Adult Population In Spain Research Articles

The drivers of adult financial literacy: Exploring the role of attitudes towards finance

AbstractThis study investigates the factors driving the financial literacy of adult population in Spain using a regression count model (specifically the latent class Poisson model). The paper pays special attention to the effect of certain financial attitudes and financial personality traits (such as financial myopia, risk aversion, attitude to financial planning and self‐perception of financial vulnerability) upon financial literacy. The results demonstrate a positive association between the financial skills, the sociodemographic characteristics and the attitudes and personality traits of individuals regarding finances. Furthermore, the analysis permits the conclusion that the effects of the financial attitudes analysed in the study vary among the different population groups, which suggests the need to adapt financial literacy promotional programs to the characteristics of the target group. Findings have implications for financial educators, practitioners and policymakers to help them recognize the proper financial program to be delivered on the basis of the FL levels and the sociodemographic composition of the individuals.

A high consumption of ultra-processed foods is associated with higher total mortality in an adult Mediterranean population

Background & AimsThe consumption of ultra-processed foods (UPF) has been associated with higher all-cause and cardiovascular disease (CVD) mortality, although this association has not been sufficiently investigated in Mediterranean populations. We aimed to evaluate the association between UPF consumption and all-cause, CVD and cancer mortality in an adult population in Spain. MethodsWe analysed data from 1,538 participants aged 20 years and above in the Valencia Nutrition Survey in 1995. Diet was assessed at baseline using a validated food frequency questionnaire and the consumption of UPF was calculated using the NOVA system. Information on socio-demographic characteristics, lifestyles, and presence of diseases was also collected at baseline. Cause of death was ascertained during an 18-year follow-up period. We used Cox regression and competing risk models as proposed by Fine and Gray's to estimate adjusted hazard ratios (HR) and 95% confidence intervals (95%CI). ResultsAfter 18 years of follow-up, we documented 312 deaths (36.5% of CVD and 25.6% of cancer). Compared with participants in the lowest tertile of UPF consumption, those in the highest tertile showed 40% higher risk of all-cause mortality, HR 1.40 (95%CI: 1.04-1.90), and evidence of a higher CVD mortality, HR 1.39 (95%CI: 0.80-2.41) and of cancer mortality, HR 1.53 (95%CI: 0.83-2.82). ConclusionsThis study suggests that a high UPF consumption is associated with a higher all-cause mortality in a Mediterranean population after a long follow-up period. Considering the increase in UPF consumption and their detrimental health effects on mortality, these results should be confirmed by other studies in other populations.

Alcohol consumption patterns and adherence to the Mediterranean diet in the adult population of Spain

PurposeThe objective is to evaluate the association between various indicators of alcohol consumption and the degree of adherence to the Mediterranean diet among the Spanish adult population.MethodsA cross-sectional study including 44,834 participants ≥ 15 years of age from the 2017 National Health Survey and the 2020 European Health Survey in Spain. Alcohol patterns were defined based on (1) average intake: individuals were classified as low risk (1–20 g/day in men and 1–10 g/day in women) and high risk (> 20 g/day in men or > 10 g/day in women), (2) binge drinking, and (3) alcoholic beverage preference. Non-adherence to the Mediterranean diet was defined as scoring < 7 points on an adapted Mediterranean Diet Adherence Screener index (range 0–10). Odds ratios (OR) were estimated using logistic regression models adjusted for relevant covariates.ResultsCompared to non-drinkers, low and high-risk drinkers were more likely to report non-adherence to the Mediterranean diet: ORs 1.35 (95% CI 1.23; 1.49) and 1.54 (95% CI 1.34; 1.76), respectively. Similarly, reports of binge drinking less than once a month was associated with higher likelihood of non-adherence (OR 1.17; 95% CI 1.04; 1.31). Individuals reporting no preference for a specific beverage and those with a preference for beer or for spirits had lower adherence: ORs 1.18 (95% CI 1.05; 1.33), 1.31 (95% CI 1.17; 1.46), and 1.72 (95% CI 1.17; 2.54), respectively, while a preference for wine showed no association (OR 1.01; 95% CI 0.90; 1.13).ConclusionAlcohol consumption, even in low amounts, is associated with lower adherence to the Mediterranean diet. Therefore, alcoholic beverages should not be included in measures that define the Mediterranean diet.

