Risk Factors For Disability Research Articles

Direct and indirect costs attributed to alcohol consumption in Brazil, 2010 to 2018.

Alcohol consumption is the main risk factor for death and disability in the world population between 15 to 49 years old, is related to more than 200 causes of death, and has an important economic impact on the health and social security systems. In 2016, three million deaths were attributable to alcohol worldwide and 131.4 million DALYs. In Brazil, alcohol consumption per inhabitant was 7.8 liters in 2016; and the prevalence of abusive consumption was 17.1% in 2019. Estimate the costs attributable of alcohol consumption in the Brazilian population 18 years-old and over, in the period 2010 to 2018. This is a prevalence-based cost-of-illness study, with a top-down and retrospective approach, including direct costs (hospital and outpatient) and indirect costs (absenteeism from work) related to alcohol consumption. A list of diseases and conditions for which alcohol is a risk factor was used, and the Population Attributable Risk (PAR) was calculated to estimate what portion of the cost of these diseases is attributable to alcohol consumption. Prevalence was calculated by sex and level of alcohol consumption, based on data from the 2019 National Health Survey. Relative risk data were identified by disease/injury and level of daily consumption obtained from the Global Burden Disease study in 2017. The cost data used are from the Brazilian Unified Health System and social security system. All costs were adjusted for inflation for the period and converted to purchasing power parity. Prevalence data revealed that 73.6% of the Brazilian population reported not consuming alcoholic beverages, which included 62.9% of men and 83.0% of women. The lowest values for the PAR were found at the consumption range of 60 grams per day. Although the 12 grams per day consumption category is the least in terms of the quantity of alcohol consumed, it is one of the main ones in terms of PAR, given the higher prevalence of consumption. The total cost attributable to alcohol between 2010 and 2018 was Int$ 1,487,417,115.43, of which Int$ 737,834,696.89 was for hospital expenses, Int$ 416,052,029.75 for outpatient care, and Int$ 333,530,388.79 due to absenteeism from work. Few comprehensive studies of alcohol-related costs have been developed, which suggests a knowledge gap in Brazil and worldwide and indicates the need for more research in this area. Understanding the economic impact of alcohol consumption is essential to help measure this public health problem in all its aspects and encourage implementation of public policies.

Key messages of the WHO European Regional Obesity Report

Abstract Obesity is a complex multifactorial disease defined by excessive adiposity and is linked to an increased risk for many noncommunicable diseases (NCDs). Overweight and obesity affect almost 60% of adults and nearly one in three children in the WHO European Region. Recent estimates suggest that overweight and obesity is the fourth most common risk factor for NCDs in the Region, after high blood pressure, dietary risks and tobacco. It is also the leading risk factor for disability and obesity is linked to greater morbidity and mortality from COVID-19. And obesity is considered a cause of at least 13 different types of cancer including cancers of the breast, colorectum, kidney, liver and ovary, multiple myeloma and meningioma. None of the countries in the Region are on track to achieve the obesity related target set in 2013. Early studies from a number of countries in the Region indicate that the prevalence of overweight and obesity and/or mean body mass index has increased in children and adolescents during the COVID-19 pandemic. This latest WHO European report on obesity examines the growing challenge and impact of obesity in the Region, building on past publications and aligning with initiatives to tackle cancer. The report focuses on managing obesity throughout the life course and tackling obesogenic environments; it also considers more recent challenges, including problematic digital marketing to children and the impact of the COVID-19 pandemic on obesity prevalence. Policy options to prevent obesity are outlined for consideration by Member States together with a suite of population-level approaches. The report highlights the importance of including prevention and control of obesity within measures to build back better in the wake of the COVID-19 pandemic. Whilst highlighting that single intervention will not be sufficient in any country, it examines the challenges faced by countries to implement known interventions to tackle obesity.

Gender specific cut-off points of age for disability among rural elderly in Anhui Province, China.

