Trends in behavioral and biological risk factors for non-communicable diseases among adults in Bhutan: results from cross-sectional surveys in 2007, 2014, and 2019

Background

The study aimed to evaluate trends in the prevalence and correlates of risk factors for non-communicable diseases (NCDs; low physical activity, insufficient fruit/vegetable intake, current tobacco use, problem alcohol use, diabetes, hypertension, increased total cholesterol, and obesity) in Bhutan.

Methods

Three repeat cross-sectional Bhutan STEPS surveys (N = 9,281) in 2007, 2014, and 2019 were analyzed.

Results

The proportion of people with 3-8 NCD risk factors significantly decreased from 62.8% in 2007 to 32.6% in 2019 (p < 0.001), and the mean number of NCD risk factors significantly decreased from 3.0 in 2007 to 2.1 in 2019 (p < 0.001). In linear regression analyses by study year, older age (p < 0.001) was positively associated with eight NCD risk factors across all study years. Furthermore, male subjects were negatively (p < 0.01) and positively (p < 0.001) associated with eight NCD risk factors, respectively. Higher education levels (p < 0.05) were positively associated with eight NCD risk factors in 2007 and negatively associated with eight NCD risk factors in 2019 (p < 0.05). Employment (p < 0.001) and urban residence (p < 0.001) were positively associated with eight risk factors for NCD in 2019, while urban residence (p < 0.001) was negatively associated with eight NCD risk factors in 2014.

Conclusion

The prevalence of eight NCD risk factors decreased in Bhutan over the past 13 years. Inadequate fruit and vegetable intake, problem alcohol use, and hypertension increased, current tobacco use, low physical activity, obesity, diabetes, and elevated total cholesterol decreased from 2007 to 2019. Several factors associated for eight and each individual NCD risk factor were identified, which can help guide interventions.

Self-rated physical and mental health among older adults 80 years and older: cross-sectional results from a National community sample in Thailand

BACKGROUND

The aim of this study was to assess the self-reported physical health (SRPH) and self-reported mental health (SRMH) of older adults 80 years and older in Thailand.

METHODS

We analyze national cross-sectional data from the Health, Aging and Retirement in Thailand (HART) in 2015. Physical and mental health status was assessed by self-report.

RESULTS

The sample included 927 participants (excluding 101 proxy interviews), 80-117 years, median age 84 years [interquartile range (IQR) 81-86 years]. The median SRPH was 70.0 (IQR = 50.0-80.0), and median SRMH was 80.0 (IQR = 70.0 to 90.0). The prevalence of (good) SRPH was 53.3%, and the prevalence of (good) SRMH was 59.9%. In the final adjusted model, low or no income, living in the Northeastern, Northern and Southern region, daily activity limitations, moderate/severe pain, having one or two or more physical conditions, and low cognitive functioning were negatively associated, and higher physical activity was positively associated with good SRPH. No or low income, residing in the northern region of the country, daily activity limitations, low cognitive functioning, and probable depression were negatively associated with good SRMH, and physical activity was positively associated with good SRMH.

CONCLUSION

SRPH and SRMH was relatively high rated among the oldest old in Thailand, and influenced by various social, economic, and health-related factors. Special attention should be given to those with no or low income, those living in the non-central regions and those having no or low formal social engagement. Health care and other services should improve physical activity, financial support, and physical and mental care management to promote physical and mental well-being of older adults 80 years and older in Thailand.

Combined victimization of face-to-face and cyberbullying and adverse health outcomes among school-age adolescents in Argentina

Face-to-face bullying victimization (FBV) and cyber bullying victimization (CBV) are of global concern, including in Latin America. The aim of this study was to evaluate the associations between combined FBV and CBV relative to single victimization (FBV or CBV) and no victimization with a wide range of adverse health outcomes among school-aged adolescents from Argentina. National cross-sectional school data from 56,981 adolescents that responded to questions on FBV, CBV, and adverse health outcomes were analyzed. The results showed a prevalence of 18.7% FBV alone, 8.1% CBV alone and 13.6% combined FBV and CBV. Combined FBV and CBV had higher odds than single victimization (FBV or CBV) in 18 negative health outcomes, including anxiety, suicidal ideation, loneliness, suicide plan and attempt, smoking, smokeless tobacco use, history of intoxication, alcohol-related problems, current cannabis use, ever use of amphetamine, school truancy, participation in physical fighting, physically attacked, injury, ever sex, multiple sexual partners and sedentary behaviour. In conclusion, combined FBV and CBV had higher odds than single BV or no BV in most adverse health outcomes.