Cross-sectional association between severe periodontitis and diabetes mellitus: A nation-wide cohort study.

To evaluate the cross-sectional association between severe periodontitis and diabetes mellitus (DM), in a representative sample of Spanish population. The di@bet.es epidemiological study is a population-based cohort study aimed to determine the prevalence and incidence of DM in the adult population of Spain. The at-risk sample at the final examination (2016-2017) included 1751 subjects who completed an oral health questionnaire. This questionnaire, together with demographic and risk factors, had been previously validated to build an algorithm to predict severe periodontitis in the Spanish population. Logistic regression models were used to evaluate the association between severe periodontitis and DM with adjustment for confounding factors. In total, 144 subjects developed DM, which yielded 8.2% cumulative incidence. Severe periodontitis was detected in 59.0%, 54.7% or 68.8% of the subjects depending on three different selected criteria at the 2016-2017 exam. All criteria used to define severe periodontitis were associated with DM in unadjusted analysis, but the magnitude of the association decreased after adjusting for significant confounders. The criteria '≥50% of teeth with clinical attachment loss ≥5 mm' presented an odds ratio of 4.9 (95% confidence interval: 2.2-10.7; p ≤ .001) for DM. Severe periodontitis is associated with DM in the Spanish population.

Smoking and COPD Knowledge in the General Spanish Population: A CONOCEPOC Study

Background: The objective of this analysis is to evaluate tobacco use and the level of chronic obstructive pulmonary disease (COPD) knowledge among the general adult population in Spain and to compare these results to those obtained in the 2011 survey. Methods: A cross-sectional, observational, epidemiological study was conducted by telephone interviews and stratified by sex, age, and setting. The study design was identical to that of the study conducted in 2011. Results: Of a total of 89,601 phone contacts, there were 6534 respondents. The average age was 61.5 years. With respect to smoking, 30.9% reported being former smokers and 14.7% were current smokers, 63.6% of whom reported having attempted to quit. Among the current smokers, 19.7% claimed to use electronic cigarettes, although 88% believe these pose a health risk. No significant differences were found in smoking prevalence or frequency of attempts to quit according to residential setting (rural/urban). The highest prevalence of current smoking in men was recorded in the 55–64 years age range (31.6%), while in women it was from 45 to 54 years (34.6%). Smoking has decreased with respect to 2011, from 21.1% to 16.1% in men and from 17.9% to 13.2% in women, with a clear variability according to region. Of the population surveyed, 32.5% had spontaneous knowledge about COPD, with significant geographic variability. The most frequent sources of information about the disease were social media and the Internet (39.6%), followed by the media (35.2%). Conclusions: The prevalence of tobacco use in adults has considerably decreased and there is greater knowledge about COPD in Spain, although there is significant variability according to region, which could explain the geographic variability in the prevalence of COPD. Strategies are needed to increase COPD education and awareness and to reinforce smoking prevention measures among women.

Polyphenol intake and mortality: A nationwide cohort study in the adult population of Spain

