevalence of EjD and erectile dysfunction in relation to all cancer sites and identify characteristics associated with EjD in cancer patients. MATERIALS AND METHODS: We performed a systematic review and meta-analysis of cross-sectional and case-control studies. We searched 4 electronic databases (Medline®, CINAHL, PsychInfo and Embase®) until July 22, 2…

The global distribution of lymphatic filariasis, 2000–18:a geospatial analysis

2020

Background Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection. Methods A global dataset of georeferenced surveyed locations was used to model annual 2000–18 lym…

Is loneliness associated with mild cognitive impairment in low- and middle-income countries?

2021

Background: Loneliness may be a risk factor for mild cognitive impairment but studies on this topic are scarce, particularly from low- and middle-income countries (LMICs). Therefore, the aim of the present study was to investigate the association between loneliness and mild cognitive impairment (MCI) in six LMICs (China, Ghana, India, Mexico, Russia and South Africa). Methods: Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer's Association criteria. Multivariable logistic regression analysis and meta-analysis were conducted t…

Active Travel and Mild Cognitive Impairment among Older Adults from Low- and Middle-Income Countries

2021

Active travel may be an easily achievable form of physical activity for older people especially in low- and middle-income countries (LMICs), but there are currently no studies on how this form of physical activity is associated with a preclinical state of dementia known as mild cognitive impairment (MCI). Therefore, we aimed to investigate the association between active travel and MCI among adults aged ≥50 years from six LMICs. Cross-sectional, community-based data from the World Health Organization’s Study on Global Ageing and Adult Health were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer’s Association criteria. Active travel (minutes/week) was as…

Food insecurity with hunger and sexual behavior among adolescents from 53 countries

2021

Objectives: To examine the relationship of food insecurity with sexual intercourse, multiple sexual partners and non-condom use. Methods: Data on food insecurity (hunger) and sexual behaviors from 205,296 adolescents from 53 countries. Associations were analyzed using meta-analysis. Results: Overall, 16.0% of the adolescents ever had sexual intercourse and the prevalence of moderate and severe food insecurity was 44.9% and 6.2%, respectively. Moderate and severe food insecurity was associated with higher odds for sexual intercourse. Any food insecurity was significantly associated with condom nonuse at last sex. Conclusions: Food insecurity was associated with higher odds of ever having sex…

Mitochondrial genetic haplogroups and depressive symptoms: A large study among people in North America.

2017

Background:\ud A possible relationship between mitochondrial haplogroups and psychiatric diseases (e.g. schizophrenia and bipolar disorder) has been postulated, but data regarding depression is still limited. We investigated whether any mitochondrial haplogroup carried a significant higher risk of depressive symptoms in a large prospective cohort of North American people included in the Osteoarthritis Initiative.\ud \ud Methods:\ud Cross sectional data was derived from the Osteoarthritis Initiative. The haplogroup was assigned through a combination of sequencing and PCR-RFLP techniques. All the mitochondrial haplogroups were named following this nomenclature: H, U, K, J, T, V, SuperHV, I, W…

Cannabis use and physical activity among 89,777 adolescents aged 12-15 years from 21 low- and middle-income countries

2019

Background: Cannabis legalization and use are increasing globally, however, little is known about associations between cannabis use and other health behaviors, such as physical activity (PA). Importantly, the extent to which cannabis use is associated with PA in adolescents is yet to be explored in low- and middle-income countries (LMICs), where there may be unique sociodemographic and environmental characteristics compared with high-income countries. Therefore, this study examined the association between PA and cannabis use among adolescents in 21 LMICs using data from the 2010–2016 Global School-based Student Health Survey. Methods: A multivariable logistic regression analysis was perform…

Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026

2023

Background The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected ne…

Sedentary behaviours and cognitive function among community dwelling adults aged 50+ years: Results from the Irish longitudinal study of ageing

2020

Background:\ud \ud Sedentary behaviours (SB) are risk factors for poor cardiovascular health and all-cause mortality. However, their role in cognitive health in older adults is unclear. A few studies have examined associations between sedentary behaviours and cognition, but are limited by heterogeneity and insufficient longitudinal analyses. Therefore more robust studies, which would address identified limitations, are needed to accurately determine associations.\ud \ud Method:\ud \ud This study analysed data collected from participants aged 50+ years of The Irish Longitudinal Study of Ageing (TILDA). We conducted cross-sectional linear regression with multivariate imputation analyses of ba…

Physical injury and depression in six low- and middle-income countries: A nationally representative study.

2019

BACKGROUND: Studies on the association between physical injury and depression in low- and middle-income countries (LMICs) are scarce. Therefore, our goal was to analyze the association between physical injury and depression using nationally representative data from six LMICs. METHODS: Cross-sectional data from the Study on Global Ageing and Adult Health (SAGE) survey (2007-2010) were analyzed (N?=?42,489). Questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview were used for the endorsement of past 12-month DSM-IV depression. Any injury in our analysis referred to having experienced traffic injury or other injury in the past 12 months. M…

Human Monkeypox: A Comprehensive Narrative Review and Analysis of the Public Health Implications.

2022

Recently, numerous cases of monkeypox were reported from several non-endemic countries in Europe, North America, and Oceania, suggesting an unusual and alarming public health issue, particularly considering that the disease is not directly related to human or animal travels. Attention is currently being drawn to this phenomenon since more than 70% of the global population is no longer vaccinated against smallpox. Indeed, the smallpox vaccination also confers some indirect degree of protection against other poxviruses, including monkeypox. We performed a narrative review to describe the existing literature with regard to monkeypox using the MEDLINE, EMBASE, and Scopus databases. This review …

Mitochondrial genetic haplogroups and incident obesity: a longitudinal cohort study.

