World Health Organization Study Research Articles

The Relationship Between Social Capital and Sleep Duration Among Older Adults in Ghana: A Cross-Sectional Study.

Objective: This study aims to investigate the connection between social capital and sleep duration among older adults in Ghana, as limited research has been conducted to explore this relationship. Methods: This study utilized Wave 2 data from a sample of Ghanaian older adults from the World Health Organization Study on Global AGEing and Adult Health (SAGE). Self-reported data on social capital and sleep duration were compiled. Using ordered logistic regression, the relationship between social capital and sleep duration was examined. Results: Older adults who did not participate in social activities showed the strongest association with the risk of short sleep (p < 0.05). Our study found that older adults who sleep for shorter periods tend to report better sleep quality. There was no correlation between medium and long sleep durations and social capital. Conclusion: This study underscores the importance of more research to truly understand the complex connections between older adults' social participation, sleep, and health. It also has important implications for the promotion of good sleep in aging populations.

Intergenerational differences in walking for transportation between older men and women in six countries

Background– Research on potential differences in walking between men and women have mixed and inconclusive results, and no study has examined differences in walking between men and women across multiple countries and generations (i.e., young-old, old-old, and oldest-old). This study aimed to compare older men and women with respect to their walking for transportation across three generations and among six countries (i.e., China, Mexico, Russia, South Africa, Ghana, and India). Methods– This study adopted the cross-sectional design that utilised data from the World Health Organization Study on AGEing and Adult Health (SAGE – wave one). The sample included 12,125 older adults aged 60–114 years from the six countries. The participants were selected with a cluster random sampling method in each country. The data were analysed using three-way Analysis of Variance (ANOVA). Results– There were significant differences in walking for transportation among countries. In only South Africa there was a significant difference in walking between men and women, as well as among the three older generations. South African men reported more walking than South African women, and younger-old South Africans reported more walking than older-old and the oldest South Africans. Conclusions– There are differences in older adults' walking for transportation among countries. Differences in walking between men and women and among the three generations were only significant in South Africa.

Mixed effects logistic regression analysis of blood pressure among Ghanaians and associated risk factors

Blood pressure (BP) control is a global health issue with an increase in BP beyond the normal BP leading to different stages of hypertension in humans and hence the need to identify risk factors of BP for efficient and effective control. Multiple BP measurement have proven to provide BP readings close to the true BP status of the individual. In this study, we used multiple BP measurement data on 3809 Ghanaians to determine risk factors associated with BP. The data were obtained from World Health Organization study on Global AGEing and Adult Health. We defined high blood pressure (HBP) as ge 130/80 mmHg or normal as le 130/80 mmHg. We provide summary statistics and also used the Chi-Square test to assess significance of association between HBP versus risk factors of HBP. The aim of this study is to identify risk factors of BP using the mixed effects logistic regression model. Data were analyzed using R version 4.2.2. The results showed that the risk of high blood pressure (HBP) decreases across the three measurement periods. There is reduced risk (OR = 0.274, 95% CI = 0.2008, 0.405) of HBP among male participants relative to female participants. The risk (OR = 2.771, 95% CI = 1.8658, 4.1145) of HBP increased by 2.771-folds among those who are 60 years and above relative to those below the age of 60 years. Those whose work involves/requires vigorous exercise has 1.631-fold increase in the risk (OR = 1.631, 95% CI = 1.1151, 2.3854) of HBP relative to those whose work does not involve vigorous exercise. There is approximately 5-folds increased in the risk (OR = 4.896, 95% CI = 1.9535, 12.2268) of among those who have ever been diagnosed with diabetes. The results also revealed high risk (OR = 1.649, 95%CI = 1.1108, 2.4486) of HBP among those who have formal education. The risk (OR = 1.009, 95% CI = 1.0044, 1.0137) of HBP increases with increasing weight and a reduced risk (OR = 0.996, 95% CI = 0.9921, 0.9993) of HBP with increasing height. We found that sad experience, either mild, moderate or severe, is associated with a reduced risk of HBP. Those who have vegetable servings at least 2 cups per day have increased risk of HBP and those who have fruits servings at least 2 cups per day is associated with a reduced risk of HBP, however this is not statistically significant. To achieve success in BP control, programs should be designed with the aim of reducing weight, educate those with formal eduction on issues relating to HBP. Those whose work requires vigorous exercise are recommended to have regular check-ups to ensure that pressure build-up in the lungs is cleared. SBP is lower for women at young age but continue to increase after menopause as their BP increase becomes salt-sensitive. Hence there is need to give more attention to menopausal women so as to improve BP. Both young and old individuals are recommended to practice regular exercise since this has shown to reduce risk of being overweight or becoming diabetic and reduces the risk of HBP at yong age and old age. Also, to improve blood pressure control, programs for management of blood pressure or hypertension should focus more short stature individuals since such people are more likely to experience HBP.

