Association of Social Relationships and Depression Among Older Mexican Adults: Does a Rural or Urban Context Matter?

Social characteristics such as strong community and family ties have been associated with positive mental health outcomes in older adults. However, this evidence is based primarily on non-Hispanic White populations and may vary according to living in a rural versus urban community. We hypothesize that the positive impact of available social networks, perceived support, and social participation on older Mexican adults’ likelihood for high depressive symptoms (i.e., depression) will be greater for those living in rural (community < 2,500 people) than urban communities. Data came from the 2012 Wave of the Mexican Health and Aging Study. Depressive symptoms were measured using a 9-item version of the Center for Epidemiologic Studies Depression Scale. Social participation is the respondent’s self-reported participation in hobbies, religious activities, volunteering, and visits with neighbors. Available social network is measured as having relatives and/or good friends living in the neighborhood. Perceived support is the respondent’s perception of friends/family’s willingness to help with finances and personal care. The final sample of 6,266 respondents was majority (62.4%) female, mean age of 69 years, 17.8% lived in a rural community, and 34.5% with depression. Logistic regression models stratified by rural/urban indicated that available social network and perceived social support were not associated with depression in rural or urban communities. In general, the social participation activities were associated with significantly lower odds of depression for older adults living in urban but not rural communities. This research highlights the influence of older adults’ community on their social relationships and mental health.

Impact of Vision and Hearing Impairment on Cognition and Loneliness: Evidence From the Mexican Health and Aging Study

Poor vision and hearing have been associated with lower cognitive function and greater social isolation (i.e., loneliness) among older adults. However, this evidence is based largely on data from non-Hispanic populations. Therefore, we investigated whether self-reported vision and hearing was associated with cognitive function and loneliness in a nationally-representative study of Mexican adults aged 50 and older in Wave 3 of the Mexican Health and Aging Study. The final sample included 12,426 participants. The majority were female (58%), and the mean age was 67. Self-reported vision and hearing status were categorized as excellent-very good [ref], good, and fair-poor. Measures for global cognition, memory, and non-memory cognition were calculated using z-scores based on nine cognitive tests. Participants who reported frequently feeling a lack of companionship, left out, or isolated were categorized as feeling lonely. All analyses controlled for age, sex, and years of education. Participants with fair-poor vision had lower global (β= -0.06, p <.01), memory (β= -0.07, p <.01), and non-memory cognition (β= -0.06, p <.01) than participants with excellent-very good vision. In addition, participants with fair-poor hearing had higher non-memory cognition (β= 0.03, p <.05) but not global cognition (β=0.02) or memory (β=0.001). Fair-poor vision (OR=1.53, 95% CI=1.25-1.87) but not fair-poor hearing (OR=1.16, 95% CI=0.97-1.38) was associated with higher odds of being lonely. Poor vision may be a potentially modifiable risk factor for lower cognition and loneliness among Mexican adults. Future research should incorporate robust measures of sensory health and investigate the longitudinal association between vision, cognition, and loneliness.

Novel Adiposity and Biochemical–Anthropometric Indices to Identify Cardiometabolic Risk and Metabolic Syndrome in Mexican Adults

Although several indices used in clinical practice identify cardiometabolic risk (CR) and metabolic syndrome (MetS), it is imperative to develop indices for specific populations. Therefore, we proposed and validated sex-specific indices to identify CR associated with visceral adipose tissue (VAT) accumulation or MetS in Mexican adults. Additionally, a cut-off value for the visceral fat area (VFA) to identify CR was proposed. Clinical, anthropometric, biochemical, and body composition variables were evaluated in 904 subjects (25–45 years old) (84.4% men). Multiple and logistic regressions were used to model the indices and ROC curve analysis to determine predictive performance. An additional cohort (n = 186) was used for indices validation, and Cohen’s kappa coefficient was employed for agreement analysis. The proposed sex-specific indices, called Mexican adiposity indices (MAIs) and biochemical–anthropometric indices (BAIs), were good predictors for CR and MetS. The kappa coefficients showed a moderate agreement level. The VFA cut-off value chosen to identify CR was 100.3 cm2 because it had the best combination of sensitivity (66.8%) and specificity (64.4%). MAIs and BAIs could be clinical tools to identify either CR associated to VAT accumulation or MetS, respectively. A VFA cut-off value of 100.3 cm2 could identify CR in Mexican men.

