Common Behavioral Risk Factors Research Articles

Prevalence of common mental disorders and treatment gap among patients with non-communicable diseases in the rural areas of East India.

Mental and physical non-communicable diseases (NCDs) coexist, because they share common environmental and behavioral risk factors. The treatment gap for common mental disorders, such as depression, anxiety, and substance use, is large compared to other NCDs. To determine the prevalence and treatment gap of common mental disorders among patients with non-communicable diseases. The community-based cross-sectional study was conducted in the rural parts of East India, in people aged 30years and older with NCDs. A simple random sample was chosen to select the villages and participants. Eligible participants administered with screening and diagnostic questionnaire for depression, anxiety, and substance use. Those diagnosed with mental disorders were again assessed for treatment status in the last 12months. Non-receipt of treatment was considered as treatment gap. A total of 515 participants were included in the analysis. The overall prevalence of common mental disorders among the study population was 46.4% (95% CI 42.0-50.8), and excluding substance use, the prevalence was 11.7% (95% CI 9.0-14.7). The treatment gap for common mental disorders among patients with non-communicable diseases, including and excluding substance use, was 98.3% (95% CI 95.8-99.5) and 93.3% (95% CI 83.8-98.2), respectively. The prevalence and treatment gap of common mental disorders among persons with NCDs was high. Public health interventions need to be emphasized for the integration of mental health care into NCD care.

Explaining the increase of incidence and mortality from cardiovascular disease in Indonesia: A global burden of disease study analysis (2000–2019)

Background In the last two decades, there has been a discernible shift in the distribution of mortality attributed to cardiovascular disease (CVD) between developing and developed nations; in developed nations, the percentage of deaths caused by CVD decreased from 48% in 1990 to 43% in 2010, while in developing nations, they increased from 18% to 25%. In Indonesia, CVD death has increased substantially and remained elevated in the last ten years. Current behavioral and metabolic risk factors, including hyperglycemia, obesity, dyslipidemia, hypertension, and smoking, enhance the risk of CVD mortality, according to several studies. Aims We undertook a study to determine whether the increase in mortality and incidence of CVD can be attributed to changes in the most common metabolic and behavioral risk factors from 2000 to 2019 across 34 Indonesian provinces. Materials and methods Data from 34 province for CVD incidence and mortality and data on changes in metabolic and behavioural risk factors between 2000 and 2019 in Indonesia were obtained from the Global Burden study (GBD) by The Institute of Health Metrics and Evaluation (IHME). A statistical model was applied to calculate the fatalities attributable to the risk factors change using Population attributable fractions (PAF) and baseline year death numbers. Furthermore, we ran multivariate regressions on Summary Exposure Value of risk factors associated with the increasing mortality, incidence rates in a lag year analysis. R software used to measure heteroscedasticity-consistent standard errors with coeftest and coefci. Covariates were added to adjusted models, including the Socio-demographic Index, Primary health care facilities coverage, and GDP per capita. Results The age-standardized mortality rate for CVD from 2000 to 2019 in Indonesia, increased from 356.05 to 412.46 deaths per 100,000 population among men and decreased from 357.52 to 354.07 deaths per 100,000 population among women, resulting in an increase of 270.928 per 100,0000 inhabitants of CVD deaths. In the same period, there was an increase in exposure to risk factors such as obesity by +9%, smoking by +1%, dyslipidemia by +1.3%, hyperglycemia by +2%, and hypertension by +1.2%. During this time span, an additional 14,517 men and 17,917 women died from CVD, which was attributable to higher obesity exposure. We apply multivariate regression with province-fixed and year-fixed analysis and find strong correlation between hyperglycemia in women (6; 95%CI 0 to 12, death per 1-point increase in hyperglycemia exposure) with an increasing death rate in ischemic heart disease. We also performed a year lag analysis and discovered a robust association between high low density lipoprotein (LDL) levels in men and women and the growing incidence of ischemic heart disease. The association between a 10-year lag of high LDL and the incidence of ischemic heart disease was five times stronger than that observed for other risk factors, particularly in men (5; 95%CI 2 to 8, incidence per 1-point increase in high LDL exposure). Conclusion Hyperglycemia in women is an important risk factor associated with increasing mortality due to Ischemic Heart Disease (IHD) in Indonesia This study also revealed that the presence of high LDL in both men and women were associated with an increase incidence of IHD that manifested several years subsequent to exposure to the risk factor. Additionally, the highest cardiovascular death portion were attributed to obesity. These findings suggest that policymakers should control high LDL and hyperglycemia 10 years earlier prior to the occurrence of IHD and employ personalized therapy to regulate associated risks.