Unclean Cooking Fuel Use and Slow Gait Speed Among Older Adults From 6 Countries.

Outdoor air pollution has been reported to be associated with frailty (including slow gait speed) in older adults. However, to date, no literature exists on the association between indoor air pollution (eg, unclean cooking fuel use) and gait speed. Therefore, we aimed to examine the cross-sectional association between unclean cooking fuel use and gait speed in a sample of older adults from 6 low- and middle-income countries (China, Ghana, India, Mexico, Russia, and South Africa). Cross-sectional, nationally representative data from the World Health Organization Study on global AGEing and adult health were analyzed. Unclean cooking fuel use referred to the use of kerosene/paraffin, coal/charcoal, wood, agriculture/crop, animal dung, and shrubs/grass based on self-report. Slow gait speed referred to the slowest quintile based on height, age, and sex-stratified values. Multivariable logistic regression and meta-analysis were done to assess associations. Data on 14 585 individuals aged ≥65 years were analyzed (mean [standard deviation] age 72.6 [11.4] years; 45.0% males). Unclean cooking fuel use (vs clean cooking fuel use) was significantly associated with higher odds for slow gait speed (odds ratio = 1.45; 95% confidence interval: 1.14-1.85) based on a meta-analysis using country-wise estimates. The level of between-country heterogeneity was very low (I2 = 0%). Unclean cooking fuel use was associated with slower gait speed among older adults. Future studies of longitudinal design are warranted to provide insight into the underlying mechanisms and possible causality.

Cardiovascular Disease and Its Implication for Higher Catastrophic Health Expenditures Among Households in Sub-Saharan Africa.

Background: Cardiovascular diseases (CVDs) impose an enormous and growing economic burden on households in sub-Saharan Africa (SSA). Like many chronic health conditions, CVD predisposes families to catastrophic health expenditure (CHE), especially in SSA due to the low health insurance coverage. This study assessed the impact of CVD on the risks of incurring higher CHE among households in Ghana and South Africa. Methods: The World Health Organization (WHO) Study on Global AGEing and Adult Health (WHO SAGE), Wave 1, implemented 2007-2010, was utilized. Following standard procedure, CHE was defined as the health expenditure above 5%, 10%, and 25% of total household expenditure. Similarly, a 40% threshold was applied to household total nonfood expenditure, also referred to as the capacity to pay. To compare the difference in mean CHE by household CVD status and the predictors of CHE, Student's t-test and logistic regression were utilized. Results: The share of medical expenditure in total household spending was higher among households with CVD in Ghana and South Africa. Households with CVD were more likely to experience greater CHE across all the thresholds in Ghana. Households who reported having CVD were twice as likely to incur CHE at 5% threshold (odds ratio [OR], 1.946; confidence interval [CI], 0.965-1.095), 3 times as likely at 10% threshold (OR, 2.710; CI, 1.401-5.239), and 4 times more likely to experience CHE at both 25% and 40% thresholds, (OR, 3.696; CI, 0.956-14.286) and (OR, 4.107; CI, 1.908-8.841), respectively. In South Africa, households with CVD experienced higher CHE across all the thresholds examined compared with households without CVDs. However, only household CVD status, household health insurance status, and the presence of other disease conditions apart from CVD were associated with incurring CHE. Households who reported having CVD were 3 times more likely to incur CHE compared with households without CVD (OR, 3.002; CI, 1.013-8.902). Conclusions: Our findings suggest that CVD predisposed households to risk of higher CHE. Equity in health financing presupposes that access to health insurance should be predicated on individual health needs. Thus, targeting and prioritizing the health needs of individuals with regard to healthcare financing interventions in SSA is needed.

