Relationship between chewing tobacco, smoking, consuming alcohol and cognitive impairment among older adults in India: a cross‐sectional study

Abstract Background Physical aging increases the sensitivity to the effects of substance use, elevating the risk for cognitive impairment among older adults. Since studies on the association of substance use with cognitive ability in later years are scant in India, we aimed to explore the factors associated with cognitive impairment especially, alcohol consumption, smoking, and chewing tobacco later in life. Methods The present research used nationally representative data from Building a Knowledge Base on Population Aging in India (BKPAI) that was conducted in 2011, across seven states of India (N=9,453). Sample distribution along with percentage distribution was calculated for cognitive impairment over explanatory variables. For finding the association between cognitive impairment over explanatory variables, binary logistic regression models were estimated. Results About 16.5 percent of older adults in rural areas consumed smoked tobacco compared to 11.7 percent in urban areas. Nearly, 23.7 percent of rural older adults consumed smokeless tobacco in comparison to 16 percent in urban areas. Alcohol consumption was high among rural residents (7.9%) than urban counterparts (6.7%). The prevalence of cognitive impairment was 62.8% and 58% among older adults from rural and urban areas respectively. Older adults who smoked tobacco had a 24 percent significantly higher likelihood to have cognitive impairment with reference to older adults who did not smoke [OR: 1.24, CI: 1.02-1.49]. Moreover, older adults who consumed alcohol had a 30 percent significantly higher likelihood to have cognitive impairment [OR: 1.02, 1.65]. It was also found that older adults who had smoked along with consuming alcohol were at risk of worse cognitive outcomes than those who neither smoke nor drink alcohol [OR: 1.56, CI: 1.21-2.00] or consumed either of them unlike consuming smokeless tobacco only. Conclusion The encouragement of older people to stop smoking and smokeless tobacco use could be considered as part of a strategy to reduce the incidence of cognitive impairment. Further, appropriate measures should be taken for the detection of early stages of cognitive decline in older individuals and efforts should be made to improve the availability and quality of care for dementing older adults.

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Rural–Urban Differences in the Factors Affecting Depressive Symptoms among Older Adults of Two Regions in Myanmar

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062818 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2818

Author(s):

Yuri Sasaki ◽

Yugo Shobugawa ◽

Ikuma Nozaki ◽

Daisuke Takagi ◽

Yuiko Nagamine ◽

...

Keyword(s):

Older Adults ◽

Middle School ◽

Depressive Symptoms ◽

Rural Areas ◽

Urban Areas ◽

Depression Scale ◽

Wealth Index ◽

School Level ◽

Cross Sectional ◽

Middle School Level

The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.

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Patterns of Alcohol Consumption in the PURE Poland Cohort Study and Their Relationship with Health Problems

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084185 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4185

Author(s):

Katarzyna Zatońska ◽

Piotr Psikus ◽

Alicja Basiak-Rasała ◽

Zuzanna Stępnicka ◽

Maria Wołyniec ◽

...

Keyword(s):