Behavioural risk factors and psychophysical well-being among University students in Pavia Colleges

Abstract Pavia, Italy, is one of the oldest university city campuses in Europe and the venue for 16 Colleges, hosting around 2,500 Italian and international students (10% of the whole student population). Colleges represent a distinctive identity of the city and quite a unicum in the Italian academic system. Since leaving their parents’ homes and starting University has an impact on young adults’ health behaviours, potentially impairing their future life pathways, we investigated students’ health status and well-being through a rigorous assessment of lifestyles and behavioural risk factors. A cross-sectional online survey was designed and administered to students living in Pavia's Colleges. The questionnaire was structured into five sections, aimed at collecting information on university careers, lifestyles and behavioural risk factors, psychological well-being, and experience in residences during the COVID-19 pandemic. Where available, validated structured scales were used to gather specific study's endpoints (i.e., IPAQ, Audit-C, Medi-Lite, GHQ-12, BHS and 3-item loneliness scale). Of the 1199 students enrolled between March and August 2022, 814 subjects participated in the study. Regarding the most common behavioural risk factors, smokers were 25.2% of our sample, while at-risk alcohol consumption and regular cannabis use stood at 42.9% and 4.0%, respectively. Around 17% of the students gambled 1-2 times/week, and 4.5% did not take measures to prevent sexually transmitted infections. In terms of psycho-physical well-being, the level of physical activity was inadequate in 11.7% of the subjects, and the results of the mental health tests showed a risk for loneliness (3-item loneliness score≥6) in 36.9% and for hopelessness (BHS≥6) in 17.7%. Our findings may provide useful information to tailor the most appropriate health promotion and health education interventions so as to design a culture for well-being across the whole lifespan. Key messages • Our study offers a comprehensive overview of the student population residing in colleges, providing representative data. • Promoting healthy behavioral risk factors early in life, with a life course perspective, is crucial to enhancing individuals’ chances for a healthy life.

Predicting Multimorbidity Using Saudi Health Indicators (Sharik) Nationwide Data: Statistical and Machine Learning Approach.

The Saudi population is at high risk of multimorbidity. The risk of these morbidities can be reduced by identifying common modifiable behavioural risk factors. This study uses statistical and machine learning methods to predict factors for multimorbidity in the Saudi population. Data from 23,098 Saudi residents were extracted from the "Sharik" Health Indicators Surveillance System 2021. Participants were asked about their demographics and health indicators. Binary logistic models were used to determine predictors of multimorbidity. A backpropagation neural network model was further run using the predictors from the logistic regression model. Accuracy measures were checked using training, validation, and testing data. Females and smokers had the highest likelihood of experiencing multimorbidity. Age and fruit consumption also played a significant role in predicting multimorbidity. Regarding model accuracy, both logistic regression and backpropagation algorithms yielded comparable outcomes. The backpropagation method (accuracy 80.7%) was more accurate than the logistic regression model (77%). Machine learning algorithms can be used to predict multimorbidity among adults, particularly in the Middle East region. Different testing methods later validated the common predicting factors identified in this study. These factors are helpful and can be translated by policymakers to consider improvements in the public health domain.

Cost-effectiveness of Digital Tools for Behavior Change Interventions Among People With Chronic Diseases: Systematic Review.