Cardiovascular Disease and Its Implication for Higher Catastrophic Health Expenditures Among Households in Sub-Saharan Africa

Background: Cardiovascular diseases (CVDs) impose an enormous and growing economic burden on households in sub-Saharan Africa (SSA). Like many chronic health conditions, CVD predisposes families to catastrophic health expenditure (CHE), especially in SSA due to the low health insurance coverage. This study assessed the impact of CVD on the risks of incurring higher CHE among households in Ghana and South Africa. Methods: The World Health Organization (WHO) Study on Global AGEing and Adult Health (WHO SAGE), Wave 1, implemented 2007-2010, was utilized. Following standard procedure, CHE was defined as the health expenditure above 5%, 10%, and 25% of total household expenditure. Similarly, a 40% threshold was applied to household total nonfood expenditure, also referred to as the capacity to pay. To compare the difference in mean CHE by household CVD status and the predictors of CHE, Student’s t-test and logistic regression were utilized. Results: The share of medical expenditure in total household spending was higher among households with CVD in Ghana and South Africa. Households with CVD were more likely to experience greater CHE across all the thresholds in Ghana. Households who reported having CVD were twice as likely to incur CHE at 5% threshold (odds ratio [OR], 1.946; confidence interval [CI], 0.965-1.095), 3 times as likely at 10% threshold (OR, 2.710; CI, 1.401-5.239), and 4 times more likely to experience CHE at both 25% and 40% thresholds, (OR, 3.696; CI, 0.956-14.286) and (OR, 4.107; CI, 1.908-8.841), respectively. In South Africa, households with CVD experienced higher CHE across all the thresholds examined compared with households without CVDs. However, only household CVD status, household health insurance status, and the presence of other disease conditions apart from CVD were associated with incurring CHE. Households who reported having CVD were 3 times more likely to incur CHE compared with households without CVD (OR, 3.002; CI, 1.013-8.902). Conclusions: Our findings suggest that CVD predisposed households to risk of higher CHE. Equity in health financing presupposes that access to health insurance should be predicated on individual health needs. Thus, targeting and prioritizing the health needs of individuals with regard to healthcare financing interventions in SSA is needed.

Heterogeneity in COVID-19 infection among older persons in South Africa: Evidence from national surveillance data.

The 2021 World Health Organization study on the impact of COVID-19 on older people (≥60 years) in the African region highlighted the difficulties they faced as the virus spread across borders and dominated the way of life. These difficulties included disruptions to both essential health care services and social support, as well as disconnections from family and friends. Among those who contracted COVID-19, the risks of severe illness, complications, and mortality were highest among near-old and older persons. Recognizing that older persons are a diverse group including younger- and older-aged individuals, a study was conducted to track the epidemic among near-old (50-59 years) and older persons (≥60 years) in South Africa covering the 2 years since the epidemic emerged. Using a quantitative secondary research approach, data for near-old and older persons were extracted for comparative purposes. COVID-19 surveillance outcomes (confirmed cases, hospitalizations, and deaths) and vaccination data were compiled up to March 5th, 2022. COVID-19 surveillance outcomes were plotted by epidemiological week and epidemic waves to visualize the overall growth and trajectory of the epidemic. Means for each age-group and by COVID-19 waves, together with age-specific rates, were calculated. Average numbers of new COVID-19 confirmed cases and hospitalizations were highest among people aged 50-59- and 60-69-years. However, average age-specific infection rates showed that people aged 50-59 years and ≥80 years were most vulnerable to contracting COVID-19. Age-specific hospitalization and death rates increased, with people aged ≥ 70 years most affected. The number of people vaccinated was slightly higher among people aged 50-59 years before Wave Three and during Wave Four, but higher among people aged ≥ 60 years during Wave Three. The findings suggest that uptake of vaccinations stagnated prior to and during Wave Four for both age groups. Health promotion messages and COVID-19 epidemiological surveillance and monitoring are still needed, particularly for older persons living in congregate residential and care facilities. Prompt health-seeking should be encouraged, including testing and diagnosis as well as taking up vaccines and boosters, particularly for high-risk older persons.