Trends in Behavioral and Biological Non-Communicable Diseases Risk Factors among Adults in Mongolia: Results from National Cross-Sectional Surveys in 2005, 2009, 2013 and 2019

Background

Understanding national trends in noncommunicable disease (NCD) risk factors may have health policy implications. We aimed to evaluate trends in the prevalence and correlates of eight risk factors for NCD from 2005 to 2019 in Mongolia.

Methods

Cross-sectional data were analyzed from 9,356 individuals (15-64/69 yr, mean age=37.3 yr) who participated in the Mongolia STEPS 2005, 2009, 2013 or 2019 surveys and had complete measurement of the risk factor for NCD.

Results

The proportion of having 3-8 NCD risk factors significantly decreased from 59.1% in 2005 to 49.4% in 2019, and the mean number of NCD risk factors significantly decreased from 2.8 in 2005 to 2.6 in 2019. In linear regression analyses by study year, older age and male sex were across all study years positively associated with eight NCD risk factors. The prevalence of low physical activity increased from 8.2% in 2005 to 28.4% in 2019, overweight/obesity from 49.6% in 2005 to 64.0% in 2019, and raised total cholesterol from 23.9% in 2005 to 27.6% in 2019, there was a significant decrease in inadequate fruit and vegetable intake from 85.1% in 2005 to 79.5% in 2019, current smoking from 26.6% in 2005 to 24.1% in 2019, hypertension from 28.2% in 2005 to 23.2% in 2019, while the prevalence of diabetes remained unchanged from 2005 to 2019.

Conclusion

The prevalence of eight risk factors for NCD decreased in the last 15 years in Mongolia. Several associated variables for eight and individual NCD risk factors were identified that can help guide interventions.

Prevalence and determinants of incident and persistent depressive symptoms among middle-aged and older adults in Thailand: prospective cohort study

BACKGROUND

There are no longitudinal studies investigating determinants of incident and persistent depressive symptoms in Southeast Asia.

AIMS

To estimate the proportion and correlates of incident and persistent depressive symptoms in a prospective cohort study among middle-aged and older adults (≥45 years) in Thailand.

METHOD

We analysed longitudinal data from the Health, Aging, and Retirement in Thailand (HART) surveys in 2015 and 2017. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Logistic regression was used to calculate predictors of incident and persistent depressive symptoms.

RESULTS

In total, 290 of 4528 participants without depressive symptoms in 2015 had incident depressive symptoms in 2017 (9.8%) and 76 of 640 adults had persistent depressive symptoms (in both 2015 and 2017) (18.3%). In adjusted logistic regression analysis, having diabetes (adjusted odds ratio AOR = 1.48, 95% CI 1.07-2.05), musculoskeletal conditions (AOR = 1.56, 95% CI 1.01-2.41) and having three or more chronic conditions (AOR = 2.55, 95% CI 1.67-3.90) were positively associated and higher subjective economic status (AOR = 0.47, 95% CI 0.31-0.72) and social participation (AOR = 0.66, 95% CI 0.49-0.90) were inversely associated with incident depressive symptoms. Having a cardiovascular disease (AOR = 1.55, 95% CI 1.01-2.39) and having three or more chronic conditions (AOR = 2.47, 95% CI 1.07-5.67) were positively associated and social participation (AOR = 0.48, 95% CI 0.26-0.87) was inversely associated with persistent depressive symptoms.

CONCLUSIONS

One in ten middle-aged and older adults had incident depressive symptoms at 2-year follow-up. The prevalence of incident and/or persistent depression was higher in people with a lower subjective economic status, low social participation, diabetes, musculoskeletal disorders, cardiovascular conditions and a higher number of chronic diseases.

Prevalence and Correlates of Cardiovascular Health Status among Adults in Afghanistan: Results of a National Survey in 2018

Background

The aim of the study was to assess the prevalence and correlates of cardiovascular health (CVH) status among adults in Afghanistan.

Methods

In a national cross-sectional household survey 3,447 adults completed CVH measurements in Afghanistan. Criteria for ideal CVH (ICVH) were physical activity, healthy diet, non-smoking, fasting blood glucose (<100 mg/dL), body mass index (<25 kg/m²), total cholesterol (<200 mg/dL), and blood pressure (<120/<80 mmHg).

Results

More than one-third (34.3%) of participants had 5-7 ICVH, 45.7% 3-4 ICVH, and 20% had 0-2 ICVH. In adjusted logistic regression analysis, secondary or more education (AOR: 1.80, 95% CI: 1.22-2.66) was positively associated, and older age (45-69 years) (AOR: 0.33, 95% CI: 0.26-0.42), and urban residence (AOR: 0.67, 95% CI: 0.51-0.88) were inversely associated with 5-7 ICVH.

