Adults In Spain Research Articles

Association between caries and periodontal diseases in a sample of employed adults in Spain: a cross-sectional study.

To study whether there is an association between caries and periodontitis in a representative sample from employed Spanish adults. This cross-sectional study is part of a wide epidemiological survey (WORALTH, Workers' ORAL healTH). Oral examination was carried out in 5130 dentate subjects. Periodontal status was assessed by clinical attachment level (CAL) and Community Periodontal Index (CPI) in index teeth. For caries, all teeth were classified as healthy, decayed (D), filled (F), or missed (M), and DMFT index and prevalence of cavitated caries were calculated. ANOVA, Chi-square tests, and regression models were performed. DMFT increased with CAL values, being 7.8, 9.6, and 10.5 for CAL 0-3 mm, 4-5 mm, and ≥ 6 mm, respectively. After adjustment for confounders, subjects with CPI ≥ 3 showed an odds ratio of 1.6 (95% confidence interval (CI) [1.3; 1.8]; p < 0.001) for presenting cavitated caries, and patients with CAL ≥ 6 mm had 0.8 higher mean DMFT (95% CI [0.2; 1.5]; p = 0.015), and 0.3 higher mean DFR (95% CI [0.2; 0.5]; p < 0.001) than those with CAL < 6 mm. The presence of CAL ≥ 6 m mm was associated with an increased DMFT and DFR, and the presence of CPI ≥ 3 was associated with a higher prevalence of cavitated caries in this representative sample. There is a tendency to present higher prevalence of dental caries among patients with periodontitis. Therefore, common preventive measures in dentistry, such as oral hygiene practices, should ideally include actions aimed to prevent at the same time dental caries and periodontitis.

Kihon Checklist to assess frailty in older adults: Some evidence on the internal consistency and validity of the Spanish version.

The aim of this study was to assess the internal consistency, hypothesis testing and criterion-related validity of the Spanish versions of the Kihon Checklist (KCL) - the original 25-item and reduced 15-item versions - for screening frailty in community-dwelling older adults. A cross-sectional study was carried out between March and September 2018 in Valencia province (Spain). A sample of 251 participants was recruited. Construct validity was assessed using four different frailty instruments, and alternative measures corresponding to the KCL domains (handgrip strength, gait speed, the Short Physical Performance Battery, skeletal muscle mass index, physical activity level, functional status, cognitive function, depressive mood, health-related quality of life and nutritional status). Fried's Frailty Phenotype was used to evaluate criterion validity. Internal consistency assessed with Kuder-Richardson Formula had a value of 0.69 for the 25-item version, slightly lower than the usual 0.7 for considering good reliability, and 0.71 for the 15-item version. There were significant correlations between KCL versions and Fried's Frailty Phenotype, Edmonton Scale, Tilburg Indicator and FRAIL Scale. Consistent significant correlations were also obtained with all frailty measurements and instrumental activities of daily living, physical strength, eating, socialization, and mood domains of the KCL. The KCL closely correlated with other standardized measurements of physical function, cognitive function, depressive mood, and health-related quality of life. The KCL also showed satisfactory diagnostic accuracy for frailty (area under the curve 0.891 for KCL-25; area under the curve 0.857 for KCL-15). The optimal cut-off points were 5/6 and 3/4, respectively. The findings suggest that both versions of the KCL, especially KCL-15, showed adequate evidence of validity and internal consistency as a preliminary screening of frailty among community-dwelling older adults in Spain. Geriatr Gerontol Int 2021; 21: 262-267.

Advertising Games of Chance in Adolescents and Young Adults in Spain.