Polyphenols are secondary metabolites present in small quantities in plant-based food and beverages, with antioxidant and anti-inflammatory properties. Main groups of polyphenols include flavonoids, phenolic acids, stilbenes, and lignans, but their association with mortality has barely been examined. We aimed to assess the association between the intake of 23 polyphenol subgroups and all-cause, cardiovascular, and cancer mortality in a representative sample of the Spanish adult population. Population-based cohort study conducted with 12,161 individuals aged 18+ recruited in 2008-2010 and followed-up during a mean of 12.5 years. At baseline, food consumption was obtained with a validated dietary history, and the Phenol-Explorer database was used to estimate polyphenol intake. Associations were examined using Cox regression adjusted for main confounders. During follow-up, 967 all-cause deaths occurred, 219 were cardiovascular, and 277 cancer. Comparing extreme categories of consumption, hazard ratios (95% CI) of total mortality for subgroups were: dihydroflavonols 0.85 (0.72-1.00; p-trend:0.046); flavonols 0.79 (0.63-0.97; p-trend:0.04); methoxyphenols 0.75 (0.59-0.94; p-trend:0.021); tyrosols 0.80 (0.65-0.98; p-trend:0.044); alkylmethoxyphenols 0.74 (0.59-0.93; p-trend:0.007); hydroxycinnamic acids 0.79 (0.64-0.98; p-trend:0.014); and hydroxyphenilacetic acids 0.82 (0.67-0.99; p-trend:0.064). For cardiovascular mortality, hazard ratios were: methoxyphenols 0.58 (0.38-0.89; p-trend:0.010); alkylmethoxyphenols 0.59 (0.39-0.90; p-trend:0.011); hydroxycinnamic acids 0.63 (0.42-0.94; p-trend:0.020); and hydroxyphenilacetic acids 0.69 (0.48-0.99; p-trend:0.044), when comparing extreme tertiles of consumption. No statistically significant associations were observed for cancer. The main food sources for these polyphenol subgroups were red wine, leafy green vegetables, olive oil, green olives, and coffee (the latter being the major contributor of methoxyphenols, alkylmethoxyphenols, and hydroxycinnamic acids). In the Spanish adult population, intake of specific polyphenol subgroups was prospectively associated with a 20% lower all-cause mortality risk. This decrease was mainly due to a 40% lower cardiovascular mortality risk over time.

High Prevalence of Intimate Partner Violence Against Women in Young Adulthood: Is Prevention Failing?

In the last decades, prevention measures have been taken globally to reduce the high prevalence of intimate partner violence against women (IPVAW) in our societies. As a consequence, a gradual reduction in the prevalence of IPVAW in the younger generations should be expected. However, international prevalence data suggest that this is not the case. In the present study, we aim to compare IPVAW-prevalence rates across age groups in the adult population in Spain. We used data from the Spanish 2019 national survey based on 9,568 interviews with women, reporting IPVAW in three time periods: lifetime, the last 4 years, and the last year. To ensure accurate comparisons of IPVAW-prevalence rates across age groups, we first examined the psychometric properties, and measurement invariance of the set of questions addressing the different types of IPVAW (i.e., physical, sexual, psychological) in this survey. Results supported a three-factor latent structure addressing psychological, physical, and sexual IPVAW, showing high-internal consistency and validity evidence. For lifetime prevalence, the youngest age groups (18-24 years) were those with the highest latent mean in psychological and physical IPVAW, with those aged 25 to 34 years having the highest score in sexual IPVAW. Women aged 18 to 24 years showed the highest factor scores in the three types of violence during the last 4 years and during the last year. A number of potential explanatory hypotheses are proposed to better understand the high prevalence of IPVAW among younger generations. The reason why IPVAW prevalence remains alarmingly high among young women, despite the preventive measures taken in recent years, is a research question that remains open. Prevention efforts should target younger generations if IPVAW is to be eradicated in the long term. However, this goal will only be achieved if those prevention efforts prove to be effective.