Attitudes towards persons with mental health conditions and psychosocial disabilities as rights holders in Ghana: a World Health Organization study

BackgroundThere are currently major efforts underway in Ghana to address stigma and discrimination, and promote the human rights of those with mental health conditions, within mental health services and the community, working with the World Health Organization’s QualityRights initiative. The present study aims to investigate attitudes towards people with lived experience of mental health conditions and psychosocial disabilities as rights holders.MethodsStakeholders within the Ghanaian mental health system and community, including health professionals, policy makers, and persons with lived experience, completed the QualityRights pre-training questionnaire. The items examined attitudes towards coercion, legal capacity, service environment, and community inclusion. Additional analyses explored how far participant factors may link to attitudes.ResultsOverall, attitudes towards the rights of persons with lived experience were not well aligned with a human rights approach to mental health. Most people supported the use of coercive practices and often thought that health practitioners and family members were in the best position to make treatment decisions. Health/mental health professionals were less likely to endorse coercive measures compared to other groups.ConclusionThis was the first in-depth study assessing attitudes towards persons with lived experience as rights holders in Ghana, and frequently attitudes did not comply with human rights standards, demonstrating a need for training initiatives to combat stigma and discrimination and promote human rights.

Cardiometabolic Multimorbidity Associated with Moderate and Severe Disabilities: Results from the Study on Global AGEing and Adult Health (SAGE) Wave 2 in Ghana and South Africa.

Integrated management of cardiometabolic diseases is crucial in improving the quality of life of older persons. The objective of the study was to identify clusters of cardiometabolic multimorbidity associated with moderate and severe disabilities in Ghana and South Africa. Data were from the World Health Organization (WHO) study on global AGEing and adult health (SAGE) Wave-2 (2015) conducted in Ghana and South Africa. We analysed the clustering of cardiometabolic diseases including angina, stroke, diabetes, obesity, and hypertension with unrelated conditions such as asthma, chronic lung disease, arthritis, cataracts, and depression. The WHO Disability Assessment Instrument version 2.0 was used to assess functional disability. We used latent class analysis to calculate the multimorbidity classes and disability severity levels. Ordinal logistic regression was used to identify the clusters of multimorbidity associated with moderate and severe disabilities. Data from 4,190 adults aged over 50 years were analysed. The prevalence of moderate and severe disabilities was 27.0% and 8.9% respectively. Four latent classes of multimorbidity were identified. These included a relatively healthy group with minimal cardiometabolic multimorbidity (63.5%), general and abdominal obesity (20.5%), hypertension, abdominal obesity, diabetes, cataracts, and arthritis (10.0%), and angina, chronic lung disease, asthma, and depression (6.0%). Compared to the participants with minimal cardiometabolic multimorbidity, the odds of moderate and severe disabilities were higher among participants with multimorbidity comprising hypertension, abdominal obesity, diabetes, cataract and arthritis [aOR = 3.0; 95% CI 1.6 to 5.6], and those with angina, chronic lung disease, asthma and depression [aOR = 2.7; 95% CI 1.6 to 4.5]. Cardiometabolic diseases among older persons in Ghana and South Africa cluster in distinct multimorbidity patterns that are significant predictors of functional disabilities. This evidence may be useful for defining disability prevention strategies and long-term care for older persons living with or at risk of cardiometabolic multimorbidity in sub-Saharan Africa.