Conclusions

The prevalence of ICVH was low in Afghan adults. Population measures may be used to improve CVH targeting identified associated factors.

Clinicomics-guided distant metastasis prediction in breast cancer via artificial intelligence

BACKGROUND

Breast cancer has become the most common malignant tumour worldwide. Distant metastasis is one of the leading causes of breast cancer-related death. To verify the performance of clinicomics-guided distant metastasis risk prediction for breast cancer via artificial intelligence and to investigate the accuracy of the created prediction models for metachronous distant metastasis, bone metastasis and visceral metastasis.

METHODS

We retrospectively enrolled 6703 breast cancer patients from 2011 to 2016 in our hospital. The figures of magnetic resonance imaging scanning and ultrasound were collected, and the figures features of distant metastasis in breast cancer were detected. Clinicomics-guided nomogram was proven to be with significant better ability on distant metastasis prediction than the nomogram constructed by only clinical or radiographic data.

RESULTS

Three clinicomics-guided prediction nomograms on distant metastasis, bone metastasis and visceral metastasis were created and validated. These models can potentially guide metachronous distant metastasis screening and lead to the implementation of individualized prophylactic therapy for breast cancer patients.

CONCLUSION

Our study is the first study to make cliniomics a reality. Such cliniomics strategy possesses the development potential in artificial intelligence medicine.

Prevalence and associated factors of incident and persistent loneliness among middle-aged and older adults in Thailand

BACKGROUND

The aim of the study was to assess the prevalence and associated factors of incident and persistent loneliness in a prospective cohort study among middle-aged and older adults (≥ 45 years) in Thailand.

METHODS

Longitudinal data from the Health, Aging, and Retirement in Thailand (HART) study in 2015 and 2017 were analysed. Loneliness was assessed with one item from the Center for Epidemiological Studies Depression scale. Logistic regression was used to calculate predictors of incident and persistent loneliness.

RESULTS

In total, at baseline 21.7% had loneliness, 633 of 3696 participants without loneliness in 2015 had incident loneliness in 2017 (22.2%), and 239 of 790 adults had persistent loneliness (in both 2015 and 2017) (30.3%). In adjusted logistic regression analysis, low income (aOR: 1.27, 95% CI: 1.03 to 1.57), poor self-rated physical health status (aOR: 1.64, 95% CI: 1.27 to 2.12), hypertension (aOR: 1.34, 95% CI: 1.09 to 1.65), depressive symptoms (aOR: 1.97, 95% CI: 1.11 to 3.49), and having three or chronic conditions (aOR: 1.76, 95% CI: 1.19 to 2.60) were positively associated and a higher education (aOR: 0.74, 95% CI: 0.55 to 0.98) and living in the southern region of Thailand (aOR: 0.43, 95% CI: 0.30 to 0.61) were inversely associated with incident loneliness. Poor self-rated physical health status (aOR: 1.91, 95% CI: 1.26 to 2.88), and having three or more chronic diseases (aOR: 1.78, 95% CI: 1.07 to 2.98), were positively associated, and living in the southern region (aOR: 0.40, 95% CI: 0.25 to 0.65) was inversely associated with persistent loneliness.

CONCLUSION

More than one in five ageing adults had incident loneliness in 2 years of follow-up. The prevalence of incident and/or persistent loneliness was higher in people with a lower socioeconomic status, residing in the central region, poor self-rated physical health status, depressive symptoms, hypertension, and a higher number of chronic diseases.

Health risk behaviour and persistent and incident depression among middle-aged and older adults in South Africa

The aim of this study was to assess the association between five health risk behaviours and persistent and incident depressive symptoms in a longitudinal study in South Africa. The sample included 5059 men and women (≥40 years) in 2014/2015, and 4176 in 2018/2019 of the 'Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa'. Depressive symptoms were assessed with the Centre for Epidemiologic Studies Depression scale. Multivariable logistic regression analysis was conducted to assess the associations between five health risk behaviours and persistent and incident depressive symptoms. Results indicate that 5.0% of participants had depressive symptoms at both wave 1 and 2 (persistent depressive symptoms), and 27.9% had incident depressive symptoms in wave 2. Higher education and moderate baseline physical activity were negatively associated and those with cardiovascular disease were positively associated with persistent depressive symptoms. Middle wealth index was negative, and being HIV positive and baseline tobacco use were positively associated with incident depressive symptoms. In conclusion, of five health risk behaviours assessed (inadequate fruit/vegetable intake, alcohol dependence, tobacco use, physical activity, and sedentary behaviour), only moderate physical activity was protective against persistent depressive symptoms, and tobacco use was associated with incident depressive symptoms.