2018

Background/Objectives: A small number of case-control studies have suggested that mitochondrial haplogroups could be associated with obesity. We examined whether obesity risk was influenced by mitochondrial haplogroup in a large North American cohort across an 8-year period. We conducted a longitudinal cohort study including individuals from the Osteoarthritis Initiative. Subjects/Methods: Mitochondrial haplogroups were determined by sequencing and PCR-RFLP techniques using this nomenclature: HV, JT, KU, IWX, and super HV/others. The strength of the association between mitochondrial haplogroups and incident obesity was quantified with hazard ratios (HRs), adjusted for potential confounders …

Depression and physical health multimorbidity: primary data and country-wide meta-analysis of population data from 190 593 people across 43 low- and …

2017

BackgroundDespite the known heightened risk and burden of various somatic diseases in people with depression, very little is known about physical health multimorbidity (i.e. two or more physical health co-morbidities) in individuals with depression. This study explored physical health multimorbidity in people with clinical depression, subsyndromal depression and brief depressive episode across 43 low- and middle-income countries (LMICs).MethodCross-sectional, community-based data on 190 593 individuals from 43 LMICs recruited via the World Health Survey were analysed. Multivariable logistic regression analysis was done to assess the association between depression and physical multimorbidity…

Human Immunodeficiency Virus Infection and Diverse Physical Health Outcomes: An Umbrella Review of Meta-analyses of Observational Studies.

2019

Abstract Background Our aim was to assess both the credibility and strength of evidence arising from systematic reviews with meta-analyses of observational studies and physical health outcomes associated with human immunodeficiency virus (HIV) but not acquired immunodeficiency syndrome. Methods We performed an umbrella review of observational studies. Evidence was graded as convincing, highly suggestive, suggestive, weak, or nonsignificant. Results From 3413 studies returned, 20 were included, covering 55 health outcomes. Median number of participants was 18 743 (range 403–225 000 000). Overall, 45 (81.8%) of the 55 unique outcomes reported nominally significant summary results (P < .05). O…

Body mass index categories and anxiety symptoms among adults aged =?50 years from low and middle income countries.

2021

Background: Body weight may be a risk factor for anxiety; however, there is a scarcity of studies on this association in older adults especially from low and middle income countries (LMICs). Therefore, we investigated the association between body mass index (BMI) and anxiety symptoms among adults aged ≥ 50 years from 6 LMICs. Methods: Cross-sectional, community-based, nationally representative data from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) were analyzed. The BMI was based on measured weight and height and was categorized as: &lt; 18.5 kg/m2 (underweight), 18.5–24.9 kg/m2 (normal weight), 25.0–29.9 kg/m2 (overweight), 30.0–34.9 kg/m2 (obesity cla…

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

2019

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained ra…

The epidemiology of back pain and its relationship with depression, psychosis, anxiety, sleep disturbances, and stress sensitivity: Data from 43 low-…

2016

Background Back pain (BP) is a leading cause of global disability. However, population-based studies investigating its impact on mental health outcomes are lacking, particularly among low- and middle-income countries (LMICs). Thus, the primary aims of this study were to: (1) determine the epidemiology of BP in 43 LMICs; (2) explore the relationship between BP and mental health (depression spectrum, psychosis spectrum, anxiety, sleep disturbances and stress). Methods Data on 190,593 community-dwelling adults aged ≥18 years from the World Health Survey (WHS) 2002–2004 were analyzed. The presence of past-12 month psychotic symptoms and depression was established using questions from the Compos…

Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease St…

2022

Correction to Lancet Gastroenterol Hepatol 2022; 7: 627-47. Lancet Gastroenterol Hepatol. 2022 Aug;7(8):704. doi: 10.1016/S2468-1253(22)00210-2. PMID: 35809605. Background: Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. Methods: Estimates of incidenc…

Perceived Stress and Mild Cognitive Impairment among 32,715 Community-Dwelling Older Adults across Six Low- and Middle-Income Countries

2018

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Perceived stress may be a modifiable risk factor for mild cognitive impairment (MCI) and ultimately dementia, but studies on this topic from low- and middle-income countries (LMICs) are lacking. &lt;b&gt;&lt;i&gt;Objective:&lt;/i&gt;&lt;/b&gt; We assessed the association between perceived stress and MCI in six LMICs (China, Ghana, India, Mexico, Russia, and South Africa) using nationally representative data. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Cross-sectional, community-based data on individuals aged ≥50 years from the World Health Organization’s Study on Global Ageing and Adult Health were analyzed. The definition of MCI was base…

Association between cannabis use and sexual behavior among adolescents aged 12-15 years in 21 low- and middle-income countries.