Estudio de prevalencia de asma en población general en España

IntroductionAsthma is a disease with high prevalence, which affects all age groups and generates high health and social care costs. Studies carried out in a number of populations show great variability in its prevalence, even in geographically close populations, with data suggesting a relevant influence of socio-economic factors. At present, we do not have reliable data on the prevalence of this disease in the adult population of Spain. The objectives of this study are to estimate the prevalence of asthma in the Spanish population for those aged 18-79, to describe the variability between autonomous communities, to estimate the prevalence of under and overdiagnosis, to analyse the prevalence of uncontrolled asthma and steroid-dependent asthma, to evaluate the health care cost, to identify the most frequent phenotypes and to establish a starting point to evaluate the temporal trend with subsequent studies. MethodsA cross-sectional, two-stage study will be carried out, including patients from 50 catchment areas. The study will be carried out in 3 phases: 1) screening and confirmation in the clinical history, in which patients with a previously correctly established diagnosis of asthma will be identified; 2) diagnosis of asthma to evaluate patients without a confirmed or excluded diagnosis; 3) characterization of asthma, where the characteristics of the asthmatic patients will be analysed, identifying the most frequent phenotypes. DiscussionIt seems necessary and feasible to carry out an epidemiological study of asthma in Spain to identify the prevalence of asthma, to optimize healthcare planning, to characterize the most frequent phenotypes of the disease, and to evaluate inaccurate diagnoses.

Review of the Nutritional Status in Older Adult Population

The leading causes of death in older adults involve nutritional risk factors, heart disease, cancer, stroke and diabetes. Prevalence of lifestyle diseases, older adults consider themselves in good, very good or excellent health. Older adults want to remain independent and not burden others; they believe proper nutrition and sufficient exercise will help them maintain their autonomy and independence. To describe the diet, nutrition and general health status of the older adult population in Spain and their adherence to the traditional MD. A bibliographic search was performed in the following databases: PubMed, ScienceDirect, and Google Scholar for original research articles, clinical trials, and observational studies published in the last 10 yrs. The articles were selected using filters and eligibility criteria. Many articles were found, and through applying the selection criteria, 21 articles were chosen for a full review. Older adults present a multitude of pathologies that are treated with drugs that with the help of an optimal diet would promote a better quality of life. Cognitive deterioration leads older adults to suffer a great loss of quality of life and must be alleviated in the best way possible. Most people meet dietary needs, but high body mass indexes are obtained. MD is a reference and a technique put into practice by this part of the population that is developed in most of life and helps them to have better aging.

Rendimiento y validación del Test del Corazón Saludable para la predicción de mortalidad cardiovascular en población mediterránea a escala nacional

Introduction and objectivesThe Healthy Heart Score (HHS) is a lifestyle-based equation for predicting cardiovascular disease (CVD) risk and may serve as a tool in primordial prevention. However, its performance outside North American populations is unknown. This study assessed the performance of the HHS for estimating CVD mortality in the adult population of Spain. MethodsWe analyzed data from the ENRICA cohort, comprising 10 228 participants free of chronic disease and representative of the Spanish population aged ≥ 18-years, who were recruited from 2008 to 2010 and were followed up to 2020. The HHS includes body mass index, alcohol, physical activity, smoking, and a 5-component dietary score. The HHS was calculated at baseline using the sex-specific beta coefficients from the original development cohorts. Model discrimination was assessed using the Harrell c-statistic and Gonen-Heller c-statistic for survival data, and calibration was evaluated through calibration plots. ResultsAfter a median follow-up of 11.8 years, 110 CVD deaths were ascertained. The discrimination of the HHS was similar for women (Harrell c, 0.91; 95%CI, 0.87-0.95; Gonen-Heller-c, 0.85; 95%CI, 0.83-0.88) and men (Harrell c, 0.91; 95%CI, 0.88-0.94; Gonen-Heller c: 0.85; 95%CI, 0.83-0.88). After recalibration by the sex-specific baseline survival function, the calibration became optimal for: a) all deciles of predicted CVD risk except the highest decile, where HHS underestimated the risk, and b) all age groups except 70 years and older, where there was an underestimation. ConclusionsIn this Spanish cohort, the HHS showed good discrimination and calibration for predicting CVD death. The performance of HHS in other European populations and its implementation in the clinical setting warrants further investigation.

