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Shan J, Yin R, Panuthai S. Body mass index and multimorbidity risk: A systematic review and dose-response meta-analysis. Arch Gerontol Geriatr 2024; 123:105418. [PMID: 38604087 DOI: 10.1016/j.archger.2024.105418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE To verify the dose-response relationship between body mass index (BMI) and multimorbidity risk. METHODS PubMed, CINAHL, and Embase were systematically studied until January 25, 2023. Original articles on BMI and multimorbidity risk were included. Random effects model and dose-response meta-analysis were used to estimate the pooled odds ratio (OR) with 95 % confidence interval (CI). Subgroup analysis was performed to explore potential heterogeneity. RESULTS A total of 43 studies involving 969,130 patients (94,978 with multimorbidity) were involved in the meta-analysis. In the longitudinal studies, the pooled results showed that, compared to being a normal BMI, being overweight was much similar with 1.32 times possibility of getting multimorbidity; in persons with obesity the risk was 1.93 times higher; and the risk decreased 0.80 times among underweight persons. Additionally, obesity was 1.75 times as likely to be multimorbidity than those non-obese persons. In the cross-sectional studies, the pooled results demonstrated that persons with overweight and obesity had a 1.38-fold and 2.38-fold risk for multimorbidity, respectively; and the risk decreased 0.90 times among underweight persons compared to those with normal BMI. Besides, obese people are 1.89 times more likely to have multimorbidity than non-obese people. Dose response analysis found the linear connection between BMI and multimorbidity risk (Pnon-linearity=0.762), that for each 1 kg/m2 and 5 kg/m2 increase in BMI, the multimorbidity risk increased by 6 % and 35 %, respectively. CONCLUSIONS Multimorbidity increased linearly with an increase in BMI. Clinicians should pay attention to persons with abnormal weight, to help them achieve normal BMI.
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Affiliation(s)
- Jun Shan
- School of Nursing and Rehabilitation, Nantong University, China; Faculty of Nursing, Chiang Mai University, under the CMU presidential Scholarship, Thailand
| | - Rulan Yin
- Department of Nursing, The First Affiliated Hospital of Soochow University, China; Faculty of Nursing, Chiang Mai University, 110/406 Inthavaroros Road, Suthep, Muang district, Chiangmai 50200, Thailand
| | - Sirirat Panuthai
- Faculty of Nursing, Chiang Mai University, 110/406 Inthavaroros Road, Suthep, Muang district, Chiangmai 50200, Thailand.
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Song G, Li W, Ma Y, Xian Y, Liao X, Yang X, Zhang H, Cade JE. Nutrient intake and risk of multimorbidity: a prospective cohort study of 25,389 women. BMC Public Health 2024; 24:696. [PMID: 38439008 PMCID: PMC10913224 DOI: 10.1186/s12889-024-18191-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/23/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Multimorbidity is becoming an increasingly serious public health challenge in the aging population. The impact of nutrients on multimorbidity remains to be determined and was explored using data from a UK cohort study. METHOD Our research analysis is mainly based on the data collected by the United Kingdom Women's Cohort Study (UKWCS), which recruited 35,372 women aged 35-69 years at baseline (1995 to 1998), aiming to explore potential associations between diet and chronic diseases. Daily intakes of energy and nutrients were estimated using a validated 217-item food frequency questionnaire at recruitment. Multimorbidity was assessed using the Charlson comorbidity index (CCI) through electronic linkages to Hospital Episode Statistics up to March 2019. Cox's proportional hazards models were used to estimate associations between daily intakes of nutrients and risk of multimorbidity. Those associations were also analyzed in multinomial logistic regression as a sensitivity analysis. In addition, a stratified analysis was conducted with age 60 as the cutoff point. RESULTS Among the 25,389 participants, 7,799 subjects (30.7%) were confirmed with multimorbidity over a median follow-up of 22 years. Compared with the lowest quintile, the highest quintile of daily intakes of energy and protein were associated with 8% and 12% increased risk of multimorbidity respectively (HR 1.08 (95% CI 1.01, 1.16), p-linearity = 0.022 for energy; 1.12 (1.04, 1.21), p-linearity = 0.003 for protein). Higher quintiles of daily intakes of vitamin C and iron had a slightly lowered risk of multimorbidity, compared to the lowest quintile. A significantly higher risk of multimorbidity was found to be linearly associated with higher intake quintiles of vitamin B12 and vitamin D (p-linearity = 0.001 and 0.002, respectively) in Cox models, which became insignificant in multinomial logistic regression. There was some evidence of effect modification by age in intakes of iron and vitamin B1 associated with the risk of multimorbidity (p-interaction = 0.006 and 0.025, respectively). CONCLUSIONS Our findings highlight a link between nutrient intake and multimorbidity risk. However, there is uncertainty in our results, and more research is needed before definite conclusions can be reached.
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Affiliation(s)
- Ge Song
- Department of Clinical Nutrition, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Weimin Li
- Department of Clinical Nutrition, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Yanfen Ma
- Department of Clinical Laboratory, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Yao Xian
- Department of Clinical Nutrition, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Xia Liao
- Department of Clinical Nutrition, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Xueliang Yang
- Department of Clinical Nutrition, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Huifeng Zhang
- Department of Clinical Nutrition, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China.