2019

Abstract Aims To investigate the relationship between cannabis use and two sexual behaviors (ever had sex, multiple partners) in a large representative sample of adolescents aged 12–15 years from 21 low- and-middle income countries. Methods Data from 84,867 adolescents aged 12–15 years participating in the Global School-based Student Health Survey were analyzed. Participants reported lifetime frequency of cannabis use (analyzed as 0, 1–2, 3–19 or ≥ 20 times), whether they had ever had sexual intercourse (yes/no) and, if yes, their lifetime number of sexual partners. We used multivariable logistic regression to analyze associations, adjusting for a range of relevant covariates. Results 12.7%…

Food insecurity and physical multimorbidity among adults aged ≥ 50 years from six low- and middle-income countries

2022

Abstract Purpose Food insecurity and multimoribidity (i.e., ≥ 2 chronic conditions) may be linked bidirectionally, but there are no studies on this topic from LMICs. Therefore, the aim of the present study was to examine the association between food insecurity and physical multimorbidity in a large representative sample of older adults from six LMICs. Methods Cross-sectional, community-based data on adults aged ≥ 50 years from the World Health Organization’s Study on Global AGEing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia, and South Africa were analyzed. A total of 11 chronic physical conditions were assessed. Past 12 month food insecurity was assessed with tw…

Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

2016

BACKGROUND: In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015.METHODS: We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10-54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underl…

Perceived Stress and Its Relationship with Chronic Medical Conditions and Multimorbidity among 229,293 Community-Dwelling Adults in 44 Low- and Middl…

2017

In this study, we assessed the association of chronic medical conditions and multimorbidity with perceived stress among community-dwelling adults in 44 low- and middle-income countries. Data from the World Health Survey (2002-2004), including 229,293 adults, were analyzed. A perceived stress score (range, 0 (lowest stress)-100 (highest stress)) was computed on the basis of 2 questions from the Perceived Stress Scale. Eleven chronic conditions were assessed.Multivariable linear regression analyses were conducted to explore the associations. All chronic conditions were associated with significantly higher mean perceived stress scores, with the exception of edentulism. The associations were pa…

Depression and pain: primary data and meta-analysis among 237 952 people across 47 low- and middle-income countries

2017

BackgroundDepression and pain are leading causes of global disability. However, there is a paucity of multinational population data assessing the association between depression and pain, particularly among low- and middle-income countries (LMICs) where both are common. Therefore, we investigated this association across 47 LMICs.MethodsCommunity-based data on 273 952 individuals from 47 LMICs were analysed. Multivariable logistic and linear regression analyses were performed to assess the association between the International Classification of Diseases, 10th Revision depression/depression subtypes (over the past 12 months) and pain in the previous 30 days based on self-reported data. Country…

Association between depression and subjective cognitive complaints in 47 low- and middle-income countries

2022

People with depression and subjective cognitive complaints (SCC) may be at particularly high risk for developing dementia. However, to date, studies on depression and SCC are limited mainly to single high-income countries. Thus, the aim of the present study was to investigate the association between depression and SCC in adults from low- and middle-income countries (LMICs). Cross-sectional, community-based data were analyzed from the World Health Survey. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). ICD-10 Diagnostic Criteria for Research was used for the diagnosis of subsyndromal de…

The association of depression and all-cause and cause-specific mortality: An umbrella review of systematic reviews and meta-analyses

2018

Background Depression is a prevalent and disabling mental disorder that frequently co-occurs with a wide range of chronic conditions. Evidence has suggested that depression could be associated with excess all-cause mortality across different settings and populations, although the causality of these associations remains unclear. Methods We conducted an umbrella review of systematic reviews and meta-analyses of observational studies. PubMed, PsycINFO, and Embase electronic databases were searched through January 20, 2018. Systematic reviews and meta-analyses that investigated associations of depression and all-cause and cause-specific mortality were selected for the review. The evidence was g…

Food Insecurity Is Associated with Mild Cognitive Impairment among Middle-Aged and Older Adults in South Africa:Findings from a Nationally Representa…

2019

There are no studies on the association between food insecurity and mild cognitive impairment (MCI). Thus, cross-sectional, community-based data on individuals aged &ge

Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019

2022

Correction to Lancet Public Health 2022; 7: e657-69. Lancet Public Health. 2022 Dec;7(12):e992. doi: 10.1016/S2468-2667(22)00294-8. PMID: 36462522. Background: Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10-24 years during the past three decades. Methods: Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional injuries for adolescents in 204 countries. Burden is reported in absolut…

Psychotic experiences and psychiatric treatment utilization in Buenos Aires.

2020

Objective: Psychotic experiences are associated with psychiatric treatment utilization, though findings have not been entirely consistent. Furthermore, it is unclear how psychotic experiences relate to specific types of psychiatric treatment, and whether mental illness moderates these associations. Methods: In total, 1,036 adult residents of Buenos Aires were recruited through convenience sampling in public places. Multivariable logistic regression models examined the associations between psychotic experiences and psychiatric treatment, adjusted for age, sex and education. Analyses were then stratified by diagnosis of mental illness. Results: Approximately 17.95% ( N = 186) of the sample re…

Physical activity correlates among people with psychosis: Data from 47 low- and middle-income countries

2018

Background: People with schizophrenia engage in low levels of physical activity (PA). However, few large-scale studies have investigated the factors that may influence PA participation in individuals with psychosis and data from low- and middle-income countries (LMICs) is especially scarce. Thus, we investigated PA correlates in a large sample of people with a psychosis diagnosis across 47 LMICs. Methods: Cross-sectional data from the World Health Survey, restricting to those with a self-reported lifetime diagnosis of schizophrenia/psychotic disorder, was analyzed. PA was assessed by the International Physical Activity Questionnaire (IPAQ) and participants were dichotomized into those that …

Declines in Sexual Activity and Function Predict Incident Health Problems in Older Adults: Prospective Findings from the English Longitudinal Study o…

2020

The objective of this study was to investigate cross-sectional and longitudinal associations between declines in sexual activity and function and health outcomes in a large population-based sample of older adults. Data were from 2577 men and 3195 women aged ≥ 50 years participating in the English Longitudinal Study of Ageing. Past-year changes in sexual desire, frequency of sexual activity, and ability to have an erection (men)/become sexually aroused (women) were assessed at baseline by self-completion questionnaire. Health outcomes (self-rated health, limiting long-standing illness, doctor-diagnosed diseases of the vascular system, and cancer) were self-reported at baseline (2012/2013) an…

Telomere length and health outcomes: An umbrella review of systematic reviews and meta-analyses of observational studies.