Gambling advertising can influence attitudes and gaming behavior of adolescents and young adults (A&Y). To study the effect of advertising on the attitudes and gaming behavior of a sample of 2887 Spanish A&Y (12-22years old), by means of a self-report assessment. On average, participants show a weak effect of advertising, however there are great variations, estimating that 11% of A&Y acknowledge being influenced by advertising and 5% recognize being severely affected. Men see themselves more impacted than women, without age differences. Those who play videogames signal a stronger effect of this kind of advertising and although these differences are not substantial in effect size, they reach statistically significance in 12 of the 13 questions assessed. A&Y who showed higher scores indicating problematic use of videogames in the IDGS9-SF, are those who indicate a greater impact of advertising on their attitudes towards gaming, as well as on the way they play or on their intention to play. These results support the idea that videogames can, albeit modestly, predispose engagement in games of chance.

Single Time-Point Study of the Home Environment and Functionality of Older Adults in Spain.

Background: The literature favors discussion on socio-spatial conditions at the macro- (city) and micro- (housing) level that promote healthy aging in place. Objectives: (a) Identify the association between physical and social characteristics of the family home and the functional level and quality of life of older people and (b) provide normative data on adequate/inadequate households based on the Home Observation for Measurement of the Environment (HOME) inventory and the Spanish Informant Questionnaire on Cognitive Decline in the Elderly (S-IQCODE) test. Methods: In total, 79 healthy older adults completed the HOME inventory and the Montreal Cognitive Assessment (MoCA), S-IQCODE, Kessler Psychological Distress Scale (K-10) and ICEpop CAPability measure for Older people (ICECAP-O) tests. A regression model, the effect size and the means of the scores of HOME (adequate/inadequate) test and the cognitive level (optimal/normal) were calculated. Results: The regression model discloses that adequate home scores are associated with cognitive level (odds ratio (OR): 0.955, confidence interval (CI)95%: 0.918–0.955); quality of life (OR: 6.542, CI95%: 1.750–24.457), living with other people (OR: 5.753, CI95%: 1.456–22.733) and level of education (OR: 0.252, CI95%: 0.064–0.991). The normative data between HOME and S-IQCODE scores showed a good adjustment (d = 0.70). Conclusion: There is a significant relationship between the physical environment of the home and personal variables (sociodemographic information, quality of life and cognitive functionality). In addition, from this last variable, the normative data of an adequate/inadequate household for an older person have been established.

Diet quality, assessed by the Healthy Eating Index-2010, and exercise associated factors of obesity: a cross-sectional study

Introduction: Certain weight management methods may be associated with unhealthy dietary intakes, skewing toward certain dietary components and lacking others. Management of weight should not ignore the quality of the diet, as both obesity and poor diet are associated with higher risk of chronic disease. Objective: To conduct a diet quality and exercise scan and observe their repercussion on BMI, in adults from Spain, Portugal, Uruguay and Mexico. Material and methods:An observational retrospective cohort study was designed, with 1181 adults aged 18-65 years. HEI-2010 score was used to assess diet quality. Data on type, days a week and hours/day of exercise, and participant’s anthropometric measures were collected.Results: The mean HEI-2010 score was 65.21. There were no statistically significant differences between HEI-2010 score and BMI [p=0.706], BMI and days of exercise per week [p=0.151], BMI and hours/day of exercise [p=0.590] and BMI and being active [&gt;3 days/week] [p=0.106]. On the contrary, overall exercise influenced BMI significantly [p&lt;0.001]. Conclusions: Dietary patterns may help to prevent weight gain and fight overweight and obesity. This study, however, did not observe associations between the quality of the diet nor specifics of exercise with lower BMIs. The quality of the diet of adults in Spain, Portugal, Uruguay and Mexico fell short of recommendations.

Ultra-Processed Food Consumption Is Associated with Abdominal Obesity: A Prospective Cohort Study in Older Adults.