- School of Food Science and Nutrition, University of Leeds, LS2 9AT, Leeds, UK.
| | - Janet E Cade
- School of Food Science and Nutrition, University of Leeds, LS2 9AT, Leeds, UK
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Bong May Ing J, Singh DKA, Tan MP, Adam Bujang M, Tiong IK, Whitney J, Kumar S. Group-based exercise interventions for community-dwelling older people in Southeast Asia: A systematic review. Australas J Ageing 2023; 42:624-637. [PMID: 37465973 DOI: 10.1111/ajag.13227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/18/2023] [Accepted: 06/22/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES Southeast Asia (SEA) is a rapidly ageing and a diversely populated region that requires strategies to maintain its populations' physical activity and sense of well-being. While the benefits of group exercise programs are known, the characteristics and types of exercises in terms of their effectiveness for physical function and fidelity of the programs have yet to be defined within this population. METHODS Ovid, MEDLINE, Scopus, PEDro (Physiotherapy Evidence Database), EBSCOHOST, Cochrane library and Open Grey databases were searched to identify relevant studies. Methodological quality was assessed using the PEDro Scale and the Newcastle Ottawa Scale (NOS). Meta-analysis was undertaken when the same outcome measures were reported in a minimum of two studies with appropriate data. (PROSPERO: CRD42020177317). RESULTS Eleven studies with 900 participants were included, out of which 395 participants were allocated to group exercise programs and 383 completed the program. Culturally adapted Thai dance programs and multicomponent exercise programs were the most-commonly reported group exercises. The Timed Up and Go test (TUG) and attendance rates were the most-frequently reported outcomes. Meta-analysis demonstrated significant improvement in physical function assessed using the Timed Up and Go test (Random effect model -1.27 s, 95% CI -1.65, -0.88, I2 = 74%). In two studies, adherence (81% and 94%) and dropout rates (4% and 19%) were reported. CONCLUSIONS Group-based exercise programs in Southeast Asia consisting mostly of culturally adapted Thai dance programs and multicomponent exercise programs appear to have positive effects on physical function. However, better descriptions of fidelity, including adherence, are required in future studies.
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Affiliation(s)
- Janet Bong May Ing
- Physiotherapy Programme, Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Physiotherapy Unit, Sarawak Heart Centre, Sarawak Health Department, Ministry of Health, Kuching, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme, Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohammad Adam Bujang
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Kuching, Malaysia
| | - Ing Khieng Tiong
- Geriatric Unit, Sarawak Heart Centre, Sarawak Health Department, Ministry of Health, Kuching, Malaysia
| | | | - Saravana Kumar
- Allied Health and Human Performance Unit, City East Campus, University of South Australia, Adelaide, South Australia, Australia
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Peila R, Xue X, Shadyab AH, Wactawski-Wende J, Espeland MA, Snetselaar LG, Saquib N, Ikramuddin F, Manson JE, Wallace RB, Rohan TE. Association Between the Healthy Lifestyle Index and Risk of Multimorbidity in the Women's Health Initiative. J Gerontol A Biol Sci Med Sci 2023; 78:2282-2293. [PMID: 37463321 DOI: 10.1093/gerona/glad170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Multimorbidity, defined as the presence of 2 or more chronic health conditions, is increasingly common among older adults. The combination of lifestyle characteristics such as diet quality, smoking status, alcohol intake, physical activity (PA), sleep duration, and body fat as assessed by body mass index (BMI) or waist circumference, and risk of multimorbidity are not well understood. OBJECTIVES We investigated the association between the healthy lifestyle index (HLI), generated by combining indicators of diet quality, smoking, alcohol, PA, sleep amount, and BMI, and risk of multimorbidity, a composite outcome that included cardiovascular disease (CVD), diabetes, cancer, and fracture. METHODS We studied 62 037 postmenopausal women aged 50-79 years at enrollment in the Women's Health Initiative, with no reported history of CVD, diabetes, cancer, or fracture at baseline. Lifestyle characteristics measured at baseline were categorized and a score (0-4) was assigned to each category. The combined HLI (0-24) was grouped into quintiles, with higher quintiles indicating a healthier lifestyle. Multivariable adjusted estimates of hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the risk of developing multimorbidity were obtained using Cox proportional hazard models. RESULTS Over an average follow-up period of 16.3 years, 5 656 women developed multimorbidity. There was an inverse association between the HLI levels and risk of multimorbidity (compared to the HLI_1st quintile: HR_2nd quintile = 0.81 95% CI 0.74-0.83, HR_3rd quintile = 0.77 95% CI 0.71-0.83, HR_4th quintile = 0.70 95% CI 0.64-0.76, and HR_5th quintile = 0.60 95% CI 0.54-0.66; p trend < .001). Similar associations were observed after stratification by age or BMI categories. CONCLUSIONS Among postmenopausal women, higher levels of the HLI were associated with a reduced risk of developing multimorbidity.
