Lifestyle health risk factors and multiple non-communicable diseases among the adult population in India: a cross-sectional study

Risk factors of multimorbidity among older adults in India: A systematic review and meta-analysis

Background

Multimorbidity among older adults is a growing concern in India. Multimorbidity is defined as the coexistence of two or more chronic health conditions in an individual. Primary studies have been conducted on risk factors of multimorbidity in India, but no systematic review has been conducted on this topic. This systematic review aimed to synthesize the existing evidence on risk factors of multimorbidity among older adults in India.

Methods

The JBI and Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. Several databases were searched for published and unpublished studies until August 03, 2022. The screening of titles and abstracts and full texts, data extraction, and quality assessment were conducted by two independent reviewers. Any disagreements were resolved through discussion or by involving a third reviewer. Data synthesis was conducted using narrative synthesis and random effects meta-analysis, where appropriate.

Results

Out of 8781 records identified from the literature search, 16 and 15 studies were included in the systematic review and meta-analysis, respectively. All included studies were cross-sectional, and 10 met a critical appraisal score of more than 70%. Broadly, sociodemographic, lifestyle, and health conditions-related factors were explored in these studies. The pooled odds of multimorbidity were higher in people aged ≥70 years compared to 60-69 years (odds ratio (OR) 1.51; 95% confidence interval (CI) 1.20-1.91), females compared to males (1.38; 1.09-1.75), single, divorced, separated, and widowed compared to married (1.29; 1.11-1.49), economically dependent compared to economically independent (1.54; 1.21-1.97), and smokers compared to non-smokers (1.33; 1.16-1.52) and were lower in working compared to not working (0.51; 0.36-0.72).

Conclusion

This systematic review and meta-analysis provided a comprehensive picture of the problem by synthesizing the existing evidence on risk factors of multimorbidity among older adults in India. These synthesized sociodemographic and lifestyle factors should be taken into consideration when developing health interventions for addressing multimorbidity among older adults in India.

Multimorbidity Among Migrant and Non-Migrant Ghanaians: The RODAM Study

Objectives: Multimorbidity is a growing public health concern due to the increasing burden of non-communicable diseases, yet information about multimorbidity in low- and middle-income countries and migrant populations is scarce. We aimed to investigate the distribution and patterns of multimorbidity in rural and urban areas in Ghana and Ghanaian migrants in Europe. Methods: The RODAM cross-sectional study included 4,833 participants. Multimorbidity was defined as presence of multiple non-communicable chronic conditions. Patterns were determined from frequent combination of conditions. Prevalence ratios were estimated by logistic regression. Results: Prevalence of multimorbidity was higher in women and in urban Ghana and Europe. We observed a cardiometabolic pattern in all sites as well as circulatory-musculoskeletal and metabolic-musculoskeletal combinations in Ghana. Multimorbidity prevalence ratios were higher in Europe (men 1.47, 95% CI 1.34-1.59, women 1.18, 1.10-1.26) and urban Ghana (men 1.46, 1.31-1.59, women 1.27, 1.19-1.34). Conclusion: Distribution and patterns of multimorbidity differed by sex and site. With a higher burden of multimorbidity in urban areas, prevention strategies should focus on forestalling its increase in rapidly growing rural areas.

Effect of Arogya Raksha Panchatantra (five lifestyle principles) on hematological parameters and anthropometric measures among healthy volunteers: a pilot study

OBJECTIVES

A healthy lifestyle is one, where the individual adapts it aiming at prevention from ailments. Unhealthy lifestyle is a behavioral risk factor for non-communicable diseases (NCDs). Arogya Raksha Panchatantra (five principles of healthy living), is a Naturopathy and Yoga lifestyle practice proposed by an eminent Indian Naturopath Dr. B. Venkat Rao, observed to modify the behavioral risk factors. The main objective of this study is to observe the changes in Hematological parameters and Anthropometric measures by practicing this Naturopathic lifestyle.

METHODS

The study adapted one group Pretest - Posttest quasi experimental design, with a total of nine healthy student volunteers between age group 18-20 years. Hematological parameters such as total blood cells count, hemoglobin concentration, MCV, MCH, PCV, and anthropometric measurements such as weight, body circumferences (waist, hip) and changes in blood pressure were measured at baseline and after practice at 25th day.

RESULTS

There was a statistically significant difference observed in weight, waist and hip circumference, hematological indices except with MCV and MCH, and blood pressure (p<0.05), with no significant changes in waist-hip ratio and blood counts.