Introduction and objectives. Ultra-processed food (UPF) consumption has been associated with increased incidence of cardiovascular disease and its risk factors. The aim of this study was to assess, for the first time in the literature, the prospective association between UPF consumption and the incidence of abdominal obesity (AO) in older adults. Methods. The study sample consists of 652 participants in the Seniors Study on Nutrition and Cardiovascular Risk in Spain: Seniors-ENRICA-1 study, (mean age 67, 44% women). At baseline, standardized anthropometric measurements were collected (including abdominal circumference). After a median follow-up of six years, the abdominal circumference was measured again, and the incidence of abdominal obesity (AO) was calculated, defined as an abdominal perimeter ≥102 cm in men and ≥88 cm in women. At baseline, dietary information was collected using a computerized and validated dietary history. Information was obtained on the usual diet in the previous year. A total number of 880 foods were classified according to their degree of processing following the NOVA classification. Foods or drinks formulated mostly or entirely from substances derived from foods, with little or no presence of the unaltered original food were classified as UPF. For each participant, the percentage of energy from UPF was derived and sex-specific tertiles were calculated. Logistic regression models were built and adjusted for sociodemographic, lifestyle, morbidity, and drug treatment variables. Results. Among those participants without AO at baseline, 177 developed AO during follow-up. The average consumption of UPF was 17% of total energy (7% in the first tertile; 29% in the third tertile). The odds ratio (95% confidence interval) for incident AO risk when compared to the lowest tertile was: 1.55 (0.99–2.44) for the second tertile of UPF consumption and 1.62 (1.04–2.54) for the third tertile; p for linear trend: 0.037. Results remained statistically significant after adjusting for potential dietary confounding factors such as fiber consumption, the intake of very long chain omega-3 fatty acids and adherence to the Mediterranean diet. Conclusions. A higher UPF consumption is positively associated with incident AO in older adults in Spain. These findings extend the current evidence of the detrimental effect of UPF consumption on cardiometabolic health.

Mathematical modeling of adulthood obesity epidemic in Spain using deterministic, frequentist and Bayesian approaches

Abstract The excess weight population is growing riskily in Spain. This is confirmed by the Spanish National Health Survey 2017, which gathers the percentage of overweight and obese adults in Spain from 1987 to 2017. In this paper we propose a mathematical model based on differential equations to calibrate the incidence of excess weight in the Spanish adulthood population. The main principle is that fatness is an epidemic, where there are three stages, namely normal weight, overweight and obese, and healthy individuals may become “infected” by social contact. We start with a well-posed deterministic formulation of the model, where the parameters are fitted by minimizing the mean square error objective function. The long-term behavior of the system shows that 37% and 24% of Spanish adults will be overweight and obese in the long run, respectively. Due to the incomplete knowledge of the underlying phenomenon and error measurements, randomness must be incorporated into the model formulation. A white noise error term is thus added to conduct nonlinear regression. The response becomes a stochastic process, whose prediction interval captures the variability of the overweight and obese populations correctly. We go a step beyond by treating the model parameters as random variables. The Bayesian inference method allows for quantifying the propagation of uncertainty in this setting, by running the Metropolis algorithm (both brute-force and Adaptive). The numerical simulations show that it provides similar results to the frequentist analysis. The sensitivity analyses from the different methods agree and suggest that prevention strategies are more important than treatment strategies to control adulthood obesity. Specially, the treatment of the transition from the obese to the overweight stages is the least recommendable for reducing the obesity epidemic.

Health Decline Is Associated with Reports of No Coffee Consumption Years After Reporting Coffee Consumption Among Older Adults in Spain