ObjectiveThe purpose of this study was to determine the optimal cut-off values of age for disability in order to predict the risk of disability for older adults in rural areas.MethodsWHO Disability Assessment Schedule 2.0 was used to assess disability. The cut-off values of age for disability were obtained by ROC curve analysis.ResultsThe cut-off points of age for cognition restriction, mobility restriction, self-care restriction, getting along with people restriction, life activities restriction, and social participation restriction for men were 70.5, 68.5, 72.5, 70.5, 71.5, and 68.5 years old, respectively. The cut-off points of age for cognition disability, mobility restriction, self-care disability, getting along with people disability, life activities disability, and social participation disability for women were 72.5, 71.5, 70.5, 70.5, 71.5, and 71.5 years old, respectively. Over the cut-off values of age was an independent risk factor for disability (P < 0.05).ConclusionPresenting first disability symptoms were different between men and women. Preventive efforts to prevent future disability should be different for men and women.

Risk of functional disability associated with solid fuel use and population impact of reducing indoor air pollution in China: A national cohort study.

BackgroundIn China, numerous people still rely on solid fuel for household use. To date, the association between household solid fuel use and functional disability, and what benefit reducing household solid fuel usage could bring at the population level to China remain unclear.MethodData were from the China Health and Retirement Longitudinal Study. Household fuel was classified as clean or solid for cooking or heating. Functional disability was defined as difficulties in any item of activities of daily living (ADL) or instrumental activities of daily living (IADL). The associations of household fuel use in 2011 and its transitions between 2011 and 2013 with subsequent ADL or IADL disability were assessed with Cox proportional-hazards models. The number of events prevented in a population (NEPP) was generated to estimate how many functionally disabled patients could be prevented by reducing solid fuel usage.ResultsA total of 6,216 and 9,716 participants without prior ADL or IADL disability in 2011 were included. Solid (vs. clean) fuel users were more likely to develop ADL and IADL disability, with hazard ratios (HRs) and 95% confidence intervals (CIs) of 1.37 (1.28~1.45) and 1.38 (1.31~1.46) for using both solid cooking and heating fuel. Furthermore, participants that switched heating fuel from solid to clean (vs. keep solid) were about 20% less likely to develop functional disability. Cooking fuel use switching from solid to clean (vs. keep solid) was also negatively associated with IADL disability (HR = 0.84, 95% CI 0.74~0.96). Over the next 7 years, raising clean fuel usage to 80% could prevent about 4.9 million ADL disability and 2.6 million IADL disability among Chinese aged 45 and older.ConclusionHousehold solid fuel use was a risk factor for functional disability. Reducing solid fuel usage could help reduce the burden of functional disability in the current aging society of China.

Risk factors of frailty and functional disability in community-dwelling older adults: a cross-sectional analysis of the FREEDOM-LNA cohort study

BackgroundFrailty is a geriatric syndrome associated with disability and negative health outcome. To determine the factors associated with frailty and functional disability in older participants living in community in France. We included 753 community-dwelling old participants with available frailty data at baseline.ResultsOverall, 31.9% were frail, 58.3% were prefrail, and 9.8% were robust. The SMAF (French acronym for Functional Autonomy Measurement System) score was significantly lower (mean ± standard deviation: -25.8 ± 11.2) in frail participants compared to prefrail (-14.3 ± 9.7) or robust participants (-8.1 ± 7.0); 82% of frail older participants had limitation in at least one ADL and 97.5% in at least one IADL compared to 54.2 and 76.8%, respectively of pre-frail and 29.7 and 47.3% of robust participants. Age, depression, impaired cognition and diabetes were significantly associated with higher odds of frailty. These variables were also strongly associated with functional disability. Female gender, polypharmacy, and smoking were additional variables significantly associated with degraded SMAF and/or ADL/IADL.ConclusionsThis study showed that functional disability increased proportionally to frailty, and depression, cognitive decline and diabetes are modifiable risk factors significantly associated with frailty and functional disability.

