scholarly journals What are the sociodemographic and gender determinants of non-fatal self-harm in older adult users and non-users of antidepressants? A national population-based study

2020 ◽  
Author(s):  
Khedidja Hedna ◽  
Johan Fastbom ◽  
Ingmar Skoog ◽  
Gunnel Hensing ◽  
Margda Waern
Keyword(s):  
Older Adults ◽  
Late Life ◽  
Sociodemographic Factors ◽  
Nordic Countries ◽  
Men And Women ◽  
Factors Associated ◽  
Total Cohort ◽  
Increased Risk ◽  
Self Harm ◽  
And Gender

Abstract Background Late-life self-harm (SH) is often linked to depression. However, very few studies have explored the role of other factors and their interaction with depression in the occurrence of late-life SH. The objective of this research was to examine sociodemographic and gender factors associated with non-fatal SH, in older adults with and without antidepressant therapy.Methods We used national longitudinal register data from a total cohort of all Swedish residents aged ≥75 years between 2006-2014 (N=1,413,806). Using personal identity numbers, we linked individuals' data from numerous national registers. We identified all those with at least one episode of non-fatal self-harm (regardless of level of intent to die) and matched 50 controls to each case. A nested case–control design was used to investigate sociodemographic factors associated with non-fatal SH in the total cohort and among antidepressant users and non-users. Risk factors were analysed in adjusted conditional logistic regression models for the entire cohort and by gender.Results In all, 2242 individuals had at least one episode of a non-fatal SH (980 men and 1262 women). Being unmarried was a risk factor for non-fatal SH in men but not in women. Among users of antidepressants, higher non-fatal SH risk was observed in those born outside the Nordic countries (IRR: 1.44; 95% CI: 1.11–1.86), whereas in AD non-users increased risk was seen in those from Nordic countries other than Sweden (IRR: 1.58; 95% CI: 1.08–2.29). Antidepressant users with higher education had an increased risk of non-fatal SH (IRR: 1.34; 95% CI: 1.12–1.61), in both men and women. Conclusions Foreign country of birth was associated with increased risk for non-fatal SH in older adults with and without AD therapies. Being married was a protective factor for non-fatal SH in men. The complex association between sociodemographic factors and use of antidepressants in the occurrence of self-harm in older men and women indicates the need for multifaceted tailored preventive strategies including healthcare and social services alike.

scholarly journals What are sociodemographic and gender determinants of non-fatal self-harm in older adults users and non-users of antidepressants? A national population-based study

2020 ◽  
Author(s):  
Khedidja Hedna ◽  
Johan Fastbom ◽  
Ingmar Skoog ◽  
Gunnel Hensing ◽  
Margda Waern
Keyword(s):  
Higher Education ◽  
Older Adults ◽  
Late Life ◽  
Nordic Countries ◽  
Antidepressant Therapy ◽  
Factors Associated ◽  
Total Cohort ◽  
Increased Risk ◽  
Self Harm ◽  
And Gender

Abstract Background Late-life self-harm (SH) is often linked to depression. However, very few studies have explored the role of other factors and their interaction with depression in the occurrence of late-life SH. The objective of this research was to examine sociodemographic and gender factors associated with non-fatal SH, in older adults with and without antidepressant therapy. Methods We used national longitudinal register data from a total cohort of all Swedish residents aged ≥75 years between 2006-2014 (N=1,413,806). Using personal identity numbers, we linked individuals' data from numerous national registers. We identified all those with at least one episode of non-fatal self-harm (regardless of level of intent to die) and matched 50 controls to each case. A nested case–control design was used to investigate the sociodemographic factors associated with non-fatal SH in the total cohort and among antidepressant users and non-users. Risk factors were analysed in adjusted conditional logistic regression models for the entire cohort and by gender. Results In all, 2242 individuals had at least one episode of a non-fatal SH (980 men and 1262 women). In the total cohort, being married was a protective factor for non-fatal SH in men but not in women. A higher non-fatal SH risk was found in antidepressant users from outside Nordic countries (IRR: 1.44; 95% CI: 1.11-1.86), and in non-users of antidepressants from other Nordic countries (IRR: 1.58; 95% CI: 1.08-2.29). Antidepressant users with higher education had an increased risk of non-fatal SH (IRR: 1.34; 95% CI: 1.12-1.61), in both men and women. Conclusions Being married did not mitigate risk of self-harm in older women. Foreign country of birth and higher education were associated with increased risk of non-fatal SH. Healthcare professionals and social workers must be informed about high-risk groups for suicidal behaviour, and ensure they are adequately monitored both in term of antidepressant therapy and access to psychosocial support.