2019

The aim of the present study was to map and grade evidence for the relationships between telomere length with a diverse range of health outcomes, using an umbrella review of systematic reviews with meta-analyses. We searched for meta-analyses of observational studies reporting on the association of telomere length with any health outcome (clinical disease outcomes and intermediate traits). For each association, random-effects summary effect size, 95% confidence interval (CI), and 95% prediction interval were calculated. To evaluate the credibility of the identified evidence, we assessed also heterogeneity, evidence for small-study effect and evidence for excess significance bias. Twenty-one…

Decline in sexuality and wellbeing in older adults: A population-based study

2019

Background: Age-related declines in sexuality and increase in mental health complications have been well documented. However, whether these two phenomena are related has not been explored. The present study therefore aimed to investigate associations between a decline in sexuality and markers of mental health and wellbeing. Method: Data were collected in 2012/13 from 2614 men and 3217 women participating in the English Longitudinal Study of Ageing, a population-representative panel study of older adults (≥ 50 years). Past-year declines in sexual desire, frequency of sexual activities, and sexual function were self-reported. Three markers of wellbeing (depressive symptoms, quality of life an…

Factors Associated With Loneliness: An Umbrella Review Of Observational Studies.

2020

Background: Evidence provides inconsistent findings on risk factors and health outcomes associated with loneliness. The aim of this work was to grade the evidence on risk factors and health outcomes associated with loneliness, using an umbrella review approach. Methods: For each meta-analytic association, random-effects summary effect size, 95% confidence intervals (CIs), heterogeneity, evidence for small-study effect, excess significance bias and 95% prediction intervals were calculated, and used to grade significant evidence (p&lt;0.05) from convincing to weak. For narrative systematic reviews, findings were reported descriptively. Results: From 210 studies initially evaluated, 14 publica…

Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Devel…

2020

BACKGROUND: Sustainable Development Goal (SDG) 3 aims to "ensure healthy lives and promote well-being for all at all ages". While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available. METHODS: We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid private) from 1995 to 2017 for 195 countries and territories. For …

Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17.

2020

Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce highresolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and…

Hearing impairment and diverse health outcomes: An umbrella review of meta-analyses of observational studies

2021

Background: Globally, it is estimated that approximately 1.3 billion people live with some form of hearing impairment. Major causes of hearing loss include infection/disease, age-related factors, and occupational factors. Numerous systematic reviews and meta-analyses have attempted to synthesise literature on these topics. To date there has not been a systematic evaluation of the relationships between hearing impairment and diverse physical, mental, and social outcomes. Objective: We performed an umbrella review of systematic reviews of observational studies with meta-analyses for any physical disease, biomarkers of disease, mental health or cognitive outcomes, and/or modifiable risk factor…

Association Between Gait Speed With Mortality, Cardiovascular Disease and Cancer:A Systematic Review and Meta-analysis of Prospective Cohort Studies

2018

Objectives: Slow gait speed may be associated with premature mortality, cardiovascular disease (CVD), and cancer, although a comprehensive meta-analysis is lacking. In this systematic review and meta-analysis, we explored potential associations between gait speed and mortality, incident CVD, and cancer. Design: A systematic search in major databases was undertaken from inception until March 15, 2018 for prospective cohort studies reporting data on gait speed and mortality, incident CVD, and cancer. Setting and Participants: All available. Measures: The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs), based on the model with the maximum number of covariates for each study bet…

Physical Multimorbidity and Sarcopenia among Adults Aged ≥65 Years in Low- and Middle-Income Countries.

2022

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; Physical multimorbidity is plausibly linked to sarcopenia. However, to date, only a few studies exist on this topic, and none have examined this association in low- and middle-income countries (LMICs). Thus, we aimed to investigate the association between multimorbidity and sarcopenia in a sample of older adults from six LMICs (China, Ghana, India, Mexico, Russia, South Africa). &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Cross-sectional, community-based data from the WHO Study on Global Ageing and Adult Health (SAGE) were analysed. Sarcopenia was defined as having low skeletal muscle mass (SMM) and weak handgrip strength, while severe …

Sexual behavior and suicide attempts among adolescents aged 12–15 years from 38 countries: A global perspective

2020

BACKGROUND: The aim was to investigate the relationship between sexual behaviors and suicide attempts by using data from 38 countries from four World Health Organization regions. METHODS: Cross-sectional data from 116,820 adolescents aged 12-15 years participating in the Global School-based Student Health Survey 2009-2016 were analyzed. Data on sexual behaviors were collected: (i) ever having had intercourse; among those who reported having had intercourse, (ii) multiple (≥2) lifetime sexual partners and (iii) condom use in last sexual intercourse and past 12-month suicide attempts were self-reported. Associations were analyzed using multivariable logistic regression. RESULTS: The prevalenc…

Network analysis of the relationship between depressive symptoms, demographics, nutrition, quality of life and medical condition factors in the Osteo…

2019

Abstract Aims A complex interaction exists between age, body mass index, medical conditions, polypharmacotherapy, smoking, alcohol use, education, nutrition, depressive symptoms, functioning and quality of life (QoL). We aimed to examine the inter-relationships among these variables, test whether depressive symptomology plays a central role in a large sample of adults, and determine the degree of association with life-style and health variables. Methods Regularised network analysis was applied to 3532 North-American adults aged ⩾45 years drawn from the Osteoarthritis Initiative. Network stability (autocorrelation after case-dropping), centrality of nodes (strength, M, the sum of weight of t…