Functional disability among older adults in India; a gender perspective

IntroductionOlder adults are always at a greater risk of physical and functional health challenges. These complications result into morbidity, disability and death making them more vulnerable at later ages. Therefore, this paper will examine the functional health status among older adults and its gender perspective, along with associated risk factors.Materials and methodsUsing the first round of Longitudinal ageing survey of India (2017–18). Functional disability was computed based on general and instrumental activities of daily living (ADL and IADL) (n = 20910). Functional disability was coined with individual having at least one of the limitations of these activities. Applying bivariate and multivariate analysis the present paper studied the association, gender perspective and risk factors of functional disability among older adults aged 50 and above in India.ResultsOur results clearly showed the gender bias in functional disability, with greater proportion of women (52%) at risk for functional disability then men (35%). Factors like multimorbidity, depression and life satisfaction are key risk factors identified by this study that increase the likelihood of disability.ConclusionFunctional disability is key to healthy ageing and needs immediate attention given its greater concentration among the elderly, particularly women. The results reflect the substantial burden of functional disability than self-care among older adults in India and therefore indicates some significant policy interventions to reduce the likely impact of functional disability.

Association between multimorbidity trajectories and incident disability among mid to older age adults: China Health and Retirement Longitudinal Study

BackgroundAlthough multimorbidity is a risk factor for disability, the relationship between the accumulative patterns of multimorbidity and disability remains poorly understood. The objective of this study was to identify the latent groups of multimorbidity trajectories among mid to older age adults and to examine their associations with incident disability.MethodsWe included 5,548 participants aged ≥ 45 years who participated in the China Health and Retirement Longitudinal Study from 2011 to 2018 and had no multimorbidity (≥ 2 chronic conditions) at baseline. The group-based multi-trajectory modeling was used to identify distinct trajectory groups of multimorbidity based on the latent dimensions underlying 13 chronic conditions. The association between multimorbidity trajectories and incident disability was analyzed using the generalized estimating equation model adjusting for potential confounders.ResultsOf the 5,548 participants included in the current analysis, 2,407 (43.39%) developed multimorbidity during the follow-up. Among participants with new-onset multimorbidity, four trajectory groups were identified according to the combination of newly diagnosed diseases: “Cardiometabolic” (N = 821, 34.11%), “Digestive-arthritic” (N = 753, 31.28%), “Cardiometabolic/Brain” (N = 618, 25.68%), and “Respiratory” (N = 215, 8.93%). Compared to participants who did not develop multimorbidity, the risk of incident disability was most significantly increased in the “Cardiometabolic/Brain” trajectory group (OR = 2.05, 95% CI: 1.55–2.70), followed by the “Cardiometabolic” (OR = 1.96, 95% CI: 1.52 –2.53) and “Digestive-arthritic” (OR = 1.70, 95% CI: 1.31–2.20) trajectory groups.ConclusionsThe growing burden of multimorbidity, especially the comorbid of cardiometabolic and brain diseases, may be associated with a significantly increased risk of disability for mid to older age adults. These findings improve our understanding of multimorbidity patterns that affect the independence of living and inform the development of strategies for the primary prevention of disability.

Nutrition Knowledge, Dietary Habits, and Food Labels Use-A Representative Cross-Sectional Survey among Adults in Poland.

An unhealthy diet is an important risk factor for disability and premature death. This study aimed to assess nutrition knowledge, dietary habits, and food label use among adults in Poland as well as to identify factors associated with diet-related behaviors. A cross-sectional survey was carried out in July 2020 on a non-probability quota-based sample of 1070 adult citizens of Poland. The most common sources of nutrition knowledge were news websites (41.8%) or family/friends (32.4%). Over one-quarter of adults in Poland were on a diet (28.7%). Over one-tenth of respondents (11.9%) consumed less than three meals per day. Half of the respondents (50.3%) declared that they use food labels when shopping, and 15.4% checked the nutrition information on restaurant menus. Female gender (OR:1.70; 95%CI:1.26–2.29; p < 0.001), presence of chronic diseases (OR:1.83; 95%CI:1.37–2.44; p < 0.001), regular physical activity (p < 0.001), and being a non-smoker (OR:1.45; 95%CI:1.02–2.06; p = 0.04) were significantly associated with higher odds of being on a diet. Females (OR:1.63; 95%CI:1.24–2.15; p < 0.001), respondents with higher education (OR:1.53; 95%CI:1.17–2.01; p = 0.002), those who had never been married (OR:1.49; 95%CI:1.07–2.07; p = 0.02), respondents with chronic diseases (OR:1.73; 95%CI:1.30–2.31; p < 0.001), those with regular physical activity (p < 0.05), as well as non-smokers (OR:1.42; 95%CI:1.04–1.95; p = 0.03) had higher odds of checking the food labels. This study showed a significant gap in nutrition knowledge among adults in Poland.