scholarly journals What are sociodemographic and gender determinants of non-fatal self-harm in older adults users and non-users of antidepressants? A national population-based study

2020 ◽  
Author(s):  
Khedidja Hedna ◽  
Johan Fastbom ◽  
Ingmar Skoog ◽  
Gunnel Hensing ◽  
Margda Waern
Keyword(s):  
Higher Education ◽  
Older Adults ◽  
Late Life ◽  
Nordic Countries ◽  
Antidepressant Therapy ◽  
Factors Associated ◽  
Total Cohort ◽  
Increased Risk ◽  
Self Harm ◽  
And Gender

Abstract Background Late-life self-harm (SH) is often linked to depression. However, very few studies have explored the role of other factors and their interaction with depression in the occurrence of late-life SH. The objective of this research was to examine sociodemographic and gender factors associated with non-fatal SH, in older adults with and without antidepressant therapy. Methods We used national longitudinal register data from a total cohort of all Swedish residents aged ≥75 years between 2006-2014 (N=1,413,806). Using personal identity numbers, we linked individuals' data from numerous national registers. We identified all those with at least one episode of non-fatal self-harm (regardless of level of intent to die) and matched 50 controls to each case. A nested case–control design was used to investigate the sociodemographic factors associated with non-fatal SH in the total cohort and among antidepressant users and non-users. Risk factors were analysed in adjusted conditional logistic regression models for the entire cohort and by gender. Results In all, 2242 individuals had at least one episode of a non-fatal SH (980 men and 1262 women). In the total cohort, being married was a protective factor for non-fatal SH in men but not in women. A higher non-fatal SH risk was found in antidepressant users from outside Nordic countries (IRR: 1.44; 95% CI: 1.11-1.86), and in non-users of antidepressants from other Nordic countries (IRR: 1.58; 95% CI: 1.08-2.29). Antidepressant users with higher education had an increased risk of non-fatal SH (IRR: 1.34; 95% CI: 1.12-1.61), in both men and women. Conclusions Being married did not mitigate risk of self-harm in older women. Foreign country of birth and higher education were associated with increased risk of non-fatal SH. Healthcare professionals and social workers must be informed about high-risk groups for suicidal behaviour, and ensure they are adequately monitored both in term of antidepressant therapy and access to psychosocial support.

scholarly journals Longitudinal Association Between Education and Disability in Older Adults Living in Iceland

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 396-396
Author(s):  
Milan Chang ◽  
Olof Geirsdottir ◽  
Lenore Launer ◽  
Vilmundur Gudnasson ◽  
Palmi Jonsson ◽  
...  
Keyword(s):  
Older Adults ◽  
Low Socioeconomic Status ◽  
Late Life ◽  
Mobility Disability ◽  
College And University ◽  
Disability Status ◽  
Adl Disability ◽  
And Gender ◽  
Access To Medical Care ◽  
Life Education

Abstract BACKGROUND: Disabilities among older adults are associated with cumulative adversities such as low socioeconomic status (SES), poor nutrition, and lack of access to medical care and education. However, there is little evidence on the long-term association between education and disability status among older adults in Iceland. The aim of the study was to examine the association between mid-life education and prevalence of disability in activities of daily living (ADL) and mobility disability in late-life using 25 years of longitudinal data. METHODS: A large community-based population residing in Reykjavik, Iceland participated in a longitudinal study with an average of 25 years of follow-up (N=5764, mean age 77±6 yrs, 57.7% of women) Mid-life education was categorized into 2 groups (primary and secondary versus college and university). Disability status in late life was defined with ADL and mobility disability with a binary outcome (no difficulty versus any difficulty). Logistic regression analysis was used to examine the association. RESULTS: After controlling for age and gender, and midlife health risk factors, those who had high education at mid-life were less likely to have ADL disability (Odds Ratio (OR) = 0.75, 95% Confidence Interval (CI): 0.64 ~ 0.88, P ≤ 0.001) and mobility disability (OR = 0.72, 95% CI: 0.61 ~ 0.86, P < 0.001) compared with those who had low education in mid-life. CONCLUSION: People with high mid-life education were less likely to have ADL and mobility disability after 25 years later.

scholarly journals Vascular lesions and functional limitations among older adults: does depression make a difference?