Chronic diseases, including cardiovascular diseases, diabetes, chronic obstructive pulmonary disease, and cerebrovascular diseases, contribute to the most significant disease burden worldwide, negatively impacting patients and their family members. People with chronic diseases have common modifiable behavioral risk factors, including smoking, alcohol overconsumption, and unhealthy diets. Digital-based interventions for promoting and sustaining behavioral changes have flourished in recent years, although evidence of the cost-effectiveness of such interventions remains inconclusive. In this study, we aimed to investigate the cost-effectiveness of digital health interventions for behavioral changes among people with chronic diseases. This systematic review evaluated published studies focused on the economic evaluation of digital tools for behavioral change among adults with chronic diseases. We followed the Population, Intervention, Comparator, and Outcomes framework to retrieve relevant publications from 4 databases: PubMed, CINAHL, Scopus, and Web of Science. We used the Joanna Briggs Institute's criteria for economic evaluation and randomized controlled trials to assess the risk of bias in the studies. Two researchers independently screened, assessed the quality, and extracted data from the studies selected for the review. In total, 20 studies published between 2003 and 2021 fulfilled our inclusion criteria. All the studies were conducted in high-income countries. These studies used telephones, SMS text messaging, mobile health apps, and websites as digital tools for behavior change communication. Most digital tools for interventions focused on diet and nutrition (17/20, 85%) and physical activity (16/20, 80%), and a few focused on smoking and tobacco control (8/20, 40%), alcohol reduction (6/20, 30%), and reduction of salt intake (3/20, 15%). Most studies (17/20, 85%) used the health care payer perspective for economic analysis, and only 15% (3/20) used the societal perspective. Only 45% (9/20) of studies conducted a full economic evaluation. Most studies (7/20, 35%) based on full economic evaluation and 30% (6/20) of studies based on partial economic evaluation found digital health interventions to be cost-effective and cost-saving. Most studies had short follow-ups and failed to include proper indicators for economic evaluation, such as quality-adjusted life-years, disability-adjusted life-years, lack of discounting, and sensitivity analysis. Digital health interventions for behavioral change among people with chronic diseases are cost-effective in high-income settings and can therefore be scaled up. Similar evidence from low- and middle-income countries based on properly designed studies for cost-effectiveness evaluation is urgently required. A full economic evaluation is needed to provide robust evidence for the cost-effectiveness of digital health interventions and their potential for scaling up in a wider population. Future studies should follow the National Institute for Health and Clinical Excellence recommendations to take a societal perspective, apply discounting, address parameter uncertainty, and apply a lifelong time horizon.

The power of connection: Self-care strategies of social wellbeing

Health care professionals have long regarded social contacts as a means for information or resources for patients and clients; however, new research in the field of relational neuroscience demonstrates how social connectedness is vital to human health and wellbeing. Social isolation and loneliness are viewed as risk factors that outpace common behavioral risk factors such as smoking, poor diet, lack of exercise and obesity. Health care professionals can learn to facilitate discussions and practice self-care strategies to strengthen connectedness, particular for those at-risk for social isolation and loneliness. Human beings are not only hardwired for close relationships, but when these falter or are limited, humans lose an essential means for accessing self-regulation, gaining an inner sense of safety, tapping into creative problem solving, and experiencing wholeness and enriched lives.

A global view of hypertensive disorders and diabetes mellitus during pregnancy

Two important maternal cardiometabolic disorders (CMDs), hypertensive disorders in pregnancy (HDP) (including pre-eclampsia) and gestational diabetes mellitus (GDM), result in a large disease burden for pregnant individuals worldwide. A global consensus has not been reached about the diagnostic criteria for HDP and GDM, making it challenging to assess differences in their disease burden between countries and areas. However, both diseases show an unevenly distributed disease burden for regions with a low income or middle income, or low-income and middle-income countries (LMICs), or regions with lower sociodemographic and human development indexes. In addition to many common clinical, demographic and behavioural risk factors, the development and clinical consequences of maternal CMDs are substantially influenced by the social determinants of health, such as systemic marginalization. Although progress has been occurring in the early screening and management of HDP and GDM, the accuracy and long-term effects of such screening and management programmes are still under investigation. In addition to pharmacological therapies and lifestyle modifications at the individual level, a multilevel approach in conjunction with multisector partnership should be adopted to tackle the public health issues and health inequity resulting from maternal CMDs. The current COVID-19 pandemic has disrupted health service delivery, with women with maternal CMDs being particularly vulnerable to this public health crisis.