Tridirectional association between probable depression, fear of falling and falls among middle-aged and older adults in Thailand

PURPOSE

Depression is a major issue in the aging population, which may be related to fear of falling (FOF) and falls contributing to increased morbidity and mortality. The aim of the study was to assess the tridirectional associations between probable depression (PD), FOF and falls in a longitudinal study in Thailand.

METHODS

Longitudinal data of participants (≥45 years; N = 3708) from two consecutive waves (in 2015 and 2017) of the Health, Aging and Retirement in Thailand (HART) study were analysed. PD was assessed with the Center for Epidemiologic Studies Depression Scale, self-reported FOF and history of falls.

RESULTS

Having no PD in 2015 and PD in 2017 (aOR: 2.35, 95% CI: 1.67 to 3.30), and having both PD in 2015 and 2017 (aOR: 3.46, 95% CI: 1.92 to 6.23) were positively associated with incident FOF with activity avoidance, and no FOF in 2015 and FOF in 2017 (aOR: 2.29, 95% CI: 1.77 to 2.95), and both FOF in 2015 and 2017 (aOR: 2.38, 95% CI: 1.69 to 3.36) were positively associated with incident PD. Two or more falls in 2015 (aOR: 2.03, 95% CI: 1.29 to 3.19) was positively associated with incident PD, and both PD in 2015 and 2017 (aOR: 3.10, 95% CI: 1.40 to 6.48) were positively associated with incident multiple (≥2) falls.

CONCLUSIONS

We found tridirectional associations between PD, FOF and falls. It is suggested to screen and manage older adults for PD, FOF and fall history simultaneously.

Food insecurity is associated with multiple psychological and behavioural problems among adolescents in five Caribbean countries

The study aimed to assess associations between food insecurity and multiple psychological and behavioural problems among adolescents in five Caribbean countries. Data from national and cross-sectional school health surveys from 9,956 adolescents (15 years, median age) in Trinidad and Tobago, Suriname, Jamaica, Anguilla and the Dominican Republic in 2016-2017 were analyzed in 2016-2017. Results show that the prevalence of moderate (rarely or sometimes) past-month food insecurity was 35.9% and severe (mostly or always) food insecurity was 4.6%. Severe food insecurity among adolescents ranged from 2.9% in Dominican Republic to 11.2% in Suriname. In adjusted logistic regression analyses, the higher severity of food insecurity was associated with negative psychological outcomes (loneliness, suicidal ideation, suicide plan, suicide attempt, anxiety, current tobacco use and any trouble from alcohol use) and negative behavioural outcomes (truancy, bullied, physically attacked, physical injury, and multiple sexual partners). Two out of five adolescents experienced some form of food security. Food interventions, such as school feeding programmes, are warranted to reduce negative psychosocial outcomes.

Prevalence and associated factors of cross-sectional and incident self-reported arthritis or rheumatism among a national community sample of middle-aged and older adults in Thailand

Background

The study aimed to assess the prevalence and associated factors of cross-sectional and incident arthritis or rheumatism among a national community sample of middle-aged and older adults in Thailand.

Methods

We analyzed cross-sectional and longitudinal data from two consecutive waves (2015 and 2017) of the Health, Aging, and Retirement in Thailand (HART) study. Arthritis or rheumatism (SRA) was assessed by self-reported health care provider diagnosis.

Results

The cross-sectional (baseline) sample included 5,616 participants (≥45 years, median age 66 years, interquartile range 57 to 76 years) and the incident (follow-up) sample included 3,545 participants. The prevalence of SRA in the cross-sectional sample (baseline) was 4.0% and in the incident (follow-up) sample 5.3%. In the cross-sectional multivariable model, obesity class I (aOR: 1.78, 95% CI: 1.19 to 2.67), obesity class II (aOR: 1.82, 95% CI: 1.02 to 3.25), hypertension (aOR: 1.90, 95% CI: 1.35 to 2.66), brain disease and/or psychiatric problems (aOR: 4.79, 95% CI: 2.27 to 10.62), sleep problem (aOR: 1.45, 95% CI: 1.01 to 2.07) and prescription drug use (aOR: 1.63, 95% CI: 1.14 to 2.33) were positively associated, and not in the labor force (aOR: 0.53, 95% CI: 0.34 to 0.84), and employed (aOR: 0.63, 95% CI: 0.41 to 0.99) were negatively associated with SRA. In the incident multivariable model, obesity class I (aOR: 1.78, 95% CI: 1.17 to 3.61), obesity class II (aOR: 2.01, 95% CI: 1.12 to 3.61), poor mental health (aOR: 1.69, 95% CI: 1.19 to 2.41), and functional disability (aOR: 2.04, 95% CI: 1.01 to 4.13) were positively associated, and current alcohol use (aOR: 0.50, 95% CI: 0.25 to 0.99) was negatively associated with SRA.

