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

2021 ◽  
pp. bjophthalmol-2021-318864
Author(s):  
Lee Smith ◽  
Jae Il Shin ◽  
Yvonne Barnett ◽  
Peter M Allen ◽  
Rosie Lindsay ◽  
...  
Keyword(s):  
Older Adults ◽  
Suicidal Ideation ◽  
Visual Impairment ◽  
Suicide Attempts ◽  
Adult Health ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Nationally Representative

BackgroundThere is currently limited literature on the association between visual impairment and suicidal thoughts and behaviours, especially among older adults from low/middle-income countries (LMICs). Thus, we aimed to investigate the associations of objectively measured distance visual impairment with suicidal ideation and suicide attempts among adults aged ≥50 years from six LMICs and to identify potential mediators.MethodsCross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health were analysed. Objective distance visual acuity was measured using the tumbling E logMAR chart, and vision impairment was categorised as none, mild, moderate and severe. Self-reported information on past 12-month suicidal ideation and suicide attempts was also collected. Multivariable logistic regression and mediation analysis were conducted.ResultsData on 34 129 individuals aged ≥50 years (mean (SD) age, 62.4 (16.0) years; 47.9% men) were analysed. After adjustment for potential confounders, compared with no visual impairment, severe visual impairment was significantly associated with suicidal ideation (OR=9.50; 95% CI=2.47 to 36.52). Moderate and severe visual impairment were significantly associated with a 2.22 (95% CI=1.14 to 4.35) and 11.50 (95% CI=1.44 to 91.88) times higher odds of suicide attempts, respectively. Disability, poor self-rated health, mobility and loneliness explained 14.0%, 9.3%, 7.2% and 6.3% of the association between moderate/severe visual impairment and suicide attempts, respectively.ConclusionInterventions to reduce suicidal ideation and suicide attempts among older adults with visual impairment in LMICs are required, targeting identified mediators, while using tested strategies for suicide prevention per se in LMICs may yield beneficial outcomes.

scholarly journals Multimorbidity and Anxiety Symptoms among Adults Aged 50 Years and Over from Six Low- and Middle-Income Countries

2021 ◽  
Vol 1 (1) ◽  
pp. 36-47
Author(s):  
Lee Smith ◽  
Guillermo F. López Sánchez ◽  
Jae Il Shin ◽  
Pinar Soysal ◽  
Nicola Veronese ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Meta Analysis ◽  
Anxiety Symptoms ◽  
Adult Health ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Nationally Representative ◽  
Meta Analyses ◽  
Low And Middle Income

Currently, there are limited data on the association between multimorbidity (i.e., ≥ 2 chronic conditions) and anxiety, especially among the older population in low- and middle-income countries (LMICs). Thus, the aim of the present study was to examine the association between multimorbidity and anxiety symptoms in a large sample of adults aged ≥ 50 years from six LMICs (China, India, Ghana, Mexico, Russia, South Africa). Cross-sectional, nationally representative, community-based data from the Study on Global Ageing and Adult Health (SAGE) were analysed. A total of 11 chronic physical conditions were assessed. Anxiety symptoms referred to extreme/severe problems with worry or anxiety in the past 30 days. Multivariable logistic regression and meta-analyses were conducted. Data on 34,129 adults aged ≥ 50 years were analysed (mean (SD) age 62.4 (16.0) years; 52.1% females). Compared with no chronic conditions, 2, 3, 4, and ≥ 5 chronic conditions were significantly associated with 1.47 (95% CI = 1.08–1.98), 2.46 (95% CI = 1.74–3.47), 3.04 (95% CI = 2.15–4.30), and 4.70 (95% CI = 2.99–7.38) times higher odds of anxiety symptoms, respectively. A country-wise analysis showed that multimorbidity was significantly associated with anxiety symptoms in all six countries (OR = 1.78–12.39) with the overall estimate based on a meta-analysis being OR = 2.29 (95% CI = 1.71–3.07). Multimorbidity was associated with higher odds of anxiety symptoms among older adults in LMICs. Future longitudinal studies are warranted to assess the temporal associations and mechanisms underlying this association.

