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Shan J, Yin R, Panuthai S. Body mass index and multimorbidity risk: A systematic review and dose-response meta-analysis. Arch Gerontol Geriatr 2024; 123:105418. [PMID: 38604087 DOI: 10.1016/j.archger.2024.105418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE To verify the dose-response relationship between body mass index (BMI) and multimorbidity risk. METHODS PubMed, CINAHL, and Embase were systematically studied until January 25, 2023. Original articles on BMI and multimorbidity risk were included. Random effects model and dose-response meta-analysis were used to estimate the pooled odds ratio (OR) with 95 % confidence interval (CI). Subgroup analysis was performed to explore potential heterogeneity. RESULTS A total of 43 studies involving 969,130 patients (94,978 with multimorbidity) were involved in the meta-analysis. In the longitudinal studies, the pooled results showed that, compared to being a normal BMI, being overweight was much similar with 1.32 times possibility of getting multimorbidity; in persons with obesity the risk was 1.93 times higher; and the risk decreased 0.80 times among underweight persons. Additionally, obesity was 1.75 times as likely to be multimorbidity than those non-obese persons. In the cross-sectional studies, the pooled results demonstrated that persons with overweight and obesity had a 1.38-fold and 2.38-fold risk for multimorbidity, respectively; and the risk decreased 0.90 times among underweight persons compared to those with normal BMI. Besides, obese people are 1.89 times more likely to have multimorbidity than non-obese people. Dose response analysis found the linear connection between BMI and multimorbidity risk (Pnon-linearity=0.762), that for each 1 kg/m2 and 5 kg/m2 increase in BMI, the multimorbidity risk increased by 6 % and 35 %, respectively. CONCLUSIONS Multimorbidity increased linearly with an increase in BMI. Clinicians should pay attention to persons with abnormal weight, to help them achieve normal BMI.
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Affiliation(s)
- Jun Shan
- School of Nursing and Rehabilitation, Nantong University, China; Faculty of Nursing, Chiang Mai University, under the CMU presidential Scholarship, Thailand
| | - Rulan Yin
- Department of Nursing, The First Affiliated Hospital of Soochow University, China; Faculty of Nursing, Chiang Mai University, 110/406 Inthavaroros Road, Suthep, Muang district, Chiangmai 50200, Thailand
| | - Sirirat Panuthai
- Faculty of Nursing, Chiang Mai University, 110/406 Inthavaroros Road, Suthep, Muang district, Chiangmai 50200, Thailand.
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Sharma SK, Nambiar D, Ghosh A. Sex differences in non-communicable disease multimorbidity among adults aged 45 years or older in India. BMJ Open 2023; 13:e067994. [PMID: 36972971 PMCID: PMC10069553 DOI: 10.1136/bmjopen-2022-067994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVE Older male and female adults differ in key characteristics such as disease-specific life expectancy, health behaviours and clinical presentations and non-communicable disease multimorbidity (NCD-MM). Therefore, examining the sex differences in NCD-MM among older adults is vital, as this issue is understudied in low-income and middle-income country (LMIC) contexts such as India, and has been growing in the past few decades. DESIGN Large scale nationally representative cross-sectional study. SETTINGS AND PARTICIPANTS Longitudinal Ageing Study in India (LASI 2017-2018) had data on 27 343 men and 31 730 women aged 45+, drawn from a sample of 59 073 individuals across India. PRIMARY AND SECONDARY OUTCOMES MEASURES We operationalised NCD-MM based on prevalence of the presence of two or more long-term chronic NCD morbidities. Descriptive statistics and bivariate analysis along with multivariate statistics were used. RESULTS Women aged 75+ had a higher prevalence of multimorbidity as compared with men (52.1% vs 45.17%). NCD-MM was more common among widows (48.5%) than widowers (44.8%). The female-to-male ratios of ORs (RORs) for NCD-MM associated with overweight/obesity and prior history of chewing tobacco were 1.10 (95% CI: 1.01 to 1.20) and 1.42 (95% CI: 1.12 to 1.80), respectively. The female-to-male RORs show that the odds of NCD-MM were greater in formerly working women (1.24 (95% CI: 1.06 to 1.44)) relative to formerly working men. The effect of increasing NCD-MM on limitations in activities of daily living and instrumental ADL was greater in men than women but reversed for the hospitalisation. CONCLUSIONS We found significant sex differences in NCD-MM prevalence among older Indian adults, with various associated risk factors. The patterns underlying these differences warrant greater study, given existing evidence on differential longevity, health burdens and health-seeking patterns all of which operate in a larger structural context of patriarchy. Health systems in turn must respond to NCD-MM mindful of these patterns and aim to redress some of the larger inequities they reflect.
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Affiliation(s)
| | - Devaki Nambiar
- The George Institute for Global Health India, New Delhi, India
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Arpita Ghosh
- The George Institute for Global Health India, New Delhi, India
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Stumpf FMDM, de Oliveira ASD, Faerstein E, Curioni CC. Cross-sectional associations between body mass index, waist circumference, and multimorbidity: Pró-Saúde study. PeerJ 2023; 11:e14744. [PMID: 36778147 PMCID: PMC9910183 DOI: 10.7717/peerj.14744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/23/2022] [Indexed: 02/08/2023] Open
Abstract
Background This study aimed (1) To investigate the association between the Body Mass Index (BMI) and waist circumference (WC) with multimorbidity (MM), and (2) To identify patterns of MM and investigate the relationship between BMI and WC with specific combinations of MM (patterns of MM). Methods A cross-sectional study was conducted with 2,698 participants of the fourth phase of the Brazilian Longitudinal Study of Adult Health (Pró-Saúde Study). MM was defined by the presence of two or more morbidities. MM patterns were identified by exploratory factor analysis based on tetrachoric correlations. Logistic regression models were used to assess associations (odds ratios (OR) with the respective confidence intervals (CI)). Results Of the total number of participants, 39.5% were overweight and 30.0% were obese; 89.0% (n = 1,468) of women and 77.0% (n = 952) of men were abdominally obese. Indeed, 60.7% (n = 1,635) was identified with MM. For the category four or more morbidities, OR values of 5.98 (95% CI 4.84-7.13) and 7.48 (95% CI 6.14-8.18) were found for each point of increase in BMI, and 6.74 (95% CI 5.48-7.99) and 8.48 (95% CI 7.64-9.29) for each additional centimeter in the WC, for female and male, respectively. Five patterns of MM were identified: respiratory, osteoarticular, cardiometabolic, gastric, and thyroid diseases (56.4% of the total variance). Positive associations were found between BMI and patterns of cardiometabolic, osteoarticular, thyroid and gastric diseases (higher OR of 1.09 [95% CI 1.04-1.14]) and less pronounced between WC and patterns of cardiometabolic and osteoarticular (higher OR of 1.04 [95% CI 1.03-1.04]). Conclusions The results showed that an increase of both BMI and WC was associated with a higher number of morbidities and with patterns of cardiometabolic and osteoarticular diseases.
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Affiliation(s)
| | | | - Eduardo Faerstein
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cintia Chaves Curioni
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Quintina de Andrade Moura E, Dumke de Siqueira C, Carolina Martins A, Fonseca Nunes B, Carolina Rabello de Moraes A, Branco Filippin-monteiro F. Drug binding and drug-drug interaction considerations in individuals with obesity before and after bariatric surgery: a retrospective cross-sectional study. Medicine in Drug Discovery 2023. [DOI: 10.1016/j.medidd.2023.100152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
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Peng P, Li J, Wang L, Ai Z, Tang C, Tang S. An analysis of socioeconomic factors on multiple chronic conditions and its economic burden: evidence from the National Health Service Survey in Yunnan Province, China. Front Public Health 2023; 11:1114969. [PMID: 37206862 PMCID: PMC10189125 DOI: 10.3389/fpubh.2023.1114969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/14/2023] [Indexed: 05/21/2023] Open
Abstract
Background The economic burden of multiple chronic conditions (MCCs) and its socio-economic influencing factors have widely raised public concerns. However, there are few large population-based studies on these problems in China. Our study aims at determining the economic burden of MCCs and associated factors specific to multimorbidity among middle-aged and older individuals. Methods As our study population, we extracted all 11,304 participants over 35 years old from the 2018 National Health Service Survey (NHSS) in Yunnan. Economic burden and socio-demographic characteristics were analyzed with descriptive statistics. Chi-square test and generalized estimating equations (GEE) regression models were used to identify influencing factors. Results The prevalence of chronic diseases was 35.93% in 11,304 participants and the prevalence of MCCs increased with age, was 10.12%. Residents who lived in rural areas were more likely to report MCCs than those who lived in urban areas (adjusted OR = 1.347, 97.5% CI: 1.116-1.626). Ethnic minority groups were less likely to report MCCs than those of Han (OR = 0.752, 97.5% CI: 0.601-0.942). Overweight or obese people were more likely to report MCCs than people with normal weight (OR = 1.317, 97.5% CI: 1.099-1.579). The per capita expenses of 2 weeks' illness, per capita hospitalization expenses, annual household income, annual household expenses, and annual household medical expenses of MCCs were ¥292.90 (±1427.80), ¥4804.22 (±11851.63), ¥51064.77 (±52158.76), ¥41933.50 (±39940.02) and ¥11724.94 (±11642.74), respectively. The per capita expenses of 2 weeks' illness, per capita hospitalization expenses, annual household income, annual household cost, and annual household medical expenses of hypertensive co-diabetic patients were more compared to those with other three comorbidity modes. Conclusion The prevalence of MCCs was relatively high among middle-aged and older individuals in Yunnan, China, which bought a heavy economic burden. This encourages policy makers and health providers to pay more attention to the behavioral/lifestyle factors, that contribute to multimorbidity to a great extent. Furthermore, health promotion and education in terms of MCCs need to be prioritized in Yunnan.