Sarcopenia and fall-related injury among older adults in five low- and middle-income countries

2021

Sarcopenia is a common condition in older people and increasing evidence suggests that it can be considered as a potential risk factor for falls and fractures. However, no studies on this topic from low- and middle-income countries (LMICs) are available. Thus, we assessed this association among older adults from five LMICs (China, India, Ghana, Mexico, and Russia). Community-based, nationally representative, cross-sectional data of the Study on Global Aging and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. The presence of fall-related injury was ascertained t…

Sleep problems and mild cognitive impairment among adults aged ≥50 years from low- and middle-income countries

2021

Background-\ud \ud The limited available literature suggests that sleep problems are linked to an increased risk of mild cognitive impairment (MCI). However, this association has been little studied to date in low-income settings.\ud \ud Objective-\ud \ud To investigate the association between sleep problems and MCI in a large sample of adults from six low-and middle-income countries (LMICs).\ud \ud Design-\ud \ud Cross-sectional.\ud \ud Setting-\ud \ud Study on Global Ageing and Adult Health (SAGE).\ud \ud Subjects-\ud \ud 32,715 individuals aged ≥50 years with preservation in functional abilities [age range 50–114 years; 51.7% females].\ud \ud Methods-\ud \ud MCI was defined using the Nat…

Mortality attributable to COVID-19 in nursing home residents: a retrospective study

2021

AbstractAimCoronavirus-19 disease (COVID-19) is a widespread condition in nursing home (NH). It is not known whether COVID-19 is associated with a higher risk of death than residents without COVID-19. Therefore, the aim of this study was to assess whether COVID-19 is associated with a higher mortality rate in NH residents, considering frailty status assessed with the Multidimensional Prognostic Index (MPI).MethodsIn this retrospective study, made in 31 NHs in Venice, Italy, the presence of COVID-19 was ascertained with a nasopharyngeal swab. Frailty was evaluated using the MPI, modified according to the tools commonly used in our NHs. A Cox’s regression analysis was used reporting the resul…

The association of physical multimorbidity with suicidal ideation and suicide attempts in England: A mediation analysis of influential factors

2022

Background: Suicide is one of the most important causes of deaths in the United Kingdom, and the numbers are currently increasing. Aim: There are numerous identified determinants of suicidality, and physical multimorbidity is potentially important but is currently understudied. Thus, this study aims to investigate the association of physical multimorbidity with suicidality. Methods: Cross-sectional data from the Adult Psychiatric Morbidity Survey 2007, which was conducted in England between October 2006 and December 2007 by the National Center for Social Research and Leicester University were analyzed. Respondents were asked about 20 physical health conditions, and suicidal ideation and sui…

Associations between cataract and multimorbidity: a cross-sectional study of 23,089 adults from Spain

2020

Background: Little is known about the association between cataract and multimorbidity. Therefore, the aim of the present study was to examine the relationship between cataract and chronic conditions and multimorbidity in a large representative sample of Spanish adults. Methods: This study used data from the Spanish National Health Survey 2017, a cross-sectional sample of 23,089 adults aged ≥15 years from Spain [54.1% female; mean (standard deviation) age 53.4 (18.9) years]. Cataract and 30 other physical and mental chronic conditions were self-reported. Multimorbidity was defined as the presence of at least two physical and/or mental chronic conditions (excluding cataract). Control variable…

Correlates of physical activity among community-dwelling individuals aged 65 years or older with anxiety in six low- and middle-income countries.

2018

ABSTRACTBackground:Given the important health benefits of physical activity (PA) and the higher risk for physical inactivity in people with anxiety, and the high prevalence of anxiety and low PA among the elderly, there is a need for research to investigate what factors influence PA participation among anxious older individuals. We investigated PA correlates among community-dwelling adults aged ≥ 65 years with anxiety symptoms 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. PA level was assessed by the Global Physical Activity Questionnaire. 980 participants with anxiety (mean ag…

Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study …

2022

Background: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods: For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and …

Relationship between depression and frailty in older adults: A systematic review and meta-analysis

2017

Aim Depression and frailty are prevalent and burdensome in older age. However, the relationships between these entities are unclear and no quantitative meta- analysis exists. We conducted a systematic review and meta-analysis to investigate the associations between depression and frailty. Methods Two authors searched major electronic databases from inception until November-2016 for cross-sectional/longitudinal studies investigating depression and frailty. The strength of the reciprocal associations between frailty and depression was assessed through odds ratios (ORs) adjusted for potential confounders. Results From 2306 non duplicated hits, 24 studies were included. The overall prevalence o…

Association of multimorbidity with higher levels of urinary incontinence: a cross-sectional study of 23 089 individuals aged ≥15 years residing in Sp…

2021

BackgroundOne can assume a relatively high prevalence of urinary incontinence (UI) in people with multimorbidity. However, literature in this area is scarce. There is a need for further robust research to aid GPs to identify patients at a particular risk for UI, and to initiate the early treatment and multidisciplinary management of this condition.AimTo examine the association between multimorbidity and UI in 23 089 individuals aged ≥15 years and residing in Spain.Design and settingThis study used data from the Spanish National Health Survey 2017, a cross-sectional sample of 23 089 participants aged ≥15 years residing in Spain (54.1% female; mean [standard deviation] age = 53.4 [18.9] years…

Chocolate Consumption and Indicators of Adiposity in US Adults.