Performance and validation of the Healthy Heart Score model for predicting 12-year cardiovascular mortality in a nationwide Mediterranean population

Introduction and ObjectivesThe Healthy Heart Score (HHS) is a lifestyle-based equation for predicting cardiovascular disease (CVD) risk and may serve as a tool in primordial prevention. However, its performance outside North American populations is unknown. This study assessed the performance of the HHS for estimating CVD mortality in the adult population of Spain. MethodsWe analyzed data from the ENRICA cohort, comprising 10 228 participants free of chronic disease and representative of the Spanish population aged ≥ 18-years, who were recruited from 2008 to 2010 and were followed up to 2020. The HHS includes body mass index, alcohol, physical activity, smoking, and a 5-component dietary score. The HHS was calculated at baseline using the sex-specific beta coefficients from the original development cohorts. Model discrimination was assessed using the Harrell c-statistic and Gonen-Heller c-statistic for survival data, and calibration was evaluated through calibration plots. ResultsAfter a median follow-up of 11.8 years, 110 CVD deaths were ascertained. The discrimination of the HHS was similar for women (Harrell c, 0.91; 95%CI, 0.87-0.95; Gonen-Heller-c, 0.85; 95%CI, 0.83-0.88) and men (Harrell c, 0.91; 95%CI, 0.88-0.94; Gonen-Heller c: 0.85; 95%CI, 0.83-0.88). After recalibration by the sex-specific baseline survival function, the calibration became optimal for: a) all deciles of predicted CVD risk except the highest decile, where HHS underestimated the risk, and b) all age groups except 70 years and older, where there was an underestimation. ConclusionsIn this Spanish cohort, the HHS showed good discrimination and calibration for predicting CVD death. The performance of HHS in other European populations and its implementation in the clinical setting warrants further investigation.

Impact of Respiratory Syncytial Virus and Influenza Virus Infection in the Adult Population in Spain between 2012 and 2020.

Respiratory syncytial virus (RSV) infection is increasingly recognized as a cause of significant morbidity and mortality in adults. We aimed to estimate the rates of age-specific hospitalization and in-hospital mortality caused by acute lower respiratory tract infections (ALRTIs) in Spain between 2012 and 2020 and to compare the relative impact of RSV and influenza virus infection in adults. We used the discharge reports from the Minimum Basic Data Set to retrospectively analyze hospital discharge data on the basis of the ICD-9-CM and ICD-10-CM diagnosis codes. A total of 1,518,244 patients were hospitalized for ALRTIs, of whom 137,794 (9.1%) were admitted for RSV-related infections and 46,288 (3.0%) for influenza-related infections. In patients aged 60 years or older, the hospitalization rates (per 100,000 population) were estimated at 1.69 (95% CI 1.68-1.70) and 2.72 (95% CI 2.71-2.73) for RSV and influenza patients, respectively. However, in-hospital mortality rates were significantly higher among RSV patients than among influenza patients, 7.91% (95% CI 7.89-7.93) (83.0% of all RSV-related deaths) versus 6.91% (95% CI 6.89-6.93) (85.6% of all influenza-related deaths), respectively (p = 0.007). RSV-associated in-hospital mortality increases exponentially with age, posing a greater risk for older adults, particularly frail and high-risk patients.

Migration, mixedness, and the partner’s role in core discussion networks

Research into migration and social networks has suggested that migrants are relationally more vulnerable than non-migrants, especially those in endogamous couples. However, non-probability samples and lack of data about partners' networks have often impeded rigorous testing. This paper analyses the influence of migration and mixedness (unions between two persons from different geographical origins) on some compositional and structural measures of the core discussion networks of the adult population in Spain, paying special attention to the partner’s role. Data from the 2013 Spanish General Social Survey (SGSS) were used. A graph census shows the predominance of complete graphs both for endogamous and exogamous couples, but more clearly in the case of natives. Multivariate models prove that, in general, Spaniards in mixed unions seem less partner-dependent, whereas endogamous immigrants seem the most affected by the effects of the geographical mobility on relational vulnerability.

Self-reported health status and mortality from all-causes of death, cardiovascular disease and cancer in an older adult population in Spain.