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Affiliation(s)
- Puxian Peng
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Jing Li
- Yunnan Health Development Research Center, Kunming, China
| | - Liping Wang
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Zhonghua Ai
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Churou Tang
- Department of Biology, University of Rochester, Rochester, NY, United States
| | - Songyuan Tang
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
- *Correspondence: Songyuan Tang,
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Brady E, Castelli M, Walker R, Grayling M, Alaba O, Chola L. The prevalence and social determinants of multimorbidity in South Africa. World Med & Health Policy 2022. [DOI: 10.1002/wmh3.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Elise Brady
- Population Health Sciences Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne UK
| | - Michele Castelli
- Population Health Sciences Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne UK
| | - Richard Walker
- Department of Medicine North Tyneside General Hospital, Rake Lane North Shields Tyne and Wear UK
| | - Michael Grayling
- Population Health Sciences Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne UK
| | - Olufunke Alaba
- Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences University of Cape Town Cape Town South Africa
| | - Lumbwe Chola
- Department of Public Health Science Univeristy of Oslo Oslo Norway
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Jackson CT, Young J, Onsando WM. High Rates of Multimorbidity Reported Among People of Color Despite Healthy Weight. Health Equity 2022; 6:662-668. [PMID: 36225658 PMCID: PMC9536332 DOI: 10.1089/heq.2022.0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose: Methods: Results: Conclusion:
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Affiliation(s)
- Carlos T. Jackson
- Community Care of North Carolina, Cary, North Carolina, USA
- The Dartmouth Institute of Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, USA
| | - Jessica Young
- Department of General Pediatrics and Adolescent Medicine, Department of Family Medicine, and Preventive Medicine Residency Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - W. Moraa Onsando
- The Dartmouth Institute of Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, USA
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Caballero FF, Lana A, Struijk EA, Arias-Fernández L, Yévenes-Briones H, Cárdenas-Valladolid J, Salinero-Fort MÁ, Banegas JR, Rodríguez-Artalejo F, Lopez-Garcia E. Prospective Association Between Plasma Amino Acids And Multimorbidity In Older Adults. J Gerontol A Biol Sci Med Sci 2022; 78:637-644. [PMID: 35876753 DOI: 10.1093/gerona/glac144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Some amino acids have been associated with aging-related disorders and risk of physical impairment. The aim of this study was to assess the association between plasma concentrations of nine amino acids, including branched-chain and aromatic amino acids, and multimorbidity. METHODS This research uses longitudinal data from the Seniors-ENRICA 2 study, a population-based cohort from Spain which comprises non-institutionalized adults older than 65. Blood samples were extracted at baseline and after a follow-up period of two years for a total of 1488 subjects. Participants' information was linked with electronic health records. Chronic diseases were grouped into a list of 60 mutually exclusive conditions. A quantitative measure of multimorbidity, weighting morbidities by their regression coefficients on physical functioning, was employed and ranged from 0 to 100. Generalized estimating equation models were used to explore the relationship between plasma amino acids and multimorbidity, adjusting for sociodemographics, socioeconomic status and lifestyle behaviors. RESULTS The mean age of participants at baseline was 73.6 (SD = 4.2) years, 49.6% were women. Higher concentrations of glutamine [coef. per mmol/l (95% confidence interval = 10.1 (3.7, 16.6)], isoleucine [50.3 (21.7, 78.9)] and valine [15.5 (3.1, 28.0)] were significantly associated with higher multimorbidity scores, after adjusting for potential confounders. Body mass index could have influenced the relationship between isoleucine and multimorbidity (p = 0.016). CONCLUSIONS Amino acids could play a role in regulating aging-related diseases. Glutamine and branched-chain amino acids as isoleucine and valine are prospectively associated and could serve as risk markers for multimorbidity in older adults.
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Affiliation(s)
- Francisco Félix Caballero
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid
| | - Alberto Lana
- Department of Medicine. Universidad de Oviedo/ISPA, Oviedo
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid
| | | | - Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid
| | - Juan Cárdenas-Valladolid
- Dirección Técnica de Sistemas de Información. Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid.,Fundación de Investigación e Innovación Biosanitaria de Atención Primaria, Madrid.,Enfermería. Universidad Alfonso X El Sabio, Villanueva de la Cañada
| | - Miguel Ángel Salinero-Fort
- Fundación de Investigación e Innovación Biosanitaria de Atención Primaria, Madrid.,Subdirección General de Investigación Sanitaria. Consejería de Sanidad, Madrid.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas.,Grupo de Envejecimiento y Fragilidad de las personas mayores. IdIPAZ, Madrid
| | - José R Banegas
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid
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Znyk M, Zajdel R, Kaleta D. Consulting Obese and Overweight Patients for Nutrition and Physical Activity in Primary Healthcare in Poland. Int J Environ Res Public Health 2022; 19:ijerph19137694. [PMID: 35805379 PMCID: PMC9265845 DOI: 10.3390/ijerph19137694] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 11/16/2022]
Abstract
The aim of this study was to evaluate the dietary and physical activity counseling provided to adults by family doctors. Predictors of counseling in primary healthcare were identified. A cross-sectional study was conducted from January 2020 to December 2021 among 896 adult primary care patients in the city of Łódź [Lodz], Poland. Almost 36% of the respondents were advised to change their eating habits, and 39.6% were advised to increase their physical activity. In a multivariate logistic regression analysis, people in poor health with chronic diseases related to overweight and obesity and with two, three or more chronic diseases, respectively, received advice on eating habits from their GP twice and three times more often than people in good health with no chronic conditions (OR = 1.81; p < 0.05 and OR = 1.63; p < 0.05; OR = 3.03; p < 0.001). People in the age groups 30−39 years and 40−49 years (OR = 1.71; p < 0.05 and OR = 1.58; p < 0.05), widowed (OR = 2.94; p < 0.05), with two, three or more chronic diseases (OR = 1.92; p < 0.01 and OR = 3.89; p < 0.001), and subjectively assessing overweight and obesity (OR = 1.61; p < 0.01) had a better chance of receiving advice on physical activity. The study found a higher proportion of advice on diet and physical activity provided to overweight and obese patients by primary care physicians than in other studies; however, still not all receive the necessary counseling. GPs should advise all patients not to become overweight and obese, not only those already affected by the problem.