scholarly journals Socioeconomic differences in handgrip strength and its association with measures of intrinsic capacity among older adults in six middle-income countries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
P. Arokiasamy ◽  
Y. Selvamani ◽  
A. T. Jotheeswaran ◽  
Ritu Sadana
Keyword(s):  
Older Adults ◽  
Handgrip Strength ◽  
Secondary Data ◽  
Cognitive Capacity ◽  
Adult Health ◽  
Cross Sectional ◽  
Middle Income ◽  
Relative Index ◽  
Middle Income Countries ◽  
Intrinsic Capacity

AbstractHandgrip strength, a measure of muscular strength is a powerful predictor of declines in intrinsic capacity, functional abilities, the onset of morbidity and mortality among older adults. This study documents socioeconomic (SES) differences in handgrip strength among older adults aged 50 years and over in six middle-income countries and investigates the association of handgrip strength with measures of intrinsic capacity—a composite of all the physical and mental capacities of an individual. Secondary data analysis of cross-sectional population-based data from six countries from the WHO’s Study on global AGEing and adult health (SAGE) Wave 1 were conducted. Three-level linear hierarchical models examine the association of demographic, socioeconomic status and multimorbidity variables with handgrip strength. Regression-based Relative Index of Inequality (RII) examines socioeconomic inequalities in handgrip strength; and multilevel linear and logistic hierarchical regression models document the association between handgrip strength and five domains of intrinsic capacity: locomotion, psychological, cognitive capacity, vitality and sensory. Wealth quintiles are positively associated with handgrip strength among men across all countries except South Africa while the differences by education were notable for China and India. Work and nutritional status are positively associated with handgrip strength. Our findings provide new evidence of robust association between handgrip strength and other measures of intrinsic capacity and confirms that handgrip strength is a single most important measure of capacity among older persons.

scholarly journals Vision and Hearing Impairments Affecting Activities of Daily Living among Malaysian Older Adults by Gender

2021 ◽  
Vol 18 (12) ◽  
pp. 6271
Author(s):  
Yee Mang Chan ◽  
Norhafizah Sahril ◽  
Ying Ying Chan ◽  
Nor’ Ain Ab Wahab ◽  
Norliza Shamsuddin ◽  
...  
Keyword(s):  
Older Adults ◽  
Gender Differences ◽  
Activities Of Daily Living ◽  
Hearing Impairment ◽  
Daily Living ◽  
Hearing Impairments ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Adl Disability

Vision and hearing impairments are common among older adults and can cause undesirable health effects. There are limited studies from low- and middle-income countries exploring gender differences between vision and hearing impairment with Activities of Daily Living (ADL) disability. Therefore, this study aimed to investigate gender differences between vision and hearing impairments with ADL disability among older adults in Malaysia. Cross-sectional data from 3977 respondents aged 60 and above from the Malaysian National Health and Morbidity Survey 2018 were used. We used logistic regression analysis to measure associations between vision and hearing impairments with ADL disability, adjusted for covariates. The prevalence of ADL disability was higher among females than males (p < 0.001). The adjusted associations between vision impairment and ADL disability were significant among males (aOR 3.79; 95%CI 2.26, 6.38) and females (aOR 2.66; 95%CI 1.36, 5.21). Similarly, significant adjusted associations were found between hearing impairment and ADL disability among males (aOR 5.76; 95%CI 3.52, 9.40) and females (aOR 3.30; 95%CI 1.17, 9.33). Vision and hearing impairments were significantly associated with ADL disability, with no gender differences identified. Early detection and effective management of vision and hearing impairments are important to prevent ADL disability and improve older adults’ level of independence.

scholarly journals Prevalence and correlates of adherence to movement guidelines among urban and rural children in Mozambique: a cross-sectional study

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Taru Manyanga ◽  
Joel D. Barnes ◽  
Jean-Philippe Chaput ◽  
Peter T. Katzmarzyk ◽  
Antonio Prista ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sleep Duration ◽  
Screen Time ◽  
Cross Sectional Study ◽  
Rural Children ◽  
Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