AimTo assess the association between self-reported health (SRH) and mortality from all-causes, cardiovascular disease (CVD) and cancer, in adults 65 years and older in Spain.MethodsWe analysed data of 894 adults (504 women, 390 men) aged 65 years and above from two population-based studies, the EUREYE-Spain study and the Valencia Nutritional Survey (VNS). SRH was assessed at baseline using a single question which is widely used in epidemiological studies: “Overall, how would you consider your health at present?” and the response options were: 1. Very good, 2. Good, 3. Fair, 4. Poor, 5. Very poor. Deaths were ascertained during a 12-year follow-up period, and we used Cox proportional hazards regression models to obtain adjusted hazard ratios (HR).ResultsDuring the 12 years of follow-up (8566.2 person-years), we observed 400 deaths, 158 (39.5%) due to CVD and 89 (22.3%) due to cancer. Fair and poor/very poor SRH were significantly associated with higher all-cause mortality after 12-years of follow-up, HR = 1.29 (95% CI, 1.03–1.61) and HR 1.53 (95% CI, 1.09–2.15), respectively. We observed evidence of higher CVD mortality among those who reported fair and poor/very poor SRH, although the association was attenuated and lost statistical significance in the fully adjusted models.ConclusionThis study suggests that a poor SRH status is associated with a higher all-cause mortality risk among older adults in Spain. Checking SHR status may be useful to plan health care in older adults.

The 7 Cardinal Sins of COPD in Spain

Chronic obstructive pulmonary disease (COPD) is a public health problem due to its high prevalence (11% in the adult population in Spain), increasing incidence, and great social and economic impact. Despite this, it is underdiagnosed (and, therefore, undertreated) at a rate of around 80%. In this paper, a group of respiratory physicians specializing in COPD discuss 7 fundamental problems (“cardinal sins”) that contribute to this situation, with the explicit aim of proposing specific solutions that may help to improve this unfavorable state of affairs.

Why are cognitive test scores of spanish adults so low? the role of schooling and socioeconomic background

ABSTRACT We explore the cognitive skill gap between the adult population in Spain and in the rest of European Union countries using the Program for the International Assessment of Adult Competencies. We find that differences in schooling account for about a third of the average difference in cognitive test scores, whereas differences in socioeconomic background explain about one fourth of the average score gap. While cognitive skill gaps are increasing across the distribution of test scores, differences in educational stocks and socioeconomic factors explain a larger fraction of the gap at the bottom than at the top of the skill distribution.

Complicated grief: a systematic review of prevalence, diagnosis, risk and protective factors in the adult population of Spain

espanolEl objetivo principal de este trabajo fue revisar el estado de la investigacion psicopatologica del duelo complicado en poblacion adulta de Espana. Una busqueda sistematica en PsycINFO, PsycArticles, PTSDpubs y PSICODOC identifico 13 estudios en los que, en conjunto, se habia evaluado a 1,655 adultos. Los resultados de esta revision ponen de manifiesto que no existe consenso en el diagnostico de duelo complicado, en el uso de instrumentos de deteccion ni en los factores de riesgo y proteccion del duelo complicado. La prevalencia media ponderada basada en 6 de los estudios revisados fue de 21,53%. Tomando en consideracion el tipo de instrumento de medida del duelo utilizado, se obtuvo una prevalencia de 7,67-10,68% en aquellos estudios que utilizaban instrumentos diagnosticos y de 28,77% en los instrumentos sintomaticos. Los resultados indican que el duelo complicado se relaciona con: un menor nivel socioeconomico y situacion laboral desfavorable, la perdida de un hijo o conyuge, menor edad del fallecido, vulnerabilidad psicologica previa, consumo de psicofarmacos y comorbilidad con otros trastornos. El apoyo social, los cuidados paliativos, las estrategias de afrontamiento centradas en el problema, el empleo de actividades agradables y la trascendencia o espiritualidad se presentan como factores protectores. EnglishThe main objective of this research was to review the status of the psychopathological investigation of complicated grief in adult population of Spain. A systematic review on PsycINFO, PsycArticles, PTSDpubs, and PSICODOC databases identified 13 studies in which, overall, 1.655 adults had been evaluated. The results of this review show that there is no consensus in the diagnosis of complicated grief, in the use of detection instruments, or in the risk and protective factors for complicated grief. The weighted mean prevalence based on 6 of the reviewed studies was 21.53%. Taking into account the type of grief measurement used, a prevalence of 7.67-10.68% was obtained in those studies that used diagnostic instruments and 28.77% in the ones using symptomatic instruments. The results indicate that complicated grief is related to: a lower socioeconomic level and unfavorable work situation, the loss of a child or spouse, younger age of the deceased, previous psychological vulnerability, the use of psychotropic medication and comorbidity with other disorders. Social support, palliative care, problem-centered coping strategies, the use of pleasant activities, and transcendence or spirituality are shown as protective factors.