2020

International audience; Purpose: The purpose of this research is to investigate the association between consumption of chocolate and measures of adiposity in a large, representative sample of US adults. Methods: Cross-sectional data from 13,626 nondiabetic adults (≥20 years) participating in the National Health and Nutrition Examination Survey study were aggregated using 5 study cycles from 2005-2006 through 2013-2014. Chocolate consumption was determined based on 2 24-hour dietary recalls. Body mass index (BMI) and waist circumference were objectively measured. We used multivariable linear regression to test associations of 1) any chocolate consumption (yes/no), and 2) the total amount of …

Predictors of Falls and Fractures Leading to Hospitalization in People With Dementia: A Representative Cohort Study.

2018

OBJECTIVES: Investigate predictors of falls and fractures leading to hospitalization in a large cohort of people with dementia. DESIGN: A retrospective cohort study. SETTING AND PARTICIPANTS: People with diagnosed dementia between January 2007 and March 2013, aged >65 years, were assembled using data from the Maudsley Biomedical Research Centre Case Register, from 4 boroughs in London serving a population of 1.3 million people. MEASURES: Falls and/or fractures leading to hospitalization were ascertained from linked national records. Demographic data, cognitive test scores, medications, and symptom and functioning scores from Health of the Nation Outcome Scales (HoNOS65+) were modeled in mul…

Mapping disparities in education across low- and middle-income countries

2020

Educational attainment is an important social determinant of maternal, newborn, and child health1–3. As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting4–6. The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness7,8; however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health9–11. Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proporti…

Physical multimorbidity predicts the onset and persistence of anxiety: A prospective analysis of the Irish Longitudinal Study on Ageing.

2022

Background: The aims of the present study were to examine prospective associations of multimorbidity (i.e., &gt;= 2 chronic conditions) at baseline with incident and persistent anxiety over a two-year follow-up period among Irish older adults, and to quantify the extent to which sleep, pain, and disability mediate the multimorbidity-anxiety relationship.&amp; nbsp;Methods: Data from The Irish Longitudinal Study on Aging (TILDA) conducted between 2009 and 2011 with a follow-up after two years were analyzed. Anxiety referred to score &gt;=&amp; nbsp;8 on the anxiety section of the Hospital Anxiety and Depression Scale. Lifetime diagnosis of 14 chronic conditions was obtained. Outcomes were in…

The association of cannabis use with fast-food consumption, overweight, and obesity among adolescents aged 12-15 years from 28 countries

2022

Background: Cannabis legalization and use have risen globally. However, the association between cannabis use, eating behaviors and body weight among adolescents is yet unexplored. Objectives: This study examined the association between cannabis use, fast-food consumption, overweight and obesity in 28 countries using data from the 2010–2016 Global School-Based Student Health Survey. Methods: Multivariable logistic regression and meta-analysis were performed among a sample of 83,726 adolescents (48.7% females) aged 12–15 years, mean (SD) age of 13.8 (0.9) years. Results: The overall prevalence of cannabis use (in past 30 days) and fast-food consumption (in past 7 days) were 2.8% and 57.3% res…

The association between sedentary behavior and sarcopenia among adults aged ≥65 years in low-and middle-income countries

2020

The present study aimed to assess the association between sedentary behavior and sarcopenia among adults aged &ge

Estimating global injuries morbidity and mortality

2020

Background. While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods. In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then est…

Mild cognitive impairment is associated with fall-related injury among adults aged ≥65 years in low- and middle-income countries.

2021

Abstract Objectives There is a scarcity of data on the association between mild cognitive impairment (MCI) and falls, especially from low- and middle-income countries (LMICs) where 70% of all older adults reside. Thus, we investigated the association between MCI and fall-related injury among older adults residing in six LMICs (China, Ghana, India, Mexico, Russia, South Africa). Design Cross-sectional, community-based data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Methods The definition of MCI was based on the National Institute on Ageing-Alzheimer's Association criteria, and information on past 12-month fall-related injury was also collected. Multivariable l…

Dietary Protein Intake and Falls in Older People: Longitudinal Analyses From the Osteoarthritis Initiative.

2019

Objectives: Literature regarding dietary protein intake and risk of falls is limited to a few studies with relatively small sample sizes and short follow-ups, which have reported contrasting findings. Thus, we investigated whether dietary protein intake is associated with risk of falls in a large cohort of North American adults. Design: Data were drawn from the Osteoarthritis Initiative, a cohort study, with 8 years of follow-up. Setting and participants: Community-dwelling adults with knee osteoarthritis or at high risk for this condition. Methods: Dietary protein intake was recorded using the Block Brief 2000 food frequency questionnaire and categorized using gender-specific quartiles (Q)…

The association of cooking fuels with depression and anxiety symptoms among adults aged ≥65 years from low- and middle-income countries

2022

Background: We aimed to investigate associations of unclean cooking fuels with depression and anxiety symptoms in a large sample of adults aged ≥65 years from six low- and middle-income countries (LMICs). Methods: Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Unclean cooking fuel referred to kerosene/paraffin, coal/charcoal, wood, agriculture/crop, animal dung, and shrubs/grass. Depression referred to DSM-IV depression based on past 12-month symptoms or receiving depression treatment in the last 12 months. Anxiety symptoms referred to severe/extreme problems with worry or anxiety in the past 30 day…

Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from th…

2020

Incluye: Correction: Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017. Inj Prev. 2020 Oct;26(Supp 1):i164. doi: 10.1136/injuryprev-2019-043296corr1. Epub 2020 Sep 28. PMID: 32989004 Background: The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjuste…

Physical multimorbidity and depression: A mediation analysis of influential factors among 34,129 adults aged ≥50 years from low- and middle-income co…