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Affiliation(s)
- Rita Peila
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Mark A Espeland
- Department of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Linda G Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Nazmus Saquib
- College of Medicine at Sulaiman, Al Rajhi University, Al Bukayriyah, Saudi Arabia
| | - Farha Ikramuddin
- Department of Rehabilitation Medicine, University of Minnesota, Medical School, Minneapolis, Minnesota, USA
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Robert B Wallace
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
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Tazzeo C, Zucchelli A, Vetrano DL, Demurtas J, Smith L, Schoene D, Sanchez-Rodriguez D, Onder G, Balci C, Bonetti S, Grande G, Torbahn G, Veronese N, Marengoni A. Risk factors for multimorbidity in adulthood: A systematic review. Ageing Res Rev 2023; 91:102039. [PMID: 37647994 DOI: 10.1016/j.arr.2023.102039] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/25/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Multimorbidity, the coexistence of multiple chronic diseases in an individual, is highly prevalent and challenging for healthcare systems. However, its risk factors remain poorly understood. OBJECTIVE To systematically review studies reporting multimorbidity risk factors. METHODS A PRISMA-compliant systematic review was conducted, searching electronic databases (MEDLINE, EMBASE, Web of Science, Scopus). Inclusion criteria were studies addressing multimorbidity transitions, trajectories, continuous disease counts, and specific patterns. Non-human studies and participants under 18 were excluded. Associations between risk factors and multimorbidity onset were reported. RESULTS Of 20,806 identified studies, 68 were included, with participants aged 18-105 from 23 countries. Nine risk factor categories were identified, including demographic, socioeconomic, and behavioral factors. Older age, low education, obesity, hypertension, depression, low pysical function were generally positively associated with multimorbidity. Results for factors like smoking, alcohol consumption, and dietary patterns were inconsistent. Study quality was moderate, with 16.2% having low risk of bias. CONCLUSIONS Several risk factors seem to be consistently associated with an increased risk of accumulating chronic diseases over time. However, heterogeneity in settings, exposure and outcome, and baseline health of participants hampers robust conclusions.
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Affiliation(s)
- Clare Tazzeo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Alberto Zucchelli
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Jacopo Demurtas
- Primary Care Department USL Toscana Sud Est, AFT Orbetello, Italy
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Daniel Schoene
- Friedrich-Alexander University Erlangen-Nürnberg, Institute of Medical Physics, Erlangen, Germany; Leipzig University, Institute of Exercise and Public Health, Leipzig, Germany; Robert-Bosch-Hospital, Department of Clinical Gerontology, Stuttgart, Germany
| | - Dolores Sanchez-Rodriguez
- Geriatrics Department, Brugmann university hospital, Université Libre de Bruxelles, Brussels, Belgium; WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; Geriatrics Department, Parc Salut Mar, Rehabilitation Research Group, Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Graziano Onder
- Department of Geriatric and Orthopedic sciences, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Cafer Balci
- Hacettepe University Faculty of Medicine Division of Geriatric Medicine, Turkey
| | - Silvia Bonetti
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Gabriel Torbahn
- Department of Pediatrics, Paracelsus Medical University, Klinikum Nürnberg, Universitätsklinik der Paracelsus Medizinischen Privatuniversität Nürnberg, Nuremberg, Germany; Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria; Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Alessandra Marengoni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Mohd Rosnu NS, Ishak WS, Abd Rahman MH, Shahar S, Musselwhite C, Mat Ludin AF, Hamid TA, Abdul Latiff AR, Singh DKA. Associations between biopsychosocial factors and transportation patterns of older adults residing in Klang Valley, Malaysia. Front Public Health 2023; 11:1153822. [PMID: 37275505 PMCID: PMC10234101 DOI: 10.3389/fpubh.2023.1153822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/13/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Aging is associated with physiological changes in multiple systems in the body and may impact the transportation choices of older adults. In this study, we examine the associations between biopsychosocial factors and the transportation choices of Malaysian older adults. Methods One hundred and nineteen (119) older adults, aged 60 and above, living in Klang Valley, Malaysia were recruited for this cross-sectional study. Participants were interviewed face-to-face to obtain sociodemographic data, health status (whether there were and, if yes, the number of comorbidities), outdoor mobility and transportation patterns, Instrumental Activity Daily Living (IADL) status and cognitive function. Participants' physical performance (dominant handgrip strength, 10-m walk, and timed up and go tests), hearing threshold (pure tone audiometry), and vision function (visual acuity, contrast sensitivity) were measured. Transportation patterns of older adults were categorized into three groups, that is, flexible (using public transport and/or private vehicles), using only private vehicles and restricted (relying on others or walking). Results Further information is needed to enable such older adults as older women, those with comorbidities and poorer functional status to access transportation, especially to meet their health care needs. Discussion The majority (51%) of participants were in the 'using only private vehicles' group, followed by the 'flexibles' (25%) and the 'restricted' (24%). Factors significantly associated with the restricted transportation group were: (a) being female (AdjOR 15.39, 95% CI 0.86-23.39, p < 0.001); (b) being Malay (AdjOR 21.72, 95% CI 0.36-16.12, p < 0.001); (c) having higher number of comorbidities (AdjOR 14.01, 95% CI 0.20-13.21, p = 0.007); and (d) being dependent in IADL (AdjOR 13.48, 95% CI 0.51-1.78, p = 0.002).