Factors That Influence Meeting the Recommended Weekly Physical Activity Target Among Older People With Physical Multimorbidity: Evidence From 6 Low- and Middle-Income Countries.

There is a scarcity of studies on the association between physical multimorbidity and lower levels of physical activity among older adults from low- and middle-income countries, while the potential mediating variables in this association are largely unknown. Cross-sectional, community-based, nationally representative data from the World Health Organization Study on global AGEing and adult health were analyzed. Data on 11 chronic physical conditions were collected. Scoring <150minutes of moderate- to high-intensity physical activity per week was considered low physical activity. Multivariable logistic regression and mediation analysis were done to assess associations and quality of life measures which might influence these associations. Data on 14,585 people aged ≥65years were analyzed (mean [SD] age 72.6 (11.5)y, maximum age 114y; 55.0% women). After adjustment for potential confounders, compared with no chronic conditions, ≥3 conditions were associated with a significant 1.59 to 2.42 times higher odds for low physical activity. Finally, mobility mediated the largest proportion of the association between ≥3 chronic physical conditions and low physical activity (mediated percentage 50.7%), followed by activities of daily living disability (30.7%), cognition (24.0%), affect (23.6%), and pain/discomfort (22.0%). Physical multimorbidity was associated with higher odds for low physical activity among older adults residing in low- and middle-income countries. Mobility, disability, cognition, affect, and pain/discomfort explained the largest proportion of this association. Given the universal benefits of regular and sustained participation in physical activity, it would be prudent to implement interventions among older people with physical multimorbidity to increase levels of physical activity. Future studies should assess the impact of addressing the identified potential mediators among people with multimorbidity on physical activity levels.

The prevalence of hypertension and its associated risk factors among older adults in Ghana.

Hypertension is a worldwide health issue that primarily affects the elderly in our society. However, in comparison to the developed world, the prevalence of hypertension is higher in Sub-Saharan Africa. This paper examines the prevalence of hypertension and its associated risk factors among older adults in Ghana. Using the World Health Organization's study on global AGEing and adult health (WHO SAGE) Wave 1 cross-sectional data collected via in-person structured interviews; paper and pencil interviews (PAPI) from ten administrative regions of Ghana using stratified multistage cluster design from respondents aged 50+ grouped by decade, this study analyzed a nationally representative sub-sample of 3,997 respondents employing binary logistic regression. Odds ratios (OR) and 95% confidence intervals (95% CI) were used to estimate risk factors associated with hypertension (blood pressure ≥ 130/80 mm/Hg). There was a 53.72% hypertension prevalence rate among older adults. Hypertension prevalence tends to increase with increasing age. The prevalence of hypertension was associated with residency (B = -0.18, OR = 0.84, p < 0.017), with urban residents being more at risk of hypertension than rural residents. The prevalence of hypertension increased with overweight (B = 0.66, OR = 1.94, p < 0.001) and obesity (B = 0.82, OR = 2.28, p < 0.001). The amount of fruit and vegetable intake was insignificant but had an inverse relationship with hypertension prevalence. This study has shown that demographic and lifestyle factors significantly affect and explain the hypertension risk among older adults. Medical factors, such as chronic diseases, were largely insignificant and accounted for less hypertension prevalence. Therefore, when interpreting test findings in clinical practice, such as hypertension, it is essential to consider demographic and lifestyle factors. In addition, health policies and primary interventions that seek to improve the standard of living, lifestyle, and wellbeing of older adults need to be critically considered moving forward to lower hypertension prevalence among older adults in Ghana.