CONCLUSIONS

The findings of the study indicate that adapting Naturopathy and Yoga lifestyle based on proposed lifestyle practices may be beneficial in reducing the risk factors for non-communicable diseases. The study does not attribute the effects observed to any particular lifestyle practiced in this study; rather it is combination of healthy practices as observed in the study and it needs further longitudinal observations whether the beneficial effect of Naturopathy lifestyle practices is sustained for longer period of time.

Clustering of lifestyle risk factors among adult population in India: A cross-sectional analysis from 2005 to 2016

Introduction

Individual’s early life style and health behaviors are directly linked to chronic non-communicable diseases. Considering the increased burden of NCDs during the last two decades, the aim of this study is to assess co-occurrence/clustering of lifestyle risk factors and its association with different socio-demographic and economic characteristics among adult men and women in India from 2005–2016.

Methods

This study utilized the data from the National Family Health Survey 2005–06 and 2015–16 survey rounds. Multinomial logistic regression is employed to evaluate co-occurrence of multiple risk factors among adult men and women of different socio-economic and demographic characteristics to identify the subgroups with elevated risk of clustering of multiple unhealthy lifestyle risk factors.

Results

More adult men in India tend to exhibit clustering of multiple non-communicable disease risk factors than females. Individuals between 30–49 years of age, residing in urban areas, the population with no education, separated couples and those from poor economic strata are the specific population subgroups show higher prevalence of co-occurrence of multiple risk factors. The regional pattern of clustering of risk factors shows that the prevalence of co-occurrence of multiple risk factors is higher among men and women from the North-Eastern part of India compared to the other regions of the country.

Conclusion

The prevalence of clustering of multiple risk factors associated with chronic NCDs is substantially high and has increased between 2005–06 to 2015–16. India may therefore experience a significant increase in the burden of chronic non-communicable diseases in the coming years. We therefore conclude that appropriate strategies should be implemented by policy makers and the government to reduce the overall health burden of NCDs due to lifestyle habits.

Alcohol consumption and fruits and vegetable intake among older adults in Ghana: a cross-sectional survey based on WHO-SAGE Wave 2 data

BACKGROUND

Alcohol consumption and inadequate fruits and vegetable (FnV) intake are major reasons for the shift from communicable to non-communicable diseases (NCDs) over the years. The older Ghanaian adult is at high risk of NCD and data on alcohol and FnV consumption are required to guide policy to mitigate its effect. This analysis aimed to determine the factors associated with alcohol consumption and assess the relationship between alcohol consumption and FnV intake among Ghanaians aged 50 years and older.

METHODS

This analysis used WHO Study on Global Ageing and Adult Health (SAGE) Wave 2, Ghana data set conducted between 2014 and 2015. Data on demographic characteristics, FnV intake, and alcohol consumption were collated and analysed. Multivariable Poisson, logistic and probit regression analyses were performed to assess the associations between alcohol consumption and inadequate FnV intake.

RESULTS

A total of 3533 Ghanaians aged 50 years and older, 41.0% men and 59.0% women, were included in this study. The prevalence of lifetime alcohol consumption was 22.8% (95% CI 20.7% to 25.1%). Alcohol consumption was significantly associated with sex, age group, marital status, religion, place of residence and history of smoking. The prevalence of adequate FnV intake was 52.6% with a mean daily intake of 6.45 servings: 2.98 for fruits and 3.47 for vegetables. There was a significant positive correlation between inadequate FnV intake and alcohol consumption. Inadequate FnV consumption was significantly higher among lifetime alcohol consumers compared with non-alcohol consumers. (Poisson estimate; adjusted Prevalence Ratio (aPR) (95% CI)=1.35 (1.12 to 1.63), logistic estimate; adjusted Old Ratio (aOR) (95% CI)=1.13 (1.05 to 1.21) and probit estimate; adjusted normalized coefficient (aβ) (95% CI)=0.19 (0.07 to 0.31)).

CONCLUSION

About a quarter and nearly half of older Ghanaian adults consume alcohol and inadequate FnV, respectively. Alcohol consumption is significantly associated with inadequate FnV intake. Interventions to address inadequate FnV intake among older adults in Ghana should also include policies that regulate the use of alcohol in this population.

Multimorbidity of chronic non-communicable diseases in low- and middle-income countries: A scoping review

Background:

Multimorbidity is rising in low- and middle-income countries (LMICs). However, the evidence on its epidemiology from LMICs settings is limited and the available literature has not been synthesized as yet.