Consumers' Preferences and Willingness to Pay for Personalised Nutrition.

Personalised nutrition (PN) has great potential for disease prevention, particularly if coupled with the power and accessibility of mobile technology. However, success of PN interventions will depend on the willingness of users to subscribe. This study investigates the factors associated with potential users' perceived value of PN and heterogeneity in these values. A discrete choice experiment was carried out in a representative sample (N = 429 valid responses) from the adult population in Spain. The results were analysed in line with McFadden's Random Utility Theory, using conditional and mixed logit models in addition to a latent class logit model. The conditional and mixed logit models revealed the existence of a significant preference and willingness to pay for personalised nutrition, but the effect on average was not large for the highest level of personalisation. The latent class logit revealed four classes of respondent: those who would be likely to pay for a high level of personalised nutrition service, those who would use it if it were heavily subsidised, those who would use only a basic nutrition service, and those who would not be willing to engage. These results could be useful for the design and targeting of effective personalised nutrition services. Over half of adults currently perceive some individual benefit in a high level of PN, which may justify some degree of public subsidy in investment and delivery of such a service.

Coffee Consumption and All-Cause, Cardiovascular, and Cancer Mortality in an Adult Mediterranean Population.

We assessed the association between usual coffee consumption and all-cause, cardiovascular (CV), and cancer mortality in an adult population in Spain, taking into account both the amount and type of coffee consumed. We used baseline data on coffee consumption and other personal variables, and the number of deaths during an 18-year follow-up period, for 1567 participants aged 20 years and older from the Valencia Nutrition Study in Spain. Total, caffeinated, and decaffeinated coffee consumption was assessed using a validated food frequency questionnaire. Cox regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). During the 18-year follow-up period, 317 died; 115 due to CV disease and 82 due to cancer. Compared with no-consumption, the consumption of ≤1 cup per day and >1 cup per day of coffee was associated with a lower risk of all-cause mortality, HR = 0.73 (95% CI: 0.56–0.97) and HR 0.56 (95% CI: 0.41–0.77), respectively. A lower cancer mortality was observed among drinkers of more than 1 cup per day compared with nondrinkers, HR 0.41 (95% CI 0.20–0.86). Regarding the type of coffee, only the overall consumption of caffeinated coffee was associated with lower all-cause mortality at 12 and 18 years of follow-up, HR = 0.66 (95% CI:0.46–0.94) and HR = 0.59 (95% CI: 0.44–0.79), respectively. In conclusion, this study suggests that the moderate consumption of coffee, particularly caffeinated coffee (range 1–6.5 cups per day), is associated with a lower all-cause and cancer mortality after a long follow-up period. No significant association was found between coffee consumption and CVD mortality.

Why Cognitive Test Scores of Spanish Adults are so Low? The Role of Schooling and Socioeconomic Background

We explore the cognitive skill gap between the adult population in Spain and in the rest of European Union countries using the Programme for the International Assessment of Adult Competencies. We find that differences in schooling account for about a third of the average difference in cognitive test scores, whereas differences in socio-economic background explain about one fourth of the average score gap. While cognitive skill gaps are increasing along the distribution of test scores, differences in educational stocks and socio-economic factors explain a larger fraction of the gap at the bottom than at the top of the skill distribution.