Part of the health benefits of coffee reported in observational studies might be due to health status influencing coffee intake rather than the opposite. We examined whether changes in health influenced subsequent reports of no coffee consumption in older adults. Data came from 718 coffee drinkers aged ≥60 y recruited in the Seniors-Estudio de Nutrición y Salud Cardiovascular en España (ENRICA) cohort in 2008-2010 (wave 0) and followed-up in 2012 (wave 1), 2015 (wave 2), and 2017 (wave 3). Health status was measured with a 52-item deficit accumulation index (DAI) with 4 domains: functionality, self-rated health/vitality, mental health, and morbidity/health services use. Coffee intake was estimated with a validated diet history. We examined how changes in health status over a 3-y period (wave 0 to wave 1) influenced reports of no coffee consumption during the subsequent 5 y (wave 1 to wave 3) by using logistic regression models. Health deterioration over 3 y was associated with a higher frequency of reports of no regular coffee consumption during the subsequent 5 y (fully adjusted OR: 1.48 per 1-SD increment in DAI; 95% CI: 1.17-1.87). Deteriorating function (OR: 1.38 per 1-SD increment; 95% CI: 1.06-1.81) and mental health (OR: 1.34 per 1-SD increment; 95% CI: 1.04-1.73) were the DAI domains associated with increased reports of no regular coffee consumption. Also, individuals with worsened perceived health or hypertension onset were more likely to report no regular coffee consumption. No associations were found for decaffeinated coffee. Health deterioration was associated with reports of no regular coffee consumption years after reporting regular coffee consumption among older adults in Spain. A potential implication of this finding is that part of the beneficial effect of coffee consumption on health in observational studies might be due to reverse causation, which should be confirmed in future research.

Trends and causes of mortality in a population-based cohort of HIV-infected adults in Spain: comparison with the general population

Combination antiretroviral therapy reduces mortality of HIV-infected persons. In Spain, where this therapy is widely available, we aim to evaluate mortality trends and causes of death in HIV-infected adults, and to estimate the excess mortality compared to the general population. From 1999 to 2018 mortality by causes was analyzed in a population-based cohort of adults aged 25 to 74 years diagnosed with HIV infection in Spain. Observed deaths and expected deaths according mortality in the general population of the same sex and age were compared using standardized mortality ratios (SMRs). HIV-infected people increased from 839 in 1999–2003 to 1059 in 2014–2018, median age increased from 37 to 47 years, the annual mortality rate decreased from 33.5 to 20.7 per 1000 person-years and the proportion of HIV-related deaths declined from 64% to 35%. HIV-related mortality declined from 21.4 to 7.3 (p < 0.001), while non-HIV-related mortality remained stable: 12.1 and 13.4 per 1000, respectively. Mortality decreased principally in persons diagnosed with AIDS-defining events. In the last decade, 2009–2018, mortality was still 8.1 times higher among HIV-infected people than in the general population, and even after excluding HIV-related deaths, remained 4.8 times higher. Excess mortality was observed in non-AIDS cancer (SMR = 3.7), cardiovascular disease (SMR = 4.2), respiratory diseases (SMR = 7.9), liver diseases (SMR = 8.8), drug abuse (SMR = 47), suicide (SMR = 5.3) and other external causes (SMR = 6). In conclusion, HIV-related mortality continued to decline, while non-HIV-related mortality remained stable. HIV-infected people maintained important excess mortality. Prevention of HIV infections in the population and promotion of healthy life styles in HIV-infected people must be a priority.

COVID-19 and care homes and nursing homes crisis in Spain: ageism and scarcity of resources

The European Welfare State crisis since 2008 has shown the weakness of these European welfare systems to cope with a health crisis such as COVID-19, which in turn has not guaranteed the rights and wellbeing of older people. This article aims at shading light on the scarcity of resources in Spanish care homes and nursing homes system, while analyzing its integrated care failure and the urgent legislative measures implemented to overcome COVID-19 health crisis. At the same time, this paper advocates for a reflexion on ageist practices, so as to foster a debate on the ‘desisntitucionalization’ process of older adults in Spain. In this COVID-19 context, it has become utmost in implementing an older adults’ policy to guarantee older adults rights as vulnerable population; likewise, which has already been done in respect to laws protecting children rights.