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Affiliation(s)
- Nurul Syuhada Mohd Rosnu
- Center for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Wan Syafira Ishak
- Center for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Harimi Abd Rahman
- Optometry and Vision Sciences Programme, Center for Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Center for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Charles Musselwhite
- Centre for Ageing and Dementia Research, Aberystwyth University, Aberystwyth, United Kingdom
| | - Arimi Fitri Mat Ludin
- Center for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Tengku Aizan Hamid
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | | | - Devinder Kaur Ajit Singh
- Center for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Tan MMC, Prina AM, Muniz-Terrera G, Mohan D, Ismail R, Assefa E, Keinert AÁM, Kassim Z, Allotey P, Reidpath D, Su TT. Prevalence of and factors associated with multimorbidity among 18 101 adults in the South East Asia Community Observatory Health and Demographic Surveillance System in Malaysia: a population-based, cross-sectional study of the MUTUAL consortium. BMJ Open 2022; 12:e068172. [PMID: 36564121 PMCID: PMC9791377 DOI: 10.1136/bmjopen-2022-068172] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To assess the prevalence and factors associated with multimorbidity in a community-dwelling general adult population on a large Health and Demographic Surveillance System (HDSS) scale. DESIGN Population-based cross-sectional study. SETTING South East Asia Community Observatory HDSS site in Malaysia. PARTICIPANTS Of 45 246 participants recruited from 13 431 households, 18 101 eligible adults aged 18-97 years (mean age 47 years, 55.6% female) were included. MAIN OUTCOME MEASURES The main outcome was prevalence of multimorbidity. Multimorbidity was defined as the coexistence of two or more chronic conditions per individual. A total of 13 chronic diseases were selected and were further classified into 11 medical conditions to account for multimorbidity. The conditions were heart disease, stroke, diabetes mellitus, hypertension, chronic kidney disease, musculoskeletal disorder, obesity, asthma, vision problem, hearing problem and physical mobility problem. Risk factors for multimorbidity were also analysed. RESULTS Of the study cohort, 28.5% people lived with multimorbidity. The individual prevalence of the chronic conditions ranged from 1.0% to 24.7%, with musculoskeletal disorder (24.7%), obesity (20.7%) and hypertension (18.4%) as the most prevalent chronic conditions. The number of chronic conditions increased linearly with age (p<0.001). In the logistic regression model, multimorbidity is associated with female sex (adjusted OR 1.28, 95% CI 1.17 to 1.40, p<0.001), education levels (primary education compared with no education: adjusted OR 0.63, 95% CI 0.53 to 0.74; secondary education: adjusted OR 0.60, 95% CI 0.51 to 0.70; tertiary education: adjusted OR 0.65, 95% CI 0.54 to 0.80; p<0.001) and employment status (working adults compared with retirees: adjusted OR 0.70, 95% CI 0.60 to 0.82, p<0.001), in addition to age (adjusted OR 1.05, 95% CI 1.05 to 1.05, p<0.001). CONCLUSIONS The current single-disease services in primary and secondary care should be accompanied by strategies to address complexities associated with multimorbidity, taking into account the factors associated with multimorbidity identified. Future research is needed to identify the most commonly occurring clusters of chronic diseases and their risk factors to develop more efficient and effective multimorbidity prevention and treatment strategies.
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Affiliation(s)
- Michelle M C Tan
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Victorian Heart Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - A Matthew Prina
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, University of Edinburgh and Western General Hospital, Scotland, UK
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Sunway City, Selangor, Malaysia
| | - Roshidi Ismail
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Sunway City, Selangor, Malaysia
| | - Esubalew Assefa
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Economics, College of Business and Economics, Jimma University, Jimma, Ethiopia
| | - Ana Á M Keinert
- Departamento de Psiquiatria e Psicologia Médica, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Zaid Kassim
- District Health Office Segamat, Ministry of Health Malaysia, Segamat, Johor, Malaysia
| | - Pascale Allotey
- Department of Sexual and Reproductive Health and Research, World Health Organization (WHO), Geneva, Switzerland
- International Institute for Global Health, United Nations University, Cheras, Kuala Lumpur, Malaysia
| | - Daniel Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Sunway City, Selangor, Malaysia
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
| | - Tin Tin Su
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Sunway City, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Sunway City, Selangor, Malaysia
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Incidence and Predictors of Mortality among Community-Dwelling Older Adults in Malaysia: A 5 Years Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158943. [PMID: 35897315 PMCID: PMC9331297 DOI: 10.3390/ijerph19158943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/30/2022] [Accepted: 07/11/2022] [Indexed: 02/04/2023]
Abstract
With older adults accounting for 10.7% of the Malaysian population, determining the predictors of mortality has now become crucial. Thus, this community-based longitudinal study aimed to investigate the predictors for mortality among community-dwelling older adults using a wide range of factors, including clinical or subclinical. A total of 2322 older adults were interviewed and assessed by trained fieldworkers using validated structured questionnaires. The questionnaire consisted of information on socio-demographic characteristics, health status, neuropsychological and psychosocial functions, lifestyle, dietary intake and biophysical measures. The incidence rate of mortality was 2.9 per 100 person-years. Cox regression analysis indicated that advancing age (Adjusted Hazard Ratio, Adj HR = 1.044, 95% CI: 1.024–1.064), male (Adj HR = 1.937, 95% CI: 1.402–2.675), non-married status (Adj HR = 1.410, 95% CI: 1.078–1.843), smoking (Adj HR = 1.314, 95% CI: 1.004–1.721), a higher fasting blood sugar (Adj HR = 1.075, 95% CI: 1.029–1.166), a lower serum albumin (Adj HR = 0.947, 95% CI: 0.905–0.990), a longer time to complete the TUG test (Adj HR = 1.059, 95% CI: 1.022–1.098), and a lower intake of total dietary fibre (Adj HR = 0.911, 95% CI: 0.873–0.980) were the predictors of mortality in this study. These findings provide an estimated rate of multiethnic mortality in middle-income countries and diet is one of the predictors. These predictors of mortality could be a reference in identifying new public health strategies to ensure longer healthier life spans with lower disability rate among community-dwelling older adults in Malaysia.