Motoric cognitive risk syndrome as a predictor of incident disability: A 7 year follow-up study.

BackgroundThough motoric cognitive risk syndrome (MCR) share risk factors with disability, whether it predict disability remains understudied.ObjectivesThis study aims to examine the association between MCR and incident disability.DesignLongitudinal study.MethodsMCR was defined as subjective cognitive complaints and objective slow gait speed. Two subtypes of MCR were defined by whether memory impairment (MI) was also present, MCR-MI and MCR-non-MI. Incident activities of daily living (ADL) disability and instrumental activities of daily living (IADL) disability were outcome measures. Multiple logistic regression analysis was used to assess the independent effect of MCR at baseline on the odds of ADL/IADL disability at a 7 year follow-up.ResultsAmong the subjects who were not disabled at baseline and followed for 7 years, 34.66% reported incident ADL disability, and 31.64% reported incident IADL disability. Compared with participants without MCR at baseline, those with MCR had 58% increased odds of incident ADL disability (OR=1.58, 95% CI: 1.19–2.09) and 46% increased odds of incident IADL disability (OR=1.46, 95% CI: 1.13–1.88) after 7 years. MCR-non-MI was associated with a 56.63% increased risk of ADL disability and a 34.73% increased risk of IADL disability. MCR-MI was associated with an even higher risk of IADL disability (OR = 2.14, 95% CI: 1.18–3.88).ConclusionsMCR is an independent risk factor for both incident ADL and IADL disability. MCR-MI predicts a higher risk for disability than MCR-non-MI. Early identification of MCR among older adult is recommended and may decrease future risk of disability.

Effects of telemedicine interventions on essential hypertension: a protocol for a systematic review and meta-analysis

IntroductionEssential hypertension is a major preventable risk factor for early cardiovascular disease, premature death and disability. It has been reported that telemedicine interventions can provide an innovative solution to essential...

How to Improve Awareness, Treatment, and Control of Hypertension in Africa, and How to Reduce Its Consequences: A Call to Action From the World Hypertension League.

Hypertension is the leading preventable risk factor for cardiovascular diseases and disability globally. In low- and middle-income countries hypertension has a major social impact, increasing the disease burden and costs for national health systems. The present call to action aims to stimulate all African countries to adopt several solutions to achieve better hypertension management. The following 3 goals should be achieved in Africa by 2030: (1) 80% of adults with high blood pressure in Africa are diagnosed; (2) 80% of diagnosed hypertensives, that is, 64% of all hypertensives, are treated; and (3) 80% of treated hypertensive patients are controlled. To achieve these aims, we call on individuals and organizations from government, private sector, health care, and civil society in Africa and indeed on all Africans to undertake a few specific high priority actions. The aim is to improve the detection, diagnosis, management, and control of hypertension, now considered to be the leading preventable killer in Africa.

In-Hospital Depressed Level of Consciousness and Long-Term Functional Outcomes in ICU Survivors.

Among critically ill patients, acutely depressed level of consciousness is associated with mortality, but its relationship to long-term outcomes such as disability and physical function is unknown. We investigated the relationship of level of consciousness during hospitalization with long-term disability and physical function in ICU survivors. Multi-center observational cohort study. Medical or surgical ICUs at five U.S. centers. Adult survivors of respiratory failure or shock. None. Depressed level of consciousness during hospitalization was defined using the Richmond Agitation Sedation Scale (RASS) score (including all negative scores) by calculating the area under the curve using linear interpolation. Sedative-associated level of consciousness was similarly defined for all hospital days that sedation was received. We measured disability in basic activities of daily living (BADLs), instrumental activities of daily living (IADLs), discharge destination, and self-reported physical function. In separate models, we evaluated associations between these measures of level of consciousness and outcomes using multivariable regression, adjusted for age, sex, race, body mass index, education level, comorbidities, baseline frailty, baseline IADLs and BADLs, hospital type (civilian vs veteran), modified mean daily Sequential Organ Failure Assessment score, duration of severe sepsis, duration of mechanical ventilation, and hospital length of stay. Of the 1,040 patients enrolled in the ICU, 781 survived to hospital discharge. We assessed outcomes in 624 patients at 3 months and 527 patients at 12 months. After adjusting for covariates, there was no association between depressed level of consciousness (total or sedation-associated) with BADLs or IADLs at either 3- or 12-month follow-up. There was also no association with self-reported physical function at 3 or 12 months or with discharge destination. Depressed level of consciousness, as defined by the RASS, was not associated with disability or self-reported physical function. Future studies should investigate additional modifiable in-hospital risk factors for disability and poor physical function following critical illness.

