scholarly journals Time‐Varying Depressive Symptoms and Cardiovascular and All‐Cause Mortality: Does the Risk Vary by Age or Sex?

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Kelsey B. Bryant ◽  
Deanna P. Jannat‐Khah ◽  
Talea Cornelius ◽  
Yulia Khodneva ◽  
Joshua Richman ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Health Status ◽  
Racial Differences ◽  
Good Health ◽  
Mortality Data ◽  
Time Varying ◽  
Reported Health ◽  
Self Reported Health Status ◽  
Age And Sex ◽  
Cvd Mortality

Background Depressive symptoms are associated with mortality. Data regarding moderation of this effect by age and sex are inconsistent, however. We aimed to identify whether age and sex modify the association between depressive symptoms and all‐cause and cardiovascular disease (CVD) mortality. Methods and Results The REGARDS (Reasons for Geographic and Racial Differences in Stroke) study is a prospective cohort of Black and White individuals recruited between 2003 and 2007. Associations between time‐varying depressive symptoms (Center for Epidemiologic Studies Depression scale score ≥4 versus <4) and all‐cause and CVD mortality were measured using Cox proportional hazard models adjusting for demographic and clinical risk factors. All results were stratified by age or sex and by self‐reported health status. Of 29 491 participants, 3253 (11%) had baseline elevated depressive symptoms. Mean age was 65 (9.4) years, with 55.1% of participants female, 41.1% Black, and 46.4% had excellent/very good health. Depressive symptoms were measured at baseline, on average 4.9 (SD, 1.5), then 2.1 (SD, 0.4) years later. Neither age nor sex moderated the association between elevated time‐varying depressive symptoms and all‐cause or CVD mortality (all‐cause: age 45–64 years adjusted hazard ratio [aHR], 1.38; 95% CI, 1.18–1.61 versus age ≥65 years aHR,1.36; 95% CI, 1.23–1.50; P =0.05; CVD: age 45–64 years aHR, 1.17; 95% CI, 0.90–1.53 versus age ≥65 years aHR, 1.26; 95% CI, 1.06–1.50; P =0.54; all‐cause: males aHR, 1.46; 95% CI, 1.29–1.64 versus female aHR, 1.34; 95% CI, 1.19–1.50; P =0.35; CVD: male aHR, 1.32; 95% CI, 1.08–1.62 versus female aHR, 1.22; 95% CI, 1.00–1.47; P =0.64). Similar results were observed when stratified by self‐reported health status. Conclusions Depressive symptoms confer mortality risk regardless of age and sex, including individuals who report excellent/very good health.

ASSOCIATION BETWEEN SELF–REPORTED HEALTH STATUS AND FRAILTY IN COMMUNITY–DWELLING ELDERLY

2014 ◽  
pp. 1-5
Author(s):  
A.M. GONZÁLEZ-PICHARDO ◽  
A.P. NAVARRETE-REYES ◽  
H. ADAME-ENCARNACIÓN ◽  
S. AGUILAR-NAVARRO ◽  
J.M.A. GARCÍA-LARA ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Health Status ◽  
Multinomial Logistic Regression ◽  
Community Dwelling ◽  
Frailty Syndrome ◽  
Cross Sectional ◽  
Adverse Health ◽  
Health Related ◽  
Reported Health ◽  
Self Reported Health Status

Background:The phenotype of frailty proposed by Fried et al. has been related with increasedvulnerability for the development of adverse health-related outcomes. However, this phenotype is not often usedin daily clinical practice. On the other hand, poor self-reported health status (SRHS) has been associated withsimilar adverse health-related outcomes. Objectives:To determine the association between poor SRHS andfrailty. Design, setting and participants: Cross-sectional study of 927 community-dwelling elderly aged 70 andolder, participating in the Mexican Study of Nutritional and Psychosocial Markers of Frailty. Measurements:SRHS was established by the question “How do you rate your health status in general?” Frailty was definedaccording to the phenotype proposed by Fried et al. The association between SRHS and frailty was determinedthrough the construction of multinomial logistic regression models. Final analyses were adjusted by socio-demographic and health covariates, including depressive symptoms. Also, agreement between SRHS and thephenotype of frailty was explored. Results:Prevalence of frailty was 14.1%, and 4.4% of participants rated theirhealth status as “poor”. The unadjusted regression analyses demonstrated that fair and poor SRHS weresignificantly associated with prefrail and frail status. After adjustment for multiple covariates, the associationremained statistically significant. However, in the final adjustment for depressive symptoms, only the associationbetween poor SRHS and frail status continued to be statistically significant. Fair agreement between poor SRHSand frail status was also found. Conclusion:Poor SRHS shares common correlates as well as health-relatedadverse outcomes with frailty syndrome, and remains associated with it even when possible confounders aretaken into account. Therefore, poor SRHS could be further explored as an option for frailty syndrome screening.