Conclusion

The middle and older Thai adults had a low prevalence and incidence of SRA, and several physical and mental risk factors for cross-sectional and/or incident SRA were identified.

Lifestyle factors, mental health, and incident and persistent intrusive pain among ageing adults in South Africa

OBJECTIVES

The purpose of this study was to evaluate longitudinal associations with incident and persistent intrusive pain among rural South Africans.

METHODS

Longitudinal data from two consecutive waves in 2014/2015 and 2018/2019 in Agincourt, South Africa, were analysed. Pain was assessed with the Brief Pain Inventory.

RESULTS

In all, 683 adults of 3,628 participants without intrusive pain in Wave 1 (19.1%) had incident intrusive pain in Wave 2, 94 adults of 254 participants who had intrusive pain in Wave 1 (38.3%) had intrusive pain at both Wave 1 and 2 (persistent intrusive pain). Furthermore, 358 (7.2%) participants had intrusive pain at baseline. In the fully adjusted model for people without intrusive pain at baseline, the study found that obesity (AOR: 1.31, 95% CI: 1.05-1.63), depressive symptoms (AOR: 1.67, 95% CI: 1.34-2.08), PTSD (AOR: 1.71, 95% CI: 1.19-2.45), and poor sleep quality (AOR: 1.30, 95% CI: 1.04-1.62) were positively associated with incident intrusive pain. Older age was positively, and male sex and daily alcohol use were negatively associated with incident intrusive pain. Furthermore, in the final adjusted logistic regression model, this study found that older age was positively, and underweight, overweight, and high sedentary behavior were negatively associated with persistent intrusive pain.

CONCLUSIONS

Several modifiable risk factors for incident and/or persistent intrusive pain were identified.

Tobacco use and incident sleep parameters among a rural ageing population in South Africa

INTRODUCTION

Tobacco use may be associated with incident insomnia. The aim of the study was to investigate the association between tobacco use and incident sleep parameters in a longitudinal study in South Africa.

METHODS

Longitudinal data from two consecutive waves of middle-aged and older adults in 2014-2015 (n=5059) and 2018-2019 (n=4176) in rural South Africa were analyzed. Tobacco use and sleep parameters were assessed by self-report. The associations between tobacco use and incident sleep parameters were estimated with multivariable logistic regression.

RESULTS

The prevalence of baseline sleep parameters was poor sleep quality 6.5%, sleep disturbance 13.6%, restless sleep 32.9%, and breathing stops 7.0%. In the fully adjusted model for people without poor sleep quality at baseline, daily tobacco smoking, smoking ≥10 units of tobacco products, current tobacco use and current smokeless tobacco use did not increase the odds of incident poor sleep quality. Smoking ≥10 units of tobacco products in a day (AOR=3.83; 95% CI: 1.77-8.28), current tobacco use (AOR=1.65; 95% CI: 1.09-2.51), and daily tobacco smoking (AOR=2.16; 95% CI: 1.15-4.07), were significantly positively associated with incident sleep disturbance. Furthermore, incident restless sleep was significantly positively associated with smoking ≥10 units of tobacco products in a day (AOR=3.97; 95% CI: 1.18-13.37), current smokeless tobacco use (AOR=2.78; 95% CI: 1.17-6.62) and current tobacco use (AOR=2.00; 95% CI: 1.00-4.00). Incident breathing stops were significantly positively associated with daily smoking tobacco (AOR=2.08; 95% CI: 1.11-3.34), smoking 1-9 units of tobacco products in a day (AOR=2.17; 95% CI: 1.20-3.94), and current tobacco use (AOR=1.77; 95% CI: 1.16-2.72).

CONCLUSIONS

Higher tobacco use was independently associated with incident sleep disturbance, incident restless sleep, and incident breathing stops, but not with incident poor sleep quality.