Preventing cognitive impairment by reducing air pollution

Preventing cognitive impairment by reducing air pollution

946HIV prevalence and common risk factors in three at-risk populations in Vietnam

Abstract Background Despite the continuing decline of HIV/AIDS incidence and prevalence in the general population of Vietnam, HIV rates remains high in three key subpopulations: injecting drug users (IDUs), men who have sex with men (MSM) and female sex workers (FSWs). This study aims to identify the common sociodemographic characteristics and behavioural risk factors among three key populations for HIV infection in Vietnam. Methods This study used a systematic review and meta-analysis to synthesise findings from published studies on HIV prevalence and associated risk factors among the three at-risk groups. Five electronic databases were used to identify peer-reviewed articles in relevant topics. Comprehensive Meta-Analysis software was used to estimate pooled prevalence in the combined study population and to determine the effect sizes of the common risk factors on HIV outcome. Results Of the 18 included studies, 6 focused on IDUs, 8 on FSWs and 4 on MSM, accounting for a total of 16,304 participants. The overall prevalence of HIV among the three at-risk groups based on meta-analysis was 11.8% (95%CI: 0.072-0.188). The identified common risk behaviours for HIV infection included injecting drug use (OR: 21.3, 95%CI: 6.5-69.3), sharing injecting equipment (OR: 4.2, 95%CI: 2.1-8.2) and inconsistent condom use (OR: 2.6, 95%CI: 1.5-4.4). The associated socio-demographic characteristics with HIV (+) included young age, single/ unmarried, low education and income. Conclusions/Key messages The findings of this study suggested that injecting drug use may can contribute to developing more affective prevention measures targeting these high-risk groups and reducing the risk of HIV transmission to the general population.

Comparison of Behavioral Risk Factors and Cardiometabolic Comorbidities of Psoriatic Arthritis and Psoriasis: A Case-Control Study in Chinese Patients.

PurposeComparison of risk factors and comorbidities could help indicate the underlying mechanisms of diseases. This study aimed to compare behavioral factors and cardiometabolic comorbidities of PsA/psoriasis versus healthy controls to implicate the similarities and differences in potential pathogenic mechanisms for further research.Patients and MethodsA case-control study in Chinese patients with PsA or psoriasis and healthy controls was conducted. Clinical information based on patient-reported and measured outcomes were collected. Multivariable logistic regression was used to investigate the associations, in terms of adjusted odds ratios (AORs).ResultsWe randomly selected 171 patients with PsA, 342 with psoriasis, and 1026 healthy controls from our database, matching by age and sex. Dyslipidemia (AOR=4.62 for PsA and 2.97 for psoriasis) and alcohol drinking (AOR=3.20 for PsA and 3.62 for psoriasis) were significantly associated with both diseases. Overweight was inversely associated with both PsA (AOR=0.46, P=0.002) and psoriasis (AOR=0.56, P=0.001), while obesity was associated with PsA (AOR=2.02, P=0.025) but not psoriasis (AOR=0.87, P=0.621). Subgroup analysis by onset age of psoriatic lesions showed that former smoking was significantly associated with early-onset psoriasis (AOR=2.44, P=0.016) but not PsA (AOR=0.59, P=0.329). Laboratory test indicated that both PsA and psoriasis were associated with altered lipid profile.ConclusionPsA and psoriasis in Chinese patients share common behavioral and cardiometabolic risk factors including dyslipidemia and alcohol consumption. There is a U-shape association between BMI and PsA/psoriasis.

Prevalence of Cardiovascular Disease Risk Factors in Vologda Oblast Districts

Relevance. There are large regional disparities in prevalence of non-communicable disease risk factors, as well as in the cardiovascular disease (CVD) incidence and mortality rates in Russian Federation (RF). Aim. To demonstrate the disparities in prevalence of CVD risk factors between Vologda Oblast districts. Materials and methods. Databases created in 2009 at the State-financed health institution of the Vologda Oblast «Vologda Regional Center for Medical Prevention», based on the results of a survey conducted within the framework of the World Health Organization CINDI program. CINDI questionnaire; cross-sectional study; the data was processed using R programming language and the Statistica software package 12. Results. The most common behavioral CVD risk factors in different Vologda Oblast districts included inadequate fruits and vegetables consumption (30–90%) and alcohol abuse (40–80%); hypertension (40–60%), overweight and obesity (30–55%) were the most frequent biological CVD risk factors; the most prevalent socio-economic risk factors included low education level (75–90%) and unemployment (20–40%). Participants residing in rural municipalities differed from urban okrugs (cities) dwellers in a higher prevalence of smoking (p < 0.01), alcohol abuse (p < 0.001), inadequate fruits and vegetables consumption (p < 0.0001), overweight and obesity (p < 0.05), unemployment (p < 0.0001), low education level (p < 0.0001), as well as a low overall assessment of their health (p < 0.05). Conclusions. We detected disparities in CVD risk factors prevalence between Vologda Oblast districts in 2009. Both behavioral and biological CVD risk factors were more common in participants from rural municipalities. The CVD risk factors distribution between the RF subjects’ districts requires further scientific research.