Parasport: Effects on Musculoskeletal Function and Injury Patterns.

Sports participation can improve gait, muscle strength, and functional abilities in patients with a wide variety of disabilities. Para athletes are also at substantial risk for injury during sports participation. Ambulant athletes with cerebral palsy are at risk for soft-tissue injuries about the knee as well as foot and ankle injuries. Wheelchair athletes are at risk for osteoporotic fractures and shoulder girdle injuries. Limb-deficient athletes are prone to low back pain and overuse injuries of the contralateral extremity. Para athletes are vulnerable to abuse during sports participation, and physicians should promptly report any possible abuse or mistreatment. Orthopaedic surgeons should understand disability and sport-specific risk factors for injury in para athletes in order to initiate early management and injury prevention protocols.

Lifetime history of TBI with loss of consciousness and disability among Appalachian and rural residents: 2016–2019 Ohio BRFSS

BackgroundWhile lifetime history of traumatic brain injury (TBI) is associated with increased risk of disabilities, little is known about disability and TBI among Appalachian and other rural residents. This study aimed to examine if the relationship between lifetime history of TBI with loss of consciousness (LOC) and disability differs by location of living (Appalachian vs. non-Appalachian; rural vs. urban).MethodsWe obtained data on lifetime history of TBI with LOC, location of living, and six sources of disability (auditory, visual, cognitive, mobility, self-care related, and independent living-related impairments) from the 2016–2019 Ohio Behavioral Risk Factor Surveillance System. We modeled the disability outcomes with Appalachian living (or rural living), lifetime history of TBI with LOC, and their interaction as independent variables.ResultsOf the 16,941 respondents included, 16.9% had a lifetime history of TBI with LOC, 19.5% were Appalachian residents and 22.9% were rural residents. Among Appalachian residents, 56.1% lived in a rural area. Appalachian (ARR = 1.92; 95%CI = 1.71–2.13) and rural residents (ARR = 1.87; 95%CI = 1.69–2.06) who had a lifetime history of TBI with LOC were at greater risk for having any disability compared to non-Appalachian and urban residents without lifetime history of TBI with LOC, respectively.ConclusionsAppalachian and rural living and lifetime history of TBI with LOC are risk factors for disability. Future research and health policies should address mechanisms for this risk as well as access to healthcare services following a TBI among Appalachian and rural residents.

The Impact of Education and Lifestyle Factors on Disability-Free Life Expectancy From Mid-Life to Older Age: A Multi-Cohort Study.

Objectives: Low education and unhealthy lifestyle factors such as obesity, smoking, and no exercise are modifiable risk factors for disability and premature mortality. We aimed to estimate the individual and joint impact of these factors on disability-free life expectancy (DFLE) and total life expectancy (TLE). Methods: Data (n = 22,304) were from two birth cohorts (1921–26 and 1946–51) of the Australian Longitudinal Study on Women’s Health and linked National Death Index between 1996 and 2016. Discrete-time multi-state Markov models were used to assess the impact on DFLE and TLE. Results: Compared to the most favourable combination of education and lifestyle factors, the least favourable combination (low education, obesity, current/past smoker, and no exercise) was associated with a loss of 5.0 years TLE, 95% confidence interval (95%CI): 3.2–6.8 and 6.4 years DFLE (95%CI: 4.8–7.8) at age 70 in the 1921–26 cohort. Corresponding losses in the 1946–51 cohort almost doubled (TLE: 11.0 years and DFLE: 13.0 years). Conclusion: Individual or co-ocurrance of lifestyle risk factors were associated with a significant loss of DFLE, with a greater loss in low-educated women and those in the 1946–51 cohort.