Food insecurity and health outcomes among community-dwelling middle-aged and older adults in India

The study assessed associations between food insecurity and mental, physical, and behavioural health outcomes in India. The study analysed national cross-sectional population-based data (N = 72,262;  ≥ 45 years) from in India in 2017-2018. The overall prevalence of food insecurity was 9.7%. Food insecurity was significantly positively associated with poor mental health [low life satisfaction (AOR: 2.75, 95% CI 2.35-3.23), low self-reported health (AOR: 1.61, 95% CI 1.11-1.42), insomnia symptoms (AOR: 1.64, 95% CI 1.45-1.85), depressive symptoms (AOR: 2.21, 95% CI 1.97-2.48), major depressive disorder (AOR: 2.37, 95% CI 2.03-2.77), Alzheimer's/dementia (AOR: 1.75, 95% CI 1.13-2.69), and poorer cognitive functioning (AOR: 0.68, 95% CI 0.49-0.93)], poor physical health [bone or joint disease (AOR: 1.18, 95% CI 1.04-1.34), angina (AOR: 1.80, 95% CI 1.58-2.06), underweight (AOR: 1.28, 95% CI 1.16-1.40), chronic lung disease (AOR: 1.22, 95% CI 1.03-1.45), and functional disability (AOR: 1.68, 95% CI 1.47-1.92)], and health risk behaviour [tobacco use (AOR: 1.13, 95% CI 1.01-1.25), heavy episodic drinking (AOR: 1.45, 95% CI 1.10-1.91) and physical inactivity (AOR: 1.42, 95% CI 1.21-1.67)]. Furthermore, food insecurity was negatively associated with overweight/obesity (AOR: 0.80, 95% CI 0.73-0.88). Food insecurity was associated with seven poor mental health indicators, five poor physical health conditions, and three health risk behaviours. Programmes and policies that improve food availability may help improve mental and physical health among middle-aged and older adults in India.

Bidirectional Association Between Probable Depression and Multimorbidity Among Middle-Aged and Older Adults in Thailand

Introduction

The purpose of this study was to assess the bidirectional association between multimorbidity (MM) and probable depression in a longitudinal study in Thailand.

Methods

We analyzed longitudinal data of participants 45 years and older from two consecutive waves (in 2015 and 2017) of Health, Aging, and Retirement in Thailand (HART). Probable depression was assessed using the Center for Epidemiological Studies Depression scale. Logistic regression analysis was conducted to assess the association between baseline probable depression and incident physical MM, and baseline physical MM and incident probable depression.

Results

In all, 2712 participants without MM at baseline and 2684 without probable depression at baseline were included. At follow-up 15.6% of probable depression cases and 11.4% of nonprobable depression cases developed physical MM, and at follow-up 13.3% of physical MM cases and 8.9% of nonphysical MM cases developed probable depression. In the final logistic regression analysis, adjusted for age, sex, marital status, income, education, body mass index, physical activity, smoking tobacco, alcohol use, and social engagement, probable depression at baseline was positively associated with incident physical MM (aOR: 1.50, 95% CI: 1.09 to 2.06), and physical MM at baseline was positively associated with incident probable depression (aOR: 1.47, 95% CI: 1.07 to 2.02).

Discussion

Baseline physical MM increases the risk of incident probable depression and baseline probable depression increases the risk of incident physical MM among middle-aged and older adults in Thailand.

A Cross-Sectional and Longitudinal Study of Pain among Middle-Aged and Older Adults in Thailand

Objective

The present study aimed to assess the prevalence and risk factors of pain among ageing adults in Thailand.

Methods

Cross-sectional and longitudinal data were analysed from two consecutive national waves of the Health, Aging, and Retirement in Thailand (HART) study in 2015 and 2017. The dependent variable pain was defined as moderate or severe pain in any of the 13 areas of the body over the past month. Independent variables included sociodemographic factors, health risk behaviour, physical and mental health conditions, and healthcare utilization.

Results

The baseline or cross-sectional sample consisted of 5,616 participants (≥45 years), and the follow-up or incident sample consisted of 2,305 participants. The proportion of pain in the cross-sectional/baseline sample was 36.0%, and in the incident/follow-up sample 39.9%. In the cross-sectional/baseline multivariable model, poor self-reported mental health, sleep problem, arthritis or rheumatism, brain disease and/or psychiatric problems, lung disease, use of hospital in-patient, conventional out-patient, and traditional medicine practitioners were positively associated with pain. In the incident/follow-up multivariable model, older age, Buddhist religion, class I obesity, poor self-reported mental health, hospital in-patient, private clinic out-patient, and use of a practitioner of traditional medicine were positively associated with pain. Male sex and higher education were negatively associated with both cross-sectional and incident pain.

Conclusions

More than one-third of older adults in Thailand had past month moderate or severe pain. Risk factors of pain from cross-sectional and/or incident analysis included older age, female sex, lower education, obesity, poor self-reported mental health, sleep problem, arthritis or rheumatism, brain disease and/or psychiatric problems, lung disease, and conventional and traditional healthcare utilization.