Shadow and extended shadow cost sharing associated to informal long-term care: the case of Spain

BackgroundA large part of the long-term care is provided by non-professional caregivers, generally without any monetary payment but a value economic of time invested. The economic relevance of informal caregivers has been recognized in Spain; however, public provision may still be scarce. The objective of this paper is to estimate the economic burden associated with informal long-term care that should assume the families through a new concept of cost sharing that consider opportunity costs of time provided by informal caregivers.MethodsThe study sample includes all dependent adults in Spain. Socioeconomic information and the number of hours of informal care was collected through the Spanish Disability and Dependency Survey. The terms of shadow and extended shadow cost sharing were defined as the difference between the maximum potential amount of money that families could receive for the provision of informal care and the amount that actually they received and the value of informal care time with respect to the amount received, respectively.Results53.87% of dependent persons received an economic benefit associated to informal care. The average weekly hours of care were 71.59 (92.62 without time restrictions). Shadow cost sharing amounted to, on average, two thirds, whereas the State financed the remaining third. In terms of extended shadow cost sharing, the State financed between 3% and 10% of informal care provided by caregivers.ConclusionsThis study reveals the deficient support received for the provision of informal care in Spain. More than 90% of informal care time is not covered by the economic benefits that families receive from the State.

Causal effects of physical activity and sedentary behaviour on health deficits accumulation in older adults.

Increasing physical activity (PA) and reducing sedentary behaviour (SB) have been associated with healthy ageing, but their effects when adjusted for reverse causation and selection bias remain unclear. A deficits accumulation (DA) index based on the number and severity of 51 health deficits (0-100%) was calculated at baseline and three biannual follow-up visits, in a representative cohort of 3228 community-dwelling older adults in Spain. Average differences in DA index by previous recreational PA, household PA, mentally-active SB and passive SB were estimated using marginal structural models with inverse probability of exposure and censoring weights. Compared with participants with previous recreational PA of 10-19.9 metabolic equivalent hours/week (MET-hours/week), average differences in DA index (95% confidence intervals) were 0.19 (-1.09, 1.48), 0.69 (-0.23, 1.61), -0.66 (-1.34, 0.02), -0.87 (-1.59, -0.13) and -0.55 (-1.37, 0.28) for 0, 0.1-9.9, 20-29.9, 30-39.9 and ≥40 MET-hours/week, respectively (P for trend = 0.006). Household PA showed no effect on subsequent DA after adjusting for reverse causation. Women, but not men, who spent 7-14.9, 15-20.9 and ≥21 h/week on mentally active SB had DA decreases of 0.09 (-1.00, 1.19), 1.08 (-0.28, 2.45) and 2.17 (0.58, 3.75), respectively, compared with 1-6.9 h/week (P for trend = 0.005); whereas women who spent 3-3.9, 4-4.9 and ≥5 h/day on passive SB showed DA increases of 0.41 (-0.52, 1.35), 1.35 (0.13, 2.57) and 2.13 (0.78, 3.47), respectively, compared with 2-2.9 h/day (P for trend = 0.001). The proposed methodology allows estimation of the causal effects of PA and SB on ageing, by simulating a random assignment in which all subjects have the same probability of exposure.

Tisagenlecleucel cost effective in children and young adults in Spain

Tisagenlecleucel cost effective in children and young adults in Spain

Cost-Effectiveness Analysis of Tisagenlecleucel in the Treatment of Relapsed or Refractory B-Cell Acute Lymphoblastic Leukaemia in Children and Young Adults in Spain.