Cohort Study ◽

Alcohol Consumption ◽

Rural Areas ◽

Urban Areas ◽

Level Of Education ◽

Adult Participants ◽

Frequent Consumption ◽

Urban And Rural Areas ◽

Socio Demographic Factors ◽

High Level

(1) Background: Alcohol is a leading risk factor of premature morbidity and mortality. The objective of this study was to investigate the patterns of alcohol consumption in the PURE Poland cohort study baseline. (2) Methods: A Polish cohort was enrolled in the baseline study in 2007–2010. The study group consisted of 2021 adult participants of urban and rural areas from the Lower Silesia voivodeship in Poland (747 men and 1274 women). (3) Results: In the overall study population, 67.3% were current drinkers, 10.3% were former drinkers, and 22.4% were abstainers. Current use of alcohol products was more prevalent in men (77.2%), people living in urban areas (73.0%), and people with a higher level of education (78.0%). The percentage of current drinkers decreased with increasing age (from 73.4% in 30- to 44-year-olds to 48.8% in participants aged 64 and more). The majority of participants (89.2%) declared a low level of alcohol intake. The chance of high level of intake of alcohol was four times higher in men than in women (OR 4.17; CI 1.64–10.6). The majority of participants (54.6%) declared most frequent consumption of low-alcohol drinks (beer, wine) and 21% declared most frequent consumption of spirits. Current drinkers had almost 1.5-fold higher odds of diabetes and cardiovascular diseases (CVD) than never drinkers (OR 1.49, CI 1.03–2.17; OR 1.66, CI 1.27–2.18, respectively). Former drinkers had higher odds for hypertension and CVD than never drinkers (1.73, CI 1.05–2.85; OR 1.76, CI 1.22–2.53, respectively). (4) Conclusions: In our cohort study, we observed several socio-demographic factors differentiating the patterns of alcohol consumption. The preventive programs should focus predominantly on men, people aged <45 years, and those with a higher level of education.

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Current Heavy Alcohol Consumption is Associated with Greater Cognitive Impairment in Older Adults

Alcoholism Clinical and Experimental Research ◽

10.1111/acer.13211 ◽

2016 ◽

Vol 40 (11) ◽

pp. 2435-2444 ◽

Cited By ~ 33

Author(s):

Adam J. Woods ◽

Eric C. Porges ◽

Vaughn E. Bryant ◽

Talia Seider ◽

Assawin Gongvatana ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Alcohol Consumption ◽

Heavy Alcohol ◽

Heavy Alcohol Consumption

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Rural–Urban Disparities in Access to Improved Sanitation in Indonesia: A Decomposition Approach

SAGE Open ◽

10.1177/21582440211029920 ◽

2021 ◽

Vol 11 (3) ◽

pp. 215824402110299

Author(s):

Sri Irianti ◽

Puguh Prasetyoputra

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Universal Access ◽

Decomposition Analysis ◽

Multivariate Regression Analysis ◽

Probit Regression ◽

Decomposition Approach ◽

Explanatory Variables ◽

Improved Sanitation ◽

The Government

One of the targets in the Sustainable Development Goals (SDGs), which is Target 6.2, aims to achieve access to adequate and equitable sanitation. The Government of Indonesia targets universal access to improved sanitation in 2019. However, almost two out of five households in Indonesia are without access to improved sanitation. Moreover, access to improved sanitation is lower in rural areas than that in urban areas. Studies examining the drivers of the disparity in Indonesia are also limited. Therefore, this study was aimed at assessing the characteristics associated with the rural–urban disparity in access to improved sanitation facilities among households in Indonesia. We employed data from the 2016 Indonesian National Socio-Economic Survey (SUSENAS) comprising 290,848 households. The analysis was twofold. First, we fitted multivariate probit regression models using average marginal effects as the measure of association. We then conducted a detailed non-linear decomposition of the rural–urban disparity attributable to all the explanatory variables. The multivariate regression analysis suggested that households living in rural areas were 11.35% (95% confidence interval = [10.97, 11.72]) less likely to have access to improved sanitation facilities than those residing in urban areas. The decomposition analysis suggested that 48.78% are attributable to spatial, demographic, housing, and socio-economic factors, which meant that almost half of the inequalities could be reduced by equalizing these factors. The results provide a decomposition of factors amenable to curtail urban–rural inequalities. Hence, equity-oriented approaches to increasing access to improved sanitation should be prioritized to achieve universal access in 2030 in line with SDG Target 6.2.

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Income differentials on regional labour markets in Southwest Germany

Panoeconomicus ◽

10.2298/pan0903379g ◽

2009 ◽

Vol 56 (3) ◽

pp. 379-396

Author(s):

Alice Guyot ◽

Stefan Berwing ◽

Maria Lauxen-Ulbrich

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Descriptive Statistics ◽

Pay Gap ◽

Explanatory Variables ◽

Income Differentials ◽

Income Disparities ◽

Regional Labour Markets ◽

Using Data ◽

Regional Types

The aim of our paper is to identify explanatory variables for income disparities between women and men across different regional types. Using data from the BA Employment Panel (BEP) descriptive statistics show that the gender pay gap grows wider from core regions to periphery. The main explanatory variables for the income differentials are vocational education in the men's case and size of enterprise in the women's case. Whereas in the case of women the importance of vocational status increases and the importance of size of enterprise decreases from rural areas to urban areas.