2022

Background There is a scarcity of literature on the association between physical multimorbidity (i.e., &gt;= 2 chronic physical conditions) and depression among older adults, especially from low- and middle-income countries (LMICs). In addition, the mediators in this association are largely unknown. Therefore, we aimed to examine this association among adults aged &gt;= 50 years from six LMICs (China, Ghana, India, Mexico, Russia, and South Africa), and to identify potential mediators. Methods Cross-sectional, nationally representative data from the Study on Global Ageing and Adult Health were analyzed. Depression was defined as past-12 months DSM-IV depression or receiving depression treat…

The burden of injury in Central, Eastern, and Western European sub-region: a systematic analysis from the Global Burden of Disease 2019 Study

2022

Abstract Background Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries…

Perceived stress and smoking across 41 countries: A global perspective across Europe, Africa, Asia and the Americas

2017

Within recent years, there has been a seismic shift in smoking rates from high-income to low- and middle-income countries (LMICs). Evidence indicates that perceived stress may comprise a barrier for smoking cessation, but little is known about the association of perceived stress and smoking in LMICs. We conducted a cross-sectional, community-based study comprising 217,561 people [mean age 38.5 (SD = 16.1) years, 49.4% males]. A perceived stress score [range 2 (lowest-stress) 10 (highest-stress)] was computed from the Perceived Stress Scale. Multivariable logistic regression analyses were conducted. In the overall sample, a one-unit increase in perceived-stress resulted in a 5% increased odd…

Handgrip strength is associated with suicidal thoughts in men: Cross-sectional analyses from NHANES

2019

OBJECTIVE: To investigate the association between handgrip strength and suicidal thoughts in a representative sample of the US adult population using data from the National Health and Nutrition Examination Survey (NHANES). POPULATION AND METHODS: Data from two waves of NHANES (2011-2014) were aggregated. Handgrip strength in kilogram (kg) was defined as the maximum value from the dominant hand. Suicidal thoughts were assessed using one question "Over the last 2 weeks, how often have you been bothered by the following problem: Thoughts that you would be better off dead or of hurting yourself in some way?" and dichotomized to no (not at all) and yes (several days/ more than half the days/ nea…

Multimorbidity increases the risk for sarcopenia onset: Longitudinal analyses from the English Longitudinal Study of Ageing.

2021

Background-\ud \ud Cross-sectional studies have demonstrated that multimorbidity is associated with sarcopenia. However, to date, this association has not been extensively investigated longitudinally. Therefore, the aim of the present paper was to explore the association between multimorbidity at baseline and sarcopenia onset over 12 years of follow-up in a large representative sample of the English older adult population.\ud \ud Methods-\ud \ud Representative data from the English Longitudinal Study of Ageing (ELSA) were analyzed. Multimorbidity at baseline was defined as ≥2 medical conditions, of 17 conditions included. Participants were considered to have sarcopenia if they had low handg…

Handgrip strength and health outcomes: Umbrella review of systematic reviews with meta-analyses of observational studies

2020

Highlights • We carried out an umbrella review of systematic reviews with meta-analyses of observational studies on handgrip strength and all health outcomes. • Three outcomes (lower all-cause mortality, lower cardiovascular mortality, and lower risk of disability) were found to have highly suggestive evidence. • One outcome (chair rise performance over time) was found to have suggestive evidence. • Five outcomes (walking speed, inability to balance, hospital admissions, cardiac death, and mortality in those with chronic kidney disease) were found to have weak evidence.

Association between physical multimorbidity and sleep problems in 46 low- and middle-income countries

2022

BACKGROUND: Little is known about the association between multimorbidity (i.e., two or more chronic conditions) and sleep problems in the general adult populations of low- and middle-income countries (LMICs). Thus, we aimed to assess this association among adults from 46 LMICs, and to quantify the extent to which anxiety, depression, stress, and pain explain this association. METHODS: Cross-sectional, predominantly nationally representative, community-based data from the World Health Survey were analyzed. Nine chronic physical conditions (angina, arthritis, asthma, chronic back pain, diabetes, edentulism, hearing problems, tuberculosis, visual impairment) were assessed. To be included in th…

Low-dose vitamin D supplementation and incident frailty in older people: An eight year longitudinal study.

2018

Hypovitaminosis D is associated with frailty, but if vitamin D supplementation may prevent the onset of frailty is poorly known. Therefore, we aimed to investigate whether vitamin D supplementation is associated with a lower risk of frailty. In this longitudinal study, 4,421 individuals at high risk or having knee osteoarthritis free from frailty at baseline (mean age: 61.3, females = 58.0%) were followed for 8 years. Details regarding vitamin D supplementation were captured by asking whether the participant took vitamin D during the previous year, at least once per month. Frailty was defined using the Study of Osteoporotic Fracture (SOF) index as the presence of at least two of the followi…

Associations between self-reported physical activity and oral health: a cross-sectional analysis in 17,777 Spanish adults

2020

Background The aim of this study was to assess the association between levels of physical activity and oral health in adults residing in Spain. Methods Cross-sectional data from the Spanish National Health Survey 2017 were analysed (n = 17,777 adults aged ≥15 years; 52.0% females). The International Physical Activity Questionnaire (IPAQ) short form was used to measure physical activity. Oral health was self-reported through eight variables. Covariates included were sex, age, marital status, education, obesity, smoking and alcohol consumption. Results Dental caries (19.8% vs 27.8%), dental extraction (72.7% vs 75.4%), gingival bleeding (15.5% vs 19.1%), tooth movement (4.3% vs 5.9%) and miss…