2014 ◽  
Vol 26 (9) ◽  
pp. 1501-1509 ◽  
Author(s):  
Celia F. Hybels ◽  
Carl F. Pieper ◽  
Lawrence R. Landerman ◽  
Martha E. Payne ◽  
David C. Steffens
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
White Matter ◽  
Functional Impairment ◽  
Functional Limitations ◽  
Late Life ◽  
Cognitive Status ◽  
Cerebral White Matter ◽  
Late Life Depression ◽  
Increased Risk

ABSTRACTBackground:The association between disability and depression is complex, with disability well established as a correlate and consequence of late life depression. Studies in community samples report that greater volumes of cerebral white matter hyperintensities (WMHs) seen on brain imaging are linked with functional impairment. These vascular changes are also associated with late life depression, but it is not known if depression is a modifier in the relationship between cerebrovascular changes and functional impairment.Methods:The study sample was 237 older adults diagnosed with major depression and 140 never depressed comparison adults, with both groups assessed at study enrollment. The dependent variable was the number of limitations in basic activities of daily living (ADL), instrumental ADLs, and mobility tasks. The independent variable was the total volume of cerebral white matter lesions or hyperintensities assessed though magnetic resonance imaging.Results:In analyses controlling for age, sex, race, high blood pressure, and cognitive status, a greater volume of WMH was positively associated with the total number of functional limitations as well as the number of mobility limitations among those older adults with late life depression but not among those never depressed, suggesting the association between WMH volume and functional status differs in the presence of late life depression.Conclusions:These findings suggest older patients with both depression and vascular risk factors may be at an increased risk for functional decline, and may benefit from management of both cerebrovascular risk factors and depression.

Abstract P347: Sex Differences in Barriers to Antihypertensive Medication Adherence: Findings from the Cohort Study of Medication Adherence among Older Adults (CoSMO)

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Elizabeth W Holt ◽  
Cara Joyce ◽  
Adriana Dornelles ◽  
Donald E Morisky ◽  
Larry S Webber ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Medication Adherence ◽  
Antihypertensive Medication ◽  
Administrative Databases ◽  
Medication Cost ◽  
Lifestyle Modifications ◽  
Cross Sectional ◽  
Men And Women ◽  
Factors Associated

Objectives: We assessed whether socio-demographic, clinical, health care system, psychosocial, and behavioral factors are differentially associated with low antihypertensive medication adherence scores among older men and women. Methods: We conducted a cross-sectional analysis using baseline data from the Cohort Study of Medication Adherence in Older Adults (CoSMO, n=2,194). Low antihypertensive medication adherence was defined as a score <6 on the 8-item Morisky Medication Adherence Scale. Risk factors for low adherence were collected using telephone surveys and administrative databases. Results: The prevalence of low medication adherence scores did not differ by sex [15.0% (193 of 1,283) in women and 13.1% (119 of 911) in men p=0.208]. In sex-specific multivariable models, having issues with medication cost and practicing fewer lifestyle modifications for blood pressure control were associated with low adherence scores among both men and women. Factors associated with low adherence scores in men but not women included reduced sexual functioning (OR = 2.03; 95% CI: 1.31, 3.16 for men and OR = 1.28; 95% CI: 0.90, 1.82 for women), and BMI ≥25 (OR = 3.23; 95% CI: 1.59, 6.59 for men and 1.23; 95% CI: 0.82, 1.85 for women). Factors associated with low adherence scores in women but not men included dissatisfaction with communication with their healthcare provider (OR = 1.75; 95% CI: 1.16, 2.65 for women and OR =1.16 95% CI: 0.57, 2.34 for men) and depressive symptoms (OR = 2.29; 95% CI: 1.55, 3.38 for women and OR = 0.93; 95% CI: 0.48, 1.80 for men). Conclusion: Factors associated with low antihypertensive medication adherence scores differed by sex. Interventions designed to improve adherence in older adults should be tailored to account for the sex of the target population.

scholarly journals Late-life suicidal behaviours among new users of antidepressants: a prospective population-based study of sociodemographic and gender factors in those aged 75 and above

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022703 ◽  
Author(s):  
Khedidja Hedna ◽  
Karolina Andersson Sundell ◽  
Gunnel Hensing ◽  
Ingmar Skoog ◽  
Sara Gustavsson ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
Nordic Country ◽  
Age Groups ◽  
Antidepressant Medication ◽  
Late Life ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Entire Cohort ◽  
Hazard Ratios ◽  
And Gender