Prevalence and correlates of major depressive disorder among a national sample of middle-aged and older adults in India

Objectives: This study aimed to assess the prevalence and correlates of major depressive disorder (MDD) among middle-age and older adults in India.Methods: The cross-sectional sample consisted of 72,262 persons (45 years and older) from the 2017 to 2018 Longitudinal Ageing Study in India (LASI) Wave 1. MDD is defined using DSM-5 criteria and measured with the CIDI-SF. Logistic regression was used to evaluate the associations with MDD.Results: The prevalence of past 12-month MDD was 7.6%, 8.1% among women and 7.0% among men, and 8.2% in persons 60 years and older. In the final adjusted model, food insecurity, having 3-6 discrimination experiences, ill-treatment, victim of violent crime, disaster exposure, unsafe home/neighbourhood, poor childhood health, hypertension, stroke, tobacco use, and physical pain were positively associated with MDD. Being male, married, high socioeconomic status, living in urban areas, high spirituality/religiosity, health insurance and medium social network were negatively associated with MDD.Conclusion: Almost one in ten middle-aged and older adults in India had MDD and several associated factors were identified.

Bidirectional association between functional disability and multimorbidity among middle-aged and older adults in Thailand

Objectives

The purpose of this study was to assess the bidirectional association between multimorbidity (MM) and functional disability among middle-aged and older adults in a longitudinal study in Thailand.

Methods

We analyzed longitudinal data of participants aged 45 years and older from two consecutive waves (in 2015 and 2017) of the Health, Aging, and Retirement in Thailand (HART). Functional disability was assessed with a 4-item activity of daily living (ADL) scale. Logistic regression analysis was conducted to assess the association between baseline functional disability and incident MM (≥2), and baseline morbidity and incident functional disability.

Results

The results indicate that a total of 1,716 individuals without morbidity at baseline and 3,529 without functional disability at baseline were included. At follow-up, 16.7 and 20.0% of functional disability cases and 7.1 and 3.6% of nonfunctional disability cases developed 2 morbidities and 3 or more morbidities, respectively, and 6.6% of MM cases and 4.0% of non-MM cases developed a functional disability. In the final logistic regression model adjusted for education, income, age, marital status, sex, smoking tobacco, body mass index (BMI), alcohol use, physical activity, and social engagement, functional disability at baseline was positively associated with incident MM (≥2) (adjusted odds ratio [aOR]: 2.58, 95% CI: 1.42-4.72), and MM (≥3) at baseline was positively associated with incident functional disability (aOR: 1.97, 95% CI: 1.13-3.43).

Conclusion

Multimorbidity and functional disability were bidirectionally associated.

Psychological and physical intimate partner violence and sexual risk behavior among South African couples: a dyadic analysis

This study aimed to examine intimate partner violence (IPV) as it relates to both partners' perceptions of IPV and sexual behaviors, considering how their IPV might be interdependent within the relationship dynamics. The sample consisted of 713 female-male dyads in which women were pregnant and living with HIV in rural South Africa. Using an actor-partner interdependence model (APIM), we examined the interdependent influence of psychological and physical IPV on men by their female partners and psychological and physical IPV on women by their male partners on sexual risk behavior. The APIM model found there were no actor (b = -0.06, SE = 0.05, p = .221) or partner (b = -1.2, SE = 0.06, p = .056) effects contributing to protected sex by female IPV victimization. In contrast, significant actor (b = -0.28, SE = 0.06, p < .001) and partner (b = -0.29, SE = 0.06, p < .001) effects for protection were related to male IPV victimization. The model also found that the covariate of female HIV disclosure was associated with both male (b = 0.5, SE = 0.12, p < .001) and female protected sexual intercourse (b = 0.58, SE = 0.1, p < .001). Female HIV disclosure was related to an increased likelihood of protected sex by both male and female partners. As male partners reported more IPV victimization, the likelihood of protected sex between male and female partners decreased.Trial registration: ClinicalTrials.gov identifier: NCT02085356.

Prevalence and factors associated with undiagnosed type 2 diabetes among adults in Iraq: analysis of cross-sectional data from the 2015 STEPS survey

OBJECTIVE

The purpose of the study was to assess the prevalence and correlates of undiagnosed type 2 diabetes (UT2D) among adults (aged 18 years and older) in Iraq.

DESIGN

Cross-sectional, population-based study.

SETTING

Nationally representative sample of general community-dwelling adult population in Iraq from the 2015 Iraq STEPS survey.