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Lee TW, Chung J, Song K, Kim E. Incidence and predictors of multimorbidity among older adults in Korea: a 10-year cohort study. BMC Geriatr 2022; 22:565. [PMID: 35799103 PMCID: PMC9264523 DOI: 10.1186/s12877-022-03250-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to the rapid growth of the older adult population, multimorbidity has become a global concern for an aging society. Multimorbidity has been associated with poor health outcomes, including low quality of life and a high risk of mortality, resulting in an overload of healthcare systems. However, multimorbidity incidence and its related factors are poorly understood among older adults. This study aimed to determine whether sociodemographic characteristics, lifestyle, and psychosocial factors predict multimorbidity incidence among older adults in Korea. METHODS This longitudinal study used the Korean Longitudinal Study of Aging (KLoSA) dataset from 2008 to 2018. The KLoSA is a panel survey of nationally representative samples aimed at providing data for developing socioeconomic policies for the increasing aging population in Korea. The study sample included 1967 older adults aged 65 years and over who had none or one of the chronic diseases at the baseline in 2008. Multimorbidity incidence was defined as the co-existence of two or more chronic diseases among 12 doctor-diagnosed diseases based on self-reports. Cox's proportional hazards models were used to identify significant predictors of multimorbidity incidence over a 10-year follow-up period. RESULTS Among 1967 respondents (female 54.5%, mean age 72.94), 625 (31.8%) incidents of multimorbidity were reported, contributing to 47.5 incidents per 1000 people after 10 years of follow-up. Low levels of social interaction, obesity, past smoking habits, and current or past drinking habits were identified as significant predictors of multimorbidity incidence among older adults in Korea. CONCLUSIONS This study identified older adults at high risk for multimorbidity incidence. These groups require more attention from health care providers in the course of chronic disease monitoring and management. Specific interventions and health policies to promote social interaction and a healthy lifestyle are essential to delay multimorbidity incidence. This longitudinal approach will contribute to developing preventive strategies to reduce the incidence of multimorbidity among older adults.
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Affiliation(s)
- Tae Wha Lee
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Jane Chung
- School of Nursing, Virginia Commonwealth University, Virginia, USA
| | - Kijun Song
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Eunkyung Kim
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea.
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Mira R, Newton T, Sabbah W. Inequalities in the progress of multiple chronic conditions: A systematic review of longitudinal studies. PLoS One 2022; 17:e0263357. [PMID: 35113920 PMCID: PMC8812855 DOI: 10.1371/journal.pone.0263357] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/18/2022] [Indexed: 11/22/2022] Open
Abstract
The objective of this review is to assess the impact of socioeconomic factors on the progress of multiple chronic health conditions (MCC) in Adults. Two independent investigators searched three databases (MEDLINE, EMBASE and LILACS) up to August 2021 to identify longitudinal studies on inequalities in progress of MCC. Grey literature was searched using Open Grey and Google Scholar. Inclusion criteria were retrospective and prospective longitudinal studies; adult population; assessed socioeconomic inequalities in progress of MCC. Quality of included studies and risk of bias were assessed using the Newcastle Ottawa Quality Assessment Scale for longitudinal studies. Nine longitudinal studies reporting socioeconomic inequalities in progress of MCC were included. Two of the studies had poor quality. Studies varied in terms of follow-up time, sample size, included chronic conditions and socioeconomic indicators. Due to high heterogeneity meta-analysis was not possible. The studies showed positive association between lower education (five studies), lower income and wealth (two studies), area deprivation (one study), lower job categories (two studies) and belonging to ethnic minority (two study) and progress of MCC. The review demonstrated socioeconomic inequality in progress of multiple chronic conditions. trial registratiom: The review protocol was registered in the International Prospective Register of Systematic Reviews (CRD42021229564).