Prevalence of behavioral risk factors that cause contagion with COVID-19 among population in belarus: results obtained via cross-sectional study

Our research objects were behavioral risk factors that could cause contagion with coronavirus infection (hereinafter called COVID-19). Our research goal was to assess prevalence of behavioral risk factors that could cause contagion with COVID-19 among population in Belarus. The present work contains results obtained via online questioning that included 7,590 respondents and employed a specifically designed questionnaire covering most common behavioral risk factors of contagion with COVID-19. The factors were related to adherence to recommendations on physical and social distancing, use of personal protective equipment, and sticking to personal hygiene rules; the questionnaire also asked respondents to give a subjective estimate of their health and whether they had specific symptoms typical for COVID-19. Data analysis involved assessing prevalence of behavioral risk factors, and occurrence of a relation between specific factors and values of prevalence ratio. We determined prevalence of the most common behavioral risk factors and assessed to what extent risk factors influenced prevalence of subjective complaints by patients that they had symptoms typical for COVID-19. It was shown that certain behavioral risk factors authentically influenced prevalence of subjective symptoms of the disease. Subjective symptoms were more widely spread among respondents who regularly went to work as well as those whose family members regularly went to work or an educational establishment; among respondents who used public transport, went to shopping centers and catering facilities every day; among respondents who didn’t keep social distance, didn’t pay proper attention to personal hygiene, didn’t use antiseptics, and had a habit to touch their face with their hands; among smoking respondents; among respondents who attended mass events, family and corporate parties; and also respondents whose relatives, close friends, or colleagues had returned from abroad. Our research results can be used for carrying out information campaigns aimed at COVID-19 prevention; they can also give grounds for performing more profound studies on assessing contributions made by various behavioral factors into risks of contagion with COVID-19

Распространенность поведенческих факторов риска инфицирования COVID-19 среди населения республики Беларусь: результаты кросс-секционного исследования

Our research objects were behavioral risk factors that could cause contagion with coronavirus infection (hereinafter called COVID-19). Our research goal was to assess prevalence of behavioral risk factors that could cause contagion with COVID-19 among population in Belarus. The present work contains results obtained via online questioning that included 7,590 respondents and employed a specifically designed questionnaire covering most common behavioral risk factors of contagion with COVID-19. The factors were related to adherence to recommendations on physical and social distancing, use of personal protective equipment, and sticking to personal hygiene rules; the questionnaire also asked respondents to give a subjective estimate of their health and whether they had specific symptoms typical for COVID-19. Data analysis involved assessing prevalence of behavioral risk factors, and occurrence of a relation between specific factors and values of prevalence ratio. We determined prevalence of the most common behavioral risk factors and assessed to what extent risk factors influenced prevalence of subjective complaints by patients that they had symptoms typical for COVID-19. It was shown that certain behavioral risk factors authentically influenced prevalence of subjective symptoms of the disease. Subjective symptoms were more widely spread among respondents who regularly went to work as well as those whose family members regularly went to work or an educational establishment; among respondents who used public transport, went to shopping centers and catering facilities every day; among respondents who didn’t keep social distance, didn’t pay proper attention to personal hygiene, didn’t use antiseptics, and had a habit to touch their face with their hands; among smoking respondents; among respondents who attended mass events, family and corporate parties; and also respondents whose relatives, close friends, or colleagues had returned from abroad. Our research results can be used for carrying out information campaigns aimed at COVID-19 prevention; they can also give grounds for performing more profound studies on assessing contributions made by various behavioral factors into risks of contagion with COVID-19

Analysis of Some Behavioral Risk Factors in Relation to Acute Coronary Events.