PARTICIPANTS

The sample included 3853 adults (mean age 41.8 years, SD=15.8), with complete fasting blood glucose values, from the 2015 Iraq STEPS survey.

OUTCOME MEASURES

Data collection included: (1) social and behavioural information, (2) physical parameters and blood pressure measurements and (3) biochemical measurements. UT2D was classified as not being diagnosed with T2D and fasting plasma glucose level ≥126 mg/dL. Multivariable multinomial and logistic regression was used to identify factors associated with UT2D.

RESULTS

The prevalence of UT2D was 8.1% and the prevalence of diagnosed T2D (DT2D) was 8.9%. Participants aged 50 years and older (adjusted relative risk ratio (ARRR): 2.11, 95% CI 1.30 to 3.43) and those with high cholesterol (ARRR: 1.54, 95% CI 1.05 to 2.24) had a higher risk of UT2D. Older age (≥50 years) (ARRR: 17.90, 95% CI 8.42 to 38.06), receipt of healthcare advice (ARRR: 2.15, 95% CI 1.56 to 2.96), history of cholesterol testing (ARRR: 2.17, 95% CI 1.58 to 2.99), stroke or heart attack (ARRR: 1.81, 95% CI 1.13 to 2.92), and high cholesterol (ARRR: 1.55, 95% CI 1.17 to 2.06) were positively associated with DT2D, and high physical activity (ARRR: 0.57, 95% CI 0.38 to 0.84) was negatively associated with DT2D. Higher than primary education (adjusted OR (AOR): 2.02, 95% CI 1.21 to 3.37) was positively associated with UT2D versus DT2D, while older age (≥50 years) (AOR: 0.12, 95% CI 0.06 to 0.25), healthcare advice (AOR: 0.45, 95% CI 0.29 to 0.70), and history of cholesterol screening (AOR: 0.37, 95% CI 0.24 to 0.58) were inversely associated with UT2D versus DT2D.

CONCLUSION

Almost one in ten adults in Iraq had UT2D, and various associated factors were identified that could be useful in planning interventions.

Factors affecting face mask-wearing behaviors to prevent COVID-19 among Thai people: A binary logistic regression model

OBJECTIVES

Face mask wearing is a standard preventive measure, in addition to handwashing and physical distancing. Individuals may find that wearing a face mask protects their physical health and prevents viral transmission. However, none of the studies in Thailand identified factors associated with face mask-wearing behaviors among Thai people. Therefore, this study aims to determine factors affecting face mask-wearing behaviors to prevent COVID-19.

METHODS

This research is analytical survey research. The data used in this study were under the project title "The assessment of psychosocial and behavioral response and compliance to restriction measures to prevent and control COVID-19: A series of the rapid survey." A total of 6,521 people participated in an online survey by multi-stage sampling. Bivariate logistic regression analysis was used to examine the factors associated with face mask-wearing behaviors.

RESULTS

After adjusting for independent variables (i.e., gender, age, education, career, smoking, and comorbidity disease), the bivariate logistic regression analysis revealed that gender, age, and career were statistically significant to the face mask-wearing behaviors (p < 0.05). Level of education, smoking, and comorbidity disease were not statistically significant with face mask-wearing behaviors among Thai people.

CONCLUSION

Further study should explore broader on individual face mask perceptions and wearing in the continuing of COVID-19 across gender, age, and careers to better understand their health behaviors and to inform further policy. In addition, the development of an intervention to promote face mask wearing should target men who age below 30 yrs. and did not work in government services careers as this group of the population was likely not to wear a face mask outside the home.

Mental distress and incident functional disability among a rural ageing population in South Africa

OBJECTIVES

The aim of the study was to investigate the association between mental symptoms and incident functional disability among middle-age and older adults in South Africa.

METHODS

Longitudinal data from two consecutive population surveys (2014/2015-2018/2019) in Agincourt, South Africa, were analysed.

RESULTS

In total, 298 of 3813 participants without functional disability in wave 1 (8.8%) had functional disability in wave 2. The prevalence of baseline functional disability was 9.1%. In the fully adjusted models for people without functional disability at baseline, depressive symptoms (AOR: 1.74, 95% CI: 1.08-2.80) among men and lower life satisfaction among men (AOR: 0.86, 95% CI: 0.80-0.93) and among women (AOR: 0.90, 95% CI: 0.83-0.98) increased the odds of incident functional disability. Posttraumatic stress disorder symptoms, poor sleep quality, restless sleep, and loneliness were not significantly associated with incident functional disability.

CONCLUSIONS

Depressive symptoms among men and lower life satisfaction among both sexes were independently associated with incident functional disability in ageing rural South Africans.