ObjectiveTo investigate sociodemographic and gender factors associated with suicide and suicide attempts among new users of antidepressants aged 75 and above.DesignRegister-based cohort study.SettingNational population-based cohort of Swedish residents aged ≥75 years.Participants185 225 patients who initiated antidepressant medication between 1 January 2007 and 31 December 2013 were followed until 31 December 2014.Main outcome measuresSuicide and suicide attempts. Fine and Gray regression models were used to analyse the sociodemographic factors (age, country of birth, marital status, education level, last occupation, income and social allowance) associated with suicidal behaviours in the entire cohort and by gender.ResultsDuring follow-up, 295 suicides and 654 suicide attempts occurred. Adjusted sub-hazard ratios (aSHRs) for suicide were lower among older age groups (aSHR 0.73, 95% CI 0.53 to 0.99 for those 85–89 years; and aSHR 0.53, 95% CI 0.33 to 0.86 for those ≥90 years). A similar pattern was observed for suicide attempts. Suicide attempts were more common among those born in foreign countries (aSHR 1.58, 95% CI 1.16 to 2.15 for those born in another Nordic country; and aSHR 1.43, 95% CI 1.06 to 1.93 for those born in non-Nordic countries). In the gender-stratified analyses, being single or divorced, and born in another Nordic country was associated with a higher risk of suicide among men. Educational and occupational history and being born in a non-Nordic country influenced risk of suicidal behaviours in women.ConclusionSuicidal behaviours occurred more commonly among new users who were ‘younger’ old adults and those with foreign background, suggesting that those groups might require greater support when initiating antidepressant therapy. Our findings suggest the need for gender-specific, multifaceted approaches to the prevention of suicidal behaviours in late life.

scholarly journals Patient perspectives on priorities for research on conventional and sex- and gender-related cardiovascular risk factors

2020 ◽  
Vol 28 (12) ◽  
pp. 656-661
Author(s):  
R. Bolijn ◽  
I. Schalkers ◽  
H. L. Tan ◽  
A. E. Kunst ◽  
I. G. M. van Valkengoed
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Minority Groups ◽  
Sex And Gender ◽  
Men And Women ◽  
Related Risk ◽  
Increased Risk ◽  
And Gender ◽  
New Research

Abstract Background Recently, cardiovascular disease (CVD) research has focused on sex- and gender-related cardiovascular risk factors, in addition to conventional risk factors. This raises the question which factors are perceived by the target group (patients with CVD) as priorities for further research. Methods We carried out a survey to study priority setting for more research into conventional and sex- and gender-related risk factors according to 980 men and women with CVD or those at increased risk of CVD in the Netherlands. Data on conventional and sex- and gender-related risk factors were descriptively analysed, stratified by gender group. Results The most frequently prioritised conventional factors according to men were heritability, overweight and unhealthy diet, while women most frequently listed stress, heritability and hypertension. The most frequently prioritised sex- and gender-related risk factors were depression or depressive feelings, migraine and having many caretaking responsibilities (men), and pregnancy complications, contraceptive pill use and early age at menopause (women). New research on sex- and gender-related risk factors was perceived roughly as relevant as that on conventional factors by men (mean 7.4 and 8.3 on a 1–10 scale, respectively) and women (8.2 and 8.6, respectively). Ethnic and gender minority groups placed more emphasis on risk factors related to sociocultural aspects (gender) than the majority group. Conclusion Men and women with CVD or those at increased risk of CVD perceived new research on conventional and sex- and gender-related risk factors as a priority. These findings may guide researchers and funders in further prioritising new CVD research.

scholarly journals Iron intake and body iron stores, anaemia and risk of hyperglycaemia among Chinese adults: the prospective Jiangsu Nutrition Study (JIN)

2009 ◽  
Vol 13 (9) ◽  
pp. 1319-1327 ◽  
Author(s):  
Zumin Shi ◽  
Minghao Zhou ◽  
Baojun Yuan ◽  
Lu Qi ◽  
Yue Dai ◽  
...  
Keyword(s):  
Joint Effect ◽  
Food Record ◽  
Men And Women ◽  
Increased Risk ◽  
Nutrition Study ◽  
And Gender ◽  
Increase Diabetes Risk ◽  
Incident Cases ◽  
Fourth Quartile