The association of acute coronary events and behavioral risk factors is already known. Of these, smoking and alcohol consumption are the behavioral risk factors with the most intense impact in the occurrence of these events. The correct knowledge of the dynamics and their involvement in the evolution of acute coronary events remains of overwhelming importance in the light of current data. To achieve the purpose of this study data from three family medicine practices from the period November 2018 to May 2019 were corroborated. Anonymous questionnaires were applyed to the subjects. For this study, questions related to the habit of smoking and consuming alcohol were selected. The study aimed to analyze the associative relationships between acute coronary events and two of the most common behavioral risk factors, smoking and alcohol consumption. The highest prevalence of acute coronary events was observed in current smokers and in former smokers. The period of exposure to smoking showed that this is one of the variables most strongly associated with an increased risk of acute coronary events. Moderate consumption of wine or beer seems to have a weak association with acute coronary events, even weaker than those who do not consume at all suggesting a protective effect.

Common risk factors for heart failure and cancer.

Cardiovascular (CV) disease and cancer are the leading causes of death.1,2 Over the last decades, it has been appreciated that both CV disease and cancer are more common in individuals in whom risk factors for disease development accumulate, and preventative measures have been extremely important in driving down the incidence of disease.3–6 In general, the field of epidemiology, risk reduction, and preventative trials is divided into health care professionals who have an interest in either CV disease or cancer. As a result, the medical literature and medical practice has largely focused on the one disease, or the other. However, human individuals do not behave according to this dogma. Emerging data clearly suggest that identical risk factors may lead to CV disease in the one individual, but may cause cancer in another, or even both diseases in the same individual. This overlap exists between risk factors that are historically classified as ‘CV risk factors’ as these factors do equally strong predict cancer development. Therefore, we propose that a holistic approach might better estimate actual risks for CV disease and cancer. In this review, we summarize current insights in common behavioural risk factors for heart failure, being the most progressed and lethal form of CV disease, and cancer.

Aussiedler Mortality (AMOR): cohort studies on ethnic German migrants from the Former Soviet Union

PurposeThe Aussiedler Mortality cohorts represent the unique migrant group of ethnic Germans (resettlers) from the former Soviet Union who migrated to Germany mainly after the fall of the iron curtain...

Work environment mediates a large part of social inequalities in the incidence of several common cardiovascular risk factors: Findings from the Gazel cohort

Whether working conditions contribute to social inequalities in cardiovascular disease is still a matter of debate. The present study investigates the extent to which the social gradient in the incidence of common behavioral and clinical risk factors is explained by work environment. In a well-characterized cohort of 20,625 middle-aged French civil servants followed for 25 years, social status and work environment were globally measured at baseline by combining respectively four socioeconomic indicators (education, wealth, income, occupational grade) and 25 physical, biomechanical, organizational and psychosocial occupational exposures. These 2 global measures are strongly correlated with each other (p < 0.0001), lower is social status, worse is work environment. In proportional hazard regression models adjusted for sex, age and parental cardiovascular disease, low social status increases the incidence of 9 risk factors with hazard ratios ranging from 1.12 to 1.72 while bad work environment increases the incidence of 7 risk factors with hazard ratios ranging from 1.15 to 2.02. Structural equation models to discrete-time survival analysis with moderated mediation show that bad work environment explains nearly 50% of the global effect of low social status on the incidence of the 9 risk factors (p < 0.01). This mediating effect varies substantially from one risk factor to another, explaining 32–39% of social gradients in the risk of physical inactivity, obesity, diabetes, dyslipidemia and 64–90% of gradients in the risk of hypertension, sleep complaints and depression (all p < 0.01). No significant mediating effect of work environment is found for social gradients in the incidence of non-moderate alcohol consumption and smoking. These results suggest that work environment mediates a large part of the social gradient in the incidence of several common cardiovascular risk factors, emphasizing the necessity to include working conditions in policies aimed to reduce social inequalities in health.