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Affiliation(s)
- Małgorzata Znyk
- Department of Hygiene and Epidemiology, Medical University of Lodz, Żeligowskiego 7/9, 90-752 Łódź, Poland;
- Correspondence:
| | - Radosław Zajdel
- Department of Computer Science in Economics, University of Lodz, POW 3/5, 90-255 Łódź, Poland;
| | - Dorota Kaleta
- Department of Hygiene and Epidemiology, Medical University of Lodz, Żeligowskiego 7/9, 90-752 Łódź, Poland;
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Chauhan S, Srivastava S, Kumar P, Patel R. Decomposing urban-rural differences in multimorbidity among older adults in India: a study based on LASI data. BMC Public Health 2022; 22:502. [PMID: 35291975 PMCID: PMC8922782 DOI: 10.1186/s12889-022-12878-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multimorbidity is defined as the co-occurrence of two or more than two diseases in the same person. With rising longevity, multimorbidity has become a prominent concern among the older population. Evidence from both developed and developing countries shows that older people are at much higher risk of multimorbidity; however, urban-rural differential remained scarce. Therefore, this study examines urban-rural differential in multimorbidity among older adults by decomposing the risk factors of multimorbidity and identifying the covariates that contributed to the change in multimorbidity. METHODS The study utilized information from 31,464 older adults (rural-20,725 and urban-10,739) aged 60 years and above from the recent release cross-sectional data of the Longitudinal Ageing Study in India (LASI). Descriptive, bivariate, and multivariate decomposition analysis techniques were used. RESULTS Overall, significant urban-rural differences were found in the prevalence of multimorbidity among older adults (difference: 16.3; p < 0.001). The multivariate decomposition analysis revealed that about 51% of the overall differences (urban-rural) in the prevalence of multimorbidity among older adults was due to compositional characteristics (endowments). In contrast, the remaining 49% was due to the difference in the effect of characteristics (Coefficient). Moreover, obese/overweight and high-risk waist circumference were found to narrow the difference in the prevalence of multimorbidity among older adults between urban and rural areas by 8% and 9.1%, respectively. Work status and education were found to reduce the urban-rural gap in the prevalence of multimorbidity among older adults by 8% and 6%, respectively. CONCLUSIONS There is a need to substantially increase the public sector investment in healthcare to address the multimorbidity among older adults, more so in urban areas, without compromising the needs of older adults in rural areas.
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Affiliation(s)
- Shekhar Chauhan
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- Research Scholar, International Institute for Population Sciences, Mumbai, India
| | - Pradeep Kumar
- Consultant- Research & Data Analysis, Population Council India Office, Zone 5A, India Habitat Centre, Lodi Road, 110003, New Delhi, India
| | - Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India.
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Muhammad T, Boro B, Kumar M, Srivastava S. Gender differences in the association of obesity-related measures with multi-morbidity among older adults in India: evidence from LASI, Wave-1. BMC Geriatr 2022; 22:171. [PMID: 35232371 PMCID: PMC8886975 DOI: 10.1186/s12877-022-02869-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 02/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Co-existence of multiple chronic diseases is increasingly becoming a norm among ageing population. The study aims to investigate the prevalence of multimorbidity and the association between anthropometric measures of obesity and multimorbidity among men and women aged 60 years and above in India. Methods The present study is based on the first wave of the Longitudinal Aging Study in India. The analytical sample size for the study was 28,050 older adults aged 60 years and above. Descriptive statistics and multivariable analysis using logistic regression models were conducted. Results Body Mass Index (BMI) based-obesity is more prevalent among older women than men (26.3% vs. 17.6%). Similarly, higher proportion of older women was at high-risk waist circumference (37.1% vs 8.9%) and waist-hip ratio (78.5 vs 75.4%) than men respectively. In Model-I, after controlling for several covariates, older adults with overweight/obesity were 1.6 times more likely to have multi-morbidity than non-obese older adults (Adjusted OR = 1.61; 95% CI: 1.48–1.74). Similarly, older adults with high-risk waist circumference [Adjusted OR: 1.66; 95% CI: 1.52–1.80] and waist-hip ratio [Adjusted OR: 1.45; 95% CI: 1.33–1.59] also had higher odds of having multi-morbidity in reference to their counterparts. In model-3 it was found that females with high-risk waist-hip ratio had 14% lower odds of multimorbidity than males with high-risk waist-hip ratio [Adjusted OR: 0.86; 95%CI: 0.78–0.94]. Conclusion The findings of the study show significant gender difference in the prevalence of multimorbidity, men being at increased risk in the multivariate analysis which is uncommon in the existing epidemiological research. Interactive effect of male gender with anthropometric measures on multimorbidity reported in our study probably due to increased unhealthy behaviours among men requires further research.
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Affiliation(s)
- T Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Bandita Boro
- Centre for the Study of Regional Development (CSRD), School of Social Sciences-3 (SSS 3), Jawaharlal Nehru University (JNU), New Delhi, 110067, India
| | - Manish Kumar
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
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Bramhankar M, Pandey M, Rana GS, Rai B, Mishra NL, Shukla A. An assessment of anthropometric indices and its association with NCDs among the older adults of India: evidence from LASI Wave-1. BMC Public Health 2021; 21:1357. [PMID: 34238276 PMCID: PMC8268209 DOI: 10.1186/s12889-021-11421-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study is to assess the status of physical body indices such as body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) among the older adults aged 45 and above in India. Further, to explore the association of anthropometric indices with various non-communicable morbidities. METHODS The study uses secondary data of the Longitudinal Ageing Survey's first wave in India (2017-18). The national representative sample for older adults 45 and above (65,662) considered for the analysis. The prevalence of the non-communicable diseases (NCDs) included in the study is based on the self-reporting of the participants. Diseases included are among the top ten causes of death, such as cancer, hypertension, stroke, chronic heart diseases, diabetes, chronic respiratory diseases, and multi-morbidity. Multi-morbidity is a case of having more than one of the morbidities mentioned above. BMI-obese indicates an individual having a BMI ≥30, and the critical threshold value for high-risk WC for men is ≥102 cm while for women is ≥88 cm. The critical limit for the high-risk WHR for men and women is ≥0.90 and ≥ 0.85, respectively. Descriptive statistics and multiple logistic regressions are used to assess the association BMI, WC, and WHR with non-communicable morbidities. RESULTS Based on the multivariate-adjusted model, odds shows that an Indian older adult aged 45 and above is 2.3 times more likely (AOR: 2.33; 95% CI (2.2, 2.5)) by obesity, 61% more likely (AOR: 1.61; 95% CI (1.629, 1.631)) by high-risk WHR and 98% more likely (AOR: 1.98; 95% CI (1.9, 2.1)) by high-risk WC to develop CVDs than their normal counterparts. Similarly, significant positive associations of obesity, high-risk WC, and high-risk WHR were observed with other NCDs and multi-morbidity. CONCLUSION Our study shows that obesity, high-risk WC, and high-risk WHR are significant risks for developing NCDs and multi-morbidity among the older adults in India. There is a need for a multi-sectoral approach to reduce the share of the elderly population in high-risk groups of BMIs, WHR, and WC.
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Affiliation(s)
| | - Mohit Pandey
- International Institute For Population Sciences, Mumbai, 400088 India
| | | | - Balram Rai
- International Institute For Population Sciences, Mumbai, 400088 India
| | - Nand Lal Mishra
- International Institute For Population Sciences, Mumbai, 400088 India
| | - Anandi Shukla
- International Institute For Population Sciences, Mumbai, 400088 India
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Srivastava S, Joseph K J V, Dristhi D, Muhammad T. Interaction of physical activity on the association of obesity-related measures with multimorbidity among older adults: a population-based cross-sectional study in India. BMJ Open 2021; 11:e050245. [PMID: 34020981 PMCID: PMC8144051 DOI: 10.1136/bmjopen-2021-050245] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/29/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To explore the associations between obesity-related measures and multimorbidity among older Indian adults and the interactive effects of physical activity in those associations. DESIGN A cross-sectional study was conducted using large representative survey data. SETTING AND PARTICIPANTS The present study used data from the Longitudinal Aging Study in India (LASI) conducted during 2017-2018. Participants included 15 098 male and 16 366 female older adults aged 60 years and above in India. PRIMARY AND SECONDARY OUTCOME MEASURES The outcome variable was multimorbidity among older adults coded as no and yes. Descriptive statistics along with bivariate analysis are presented in the paper. Additionally, binary logistic regression analysis was used to fulfil the study objectives. RESULTS About 24% of older adults in the LASI cohort suffered from multimorbidity. Older adults who were overweight/obese (adjusted OR (AOR): 1.61, CI 1.48 to 1.74), had high-risk waist circumference (AOR: 1.66, CI 1.52 to 1.80) and had high-risk waist to hip ratio (AOR: 1.45, CI 1.33 to 1.59) were significantly more likely to suffer from multimorbidity compared with their counterparts. Older adults who were obese and physically inactive had significantly increased odds of suffering from multimorbidity compared with older adults who were obese and physically active. Similarly, older adults with high-risk waist circumference (AOR: 1.30, CI 1.11 to 1.53) and high-risk waist to hip ratio (AOR: 1.32, CI 1.20 to 1.46) along with being physically inactive had significantly higher odds of suffering from multimorbidity in comparison with older adults with high-risk waist circumference and waist to hip ratio along with being physically active. CONCLUSION While developing health strategies for older adults, physical activity needs to be recognised as a way of minimising comorbidities. Further, the study highlights the importance of using multiple obesity-related measures to predict chronic conditions in the older population.