AbstractObjectiveFe supplementation has been used to prevent anaemia in China; however, high Fe intake and body Fe stores may increase diabetes risk. The present study aimed to prospectively examine the association between Fe intake/stores and hyperglycaemia, and to assess the joint effects on anaemia.DesignWe followed 1056 healthy adults aged 20 years and older from 2002 to 2007. Body Fe stores were measured. Dietary data were collected using a 3 d food record and FFQ. Hyperglycaemia was defined as fasting plasma glucose >5·6 mmol/l.ResultsOf the participants, 28·8 % were anaemic at baseline. During the 5 years of follow-up, we documented 125 incident cases of hyperglycaemia, among them twenty-three were diabetic. Haem Fe intake was positively associated with the risk of hyperglycaemia in men and women: the OR (95 % CI) across increasing quartiles of haem Fe intake was 1·00 (referent), 1·49 (0·74, 3·01), 2·16 (1·06, 4·42) and 3·48 (1·71, 7·11), respectively (P for trend <0·001). Comparing the fourth quartile of serum ferritin with the others, the age- and gender-adjusted OR (95 % CI) was 1·54 (1·01, 2·34), P for trend = 0·043. The association between total Fe intake and the risk of hyperglycaemia was significant in men (P for trend = 0·002). Anaemia added additional risk of hyperglycaemia on haem Fe intake. Comparing extreme quartiles of haem Fe intake, the OR (95 % CI) was 5·67 (1·43, 22·49) and 3·44 (1·51, 7·85) for hyperglycaemia among anaemic and non-anaemic participants (P for trend = 0·008 and 0·010, respectively).ConclusionsThe present cohort study suggests that high haem Fe intake, anaemia and high ferritin are associated with an increased risk of hyperglycaemia in Chinese men and women. There was a joint effect between anaemia and haem Fe intake on the risk of hyperglycaemia.

scholarly journals Ageing rate of older adults affects the factors associated with, and the determinants of malnutrition in the community: a systematic review and narrative synthesis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Laura A. Bardon ◽  
Clare A. Corish ◽  
Meabh Lane ◽  
Maria Gabriella Bizzaro ◽  
Katherine Loayza Villarroel ◽  
...  
Keyword(s):  
Older Adults ◽  
Food Intake ◽  
Sociodemographic Factors ◽  
Community Dwelling ◽  
Accelerated Ageing ◽  
Cross Sectional ◽  
Factors Associated ◽  
Ageing Rate ◽  
Rate Of Ageing ◽  
Ageing Populations

Abstract Background Malnutrition negatively impacts on health, quality of life and disease outcomes in older adults. The reported factors associated with, and determinants of malnutrition, are inconsistent between studies. These factors may vary according to differences in rate of ageing. This review critically examines the evidence for the most frequently reported sociodemographic factors and determinants of malnutrition and identifies differences according to rates of ageing. Methods A systematic search of the PubMed Central and Embase databases was conducted in April 2019 to identify papers on ageing and poor nutritional status. Numerous factors were identified, including factors from demographic, food intake, lifestyle, social, physical functioning, psychological and disease-related domains. Where possible, community-dwelling populations assessed within the included studies (N = 68) were categorised according to their ageing rate: ‘successful’, ‘usual’ or ‘accelerated’. Results Low education level and unmarried status appear to be more frequently associated with malnutrition within the successful ageing category. Indicators of declining mobility and function are associated with malnutrition and increase in severity across the ageing categories. Falls and hospitalisation are associated with malnutrition irrespective of rate of ageing. Factors associated with malnutrition from the food intake, social and disease-related domains increase in severity in the accelerated ageing category. Having a cognitive impairment appears to be a determinant of malnutrition in successfully ageing populations whilst dementia is reported to be associated with malnutrition within usual and accelerated ageing populations. Conclusions This review summarises the factors associated with malnutrition and malnutrition risk reported in community-dwelling older adults focusing on differences identified according to rate of ageing. As the rate of ageing speeds up, an increasing number of factors are reported within the food intake, social and disease-related domains; these factors increase in severity in the accelerated ageing category. Knowledge of the specific factors and determinants associated with malnutrition according to older adults’ ageing rate could contribute to the identification and prevention of malnutrition. As most studies included in this review were cross-sectional, longitudinal studies and meta-analyses comprehensively assessing potential contributory factors are required to establish the true determinants of malnutrition.

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