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Decomposing Urban-rural Differences in Multimorbidity Among Older Adults in India: A Study Based on Lasi Data

10.21203/rs.3.rs-701569/v1 ◽

2021 ◽

Author(s):

Shekhar Chauhan ◽

Shobhit Srivast ◽

Pradeep Kumar ◽

Ratna Patel

Keyword(s):

Older Adults ◽

Rural Areas ◽

Urban Areas ◽

Decomposition Analysis ◽

The Public ◽

Analysis Techniques ◽

Ageing Study ◽

Urban Rural ◽

The Difference ◽

Urban And Rural Areas

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 of the Longitudinal Ageing Study in India (LASI) wave 1 data. 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). 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.Conclusion: 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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Older adults’ functional capacity and cognitive impairment in rural areas Tungurahua – Ecuador

Medwave ◽

10.5867/medwave.2020.s1.cs25 ◽

2020 ◽

Vol 20 (S1) ◽

pp. eCS25-eCS25

Author(s):

Alicia Zavala ◽

Paola Ortiz ◽

Victoria Espín

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Functional Capacity ◽

Rural Areas

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Comparison of The Risk Factors For Falls Among Older Adults Between Urban and Rural Areas of Shantou City, China

10.21203/rs.3.rs-72830/v1 ◽

2020 ◽

Author(s):

Xiaodong Chen ◽

Zeting Lin ◽

Ran Gao ◽

Yijian Yang ◽

Liping Li

Keyword(s):

Risk Factors ◽

Older Adults ◽

Fall Prevention ◽

Rural Areas ◽

Urban Areas ◽

Multivariable Analysis ◽

Living Environment ◽

Balance Function ◽

Urban And Rural Areas ◽

Risk Factors For Falls

Abstract Background: To investigate the prevalence of falls and risk factors among older adults in urban and rural areas and to facilitate the design of fall prevention interventions.Methods: We used cluster random sampling to investigate the sociodemographic information, living habits, medical history, and falls among 649 older adult participants. Univariable and multivariable logistic regression was used to examine fall risk factors in urban and rural areas.Results: The fall rate and rate of injury from falls among older adults in urban areas were 27.3% and 18.6%, respectively, which were higher than those in rural areas (17.0% and 12.2%; P<0.05). Multivariable analysis showed that the risk factors for falls among urban older adults included a high school or below education level (OR=3.737, 95% CI: 1.503~9.291); diabetes medicine use (OR=4.518, 95% CI: 1.228~16.626); incontinence (OR=8.792, 95% CI: 1.894~40.824); lack of fall prevention education (OR = 11.907, 95% CI: 1.321～107.354); and reduced balance function (OR = 3.901, 95% CI: 1.894~7.815). The risk factors among rural older adults included a previous nonfarming occupation (OR=2.496, 95% CI: 1.416~4.398); incontinence (OR =11.396, 95% CI: 1.901~68.327); poor living environment (OR=3.457, 95% CI: 1.488~8.033); and reduced balance function (OR =4.260, 95% CI: 2.361~7.688).Discussion: The rate of falls among older adults in urban areas is higher than that in rural areas of Shantou City. Fall prevention in urban areas should target older adults with low education and modify the diabetes medication use. Interventions should focus on improving the home environment of older adults in rural areas.