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Affiliation(s)
- Shobhit Srivastava
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Vinod Joseph K J
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Drishti Dristhi
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - T Muhammad
- Department of Population Policies and Programs, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Geda NR, Janzen B, Pahwa P. Chronic disease multimorbidity among the Canadian population: prevalence and associated lifestyle factors. ACTA ACUST UNITED AC 2021; 79:60. [PMID: 33910618 DOI: 10.1186/s13690-021-00583-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/18/2021] [Indexed: 11/10/2022]
Abstract
Background Chronic diseases is increasingly becoming one of the most pressing public health concerns in most part of the world, including the Canadian population. The purpose of this study was to estimate the prevalence of multimorbidity in the general population based on 14 major chronic diseases and examine associations with lifestyle/behavioral factors. Methods The data source was the 2015–2016 Canadian Community Health Survey (CCHS). The CCHS is a cross sectional, complex multi-stage survey based on information collected from 109,659 participants aged 12+, covering all provinces and territories. Multimorbidity was defined as the co-occurrence of two or more chronic diseases within a person. Multiple logistic regression was used to examine the key determinants of multimorbidity. Results The prevalence of multimorbidity was 33 %. Adjusting for sociodemographic variables, there was an increased odd of multimorbidity for those having a sedentary lifestyle (AOR = 1.06; CI:1.01–1.11) and being obese (AOR = 1.37; CI:1.32–1.43) or overweight (AOR = 2.65; CI: 2.54–2.76). There were two statistically significant interactions, between sex and smoking, and between immigration status and alcohol intake. Smoking was more strongly associated with multimorbidity in females than males. The association between alcohol intake and multimorbidity was also dependent upon immigration status. Conclusions Given the high prevalence of multimorbidity among the general Canadian population, policy makers and service providers should give more attention to the behavioral/lifestyle factors which significantly predicted multimorbidity. Policy and program efforts that promote a healthy lifestyle should be a priority.
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Puri P, Kothavale A, Singh S, Pati S. Burden and determinants of multimorbidity among women in reproductive age group: a cross-sectional study based in India. Wellcome Open Res 2021; 5:275. [PMID: 34131591 PMCID: PMC8182697 DOI: 10.12688/wellcomeopenres.16398.2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 01/07/2023] Open
Abstract
Background: India's government is currently running several programs with a sole focus on women's health during their child-bearing years. However, none of these programs incorporate the management of chronic health conditions during the reproductive span. This issue is an emerging public health concern; therefore, the present study aims to identify the patterns and correlates of multimorbidity among women in reproductive age groups in India. Methods: The study utilizes nationally-representative cross-sectional data from the Demographic and Health Survey on 661,811 women in the reproductive age group of 15-49 years. The study uses information on seven chronic morbidities, namely asthma, cancers, heart disease, diabetes, tuberculosis, hypertension, and thyroid disorder. Descriptive, bivariate, and multivariable techniques were utilized to accomplish the study objective. Results: The findings show that 17.4 and 3.5 per 100 women of reproductive age suffered from any one morbidity and multimorbidity, respectively. Hypertension, diabetes, and thyroid disorders were commonly occurring morbidities. The prevalence of having any one morbidity or multimorbidity increased with age. Variables like religion, wealth, parity, menopause, consumption of tobacco and alcohol, body mass index, and type of diet were found to be significantly related to the burden of multimorbidity. The prevalence of multimorbidity was found to be higher for women who belong to the Southern, Eastern, and North-Eastern regions of India. Conclusions: Findings suggest the importance of multimorbidity in the context of women of reproductive age. Inclusion of chronic disease management strategies with maternal and child health services needs to be taken into consideration by the program and policymakers. The annexation of social marketing approaches at the primary level of healthcare would assist policy-makers in educating women about the importance of leading a healthy lifestyle. Practicing dietary diversity can help in maintaining optimal estrogen levels, which would further help in decreasing multimorbidity rates among women in India.
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Affiliation(s)
- Parul Puri
- International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India
| | - Ajinkya Kothavale
- International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India
| | - S.K. Singh
- International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India
| | - Sanghamitra Pati
- ICMR Regional Medical Research Centre, Indian Council of Medical Research, Department of Health Research, Bhubaneswar, Odisha, 751023, India
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Bezerra de Souza DL, Oliveras-Fabregas A, Espelt A, Bosque-Prous M, de Camargo Cancela M, Teixidó-Compañó E, Jerez-Roig J. Multimorbidity and its associated factors among adults aged 50 and over: A cross-sectional study in 17 European countries. PLoS One 2021; 16:e0246623. [PMID: 33571285 PMCID: PMC7877625 DOI: 10.1371/journal.pone.0246623] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/22/2021] [Indexed: 11/18/2022] Open
Abstract
AIMS To estimate the prevalence of multimorbidity among European community-dwelling adults, as well as to analyse the association with gender, age, education, self-rated health, loneliness, quality of life, size of social network, Body Mass Index (BMI) and disability. METHODS A cross-sectional study based on wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE) was conducted, and community-dwelling participants aged 50+ (n = 63,844) from 17 European countries were selected. Multimorbidity was defined as presenting two or more health conditions. The independent variables were gender, age group, educational level, self-rated health, loneliness, size of network, quality of life, BMI and disability (1+ limitations of basic activities of daily living). Poisson regression models with robust variance were fit for bivariate and multivariate analysis. RESULTS The prevalence of multimorbidity was 28.2% (confidence interval-CI 95%: 27.5.8-29.0) among men and 34.5% (CI95%: 34.1-35.4) among women. The most common health conditions were cardiometabolic and osteoarticular diseases in both genders, and emotional disorders in younger women. A large variability in the prevalence of multimorbidity in European countries was verified, even between countries of the same region. CONCLUSIONS Multimorbidity was associated with sociodemographic and physical characteristics, self-rated health, quality of life and loneliness.
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Affiliation(s)
- Dyego Leandro Bezerra de Souza
- Department of Collective Health, Graduate Programme in Collective Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduate Programme in Collective Health, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
- Faculty of Health Sciences and Welfare, Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Barcelona, Spain
| | - Albert Oliveras-Fabregas
- Faculty of Health Sciences and Welfare, Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Barcelona, Spain
- Faculty of Psychology, Education and Sport Sciences Blanquerna, Physical Activity, Sport and Health Research Group, Universitat Ramon Llull, Barcelona, Spain
| | - Albert Espelt
- Faculty of Health Sciences of Manresa, University of Vic–Central University of Catalonia, Manresa, Spain
- Departament de Psicobiologia i Metodologia en Ciències de la Salut, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marina Bosque-Prous
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | | | - Ester Teixidó-Compañó
- Faculty of Health Sciences of Manresa, University of Vic–Central University of Catalonia, Manresa, Spain
| | - Javier Jerez-Roig
- Postgraduate Programme in Collective Health, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
- Faculty of Health Sciences and Welfare, Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Barcelona, Spain
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Zhao Q, Wang J, Nicholas S, Maitland E, Sun J, Jiao C, Xu L, Leng A. Health-Related Quality of Life and Health Service Use among Multimorbid Middle-Aged and Older-Aged Adults in China: A Cross-Sectional Study in Shandong Province. Int J Environ Res Public Health 2020; 17:E9261. [PMID: 33322307 DOI: 10.3390/ijerph17249261] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 12/17/2022]
Abstract
(1) Background: The management of multiple chronic diseases challenges China's health system, but current research has neglected how multimorbidity is associated with poor health-related quality of life (HRQOL) and high health service demands by middle-aged and older adults. (2) Methods: A cross-sectional study was conducted in Shandong province, China in 2018 across three age groups: Middle-aged (45 to 59 years), young-old (60 to 74 years), and old-old (75 or above years). The information about socio-economic, health-related behaviors, HRQOL, and health service utilization was collected via face-to-face structured questionnaires. The EQ-5D-3L instrument, comprising a health description system and a visual analog scale (VAS), was used to measure participants' HRQOL, and χ2 tests and the one-way ANOVA test were used to analyze differences in socio-demographic factors and HRQOL among the different age groups. Logistic regression models estimated the associations between lifestyle factors, health service utilization, and multimorbidity across age groups. (3) Results: There were 17,867 adults aged 45 or above in our sample, with 9259 (51.82%) female and 65.60% living in rural areas. Compared with the middle-aged adults, the young-old and old-old were more likely to be single and to have a lower level of education and income, with the old-old having lower levels than the young-old (P < 0.001). We found that 2465 (13.80%) suffered multimorbidities of whom 75.21% were older persons (aged 60 or above). As age increased, both the mean values of EQ-5D utility and the VAS scale decreased, displaying an inverse trend to the increase in the number of chronic diseases (P < 0.05). Ex-smokers and physical check-ups for middle or young-old respondents and overweight/obesity for all participants (P < 0.05) were positively correlated with multimorbidity. Drinking within the past month for all participants (P < 0.001), and daily tooth-brushing for middle (P < 0.05) and young-old participants (P < 0.001), were negatively associated with multimorbidity. Multimorbidities increased service utilization including outpatient and inpatient visits and taking self-medicine; and the probability of health utilization was the lowest for the old-old multimorbid patients (P < 0.001). (4) Conclusions: The prevalence and decline in HRQOL of multimorbid middle-aged and older-aged people were severe in Shandong province. Old patients also faced limited access to health services. We recommend early prevention and intervention to address the prevalence of middle-aged and old-aged multimorbidity. Further, the government should set-up special treatment channels for multiple chronic disease sufferers, improve medical insurance policies for the older-aged groups, and set-up multiple chronic disease insurance to effectively alleviate the costs of medical utilization caused by economic pressure for outpatients and inpatients with chronic diseases.