PurposeTisagenlecleucel, a chimeric antigen receptor T-cell (CAR-T) therapy, is a promising alternative for the management of children and young adults with relapsed and refractory B-cell acute lymphoblastic leukemia (r/r ALL). The aim of this study was to determine whether treatment with tisagenlecleucel is a cost-effective intervention compared with salvage chemotherapy in paediatric and young adult patients with r/r ALL in Spain.Materials and MethodsA partitioned survival model of monthly cycles with three health states was used (event-free survival, progressive/relapsed disease and death). A lifetime time horizon and the Spanish National Health System perspective were adopted. During the first 5 years, permanence in the different health states was determined according to the results in the clinical studies. In successive years, mortality tables of the Spanish general population adjusted by standardized mortality rate for survivors of childhood cancer were used. Clinical, economic, and quality of life parameters were drawn from clinical trials and the literature. Only direct health costs (pharmacological costs and the costs derived from health resource use) were included. The robustness of the results was evaluated in a sensitivity analysis.ResultsThis cost-effectiveness analysis showed a greater benefit (10.10 and 8.97 life-years gained [LYGs] and quality-adjusted life-years [QALYs] gained, respectively) and a higher cost (€ 258,378.40) for tisagenlecleucel compared to salvage chemotherapy. The resulting incremental cost-effectiveness and cost-utility ratios were € 25,576.80 per LYG and € 28,818.52 per QALY gained, respectively. In the sensitivity analysis, all the results were below € 50,000/QALY.ConclusionTisagenlecleucel would represent a cost-effective intervention for the treatment of children and young adults with r/r ALL in Spain.

From Internet access to problematic use: multigroup analysis of push and pull factors

ABSTRACT Frequency of Internet use is usually emphasised, in systematic reviews and meta-analyses, as a risk factor in problematic Internet use (PIU). Likewise, studies that focus on the analysis of online activities associated to PIU offer confounding results, although they coincide in pointing out the relevance of motivations associated to online activities. The Internet Addiction Model (IAM) offers a comprehensive focus of the influence of Internet activity on PIU. Which differentiates between aspects inherent to the needs of individuals (push factors) associated with negative consequences, and aspects of the Internet that help satisfy such needs (pull factors). However, it is a conceptual model requiring empirical evidence. This study utilised a cross-generational sample (N = 575) of adolescent students and young adults in Spain. Considering the IAM, the objectives were to (a) verify the effect of the frequency of Internet use in multiple contexts on motivations – push factors – (b) verify the relationship between push factors and IPU, and (c) determine the moderating effect of social relation activities, online games, and antisocial entertainment – pull factors – . The data supported the relationship between push factors – escape, fantasy, and social interaction – and PIU, and revealed the complexity of moderating pull factors.

Association between Physical Activity, Food Consumption and Depressive Symptoms Among Young Adults in Spain: Findings of a National Survey

Young adults have a significant prevalence of mental disorders, which could lead to dysfunctional quality of life. Records of 1,645 Spanish adolescents were examined and multiple logistic regressions were performed. Being a woman, being older and having a sedentary life were all associated with a higher psychological vulnerability, whereas a low frequency of fresh fruit and bread/cereals consumption, as well as regular intense physical activity, were considered protective against such susceptibility. Regular physical activity and a diet with a high consumption of fruit and cereals may help reduce depressive symptoms, but sociodemographic features are as much as important as lifestyle habits.

Antecedents of Entrepreneurial Intention among Young People: Model and Regional Evidence

Entrepreneurial intentions determine to a large extent the entrepreneurial behavior; therefore, the study of those intentions and the factors that influence them constitute a valid research area. The purpose of this regional comparative study was to design a new causal model of the formation of the entrepreneurial intention among young adults in Spain and Poland. Using the Structural Equation Modeling (PLS) methodology, the results show that subjective variables (beliefs, social norms, values) initiate the chain of effects that influence the action variables (motivation, self-efficacy, intention). Attitude is the nexus variable between both groups of variables. It is verified that there are no significant differences in the responses to the items or in the causal relationships of the model between both countries. This confirms the relevance of a homogenizing generational approach at a global level that allows the application of policies to promote the entrepreneurial intention for the entire segment. The proposed model takes into account and complements the previous designs, and is practical because it can be used at different levels of the education sector and by institutions promoting entrepreneurship and sustainability.

Time Trends in the Co-use of Cannabis and the Misuse of Tranquilizers, Sedatives and Sleeping Pills among Young Adults in Spain between 2009 and 2015.