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Affiliation(s)
- Rolla Mira
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, United Kingdom
- * E-mail:
| | - Tim Newton
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, United Kingdom
| | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, United Kingdom
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Muhammad T, Boro B, Kumar M, Srivastava S. Gender differences in the association of obesity-related measures with multi-morbidity among older adults in India: evidence from LASI, Wave-1. BMC Geriatr 2022; 22:171. [PMID: 35232371 PMCID: PMC8886975 DOI: 10.1186/s12877-022-02869-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 02/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Co-existence of multiple chronic diseases is increasingly becoming a norm among ageing population. The study aims to investigate the prevalence of multimorbidity and the association between anthropometric measures of obesity and multimorbidity among men and women aged 60 years and above in India. Methods The present study is based on the first wave of the Longitudinal Aging Study in India. The analytical sample size for the study was 28,050 older adults aged 60 years and above. Descriptive statistics and multivariable analysis using logistic regression models were conducted. Results Body Mass Index (BMI) based-obesity is more prevalent among older women than men (26.3% vs. 17.6%). Similarly, higher proportion of older women was at high-risk waist circumference (37.1% vs 8.9%) and waist-hip ratio (78.5 vs 75.4%) than men respectively. In Model-I, after controlling for several covariates, older adults with overweight/obesity were 1.6 times more likely to have multi-morbidity than non-obese older adults (Adjusted OR = 1.61; 95% CI: 1.48–1.74). Similarly, older adults with high-risk waist circumference [Adjusted OR: 1.66; 95% CI: 1.52–1.80] and waist-hip ratio [Adjusted OR: 1.45; 95% CI: 1.33–1.59] also had higher odds of having multi-morbidity in reference to their counterparts. In model-3 it was found that females with high-risk waist-hip ratio had 14% lower odds of multimorbidity than males with high-risk waist-hip ratio [Adjusted OR: 0.86; 95%CI: 0.78–0.94]. Conclusion The findings of the study show significant gender difference in the prevalence of multimorbidity, men being at increased risk in the multivariate analysis which is uncommon in the existing epidemiological research. Interactive effect of male gender with anthropometric measures on multimorbidity reported in our study probably due to increased unhealthy behaviours among men requires further research.
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Affiliation(s)
- T Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Bandita Boro
- Centre for the Study of Regional Development (CSRD), School of Social Sciences-3 (SSS 3), Jawaharlal Nehru University (JNU), New Delhi, 110067, India
| | - Manish Kumar
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
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Feng X, Kelly M, Sarma H. The association between educational level and multimorbidity among adults in Southeast Asia: A systematic review. PLoS One 2021; 16:e0261584. [PMID: 34929020 PMCID: PMC8687566 DOI: 10.1371/journal.pone.0261584] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/03/2021] [Indexed: 12/27/2022] Open
Abstract
Background In Southeast Asia, the prevalence of multimorbidity is gradually increasing. This paper aimed to investigate the association between educational level and multimorbidity among over 15-years old adults in Southeast Asia. Methods We conducted a systematic review of published observational studies. Studies were selected according to eligibility criteria of addressing definition and prevalence of multimorbidity and associations between level of education and multimorbidity in Southeast Asia. The Newcastle-Ottawa Scale (NOS) was used to measure the quality and risk of bias. The methodology has been published in PROSPERO with registered number ID: CRD42021259311. Results Eighteen studies were included in the data synthesis. The results are presented using narrative synthesis due to the heterogeneity of differences in exposures, outcomes, and methodology. The prevalence of multimorbidity ranged from 1.7% to 72.6% among over 18 years-old adults and from 1.5% to 51.5% among older people (≥ 60 years). There were three association patterns linking between multimorbidity and education in these studies: (1) higher education reducing odds of multimorbidity, (2) higher education increasing odds of multimorbidity and (3) education having no association with multimorbidity. The association between educational attainment and multimorbidity also varies widely across countries. In Singapore, three cross-sectional studies showed that education had no association with multimorbidity among adults. However, in Indonesia, four cross-sectional studies found higher educated persons to have higher odds of multimorbidity among over 40-years-old persons. Conclusions Published studies have shown inconsistent associations between education and multimorbidity because of different national contexts and the lack of relevant research in the region concerned. Enhancing objective data collection such as physical examinations would be necessary for studies of the connection between multimorbidity and education. It can be hypothesised that more empirical research would reveal that a sound educational system can help people prevent multimorbidity.