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Shang X, Peng W, Wu J, He M, Zhang L. Leading determinants for multimorbidity in middle-aged Australian men and women: A nine-year follow-up cohort study. Prev Med 2020; 141:106260. [PMID: 33017600 DOI: 10.1016/j.ypmed.2020.106260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/14/2020] [Accepted: 09/01/2020] [Indexed: 02/05/2023]
Abstract
Although socioeconomic, behavioural, psychological, and biological factors have been individually linked to multimorbidity, data on the importance of these factors are limited. Our study aimed to determine the leading predictors for multimorbidity of chronic conditions in middle-aged Australian adults using machine learning methods. We included 53,867 participants aged 45-64 years from the 45 and Up Study who were free of eleven predefined chronic conditions at baseline (2006-2009) in the analysis. Incident multimorbidity was defined by the co-existence of ≥2, ≥3, or ≥ 4 conditions during follow-up until December 31, 2016. The five leading predictors for multimorbidity in men were age (7.2-20.5% of total variance), body mass index (6.5-15.4%), smoking (4.0-8.3%), chicken intake (3.6-7.5%), and red meat intake (4.6-6.3%) across the three definitions. Leading predictors varied across the three definitions in women, but the four common ones were body mass index (6.3-20.1%), age (6.2-16.4%), chicken intake (4.1-8.3%), and red meat intake (4.2-4.7%). The ten leading modifiable health factors accounted for 39.4-46.1% of total variance across the three definitions. Men with 6-10 health factors had 46-54% lower risks for multimorbidity compared with those reporting ≤2. The corresponding percentage for women was 45-52%. Non-behavioural factors including psychological distress, low education and income and high relative economic disadvantage were among the leading risk factors for multimorbidity. In conclusion, modifications on behavioural factors including diets, physical activity, smoking, alcohol consumption may reduce the risk of multimorbidity in middle-aged adults, whereas individuals with low socioeconomic status or psychological distress are at the highest priority for intervention.
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Affiliation(s)
- Xianwen Shang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; School of Behavioural and Health Sciences, Australian Catholic University, Australia; Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Australia
| | - Wei Peng
- Research Centre for Data Analytics and Cognition, La Trobe University, Melbourne, Australia
| | - Jinrong Wu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Mingguang He
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia; State Key Laboratory of Ophthalmology, National Clinical Research Center, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
| | - Lei Zhang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health, Science Center, Xi'an, Shaanxi, China; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia; Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia; Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China..
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Puri P, Kothavale A, Singh S, Pati S. Burden and determinants of multimorbidity among women in reproductive age group: a cross-sectional study based in India. Wellcome Open Res 2020; 5:275. [PMID: 34131591 PMCID: PMC8182697 DOI: 10.12688/wellcomeopenres.16398.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 08/23/2023] Open
Abstract
Background: India's government is currently running several programs with a sole focus on women's health during their child-bearing years. However, none of these programs incorporate the management of chronic health conditions during the reproductive span. This issue is an emerging public health concern; therefore, the present study aims to identify the patterns and correlates of multimorbidity among women in reproductive age groups in India. Methods: The study utilizes nationally-representative cross-sectional data from the Demographic and Health Survey on 661,811 women in the reproductive age group of 15-49 years. The study uses information on seven chronic morbidities, namely asthma, cancers, heart disease, diabetes, tuberculosis, hypertension, and thyroid disorder. Descriptive, bivariate, and multivariable techniques were utilized to accomplish the study objective. Results: The findings show that 17.4 and 3.5 per 100 women of reproductive age suffered from any one morbidity and multimorbidity, respectively. Hypertension, diabetes, and thyroid disorders were commonly occurring morbidities. The prevalence of having any one morbidity or multimorbidity increased with age. Variables like religion, wealth, parity, menopause, consumption of tobacco and alcohol, body mass index, and type of diet were found to be significantly related to the burden of multimorbidity. The prevalence of multimorbidity was found to be higher for women who belong to the Southern, Eastern, and North-Eastern regions of India. Conclusions: Findings suggest the importance of multimorbidity in the context of women of reproductive age. Inclusion of chronic disease management strategies with maternal and child health services needs to be taken into consideration by the program and policymakers. The annexation of social marketing approaches at the primary level of healthcare would assist policy-makers in educating women about the importance of leading a healthy lifestyle. Practicing dietary diversity can help in maintaining optimal estrogen levels, which would further help in decreasing multimorbidity rates among women in India.
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Affiliation(s)
- Parul Puri
- International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India
| | - Ajinkya Kothavale
- International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India
| | - S.K. Singh
- International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India
| | - Sanghamitra Pati
- ICMR Regional Medical Research Centre, Indian Council of Medical Research, Department of Health Research, Bhubaneswar, Odisha, 751023, India
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Hu F, Xu L, Zhou J, Zhang J, Gao Z, Hong Z. Association between Overweight, Obesity and the Prevalence of Multimorbidity among the Elderly: Evidence from a Cross-Sectional Analysis in Shandong, China. Int J Environ Res Public Health 2020; 17:E8355. [PMID: 33198066 DOI: 10.3390/ijerph17228355] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 12/11/2022]
Abstract
(1) Background: Multimorbidity, defined as the occurrence of two or more chronic diseases, is a global public health problem which has a significant negative impact on individuals, families and the society. The aim of this study was to evaluate the association between overweight, obesity and the prevalence of multimorbidity among male and female older adults; (2) Methods: Cross-sectional data of the 7070 participants from China, aged 60 years and above included in 2017 the Shandong Elderly Family Health Service Survey were analyzed. Multivariate logistic regression analysis was used to examine the relationship between overweight, obesity and the prevalence of multimorbidity in males and females; (3) Results: Among the 7070 participants, of which 40.25% were males and 59.75% were females, the average age of all participants was (69.81 ± 6.45) years old. The prevalence of multimorbidity in older adults was 34.71%, and the overweight and obesity rates were 39.25% and 16.89%. Among the male elderly, the likelihood of multimorbidity was more than two times higher among the obese than the normal BMI population (OR: 2.14; 95%CI: 1.63–2.82). A less strong association was found in the overweight male older population (OR: 1.43; 95%CI: 1.18–1.74). In the females, compared with individuals with normal BMI, the risks for incident multimorbidity were high in the overweight and obese groups, with odds ratios of 1.42 (95%CI: 1.21–1.65) and 1.81 (95%CI: 1.51–2.17), respectively. (4) Conclusions: In this study, overweight and obesity had the strongest association with the prevalence of multimorbidity among Chinese older adults, and the associations were different between the male and female elderly. The prevalence of multimorbidity might be effectively prevented by controlling body mass index. Encouraging the elderly to eat the recommended amount of vegetables and fruits, walk at least 30 min a day and have enough sleep to maintain a healthy weight.