Therapeutic efficacy of dihydroartemisinin–piperaquine for the treatment of uncomplicated Plasmodium vivax malaria in Seacha area, Arbaminch Zuria District, South West Ethiopia

BackgroundDeclining efficacy of chloroquine against Plasmodium vivax malaria has been documented in Ethiopia. Thus, there is a need to assess the efficacy of alternative schizontocidal anti-malarials such as dihydroartemisinin–piperaquine (DHA–PPQ) in P. vivax malaria-infected patients. This study was conducted to evaluate the therapeutic efficacy of DHA–PPQ drug in South West Ethiopia.MethodsThis is a single-arm, prospective therapeutic efficacy study in patients with uncomplicated P. vivax malaria. The study was conducted from May 2021 to August 2021, based on the standard World Health Organization study protocol for surveillance of anti-malarial therapeutic efficacy. The study endpoint was adequate clinical and parasitological response on day 42.ResultsA total of 86 patients with uncomplicated vivax malaria were enrolled. Of these, 79 patients completed the scheduled follow up; all showing adequate clinical and parasitological responses to day 42, with a successful cure rate of 100% (95% CI 96–100). Parasitaemias were cleared rapidly (86% by day 1 and 100% by day 3), as were clinical symptoms (100% by day 1). Gametocyte carriage decreased from 44% on Day 0 to 1% on day 1 and 0% on Day 2. Mean haemoglobin concentrations increased between day 0 (mean 12.2 g/dL) and day 42 (mean 13.3 g/dL). Treatment was well tolerated and no severe adverse events were observed.ConclusionIn summary, treatment with DHA–PPQ demonstrated excellent efficacy for uncomplicated P. vivax, with no recurrences to day 42, and no safety concerns. This treatment, which is also effective against P. falciparum, appears to be an ideal alternative for P. vivax as part of the malaria elimination programme.

A prospective cohort study on the association between grip strength and cognitive function in adults aged 50 years and above

Objective: To evaluate the association between grip strength (GS) and cognitive function in a population-based longitudinal cohort of Chinese adults aged ≥50 years. Methods: The study population of 3 600 adults was from the baseline survey and two rounds of follow up of World Health Organization (WHO) study of global ageing and adult health (SAGE) in five districts of Shanghai (Hongkou, Huangpu, Minhang, Qingpu and Pudong) after excluding individuals with self-report stroke and depression. The effects of baseline GS on cognitive function and its changes were evaluated. Factor analysis was applied to generate an overall cognition score based on verbal recall trials, verbal fluency test, forward digit span test and backward digit span test. Linear mixed effects model was used to examine the predictive capability of baseline GS for changes in cognitive function. Results: A total of 3 600 participants aged (61.2±8.1) years at baseline survey were included in this study, including 1 668 (46.3%) men and 1 932 (53.7%) women. The average of baseline GS and total cognitive function score were (28.19±12.18) kg and (58.93±14.56) respectively. Cognitive function score declined significantly during the follow-up, however, the changes were different among different age groups, education level groups and household income groups. After adjusted for age, education level, marital status, household income, co-morbidity of chronic conditions, drinking status, smoking status, physical activity level, vegetable/fruit intakes and BMI, no relationships between the baseline GS and cognitive score at baseline survey and at 1st follow-up were observed, however, compared with lower GS quartile group, there was a significant relationship between higher baseline GS level and better cognitive function at 2nd follow-up. The participants with highest GS quartile had better cognitive performance over time (male: β=1.938,95%CI:0.644-3.231,P=0.003, female: β=2.192,95%CI:0.975-3.409,P<0.001 and those aged 50-64 years: β=1.652,95%CI:0.646-2.659,P=0.001) than those with the lowest quartile. Conclusions: Higher baseline GS was significantly related to better cognitive function with slow decline. Thus, it is an indicator of cognitive function in middle-aged and elderly Chinese.

Association of back pain with major depressive disorder among older adults in six low- and middle-income countries: A cross-sectional study.