Abstract Background Insufficient physical activity, short sleep duration, and excessive recreational screen time are increasing globally. Currently, there are little to no data describing prevalences and correlates of movement behaviours among children in low-middle-income countries. The few available reports do not include both urban and rural respondents, despite the large proportion of rural populations in low-middle-income countries. We compared the prevalence of meeting 24-h movement guidelines and examined correlates of meeting the guidelines in a sample of urban and rural Mozambican schoolchildren. Methods This is cross-sectional study of 9–11 year-old children (n = 683) recruited from 10 urban and 7 rural schools in Mozambique. Moderate- to vigorous-intensity physical activity (MVPA) and sleep duration were measured by waist-worn Actigraph GT3X+ accelerometers. Accelerometers were worn 24 h/day for up to 8 days. Recreational screen time was self-reported. Potential correlates of meeting 24-h movement guidelines were directly measured or obtained from validated items of context-adapted questionnaires. Multilevel multivariable logit models were used to determine the correlates of movement behaviours. Meeting 24-h movement guidelines was defined as ≥60 min/day of MVPA, ≤2 h/day of recreational screen time, and between 9 and 11 h/night of sleep. Results More rural (17.7%) than urban (3.6%) children met all three 24-h movement guidelines. Mean MVPA was lower (82.9 ± 29.5 min/day) among urban than rural children (96.7 ± 31.8 min/day). Rural children had longer sleep duration (8.9 ± 0.7 h/night) and shorter recreational screen time (2.7 ± 1.9 h/day) than their urban counterparts (8.7 ± 0.9 h/night and 5.0 ± 2.3 h/day respectively). Parental education (OR: 0.37; CI: 0.16–0.87), school location (OR: 0.21; CI: 0.09–0.52), and outdoor time (OR: 0.67; CI: 0.53–0.85) were significant correlates of meeting all three 24-h movement guidelines. Conclusions Prevalence and correlates of meeting movement guidelines differed between urban and rural schoolchildren in Mozambique. On average, both groups had higher daily MVPA minutes, shorter sleep duration, and higher recreational screen time than the 24-h movement guidelines recommend. These findings (e.g., higher than recommended mean daily MVPA minutes) differ from those from high-income countries and highlight the need to sample from both urban and rural areas.

scholarly journals Built environment correlates of physical activity and sedentary behaviour in older adults: A comparative review between high and low-middle income countries

2019 ◽  
Vol 57 ◽  
pp. 277-304 ◽  
Author(s):  
Claire Cleland ◽  
Rodrigo Siqueira Reis ◽  
Adriano Akira Ferreira Hino ◽  
Ruth Hunter ◽  
Rogério César Fermino ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Built Environment ◽  
Sedentary Behaviour ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Comparative Review

scholarly journals Patients with more comorbidities have better detection of chronic conditions, but poorer management and control: findings from six middle-income countries

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Grace Sum ◽  
Gerald Choon-Huat Koh ◽  
Stewart W. Mercer ◽  
Lim Yee Wei ◽  
Azeem Majeed ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
World Health Organisation ◽  
World Health ◽  
Uncontrolled Hypertension ◽  
Adult Health ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Increased Risk ◽  
And Control

Abstract Background The burden of non-communicable diseases (NCDs) is rising rapidly in middle-income countries (MICs), where NCDs are often undiagnosed, untreated and uncontrolled. How comorbidity impacts diagnosis, treatment, and control of NCDs is an emerging area of research inquiry and have important clinical implications as highlighted in the recent National Institute for Health and Care Excellence guidelines for treating patients suffering from multiple NCDs. This is the first study to examine the association between increasing numbers of comorbidities with being undiagnosed, untreated, and uncontrolled for NCDs, in 6 large MICs. Methods Cross-sectional analysis of the World Health Organisation Study of Global Ageing and Adult Health (WHO SAGE) Wave 1 (2007–10), which consisted of adults aged ≥18 years from 6 populous MICs, including China, Ghana, India, Mexico, Russia and South Africa (overall n = 41, 557). Results A higher number of comorbidities was associated with better odds of diagnosis for hypertension, angina, and arthritis, and higher odds of having treatment for hypertension and angina. However, more comorbidities were associated with increased odds of uncontrolled hypertension, angina, arthritis, and asthma. Comorbidity with concordant conditions was associated with improved diagnosis and treatment of hypertension and angina. Conclusion Patients with more comorbidities have better diagnosis of chronic conditions, but this does not translate into better management and control of these conditions. Patients with multiple NCDs are high users of health services and are at an increased risk of adverse health outcomes. Hence, improving their access to care is a priority for healthcare systems.

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