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Abstract
OBJECTIVES Whether the association between obesity-related anthropometric indices and multimorbidity differs by age among Chinese older adults (aged 65+) is unclear. We aimed to investigate the association between body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) with multimorbidity among the young-old (aged 65-79) and old-old (aged 80+) adults. DESIGN Cross-sectional population-based study. SETTING Shandong province on the eastern coast of China. PARTICIPANTS 5493 subjects aged 65 years or above. MEASUREMENTS Details on sociodemographics, lifestyle characteristics and chronic conditions were collected using a structured questionnaire. The respondents were assessed with anthropometric measurements including height, weight, WC, hip circumference. RESULTS The overall prevalence of multimorbidity in older adults (aged 65+) was 35.2%. The BMI-obesity, WC-obesity and WHR-obesity rates were 7.4%, 57.5% and 80.4%, respectively. In the young-old adults (aged 65-79), the likelihood of multimorbidity was more than two times higher among the BMI-obese than the BMI-normal population (OR 2.08, 95% CI 1.66 to 2.60). Similar but less strong associations were found for the WC-obese and WHR-obese young-old population (OR 1.60, 95% CI 1.42 to 1.81; OR 1.31, 95% CI 1.10 to 1.56, respectively). For the old-old group (aged 80+), the BMI-obese, WC-obese and WHR-obese had a higher likelihood of having multimorbidity compared with the normal weight category (OR 2.10, 95% CI 0.96 to 4.57; OR 1.75, 95% CI 1.21 to 2.54; OR 2.15, 95% CI 1.18 to 3.93, respectively). CONCLUSION BMI-obesity, WC-obesity and WHR-obesity were associated with a greater risk of multimorbidity, and the associations were different between the young-old and the old-old adults. These age differences need to be considered in assessing healthy body weight in old age. These findings may be vital for public health surveillance, prevention and management strategies for multimorbidity in older adults.
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Affiliation(s)
- Jiao Zhang
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China
- Center for Health Economics Experiment and Public Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lingzhong Xu
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China
- Center for Health Economics Experiment and Public Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jiajia Li
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China
- Center for Health Economics Experiment and Public Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Long Sun
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wenzhe Qin
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China
- Center for Health Economics Experiment and Public Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China
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Fideles IC, Akutsu RDCCDA, Costa PRF, Costa-souza J, Botelho RBA, Zandonadi RP. Brazilian Community Restaurants’ Low-Income Food Handlers: Association between the Nutritional Status and the Presence of Non-Communicable Chronic Diseases. Sustainability 2020; 12:3467. [DOI: 10.3390/su12083467] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This cross-sectional study aimed primarily to determine the association between the nutritional status and the presence of non-communicable chronic diseases (NCDs) among community restaurants’ food handlers, since their access to food can influence their body mass index (BMI). The study discusses the socio-demographic status of participants, dietary intake, the prevalence of overweightness/obesity, and self-reported diagnosed NCDs. In 36 Community Restaurants (CRs) from all of the Brazilian regions, we collected data from 559 food handlers. We used a questionnaire to collect socio-demographic data and the reported diagnosed chronic diseases. For the anthropometric evaluation with Body Mass Index calculation, we measured the weight and the height of the individuals. They were all weighed before having lunch at the CR, without shoes and coats. Associations between variables were analyzed by the chi-square test and Poisson regression at a significance level of 5%, considering health as the outcome variable. Most of the food handlers were female (63.1%), married or with a partner (51.7%), and overweight (59.9%). Among the food handlers that presented diagnosed NCDs (n = 96, 17.2% of food handlers), 45.8% (n = 44) presented hypertension and 12.5% (n = 12) type 2 diabetes mellitus. There was a significant association between BMI and NCD status in the studied population. The total daily sodium intake of food handlers was higher than the recommendations of the World Health Organization (WHO), especially from the CR lunch, which may raise the risk of chronic diseases such as hypertension (the most prevalent non-communicable disease found in our study). Despite that, in general, the CRs provide access to cheap and adequate meals to their workers, considering energy intake and the proportion of macronutrients. In this population, overweightness and obesity were prevalent; there was an association of obesity with chronic disease in the study population. Therefore, it is necessary for better menu planning for CRs to guarantee sodium reduction throughout time.
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Williamson K, Nimegeer A, Lean M. Rising prevalence of BMI ≥40 kg/m 2 : A high-demand epidemic needing better documentation. Obes Rev 2020; 21:e12986. [PMID: 32017386 PMCID: PMC7078951 DOI: 10.1111/obr.12986] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/31/2019] [Accepted: 11/18/2019] [Indexed: 12/13/2022]
Abstract
Whilst previously rare, some surveys indicate substantial increases in the population with body mass index (BMI) ≥40 kg/m2 since the 1980s. Clinicians report emerging care challenges for this population, often with high resource demands. Accurate prevalence data, gathered using reliable methods, are needed to inform health care practice, planning, and research. We searched digitally for English language sources with measured prevalence data on adult BMI ≥40 collected since 2010. The search strategy included sources identified from recent work by NCD-RisC (2017), grey sources, a literature search to find current sources, and digital snowball searching. Eighteen countries, across five continents, reported BMI ≥40 prevalence data in surveys since 2010: 12% of eligible national surveys examined. Prevalence of BMI ≥40 ranged from 1.3% (Spain) to 7.7% (USA) for all adults, 0.7% (Serbia) to 5.6% (USA) for men, and 1.8% (Poland) to 9.7% (USA) for women. Limited trend data covering recent decades support significant growth of BMI ≥40 population. Methodological limitations include small samples and data collection methods likely to exclude people with very high BMIs. BMI ≥40 data are not routinely reported in international surveys. Lack of data impairs surveillance of population trends, understanding of causation, and societal provision for individuals living with higher weights.
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Affiliation(s)
- Kath Williamson
- School of Medicine, Dentistry and NursingUniversity of GlasgowGlasgowUK
- NHS LothianEdinburghUK
| | - Amy Nimegeer
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Michael Lean
- School of Medicine, Dentistry and NursingUniversity of GlasgowGlasgowUK
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Kriaucioniene V, Petkeviciene J, Raskiliene A. Nutrition and physical activity counselling by general practitioners in Lithuania, 2000-2014. BMC Fam Pract 2019; 20:125. [PMID: 31493793 PMCID: PMC6732190 DOI: 10.1186/s12875-019-1022-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 09/03/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Primary health care plays a crucial role in providing recommendations on a healthy diet and physical activity to assist patients in weight management. The study aimed to evaluate health behaviour counselling provided by general practitioners (GPs) for adults with overweight and obesity in Lithuania between 2000 and 2014. METHODS Eight biennial postal surveys to independent nationally representative random samples of Lithuanians aged 20-64 were conducted. Response rates varied from 41.1 to 74%, with a decreasing trend over time. The data of 5867 participants who visited a GP at least once during the last year and had BMI of ≥25.0 kg/m2 were analysed. Respondents were asked about GP advice on nutrition and physical activity and changes in their health behaviour during the last year. RESULTS The proportion of persons with overweight who reported GP advice on nutrition increased from 23.6% in 2000 to 37.5% in 2010 and advice on physical activity from 11.9 to 17.2% respectively; however, later both proportions decreased slightly. The likelihood of reporting was higher in respondents with higher BMI, more chronic conditions and frequent contact with a GP. Respondents who were living in cities, older and highly educated women were all more likely to report being advised on physical activity. Men and women who received advice from a GP more often reported changes in health behaviour as compared with non-advised individuals. CONCLUSIONS Despite increasing trends, the rate of GP advice on nutrition and physical activity reported by patients with overweight and obesity remains low in Lithuania. GP advice appears to have a significant impact on attempts by patients to change behaviour related to weight control. Therefore, there is an obvious need to make additional efforts to increase the frequency of GP counselling and to identify and address barriers to advising patients with overweight.