Objectives:

To review the available evidence on the epidemiology of multimorbidity in LMICs.

Methods:

PubMed, Scopus, PsycINFO and Grey literature databases were searched. We followed the PRISMA-ScR reporting guideline.

Results:

Of 33, 110 articles retrieved, 76 studies were eligible for the epidemiology of multimorbidity. Of these 76 studies, 66 (86.8%) were individual country studies. Fifty-two (78.8%) of which were confined to only six middle-income countries: Brazil, China, South Africa, India, Mexico and Iran. The majority (n = 68, 89.5%) of the studies were crosssectional in nature. The sample size varied from 103 to 242, 952. The largest proportion (n = 33, 43.4%) of the studies enrolled adults. Marked variations existed in defining and measuring multimorbidity. The prevalence of multimorbidity in LMICs ranged from 3.2% to 90.5%.

Conclusion and Recommendations:

Studies on the epidemiology of multimorbidity in LMICs are limited and the available ones are concentrated in few countries. Despite variations in measurement and definition, studies consistently reported high prevalence of multimorbidity. Further research is urgently required to better understand the epidemiology of multimorbidity and define the best possible interventions to improve outcomes of patients with multimorbidity in LMICs.

High BMI: an important health risk factor among older adults in Ghana

OBJECTIVE

We examined BMI as a health risk factor for self-reported diabetes mellitus, angina, strokes and arthritis among older Ghanaians aged 50 years and above.

DESIGN

We analysed the individual-level data from the World Health Organization Study on global AGEing and adult health Ghana Wave 2 (2014/2015). The influence of BMI on self-reported chronic conditions including diabetes, angina, stroke and arthritis was examined.

SETTING

Households from all the administrative regions of Ghana.

PARTICIPANTS

Included 3350 adults aged 50 years and older.

RESULTS

The prevalence of overweight and obesity among participants was 22·8 % (95 % CI 20·6, 25·2) and 13·2 %, respectively (95 % CI 11·5, 15·1). With respect to individual chronic conditions, arthritis emerged with the highest prevalence rate of 7·3 (95 % CI 5·3, 9·9), while the prevalence rate of diabetes, angina and stroke was 2·8 % (95 % CI 2·0, 3·9), 1·7 % (95 % CI 1·1, 2·6) and 1·3 % (95 % CI 1·0, 1·8), respectively. The risk of diabetes among overweight and obesity was over three and two times, respectively, higher compared with participants with normal weights. Overweight and obesity were significantly more than two and three times likely to experience angina, respectively, compared with participants with normal weight. Obesity significantly influences arthritis with approximately two times increased odds compared with normal weight participants.

CONCLUSION

Prevalence of obesity and overweight in Ghana is high and increasing, which poses a health risk at the individual and population levels. Inter-sectorial and multidisciplinary measures in line with the national non-communicable disease policies aimed at curbing this trend are imperative.

Differences in quality of life among older adults in Brazil according to smoking status and nicotine dependence

BACKGROUND

Research on quality of life QOL is limited in Brazil and few studies have examined the association between smoking status and quality of life. This study addresses this gap and also examines the association between smoking, nicotine dependence, and duration of smoking cessation on (QOL) among older adults in an urban area in Brazil.

METHODS

Data are from a household survey conducted in urban areas of Uberaba, Brazil, in 2012 (n = 980). Multivariable linear regressions were used to evaluate the association between smoking, nicotine dependence based on Fageström test, and smoking cessation on the World Health Organization Quality of Life WHOQOL-BREF and Quality of Life Assessment for Older Adults WHOQOL-OLD.

RESULTS

The mean age of older adults in the study was 74.0 (SD = 6.9 years) and 64% of participants were women. The majority, 55% had never smoked, 12.4% were current smokers, and 32.7% were past-smokers. Current smokers had lower scores for social participation (β = - 2.6) and intimacy (β = - 3.8) than never smokers. Smokers with high or very high dependence reported higher levels of fear and concern about death and pain before death than those with low or very low dependence (β = - 10.6). However, smokers with medium levels of nicotine dependence had higher scores on social relationship. Longer cessation time was positively associated with higher scores for psychological health.

CONCLUSIONS

Except for the positive association between medium levels of nicotine dependence and better social relationships, smoking and higher levels of nicotine dependence were associated with worse QOL among older adults in Brazil. Nonetheless, smoking cessation had positive effects in QOL. Campaigns targeting older adults should point to the negative impact of tobacco use on QOL and the benefits of smoking cessation.