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Affiliation(s)
- Xiyu Feng
- Department of Global Health, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Matthew Kelly
- Department of Global Health, Research School of Population Health, The Australian National University, Canberra, Australia
- * E-mail:
| | - Haribondhu Sarma
- Department of Global Health, Research School of Population Health, The Australian National University, Canberra, Australia
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Shariff Ghazali S, Seman Z, Zainuddin NH, Omar MA, Sooryanarayana R, Ariaratnam S, Mohd Tohit N, Ho BK, Krishnapillai AD, Zainal Abidin SI. Prevalence and factors associated with multimorbidity among older adults in Malaysia: a population-based cross-sectional study. BMJ Open 2021; 11:e052126. [PMID: 34670764 PMCID: PMC8529977 DOI: 10.1136/bmjopen-2021-052126] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To determine the prevalence and factors associated with multimorbidity among community-dwelling older adults in Malaysia. DESIGN A population-based cross-sectional study. SETTING 13 states and 3 Federal Territories in Malaysia. PARTICIPANTS A total of 3966 adults aged 60 years and above were extracted from the nationwide National Health and Morbidity Survey (NHMS) 2018 data set. PRIMARY OUTCOME MEASURES Multimorbidity was defined as co-occurrence of at least two known chronic non-communicable diseases in the same individual. The chronic diseases included hypertension, type 2 diabetes mellitus, dyslipidaemia and cancer. RESULTS The prevalence of multimorbidity among Malaysian older adults was 40.6% (95% CI: 37.9 to 43.3). The factors associated with multimorbidity were those aged 70-79 years (adjusted OR (AOR)=1.30; 95% CI=1.04 to 1.63; p=0.019), of Indian (AOR=1.69; 95% CI=1.14 to 2.52; p=0.010) and Bumiputera Sarawak ethnicities (AOR=1.81; 95% CI=1.14 to 2.89; p=0.013), unemployed (AOR=1.53; 95% CI=1.20 to 1.95; p=0.001), with functional limitation from activities of daily livings (AOR=1.66; 95% CI=1.17 to 2.37; p=0.005), physically inactive (AOR=1.28; 95% CI=1.03 to 1.60; p=0.026), being overweight (AOR=1.62; 95% CI=1.11 to 2.36; p=0.014), obese (AOR=1.88; 95% CI=1.27 to 2.77; p=0.002) and with abdominal obesity (AOR=1.52; 95% CI=1.11 to 2.07; p=0.009). CONCLUSION This study highlighted that multimorbidity was prevalent among older adults in the community. Thus, there is a need for future studies to evaluate preventive strategies to prevent or delay multimorbidity among older adults in order to promote healthy and productive ageing.
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Affiliation(s)
- Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Laboratory of Medical Gerontology, Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Zamtira Seman
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Nabilah Hanis Zainuddin
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Rajini Sooryanarayana
- Elderly Health Sector, Family Health Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Suthahar Ariaratnam
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Cawangan Selangor, Kampus Selayang, Batu Caves, Malaysia
| | - Noorlaili Mohd Tohit
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Cheras, Malaysia
| | - Bee Kiau Ho
- Klinik Kesihatan Bandar Botanik, Ministry of Health Malaysia, Bandar Botanic, Klang, Malaysia
| | - Ambigga Devi Krishnapillai
- Department of Family Medicine, Faculty of Medicine and Health, National Defense University of Malaysia, Kem Sg. Besi, Malaysia
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FARGHALY MAHASSENMOHAMED, SABAH AYMANABDELHAMID, KERAA KHALEDMOHAMED. Association between oral health-related quality of life and general health among dental patients: a cross-sectional study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E67-E74. [PMID: 34322619 PMCID: PMC8283636 DOI: 10.15167/2421-4248/jpmh2021.62.1.1649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022]
Abstract
Globally, the prevalence of chronic diseases is increasing significantly, causing deterioration of oral and general health and therefore quality of life. The present study was designed to assess the relationship between oral health-related quality of life and general health of dental patients. The study is part of the University's plan to achieve the United Nations Sustainable Development Goals number 1, 3, 4 and 5. Dental school students' satisfaction with their early engagement in clinical activities and research work was also evaluated. A convenience sample of 600 subjects attending dental clinics aged ≥18 years of both sexes was included in the study. Second-year dental students conducted the study under the supervision of public health staff members over two successive academic years (2015-2016 and 2016-2017). Oral health-related quality of life was assessed using the Dental Impact on Daily Living (DIDL) questionnaire. Blood pressure, random blood glucose level, body mass index, and waist circumference were measured as indicators of general health. There were statistically significant inverse correlations between DIDL scores and both mean blood pressure (r = -0.215, p < 0.001) and mean blood glucose level (r = -0.272, p < 0.001). Non-significant inverse correlations were observed between DIDL scores and both body mass index (r = -0.062, p = 0.131) and waist circumference (r = -0.040, p = 0.340). Students' satisfaction scores with research activities were high, ranging from 75.9% to 78%. Dentists must raise patients' awareness about the importance of oral health and its impact on their quality of life and general health. Participation of dental students in dental research is encouraged even in their early academic years.
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Affiliation(s)
| | | | - KHALED MOHAMED KERAA
- Correspondence: Khaled Mohamed Keraa, Faculty of Oral & Dental Medicine, Misr International University, Cairo, Egypt - E-mail:
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15
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Plasma metabolites to profile pathways in noncommunicable disease multimorbidity. Nat Med 2021; 27:471-479. [PMID: 33707775 PMCID: PMC8127079 DOI: 10.1038/s41591-021-01266-0] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 01/27/2021] [Indexed: 02/07/2023]
Abstract
Multimorbidity, the simultaneous presence of multiple chronic conditions, is an increasing global health problem and research into its determinants is of high priority. We used baseline untargeted plasma metabolomics profiling covering >1,000 metabolites as a comprehensive readout of human physiology to characterize pathways associated with and across 27 incident noncommunicable diseases (NCDs) assessed using electronic health record hospitalization and cancer registry data from over 11,000 participants (219,415 person years). We identified 420 metabolites shared between at least 2 NCDs, representing 65.5% of all 640 significant metabolite-disease associations. We integrated baseline data on over 50 diverse clinical risk factors and characteristics to identify actionable shared pathways represented by those metabolites. Our study highlights liver and kidney function, lipid and glucose metabolism, low-grade inflammation, surrogates of gut microbial diversity and specific health-related behaviors as antecedents of common NCD multimorbidity with potential for early prevention. We integrated results into an open-access webserver ( https://omicscience.org/apps/mwasdisease/ ) to facilitate future research and meta-analyses.