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Affiliation(s)
- Vilma Kriaucioniene
- Faculty of Public Health, Academy of Medicine, Lithuanian University of Health Sciences, Tilzes 18, Kaunas, Lithuania.
| | - Janina Petkeviciene
- Faculty of Public Health, Academy of Medicine, Lithuanian University of Health Sciences, Tilzes 18, Kaunas, Lithuania
| | - Asta Raskiliene
- Faculty of Public Health, Academy of Medicine, Lithuanian University of Health Sciences, Tilzes 18, Kaunas, Lithuania
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Romain AJ, Marleau J, Baillot A. Association between physical multimorbidity, body mass index and mental health/disorders in a representative sample of people with obesity. J Epidemiol Community Health 2019; 73:874-880. [DOI: 10.1136/jech-2018-211497] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 04/08/2019] [Accepted: 05/20/2019] [Indexed: 11/04/2022]
Abstract
BackgroundObesity is known to be associated with poor mental health. Studies suggested that multimorbidity might explain the consequences of obesity on mental health. The objective of the present study was to examine to what extent physical multimorbidity and the severity of obesity were associated with mental health and with mental disorders.MethodsCross-sectional study including a weighted representative sample of individuals in obesity from the province of Quebec included in the 2013–2014 Canadian Community Health Survey (N=1315) and test of the replicability of the association in the three previous cycles (2011–2012, N=1180; 2009–2010, N=1166; 2007–2008, N=1298).ResultsAdjusted logistic regressions showed that when obesity classes and physical multimorbidity were considered, the latter was preferentially associated with poor perceived mental health (OR 3.58, 95% CI 2.07 to 6.22), psychological distress (OR 3.71, 95% CI 2.14 to 6.42), major depressive episode (OR 5.16, 95% CI 2.92 to 9.13), mood disorders (OR 2.31, 95% CI 1.41 to 3.78) and anxiety disorders (OR 2.46, 95% CI 1.46 to 4.16). The same associations were confirmed in the previous cycles. Obesity class was only associated with stress (OR 2.05, 95% CI 1.36 to 3.07), but this association was not confirmed in the other cycles. Both physical multimorbidity and severe obesity were associated with mental multimorbidity.ConclusionAmong people with obesity, physical multimorbidity is preferentially associated with poor mental health/disorders. There is an existence of a somatic-mental multimorbidity which should be assessed and prevented in the management of obesity.
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Calderón-Larrañaga A, Vetrano DL, Ferrucci L, Mercer SW, Marengoni A, Onder G, Eriksdotter M, Fratiglioni L. Multimorbidity and functional impairment-bidirectional interplay, synergistic effects and common pathways. J Intern Med 2019; 285:255-271. [PMID: 30357990 PMCID: PMC6446236 DOI: 10.1111/joim.12843] [Citation(s) in RCA: 184] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This review discusses the interplay between multimorbidity (i.e. co-occurrence of more than one chronic health condition in an individual) and functional impairment (i.e. limitations in mobility, strength or cognition that may eventually hamper a person's ability to perform everyday tasks). On the one hand, diseases belonging to common patterns of multimorbidity may interact, curtailing compensatory mechanisms and resulting in physical and cognitive decline. On the other hand, physical and cognitive impairment impact the severity and burden of multimorbidity, contributing to the establishment of a vicious circle. The circle may be further exacerbated by people's reduced ability to cope with treatment and care burden and physicians' fragmented view of health problems, which cause suboptimal use of health services and reduced quality of life and survival. Thus, the synergistic effects of medical diagnoses and functional status in adults, particularly older adults, emerge as central to assessing their health and care needs. Furthermore, common pathways seem to underlie multimorbidity, functional impairment and their interplay. For example, older age, obesity, involuntary weight loss and sedentarism can accelerate damage accumulation in organs and physiological systems by fostering inflammatory status. Inappropriate use or overuse of specific medications and drug-drug and drug-disease interactions also contribute to the bidirectional association between multimorbidity and functional impairment. Additionally, psychosocial factors such as low socioeconomic status and the direct or indirect effects of negative life events, weak social networks and an external locus of control may underlie the complex interactions between multimorbidity, functional decline and negative outcomes. Identifying modifiable risk factors and pathways common to multimorbidity and functional impairment could aid in the design of interventions to delay, prevent or alleviate age-related health deterioration; this review provides an overview of knowledge gaps and future directions.
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Affiliation(s)
- A Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - D L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.,Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.,Centro di Medicina dell'Invecchiamento, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - L Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - S W Mercer
- Institute of Health and Wellbeing, General Practice and Primary Care, University of Glasgow, Glasgow, UK
| | - A Marengoni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - G Onder
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.,Centro di Medicina dell'Invecchiamento, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - M Eriksdotter
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
| | - L Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
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Hussin NM, Shahar S, Din NC, Singh DKA, Chin AV, Razali R, Omar MA. Incidence and predictors of multimorbidity among a multiethnic population in Malaysia: a community-based longitudinal study. Aging Clin Exp Res 2019; 31:215-24. [PMID: 30062670 DOI: 10.1007/s40520-018-1007-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 07/13/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND Multimorbidity in older adults needs to be assessed as it is a risk factor for disability, cognitive decline, and mortality. AIMS A community-based longitudinal study was performed to determine the incidence and to identify possible predictors of multimorbidity among multiethnic older adults population in Malaysia. METHODS Comprehensive interview-based questionnaires were administered among 729 participants aged 60 years and above. Data were analyzed from the baseline data of older adults participating in the Towards Useful Aging (TUA) study (2014-2016) who were not affected by multimorbidity (349 without any chronic diseases and 380 with one disease). Multimorbidity was considered present in an individual reporting two or more chronic diseases. RESULTS After 1½ years of follow-up, 18.8% of participants who were initially free of any diseases and 40.9% of those with one disease at baseline, developed multimorbidity. The incidence rates were 13.7 per 100 person-years and 34.2 per 100 person-years, respectively. Female gender, smoking, and irregular preparing of food (lifestyle) were predictors for incidence of multimorbidity, especially in those without any disease, while Body Mass Index (BMI) 22-27 kg/m2 and inadequate daily intake of iron were identified as predictors of multimorbidity among participants who already have one disease. CONCLUSIONS The incidence rates of multimorbidity among Malaysian older adults were between the ranges of 14-34 per 100 person-years at a 1½-year follow-up. Gender, smoking, BMI 22-27 kg/m2, inadequate daily intake of iron and lack of engagement in leisure or lifestyle physical activities were possible predictors in the development of multimorbidity. There is a need to formulate effective preventive management strategies to decelerate multimorbidity among older adults.
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Bastin A, Romain AJ, Marleau J, Baillot A. Health behaviours, intentions and barriers to change among obesity classes I, II and III. Clin Obes 2019; 9:e12287. [PMID: 30458581 DOI: 10.1111/cob.12287] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 08/22/2018] [Accepted: 09/06/2018] [Indexed: 11/30/2022]
Abstract
Health behaviour change is a cornerstone in the management of obesity, and data on health behaviours, intentions and barriers to change would be useful to inform the development of interventions. The aim of this study was to describe these variables in individuals with obesity, and to compare obesity classes. The study obtained data from the Canadian Community Health Survey 2011-2012 including 5614 adults with body mass index (BMI) ≥30 kg m-2 . The majority of participants reported eating four or more fruits and vegetables daily (65.3% [95% confidence interval {CI}: 64.1-66.6]), being a regular drinker (59.6% [95% CI: 58.4-61.0]) and inactive (58.0% [95% CI: 56.7-59.3]). About 84% of participants answered they should do and/or intend to do something in the next year to improve their health, with increasing exercise being the most reported choice (69.2% [95% CI: 67.1-71.5]). Among the 58.0% (95% CI: 55.9-60.2) of participants facing barriers to change, the lack of willpower was the most reported (37.0% [95% CI: 34.2-39.7]). No difference between classes for intention to change and barriers were found. Comorbidities were the most important factor explaining several health behaviours and barriers to change. The vast majority of participants, regardless of the severity of obesity, know they should do and also want to do something to improve their health, but faced a lack of willpower. Thus, the most important thing to consider during an obesity intervention is the lack of motivation to modify health behaviours and beyond BMI, the presence of comorbidities.
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Affiliation(s)
- A Bastin
- Nursing Departement, Université du Québec en Outaouais, Gatineau, Quebec, Canada
| | - A J Romain
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec, Canada
| | - J Marleau
- Centre Intégré de Santé et de Services Sociaux de l'Outaouais, Gatineau, Quebec, Canada
| | - A Baillot
- Nursing Departement, Université du Québec en Outaouais, Gatineau, Quebec, Canada
- Institut du Savoir Montfort-Recherche, Ottawa, Ontario, Canada
- Centre de Recherche du Centre Intégré de Santé et Services Sociaux de l'Outaouais (CISSSO), Gatineau, Quebec, Canada
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Abstract
Very few studies have examined trends in multimorbidity over time and even fewer have examined trends over time across different body mass index (BMI) groups. Given a general decline in death rates but increased cardiovascular risk factors among individuals with obesity, the trend in the association between obesity and multimorbidity is hypothesized to be increasing over time. The data for our study came from the 1996-97 National Population Health Survey and the 2005 and 2012-13 Canadian Community Health Surveys (N = 277,366 across all 3 surveys). We examined trends in the association between BMI groups and multimorbidity using a logistic regression model. We also investigated trends in the prevalence of specific chronic conditions, pairs of chronic conditions and different levels of multimorbidity across BMI groups. We found significantly greater levels of multimorbidity in 2005 (OR = 1.42; p < 0.001) and 2012-13 (OR = 1.58; p < 0.001) relative to 1996-97. Changes in multimorbidity levels were much greater among individuals with class II/III (OR = 1.48; p = 0.005) and class I obesity (OR = 1.38; p = 0.001) in 2012-13 relative to 1996-97. Much of the increase in multimorbidity among individuals living with obesity was due to increases in 3+ chronic conditions and conditions in combination with hypertension, and the greatest increase was found among seniors living with obesity. Our results highlight the need for interventions aimed at preventing obesity and the prevention of chronic conditions among individuals with obesity, especially among seniors.