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Factors associated with elevated consumption of alcohol in older adults—comparison between China and Norway: the CLHLS and the HUNT Study

BMJ Open ◽

10.1136/bmjopen-2018-028646 ◽

2019 ◽

Vol 9 (8) ◽

pp. e028646 ◽

Cited By ~ 4

Author(s):

Juan Li ◽

Bei Wu ◽

Kjerstin Tevik ◽

Steinar Krokstad ◽

AS Helvik

Keyword(s):

Public Health ◽

Older Adults ◽

Alcohol Consumption ◽

Rural Areas ◽

Secondary Data ◽

Primary Objective ◽

Health Study ◽

Cross Sectional ◽

Chinese Sample ◽

Factors Associated

ObjectivesThe primary objective was to investigate the prevalence and factors associated with elevated alcohol consumption among older adults 65 years and above in China and Norway. The secondary objective was to compare the prevalence and factors in the two countries.DesignA secondary data analysis was conducted using two large cross-sectional studies (Chinese Longitudinal Healthy Longevity Survey data in 2008–2009 and Nord-Trøndelag Health Study data in 2006–2008).ParticipantsA total of 3223 (weighted) Chinese older adults and 6210 Norwegian older adults who responded drinking alcohol were included in the analysis.Outcome measuresThe dependent variable was elevated alcohol consumption, which was calculated as a ratio of those with elevated drinking among current drinkers. Multivariable logistic regression was used to test the dependent variable.ResultsThe prevalence of elevated alcohol consumption among current drinkers for the Chinese and Norwegian samples were 78.3% (weighted) and 5.1%, respectively. Being male was related to a higher likelihood of elevated alcohol consumption in both Chinese and Norwegian samples (OR=2.729, 95% CI 2.124 to 3.506, OR=2.638, 95% CI 1.942 to 3.585). Being older, with higher levels of education and a living spouse or partner were less likely to have elevated drinking in the Chinese sample (OR=0.497, 95% CI 0.312 to 0.794, OR=0.411, 95% CI 0.260 to 0.649, OR=0.533, 95% CI 0.417 to 0.682, respectively). Among Norwegian older adults, a higher level of education was related to higher likelihood of elevated drinking (OR=1.503, 95% CI 1.092 to 2.069, OR=3.020, 95% CI 2.185 to 4.175). Living in rural areas and higher life satisfaction were related to lower likelihood of elevated drinking in the Norwegian sample (OR=0.739, 95% CI 0.554 to 0.984, OR=0.844, 95% CI 0.729 to 0.977, respectively).ConclusionsThe elevated alcohol consumption patterns were strikingly different between China and Norway in regards to prevalence and socioeconomic distribution. To develop and implement culturally appropriate public health policies regarding alcohol in the future, public health policy makers and professionals need to be aware of the cultural differences and consider the demographic, social and economic characteristics of their intended population.

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Social Determinants and Disparities in Active Aging Among Older Taiwanese

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16163005 ◽

2019 ◽

Vol 16 (16) ◽

pp. 3005

Author(s):

Hui-Chuan Hsu ◽

Jersey Liang ◽

Dih-Ling Luh ◽

Chen-Fen Chen ◽

Ying-Wei Wang

Keyword(s):

Physical Activity ◽

Cognitive Impairment ◽

Lifelong Learning ◽

Social Determinants ◽

Rural Areas ◽

Urban Areas ◽

Well Being ◽

Information And Communications Technology ◽

Active Aging ◽

Severe Cognitive Impairment

This study assesses equity in active aging across social determinants among older Taiwanese. The data were collected from face-to-face interviews with adults aged 55 years or more in Taiwan in 2017 (n = 738). A total of 30 individual-level Taiwan active aging indicators were chosen, and the relationship between social determinants and active aging indicators were analyzed by logistic regression models. Women were more likely to participate in volunteering and other social groups and in lifelong learning activities, whereas men were more likely to be employed, to engage in physical activity, to feel safe from violence, and to use preventive care. Higher education was related to higher employment, social participation, independent living, lifelong learning, and a lower likelihood of poverty and severe cognitive impairment. Those living in rural areas were more likely to be employed, perform physical activity, feel physically safe, have better mental well-being, and have higher social respect and social integration ratings, whereas living in urban areas was related to greater access to medical care, owning assets, less severe cognitive impairment, greater likelihood of using information and communications technology, higher level of education, and higher access to convenient transportation. The significant disparities that exist in active aging may suggest inequality.

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