Lower limb muscle strength and muscle mass are associated with incident symptomatic knee osteoarthritis: a Longitudinal Cohort Study

2021

Recent literature suggests that sarcopenia, often represented by low lower limbs muscle mass and strength, can be considered a potential risk factor for knee osteoarthritis (OA), but the available literature is still limited. We therefore aimed to investigate whether sarcopenia is associated with a higher risk of radiographic (ROA) and symptomatic knee OA (SxOA) in a large cohort of North American people in the context of the OA initiative. Sarcopenia at baseline was diagnosed in case of low skeletal muscle mass (i.e., lower skeletal mass index) and poor performance in the chair stands test. The outcomes of interest for this study included ROA (radiographical osteoarthritis) if a knee devel…

Body Mass Index May Explain Some (But Not All) of the Association Between Declines in Sexual Activity and Incident Health Problems in Older Adults: R…

2019

Physical activity and depression: a large cross-sectional, population-based study across 36 low- and middle-income countries

2016

Objective: Physical activity (PA) is good for health, yet several small-scale studies have suggested that depression is associated with low PA. A paucity of nationally representative studies investigating this relationship exists, particularly in low- and middle-income countries (LMICs). This study explored the global association of PA with depression and its mediating factors. Method: Participants from 36 LMICs from the World Health Survey were included. Multivariable logistic regression analyses were undertaken exploring the relationship between PA and depression. Results: Across 178 867 people (mean ± SD age = 36.2 ± 13.5 years; 49.9% male), the prevalence of depression and the prevalenc…

Depression comorbid with tuberculosis and its impact on health status: cross-sectional analysis of community-based data from 48 low- and middle-incom…

2017

Background Depression in tuberculosis increases the risk for adverse health outcomes. However, little is known about comorbid depression and tuberculosis in the general population. Thus, we assessed the association between depression and tuberculosis, and the decrements in health status associated with this comorbidity in 48 low- and middle-income countries. Methods Cross-sectional, community-based data from the World Health Survey on 242,952 individuals aged ≥ 18 years were analyzed. Based on the World Mental Health Survey version of the Composite International Diagnostic Interview, past 12-month depression was categorized into depressive episode, brief depressive episode, subsyndromal dep…

The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness.

2019

The poor physical health of people with mental illness is a multifaceted, transdiagnostic, and global problem. People with mental illness have an increased risk of physical disease, as well as reduced access to adequate health care. As a result, physical health disparities are observed across the entire spectrum of mental illnesses in low-income, middle-income, and high-income countries. The high rate of physical comorbidity, which often has poor clinical management, drastically reduces life expectancy for people with mental illness, and also increases the personal, social, and economic burden of mental illness across the lifespan. This Commission summarises advances in understanding on the…

Social environmental impact of Covid-19 and erectile dysfunction: an explorative review

2021

Background-\ud \ud To date, no attempt has been made to collate literature on the relationship between the social environmental impact of COVID-19 and erectile dysfunction. The aim of this explorative review was to assess and compare the prevalence of erectile dysfunction (ED) in male healthcare workers and males during the COVID-19 pandemic.\ud \ud Methods-\ud \ud A systematic review of major databases from inception to February 2021 was conducted. Prevalence data were extracted, and a random-effects meta-analysis was undertaken.\ud \ud Outcomes-\ud \ud The pooled prevalence of ED amongst healthcare workers working in COVID-19 specific environments, and non-healthcare during the COVID-19 p…

Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 20…

2020

Artículo con numerosos autores. Sólo se hace referencia al primero que coincide con el de la UAM y al colectivo

Associations between mental and oral health in Spain: a cross-sectional study of more than 23,000 people aged 15 years and over.

2020

Background:\ud \ud This study aimed to investigate associations between mental health and several parameters of oral health, controlling for a variety of important covariates, in a large representative sample of Spanish people.\ud \ud Methods:\ud \ud Data from the Spanish National Health Survey 2017 were analysed. Mental (i.e., depression, chronic anxiety, other psychiatric disorders) and oral health (i.e., dental caries, dental extraction, dental filling, gingival bleeding, tooth movement, dental material, missing tooth) were evaluated. Control variables included sex, age, marital status, education, smoking, alcohol consumption, and physical multimorbidity. Associations between psychiatric…

Association of objective visual impairment with suicidal ideation and suicide attempts among adults aged =50 years in low/middle-income countries.

2021

BackgroundThere is currently limited literature on the association between visual impairment and suicidal thoughts and behaviours, especially among older adults from low/middle-income countries (LMICs). Thus, we aimed to investigate the associations of objectively measured distance visual impairment with suicidal ideation and suicide attempts among adults aged ≥50 years from six LMICs and to identify potential mediators.MethodsCross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health were analysed. Objective distance visual acuity was measured using the tumbling E logMAR chart, and vision impairment was categorised as none, mild, m…

Sedentary behavior and perceived stress among adults aged ≥50 years in six low- and middle-income countries.

2018

Background:\ud Sedentary behavior and perceived stress are both negatively associated with physical and mental health. Little is known about the association between sedentary behavior and \ud perceived stress, and there is a particular paucity of data on people aged ≥50 years from low- and middle-income countries (LMICs). \ud Methods:\ud We analyzed cross-sectional, community-based data from 34,129 individuals aged ≥50 years [mean age 62.4 (SD=16.0) years, 52% females] from six LMICs. Perceived stress was assessed using the Perceived Stress Scale and time spent sedentary per day was self-reported. Multivariable linear regression analyses were conducted, adjusting for important socio economi…