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Affiliation(s)
- Michael Lebenbaum
- Institute of Health Policy, Management and Evaluation, University of Toronto, 4th Floor, 155 College St, Toronto, Ontario M5T 3M6, Canada.
| | - Gregory S Zaric
- Epidemiology and Biostatistics, Kresge Building, London, Ontario N6A 5C1, Canada; Ivey Business School, University of Western Ontario, 255 Western Road, London, Ontario N6G 0N1, Canada.
| | - Amardeep Thind
- Epidemiology and Biostatistics, Kresge Building, London, Ontario N6A 5C1, Canada.
| | - Sisira Sarma
- Epidemiology and Biostatistics, Kresge Building, London, Ontario N6A 5C1, Canada.
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Jovic D, Dimkovic N, Rakocevic I, Boricic K, Atanasijevic D, Vasic M. Prevalence and factors associated with self-reported kidney disease among Serbian adults: Results of 2013 National Health Survey. PLoS One 2018; 13:e0203620. [PMID: 30208086 PMCID: PMC6135488 DOI: 10.1371/journal.pone.0203620] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 08/23/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Data from developing countries on the rates of kidney disease are scarce. The study aimed to estimate population-based prevalence of self-reported kidney disease (SRKD) in Serbia, describe co-occurrence of chronic diseases/conditions/functional limitations in respondents with SRKD and explore association between SRKD and possible risk factors. METHODS We performed a secondary analysis of 2013 National Health Survey data. Data on a total of 14,587 respondents aged 15 years or older were analyzed using means of descriptive statistics, principal component analysis and logistic regression analysis. RESULTS Out of all study respondents, 5.6% (95%CI 5.2-6.0) reported presence of kidney disease. Prevalence of all analyzed morbidities and functional limitations was higher in respondents with SRKD, and they had 8 times higher likelihood of being diagnosed with cirrhosis, 6.3 times higher likelihood of being diagnosed with urinary incontinence, more than 3 times higher likelihood of being diagnosed with degenerative disorder of bone and joint system. For cardiovascular diseases we obtained odds ratios (ORs) from 2.27 (95%CI 2.32-3.44) for heart attack to 2.95 (95%CI 2.43-3.57) for coronary heart disease. Number of co-occurrence patterns of kidney and other chronic diseases/conditions varied depending on inclusion of obesity in models. Logistic regression analysis showed that age explained most part of variability in the prevalence of SRKD and in the prevalence of two morbidities in respondents with SRKD, whereas the presence of three or more morbidities were associated with female gender, aging and low education level. CONCLUSIONS Our study provided evidence that the presence of kidney disease was significantly associated with socio-demographic, lifestyle characteristics and a number of morbidities in Serbia. There is a need for integrated care and public health interventions, tackling management of NCDs and their risk factors. Detailed well-designed studies, as part of cost-effective preventive approach, are needed for chronic kidney disease screening.
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Affiliation(s)
- Dragana Jovic
- Center for Hygiene and Human Ecology, Institute of Public Health of Serbia, Belgrade, Serbia
| | - Nada Dimkovic
- Clinical Department for Renal Disease, Zvezdara University Medical Center, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivana Rakocevic
- Department for Prevention and Control of Non-communicable Diseases, Institute of Public Health of Serbia, Belgrade, Serbia
| | - Katarina Boricic
- Center for Health Promotion, Institute of Public Health of Serbia, Belgrade, Serbia
| | - Dragana Atanasijevic
- Center for Analysis, Planning and Organization of Health Care, Institute of Public Health of Serbia, Belgrade, Serbia
| | - Milena Vasic
- Center for Analysis, Planning and Organization of Health Care, Institute of Public Health of Serbia, Belgrade, Serbia
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Fortin M, Almirall J, Nicholson K. Development of a research tool to document self-reported chronic conditions in primary care. J Comorb 2017; 7:117-23. [PMID: 29354597 DOI: 10.15256/joc.2017.7.122] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 10/31/2017] [Indexed: 11/18/2022]
Abstract
Background Researchers interested in multimorbidity often find themselves in the dilemma of identifying or creating an operational definition in order to generate data. Our team was invited to propose a tool for documenting the presence of chronic conditions in participants recruited for different research studies. Objective To describe the development of such a tool. Design A scoping review in which we identified relevant studies, selected studies, charted the data, and collated and summarized the results. The criteria considered for selecting chronic conditions were: (1) their relevance to primary care services; (2) the impact on affected patients; (3) their prevalence among the primary care users; and (4) how often the conditions were present among the lists retrieved from the scoping review. Results Taking into account the predefined criteria, we developed a list of 20 chronic conditions/categories of conditions that could be self-reported. A questionnaire was built using simple instructions and a table including the list of chronic conditions/categories of conditions. Conclusions We developed a questionnaire to document 20 self-reported chronic conditions/categories of conditions intended to be used for research purposes in primary care. Guided by previous literature, the purpose of this questionnaire is to evaluate the self-reported burden of multimorbidity by participants and to encourage comparability among research studies using the same measurement.
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Marshall TA, Van Buren JM, Warren JJ, Cavanaugh JE, Levy SM. Beverage Consumption Patterns at Age 13 to 17 Years Are Associated with Weight, Height, and Body Mass Index at Age 17 Years. J Acad Nutr Diet 2017; 117:698-706. [PMID: 28259744 DOI: 10.1016/j.jand.2017.01.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 01/11/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Sugar-sweetened beverages (SSBs) have been associated with obesity in children and adults; however, associations between beverage patterns and obesity are not understood. OBJECTIVE Our aim was to describe beverage patterns during adolescence and associations between adolescent beverage patterns and anthropometric measures at age 17 years. DESIGN We conducted a cross-sectional analyses of longitudinally collected data. PARTICIPANTS/SETTING Data from participants in the longitudinal Iowa Fluoride Study having at least one beverage questionnaire completed between ages 13.0 and 14.0 years, having a second questionnaire completed between 16.0 and 17.0 years, and attending clinic examination for weight and height measurements at age 17 years (n=369) were included. EXPOSURE Beverages were collapsed into four categories (ie, 100% juice, milk, water and other sugar-free beverages, and SSBs) for the purpose of clustering. Five beverage clusters were identified from standardized age 13 to 17 years mean daily beverage intakes and named by the authors for the dominant beverage: juice, milk, water/sugar-free beverages, neutral, and SSB. OUTCOMES Weight, height, and body mass index (BMI; calculated as kg/m2) at age 17 years were analyzed. STATISTICAL ANALYSES We used Ward's method for clustering of beverage variables, one-way analysis of variance and χ2 tests for bivariable associations, and γ-regression for associations of weight or BMI (outcomes) with beverage clusters and demographic variables. Linear regression was used for associations of height (outcome) with beverage clusters and demographic variables. RESULTS Participants with family incomes <$60,000 trended shorter (1.5±0.8 cm; P=0.070) and were heavier (2.0±0.7 BMI units; P=0.002) than participants with family incomes ≥$60,000/year. Adjusted mean weight, height, and BMI estimates differed by beverage cluster membership. For example, on average, male and female members of the neutral cluster were 4.5 cm (P=0.010) and 4.2 cm (P=0.034) shorter, respectively, than members of the milk cluster. For members of the juice cluster, mean BMI was lower than for members of the milk cluster (by 2.4 units), water/sugar-free beverage cluster (3.5 units), neutral cluster (2.2 units), and SSB cluster (3.2 units) (all P<0.05). CONCLUSIONS Beverage patterns at ages 13 to 17 years were associated with anthropometric measures and BMI at age 17 years in this sample. Beverage patterns might be characteristic of overall food choices and dietary behaviors that influence growth.
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