Fast walking and physical activity are independent contributors to improved physical function.

To clarify whether the presence or absence of fast walking and habitual physical activity are independently associated with the incidence of functional disability. This historical cohort study was comprised of 9,652 (4,412 men, mean age 65 years) individuals aged 39-98 years without functional disability at baseline. Functional disability was determined based on the Japanese long-term care insurance system, which specified requirements for assistance in the activities of daily living. The impact of fast walking and habitual physical activity on the incidence of functional disability was analysed by Cox proportional hazards models. The follow-up period was a median of 3.7 years during which 165 patients were newly certified as having functional disability. In the multivariate analysis, baseline age in 5-year increments (hazard ratio 2.42 [95% confidence interval 2.18-2.69]), no habitual physical activity (1.56 [1.07-2.27]), and not fast walking (1.89 [1.32-2.69]) significantly increased the risk of functional disability after adjustment for covariates. The stratified analysis showed that compared with physical activity (+), the impact of physical activity (-) on the incidence of functional disability was observed in those aged ≥75 years regardless of fast walking (+). Fast walking (-) significantly increased the risk of disability compared with fast walking (+) in those aged <75 years regardless of a physical activity habit. In Japanese, slow walking speed and lack of a physical activity habit were shown to be independent risk factors for incident functional disability, with their impact differing according to age.

Profile of Disability in Leprosy Patients: A Retrospective Study

Background: Leprosy is a chronic granulomatous infectious disease caused by Mycobacterium leprae that affects peripheral nerves and skin. The interaction between M. leprae and Schwann cells causes irreversible damage to peripheral nervous tissue afterward disability occurs. Involvement of the major nervous trunks of the extremities can produce sensory-motor deficits. The risk factors are delay in diagnosis, gender, age, type of leprosy, duration of disease, number of affected nerves, leprosy reaction, type of treatment, socioeconomic factors, education, ethnicity, and occupation. Purpose: The aim was to study the profile of leprosy patients with disability who seek treatment in Leprosy Division Dermatovenerology Outpatient Clinic RSUD Dr. Soetomo Surabaya. Methods: This was a descriptive retrospective study of leprosy patients with disability from January 2017 to December 2019. Result: The results of this study obtained a total of 275 leprosy patients with disabilities, which consisted of 76 patients (27.6%) with grade-1 disability and 199 patients (72.4%) with grade-2 disability. The majority were male (73.4%) and aged 25-44 years old (42.2%). Other dominant risk factors were MB type leprosy (92%), duration of disease more than 12 months (52.3%), no leprosy reaction (68%), and had received multidrug therapy (45.5%). Conclusion: Knowledge of disability risk factors can assist in improving management and education to prevent disability in leprosy patients.

γ-Glutamylcysteine alleviates ethanol-induced hepatotoxicity via suppressing oxidative stress, apoptosis, and inflammation.

Alcohol abuse is a major cause of alcoholic liver disease (ALD) and can result in fibrosis and cirrhosis. γ-glutamylcysteine (γ-GC) is a precursor of glutathione (GSH) with antioxidant and anti-inflammatory properties. Our research aimed to explore the protective impact of γ-GC on ALD and its potential mechanisms of efficiency in vitro and in vivo. L02 cells were pretreated with γ-GC (20, 40, and 80 μM) for 2h and exposed to ethanol for 24 h. Cell viability, apoptosis, oxidative stress, and inflammatory levels were measured. The expression of protein cleaved caspase-3 and cleaved PARP and flow cytometry results indicated that γ-GC decreases apoptosis on L02 cells after ethanol treatment. Moreover, γ-GC also attenuated oxidative stress and mitochondrial damage in hepatocytes caused by ethanol via increasing cellular GSH, SOD activity, and mitochondrial membrane potential. In vivo experiments, γ-GC effectively reduced the AST, ALT, and TG levels in mice. The inflammation of ALD was alleviated by γ-GC both in vivo and in vitro. Additionally, histopathological examination demonstrated that γ-GC treatment lessened lipid droplet formation and inflammatory damage. In conclusion, these results showed that γ-GC has anti-inflammatory and anti-apoptotic effects on ALD because it could help hepatocytes maintain sufficient GSH levels to combat the excess reactive oxygen species (ROS) generated during ethanol metabolism. PRACTICAL APPLICATIONS: Alcohol intake is the fifth highest risk factor for premature death and disability among all risk variables. However, few medicines are both safe and effective for the treatment of ALD. As a direct precursor of GSH, γ-GC has a broad variety of potential antioxidant and anti-inflammatory applications for the treatment of numerous medical conditions. In conclusion, these results showed that γ-GC could protect cells from ALD via suppressing oxidative stress, alleviating inflammation, and preventing apoptosis.