Back pain is one of the leading causes of disability and decreased quality of life. In this study, we examined the association between back pain and major depressive disorder (MDD) in six low- and middle-income countries. We also examined the association of back pain duration and severity with MDD among middle-aged and older adults in these countries. Nationally representative data from the World Health Organization's Study on global AGEing and adult health (WHO-SAGE) consisting of 33,878 middle-aged and older adults aged 50years or above were analysed. The linkages of back pain, pain duration and severity with MDD were examined using multivariable logistic regression analyses. Across six countries, the prevalence of MDD was higher among middle-aged and older adults who reported back pain than those who did not report back pain (14.5% vs 4.5%). In the pooled data, middle-aged and older adults who suffered from back pain had higher odds of depression [adjusted odds ratio (aOR): 2.41, confidence interval (CI): 2.19-2.64] compared to those with no back pain. Particularly, the association was stronger in Ghana [aOR: 4.78] and South Africa [aOR: 2.42]. Further, the association was stronger for those who experienced back pain for >2weeks as well as those who reported severe and extreme back pain than those with no back pain across all the countries. In this study, the association of back pain and its duration and severity with MDD is consistent and significant among middle-aged and older adults in six countries. Government policies should consider the role of back pain in improving the mental health of middle-aged and older adults.

Perceived neighborhood social cohesion and the 10-year risk of cardiovascular disease in low- and middle-income countries: The World Health Organization Study on Global Aging and Adult Health

Low- and middle-income countries (LMICs) bear the greatest burden of cardiovascular disease (CVD) worldwide. Emerging evidence, mostly from industrialized countries, suggest that neighborhood characteristics influence cardiovascular health. This study presents results from 27,797 participants living in six LMICs on the association of perceived neighborhood social cohesion, the degree of connectedness among neighbors, with 10-year risk of CVD. We observed that greater perceived neighborhood social cohesion was associated with lower odds of high (>20%) 10-year CVD risk (OR=0.67, 95%CI: 0.53-0.86). These novel findings, suggest that interventions to enhance social cohesion may have beneficial effects on cardiovascular health in LMICs.

Association between cooking fuels and mild cognitive impairment among older adults from six low- and middle-income countries

There is a small body of evidence suggesting that unclean cooking fuel use may be associated with cognitive decline. However, to date, no study has investigated the association between unclean cooking fuel and mild cognitive impairment (MCI). Thus, we investigated the association between cooking fuel type or ventilation type and MCI among adults aged ≥ 65 years using nationally representative datasets from six low- and middle-income countries. Cross-sectional, community-based data from the World Health Organization (WHO) Study on global Ageing and adult health (SAGE) were analyzed. MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Unclean cooking fuel referred to kerosene/paraffin, coal/charcoal, wood, agriculture/crop, animal dung, and shrubs/grass. Multivariable logistic regression analysis was conducted to assess associations. Data on 13,623 individuals were analyzed [mean (SD) age 72.8 (11.0) years; 45.5% males]. Unclean cooking fuel (vs. clean cooking fuel) was associated with a significant 1.48 (95% CI = 1.08–2.03) times higher odds for MCI. Having no chimney or hood for cooking ventilation was also associated with significantly higher odds for MCI (OR = 1.88; 95% CI = 1.25–2.84). Unclean cooking fuel use and lack of chimney or hood for cooking ventilation were associated with higher odds for MCI. Findings support the implementation of the United Nations Sustainable Goal 7, which advocates affordable, reliable, sustainable, and modern energy for all, as this may also help reduce MCI and ultimately dementia.

Comparison of Diabetes Mellitus Risk Factors in Mexico in 2003 and 2014.