Trends in the prevalence of metabolic syndrome and its components in Mexican adults, 2006-2018

Objective. To examine trends in the prevalence of metabolic syndrome (MS) and its components. Materials and methods. Data from 27 800 Mexican adults who participated in Ensanut 2006, 2012, 2016 and 2018 were analyzed. Linear regression was used across each Ensanut period to assess temporal linear trends in the prevalence of MS. Logistic regression models were obtained to calculate the percentage change, p-value for the trend and the association between the presence of MS and the risk of developing type 2 diabetes mellitus (T2DM) over 10 years using the Finnish Diabetes Risk Score (FINDRISC) and cardiovascular disease (CVD) using Globorisk. Results. The prevalence of MS in Mexican adults according to the harmonized definition was: 40.2, 57.3, 59.99 and 56.31%, in 2006, 2012, 2016 and 2018 respectively (p for trend <0.0001). In 2018, 7.62% of metabolic syndrome cases had a significant risk for incident DM2 and 11.6% for CVD. Conclusion. It is estimated that there are 36.5 million Mexican adults living with metabolic syndrome, of which 2 million and 2.5 million have a high risk of developing T2DM or cardiovascular disease respectively, over the next 10 years.

Body Image, Anxiety, and Bulimic Behavior during Confinement Due to COVID-19 in Mexico

Background: The potential impact of the COVID-19 pandemic on weight, shape-related appearance behaviors (body image dissatisfaction), and bulimic symptoms in nonclinical participants is poorly evaluated. This study aimed to identify the relationship between labor status, confinement degree due to COVID-19, dissatisfaction with body image, and anxiety and to discover its effect on bulimic behavior in Mexican adults. Methods: A cross-sectional study was conducted with a non-probabilistic sample of 276 participants via an online survey. Questions addressed their anxiety, body image dissatisfaction, and bulimic behavior. Results: The path analysis showed direct effects on the confinement degree (β = −0.157); of the labor situation (β = −0.147) and gender (β = 0.129) on anxiety; of dissatisfaction on bulimic behavior (β = 0.443) and anxiety about bulimic behavior (β = 0.184); and dissatisfaction (β = 0.085). Conclusions: The confinement, gender, and labor status are predictors of anxiety, while anxiety and body dissatisfaction directly influence bulimic behavior.

Prevalence of Covid-19 sequelae in the National Health and Nutrition Survey 2020

Objective. To estimate the prevalence of Covid-19 sequelae and its association with sociodemographic and medical care characteristics. Materials and methods. Mexican adults that experienced Covid-19 symptoms and were seropositive to the N-protein of Sars-CoV-2 in the Ensanut 2020 responded to a question regarding sequelae. Associations were estimated using Poisson regression. Results. The prevalence of sequelae was 15.7%, being higher for people with higher education and who were hospitalized or treated at an emergency room during the acute Covid-19 phase. Conclusions. Self-reported sequelae associated to Covid-19 was frequent. Covid-19 sequelae could represent an important challenge for the health system and the Mexican society.

Total, Bioavailable, and Free 25-Hydroxyvitamin D Equally Associate with Adiposity Markers and Metabolic Traits in Mexican Adults

Epidemiological studies suggest a relationship between total 25-hydroxyvitamin D [25(OH)D], adiposity, and metabolic traits. The bioavailability of 25(OH)D is regulated by the albumin, vitamin D binding protein (VDBP), and variants of the GC gene. Therefore, it is not clear if bioavailable or free 25(OH)D offer additional benefits compared to total 25(OH)D when estimating the magnitude of these associations. Our aim was to evaluate the association between 25(OH)D (total, free and bioavailable) with adiposity and metabolic traits. This was a cross-sectional study of 1904 subjects from the Health Workers Cohort Study from Mexico. Free and bioavailable 25(OH)D were calculated based on VDBP and albumin determinations, using a formula adjusted for the GC gene diplotypes. Adiposity and metabolic traits were measured with standardized procedures. Free and bioavailable 25(OH)D levels correlated with total 25(OH)D, r = 0.71 and 0.70, respectively (p < 0.001). Total, bioavailable and free 25(OH)D levels were negatively associated with the adiposity marker (visceral adiposity index) and metabolic traits (metabolic syndrome, type 2 diabetes, triglycerides, triglycerides/HDL-c ratio, and triglycerides/glucose index) in multivariate regression models (ORs = 0.73 to 0.96). Our findings suggest that free and bioavailable 25(OH)D do not offer additional advantages over total 25(OH)D regarding its association with adiposity and several metabolic traits in Mexican adults.