The aims of this study were: (a) to estimate time trends in the prevalence of the co-use of cannabis and other cannabis-based products (CBP) with the misuse of tranquilizers, sedatives, and sleeping pills (TSSp) between 2009 and 2015; and (b) to identify the factors associated with the probability of the co-use of CBP with TSSp misuse during this period among Spanish younger adults (15–34 years old). We analyzed data collected from the Spanish National Surveys on Alcohol and Other Drugs (EDADES) in 2009, 2011, 2013, and 2015. CBP co-use with TSSp misuse were the dependent variables. We also analyzed sociodemographic features, self-perceived health status, lifestyle habits, perceived health risk of consumption, and perceived availability of substance using logistic regression models. The prevalence of CBP co-use with TSSp misuse has decreased in Spain. The factors associated with co-use were a lack of education (OR 2.34), alcohol (OR 7.2), tobacco (OR 6.3) and other illicit psychoactive drug (OR 6.5) consumption, perceived non-health risk for the consumption of CBP and TSSp (OR 3.27), and perceived availability of CBP (OR 2.96). Our study identified several factors that appear to affect CBP and TSSp co-use in younger adults, with potential implications for healthcare providers.

Homelessness and self-rated health: evidence from a national survey of homeless people in Spain

BackgroundInternationally, acute homelessness is commonly associated with complex health and social care needs. While homelessness can be understood as an outcome of structural housing exclusion requiring housing led solutions, the health care issues faced by homeless people equally require attention. A substantive evidence base on the health needs of homeless people exists, but relatively little is known about what influences the self-rated health of homeless people. This article presents new evidence on whether drug use (alcohol consumption, ever having used drugs), health variables (visiting a hospital once in the last year, visiting the doctor in the last month, having a health card, sleeping difficulties, and having a disabling impairment) and sociodemographic characteristics are significantly associated with Self-Rated Health (SRH) among Spanish homeless people.MethodThe approach applies secondary analysis to cross-sectional data from a sample of 2437 homeless adults in Spain (83.8% were male). Multinomial logistic regression modelling was used to analyse the relationships between drug use, other health variables and SRH.ResultsBeing male, an abstainer, having a health card and being in the youngest age groups were significant factors associated with perceived good health. On the other hand, ever having used drugs, having been a night in hospital, having gone to the doctor in the last month, having sleeping difficulties, having a disabling impairment and being in the older age group were all significant risk factors associated with perceived poor health.ConclusionsThese results help to improve understanding of the key factors that influence the SRH among homeless people. The findings can contribute to development and delivery of preventive policies, suggesting that interventions to reduce drug consumption and ensure access to a health card/health services, as well as enhancing services for older, female and disabled homeless people are all measures which could improve health and well-being for those who face homelessness. Effective housing interventions (e.g. Housing First or Permanent Supported Housing programmes) are equally important to underpin the effectiveness of measures to improve the self-rated health of homeless people.

Changes in Alcohol Consumption and Associated Variables among Older Adults in Spain: A population-based cohort study

We examined prospective changes in drinking patterns and their associations with socio-behavioral and health status variables in older adults in Spain using data from a prospective cohort of 2,505 individuals (53.3% women) representative of the non-institutionalized population aged >60 years in Spain. Alcohol consumption was assessed at baseline (2008–10) and at follow-up (2012) with a validated diet history. At risk drinking was defined as consuming >14 g of alcohol/day on average or any binge drinking in the last 30 days; lower amounts were considered light drinking. A total of 26.5% of study participants changed their intake during follow-up. Most participants reduced alcohol intake, but 23.3% of men and 8.9% of women went from light to at risk drinking during the study period. Low social connectivity at baseline was linked to at risk drinking for both sexes. However, the observed associations between changes in social connectivity, morbidity, BMI, or dietary habits and changes in drinking patterns differed by sex. We concluded that since about a quarter of older adults in Spain consume more alcohol than recommended, identifying socio-behavioral factors associated with this behavior is key for designing health campaigns targeting excessive alcohol consumption in this vulnerable population.