Migraine, Migraine Disability, Trauma, and Discrimination in Sexual and Gender Minority Individuals.

Background and ObjectivesThis study sought to describe migrainous headache frequency and severity and to examine the relationship between trauma, discrimination, and migraine-associated disability in a sample of sexual and/or gender minority (SGM) adults.MethodsWe performed a cross-sectional study of SGM people in The Population Research in Identity and Disparities for Equality Study from August to October 2018. The primary exposure was any trauma or discrimination, regardless of attribution. The primary outcome was moderate-severe migraine disability, as defined by a Migraine Disability Assessment (MIDAS) Questionnaire score of ≥11. We performed descriptive analysis comparing respondents with any migrainous headache with those without. Multivariable logistic regression examined the association between trauma/discrimination and migraine disability, controlling first for sociodemographic and clinical factors and then for psychiatric comorbidities.ResultsOf the 3,325 total respondents, 1,126 (33.9%) screened positive for migrainous headache by ID-Migraine criteria. Most people with migraine self-reported moderate (n = 768, 68.2%) or severe (n = 253, 22.5%) intensity. The median MIDAS score was 11 (interquartile range 5–25). Most respondents with migraine (n = 1,055, 93.7%) reported a history of trauma or discrimination. In unadjusted analysis, exposure to both trauma and discrimination was associated with higher odds of moderate-severe disability (OR 1.76, 95% CI 1.34–2.32). After adjustment for self-reported psychiatric comorbidities of anxiety, depression, and posttraumatic stress disorder, this association lost statistical significance.DiscussionMigrainous headache is common among our sample of SGM adults, and prior experiences with trauma and discrimination are associated with increased migraine disability. Our findings suggest that psychiatric comorbidities play a significant role in this relationship, identifying a potentially modifiable risk factor for disability in SGM people with migraine.

Early Desadaptation in Children with Autism Spectrum Disorders: Disability Risk Factors

Background: according to WHO, mental disorders that occur in childhood account for the largest share of child disability among all diseases. Special attention is paid to the problem of autism spectrum disorders, the growth of which in the world over the past 10 years has amounted to 1300%, and the disability rate has increased by 107.1% in 5 years. The purpose of the study : identication of risk factors for the formation of early disability in children with autism spectrum disorders. Patients and methods: the study made up 518 children diagnosed with autism spectrum disorder, divided into 2 groups: disabled children and non-disabled children. Clinical-psychopathological, clinical-catamnestic, psychometric, and statistical methods were used in the work. Results: the inuence of a signicant number of disabling risk factors in children with ASD was revealed, while the strength of their impact varied in a very wide range. For practical application, 3 main groups of disability risk factors are identied (organizational, reproductive health of parents, factors of pregnancy and childbirth) and the strength of their total inuence on the formation of disability is established statistically. Discussion: t he obtained data showed that the power of the total inuence of “organizational” factors on the formation of disability in autism spectrum disorders is 2 times greater than the power of factors “reproductive health of parents” and more than 5 times the power of the impact of pregnancy and childbirth, which corresponded to a high statistical signicance ( p &lt; 0.001). Hereditary factors did not have a signicant impact on the formation of disabling mental disorders. Conclusion: the system of prevention, early diagnostics and comprehensive rehabilitation based on interdisciplinary interaction contributes to improve adaptation and quality of life of children with autism spectrum disorders and their families.