Vessel stiffness, calcification and osteoporosis. Common pathogenetic components

Atherosclerosis and osteoporosis until recently were regarded as the diseases of modern society, and their simultaneous development was explained just by the increased chances with longevity. Currently, there are studies showing evidence on these diseases in ancient populations, regardless the age and gender. The diseases found in younger age, with the early Egyptian civilization, witness on the common genetic and behavioral risk factors and pathogenetic components, than simple age-related chance. Scientific publications show more and more data on common properties of these diseases and pathogenetic mechanisms. High risk of premature death from atherosclerosis and osteoporosis complications facilitates the search for individual and general predictors of the disorders with the aim of on-time prevention. Treatment of atherosclerosis and osteoporosis presentation events in one patient demands for a range of medications that leads to polypragmasia. The review is focused on common mechanisms of vascular stiffness development, calcification and bone density decrease. Profound understanding might make it to open novel targets for one drug to both diseases, with decreased rate of complications.

The impact of poverty reduction and development interventions on non-communicable diseases and their behavioural risk factors in low and lower-middle income countries: A systematic review.

IntroductionNon-communicable diseases (NCDs) disproportionately affect low- and lower-middle income countries (LLMICs) where 80% of global NCD related deaths occur. LLMICs are the primary focus of interventions to address development and poverty indicators. We aimed to synthesise the evidence of these interventions' impact on the four primary NCDs (cardiovascular disease, diabetes, chronic respiratory disease and cancer) and their common behavioural risk factors (unhealthy diets, physical inactivity, tobacco and alcohol use).MethodsWe systematically searched four online databases (Medline, Embase, Web of Science and Global Health) for primary research conducted in LLMICS, published between January 1st 1990 and February 15th 2016. Studies involved development or poverty interventions which reported on outcomes relating to NCDs. We extracted summary level data on study design, population, health outcomes and potential confounders.ResultsFrom 6383 search results, 29 studies from 24 LLMICs published between 1999 and 2015 met our inclusion criteria. The quality of included studies was limited and heterogeneity of outcome measures required narrative synthesis. One study measured impact on NCD prevalence, one physical activity and 27 dietary components. The majority of papers (23), involved agricultural interventions. Primary outcome measures tended to focus on undernutrition. Intensive agricultural interventions were associated with improved calorie, vitamin, fruit and vegetable intake. However, positive impacts were reliant on participant's land ownership, infection status and limited in generalisability. Just three studies measured adult obesity; two indicated increased income and consequential food affordability had the potential to increase obesity. Overall, there was poor alignment between included studies outcome measures and the key policy options and objectives of the Global Action Plan on NCDs.ConclusionsThough many interventions addressing poverty and development have great potential to impact on NCD prevalence and risk, most fail to measure or report these outcomes. Current evidence is limited to behavioural risk factors, namely diet and suggests a positive impact of agricultural-based food security programmes on dietary indicators. However, studies investigating the impact of improved income on obesity tend to show an increased risk. Embedding NCD impact evaluation into development programmes is crucial in the context of the Sustainable Development Goals and the rapid epidemiological transitions facing LLMICs.

Facets of Conscientiousness and risk of dementia.

Multiple studies have found Conscientiousness to be protective against dementia. The purpose of this study is to identify which specific aspects, or facets, of Conscientiousness are most protective against cognitive impairment and whether these associations are moderated by demographic factors and/or genetic risk. Health and Retirement Study participants were selected for analysis if they completed the facets of Conscientiousness measure, scored in the range of normal cognitive functioning at the baseline personality assessment, and had at least one follow-up assessment of cognition over the up to 6-year follow-up (N = 11 181). Cox regression was used to test for risk of incident dementia and risk of incident cognitive impairment not dementia (CIND). Over the follow-up, 278 participants developed dementia and 2186 participants developed CIND. The facet of responsibility had the strongest and most consistent association with dementia risk: every standard deviation increase in this facet was associated with a nearly 35% decreased risk of dementia; self-control and industriousness were also protective. Associations were generally similar when controlling for clinical, behavioral, and genetic risk factors. These three facets were also independent predictors of decreased risk of CIND. The present research indicates that individuals who see themselves as responsible, able to control their behavior, and hard workers are less likely to develop CIND or dementia and that these associations persist after accounting for some common clinical, behavioral, and genetic risk factors.