Insights From a Developing Country: Self-Reported Health Status of Elderly Men (60 Years and Over) in Jamaica

2013 ◽  
Vol 12 (2) ◽  
pp. 106-120 ◽  
Author(s):  
Chloe Morris ◽  
Kenneth James ◽  
Desmale Holder-Nevins ◽  
Denise Eldemire-Shearer
Keyword(s):  
Health Status ◽  
Developing Country ◽  
Elderly Men ◽  
Reported Health ◽  
Self Reported Health Status

scholarly journals Use of Complementary and Alternative Medical Services by HMO Members, 1995-1996

2001 ◽  
Vol 7 (2) ◽  
pp. 85-98 ◽  
Author(s):  
Evelyn P. Whitlock
Keyword(s):  
Multivariate Analysis ◽  
Patient Satisfaction ◽  
Health Status ◽  
Service Users ◽  
Improve Patient Satisfaction ◽  
Kaiser Permanente ◽  
Reported Health ◽  
Self Reported Health Status ◽  
Improve Patient ◽  
Complementary And Alternative

We investigated HMO members' use of complementary and alternative medicine (CAM) providers outside the HMO in 1995-1996. A random 2% survey of Kaiser Permanente Northwest members addressed HMO service satisfaction, self-reported health status and behaviors, and HMO utilization. Among respondents, 15.7% (n = 380) used CAM providers (chiropractors, naturopaths, acupuncturists, others) in the prior 12 months, while 35% were ever users. Multivariate analysis found that those more likely to consult CAM providers were females, more educated, and more dissatisfied with the HMO. These results suggest that HMOs may wish to focus efforts to improve patient satisfaction among CAM service users.

scholarly journals ‘At-risk’ individuals’ responses to direct to consumer advertising of prescription drugs: a nationally representative cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e017865 ◽  
Author(s):  
Neda Khalil Zadeh ◽  
Kirsten Robertson ◽  
James A Green
Keyword(s):  
At Risk ◽  
Health Status ◽  
Prescription Drugs ◽  
Cross Sectional ◽  
Drug Advertising ◽  
Behavioural Responses ◽  
Reported Health ◽  
Nationally Representative ◽  
Self Reported Health Status ◽  
Direct To Consumer Advertising

ObjectivesThe factors determining individuals’ self-reported behavioural responses to direct to consumer advertising of prescription drugs were explored with an emphasis on ‘at-risk’ individuals’ responses.DesignNationally representative cross-sectional survey.SettingCommunity living adults in New Zealand.Participants2057 adults (51% women).Primary outcome measuresSelf-reported behavioural responses to drug advertising (asking a physician for a prescription, asking a physician for more information about an illness, searching the internet for more information regarding an illness and asking a pharmacist for more information about a drug).MethodsMultivariate logistic regressions determined whether participants’ self-reported behavioural responses to drug advertising were predicted by attitudes towards advertising and drug advertising, judgements about safety and effectiveness of advertised drugs, self-reported health status, materialism, online search behaviour as well as demographic variables.ResultsIdentifying as Indian and to a less extent Chinese, Māori and ‘other’ ethnicities were the strongest predictors of one or more self-reported responses (ORs 1.76–5.00, Ps<0.05). Poorer self-reported health status (ORs 0.90–0.94, all Ps<0.05), favourable attitude towards drug advertising (ORs 1.34–1.61, all Ps<0.001) and searching for medical information online (ORs 1.32–2.35, all Ps<0.01) predicted all self-reported behavioural outcomes. Older age (ORs 1.01–1.02, Ps<0.01), less education (OR 0.89, P<0.01), lower income (ORs 0.89–0.91, Ps<0.05) and higher materialism (ORs 1.02–1.03, Ps<0.01) also predicted one or more self-reported responses.ConclusionsTaken together, the findings suggest individuals, especially those who are ‘at-risk’ (ie, with poorer self-reported health status, older, less educated, lower income and ethnic minorities), may be more vulnerable to drug advertising and may make uninformed decisions accordingly. The outcomes raise significant concerns relating to the ethicality of drug advertising and suggest a need for stricter guidelines to ensure that drug advertisements provided by pharmaceutical companies are ethical.

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