ObjectiveThe prevalence of diabetes mellitus in Mexico is very high. This study aimed to compare the risk factors of diabetes mellitus in Mexican adults in 2003 and in 2014.MethodsThis study had a repeated cross-sectional design. Data from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) from Mexico (Wave 0, 2003, and Wave 2, 2014) were compared. Self-reported diabetes mellitus (outcome) was evaluated with the yes/no question: “Have you ever been diagnosed with diabetes mellitus (high blood sugar)?” Bivariate analyses and multivariable logistic regression analyses adjusted for potential risk factors were conducted.ResultsIn 11 years (2003–2014), the prevalence of self-reported diabetes mellitus in Mexican adults increased by 2.6 times in those younger than 50 years (2003: 2.1%; 2014: 5.5%) and by 1.9 times in those ≥50 years (2003: 12.7%; 2014: 24.2%). In 2003, the risk factors associated with diabetes mellitus were female sex (OR 1.344, 95% CI 1.176–1.536), age ≥50 years (OR 6.734, 95% CI 5.843–7.760), being overweight (OR 1.359, 95% CI 1.175–1.571), obesity (OR 1.871, 95% CI 1.583–2.211), and lower physical activity of <600 MET-minutes/week (OR 1.349, 95% CI 1.117–1.630). In 2014, the exposure characteristics significantly associated with diabetes mellitus were female sex (OR 1.244, 95% CI 1.025–1.511), older age ≥50 years (OR 4.608, 95% CI 3.260–6.515), being overweight (OR 1.649, 95% CI 1.305–2.083), obesity (OR 1.778, 95% CI 1.398–2.261), and in those who had not attended/completed primary school (OR 1.360, 95% CI 1.042–1.773).ConclusionThe prevalence of diabetes mellitus in Mexico significantly increased from 2003 to 2014. Female sex, age older than 50 years, and being overweight or obese were significant risk factors in both 2003 and 2014. Not having completed primary school was a new significant risk factor in 2014. Public health policies and strategies should prioritize decreasing the high levels of overweight and obesity, and improve health literacy in Mexico.

Association of food insecurity with suicidal ideation and suicide attempts in adults aged ≥50 years from low- and middle-income countries

BackgroundThe aim of the present study was to investigate associations between food insecurity with suicidal ideation and suicide attempts in adults aged ≥50 years from six low- and middle-income countries (LMICs). MethodsCross-sectional, community-based data from the World Health Organisation's Study on Global Aging and Adult Health were analyzed. Self-reported information on past 12-month suicidal ideation and suicide attempts was collected. Past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable logistic regression analysis was conducted to assess the association between food insecurity and suicidal ideation or suicide attempts. ResultsThe final analytical sample included 34,129 individuals aged ≥50 years [mean (SD) age 62.4 (16.0) years; 52.1% females]. Compared to no food insecurity, severe food insecurity was associated with a significant 2.78 (95%CI = 1.73–4.45) times higher odds for suicidal ideation, while moderate and severe food insecurity were associated with 2.59 (95%CI = 1.35–4.97) and 5.15 (95%CI = 2.52–10.53) times higher odds for suicide attempts, respectively. LimitationsThe cross-sectional design, the use of self-reported wish to die as a measure of suicide ideation, and that suicidal ideation and suicide attempts were only assessed among those who had depressive symptoms, could be considered limitations of our study. ConclusionsFood insecurity was positively associated with suicidal ideation and suicide attempts. Targeting food insecurity among older adults in LMICs may lead to reduction in suicidal ideation and suicide attempts, although future longitudinal studies are warranted to confirm this.

Activity limitations and participation restrictions among people with non-communicable diseases in Ghana

AbstractAnecdotal evidence suggests that non-communicable diseases (NCDs) contribute substantially to mortality, morbidity and disability in Ghana. Nonetheless, no data are presently available on Ghanaians with disability from major NCDs, such as hypertension, diabetes and stroke. Using data from the 2007/2008 Ghana World Health Organization Study on Global Ageing and Adult Health (SAGE) and applying ordinary least squares techniques, the prevalence of and associations between activity limitations and participation restrictions in Ghanaians with NCDs are examined in the present study. The results show stroke is the major contributor to activity limitations and participation restrictions among the Ghanaian population with NCDs. The study results further revealed that respondents with higher education reported high levels of disability compared to those with no education. The results suggest that functioning can be restored by providing assistive technologies, such as wheelchairs, prosthetic limbs, walking aids, etc., that can enhance participation of persons with disability in society.

Детерминанты здоровья и гетерогенность ответов при самооценке здоровья в России: подход якорных виньеток

We show the reporting heterogeneity bias into all 7 domains of health using the anchoring vignettes approach with the hierarchical ordered probit model. The paper uses the data of the Russian sample of the first wave of the global survey SAGE provided by the World Health Organization Study. The heterogeneity bias correction has changed the significance level of education level, permanent income, rural/ urban living, and marital status.