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16
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Kudesia P, Salimarouny B, Stanley M, Fortin M, Stewart M, Terry A, Ryan BL. The incidence of multimorbidity and patterns in accumulation of chronic conditions: A systematic review. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2021; 11:26335565211032880. [PMID: 34350127 PMCID: PMC8287424 DOI: 10.1177/26335565211032880] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/24/2021] [Indexed: 12/17/2022]
Abstract
Multimorbidity, the presence of 1+ chronic condition in an individual, remains one of the greatest challenges to health on a global scale. Although the prevalence of multimorbidity has been well-established, its incidence is not fully understood. This systematic review determined the incidence of multimorbidity across the lifespan; the order in which chronic conditions accumulate to result in multimorbidity; and cataloged methods used to determine and report accumulation of chronic conditions resulting in multimorbidity. Studies were identified by searching MEDLINE, Embase, CINAHL, and Cochrane electronic databases. Two independent reviewers evaluated studies for inclusion and performed quality assessments. Of 36 included studies, there was high heterogeneity in study design and operational definitions of multimorbidity. Studies reporting incidence (n = 32) reported a median incidence rate of 30.7 per 1,000 person-years (IQR 39.5 per 1,000 person-years) and a median cumulative incidence of 2.8% (IQR 28.7%). Incidence was notably higher for persons with older age and 1+ chronic conditions at baseline. Studies reporting patterns in accumulation of chronic conditions (n = 5) reported hypertensive and heart diseases, and diabetes, as among the common starting conditions resulting in later multimorbidity. Methods used to discern patterns were highly heterogenous, ranging from the use of latent growth trajectories to divisive cluster analyses, and presentation using alluvial plots to cluster trajectories. Studies reporting the incidence of multimorbidity and patterns in accumulation of chronic conditions vary greatly in study designs and definitions used. To allow for more accurate estimations and comparison, studies must be transparent and consistent in operational definitions of multimorbidity applied.
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Affiliation(s)
- Prtha Kudesia
- Schulich Interfaculty Program in Public Health, University of Western
Ontario, London, Ontario, Canada
| | - Banafsheh Salimarouny
- Schulich Interfaculty Program in Public Health, University of Western
Ontario, London, Ontario, Canada
| | - Meagan Stanley
- Allyn & Betty Taylor Library, University of Western
Ontario, London, Ontario, Canada
| | - Martin Fortin
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Moira Stewart
- Centre for Studies in Family Medicine & Department of Family
Medicine, Schulich School of Medicine & Dentistry, University of Western
Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, University of Western Ontario, London, Ontario,
Canada
| | - Amanda Terry
- Schulich Interfaculty Program in Public Health, University of Western
Ontario, London, Ontario, Canada
- Centre for Studies in Family Medicine & Department of Family
Medicine, Schulich School of Medicine & Dentistry, University of Western
Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, University of Western Ontario, London, Ontario,
Canada
| | - Bridget L Ryan
- Centre for Studies in Family Medicine & Department of Family
Medicine, Schulich School of Medicine & Dentistry, University of Western
Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, University of Western Ontario, London, Ontario,
Canada
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Abebe F, Schneider M, Asrat B, Ambaw F. Multimorbidity of chronic non-communicable diseases in low- and middle-income countries: A scoping review. JOURNAL OF COMORBIDITY 2020; 10:2235042X20961919. [PMID: 33117722 PMCID: PMC7573723 DOI: 10.1177/2235042x20961919] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/07/2020] [Indexed: 12/14/2022]
Abstract
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.
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Affiliation(s)
- Fantu Abebe
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.,Jhpiego Corporation, Ethiopia Country Office, Bahir Dar, Ethiopia
| | - Marguerite Schneider
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Biksegn Asrat
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Fentie Ambaw
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Seo S. Multimorbidity Development in Working People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4749. [PMID: 31783589 PMCID: PMC6926901 DOI: 10.3390/ijerph16234749] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 11/22/2019] [Accepted: 11/23/2019] [Indexed: 12/13/2022]
Abstract
Multimorbidity is defined as the coexistence of multiple chronic conditions in one person. It affects the way people lead their lives and might be a heavy burden, especially for those with limited material resources. This study explores the prevalence of multimorbidity in the working population and discusses the distribution of multimorbidity in specific sub-groups. We conducted a longitudinal analysis of nationally representative data in South Korea (Korea Health Panel, 2010-2015). Generalized estimation models were applied to examine the individual effect of socioeconomic status (SES) and job-related variables. We found that about five percent of workers who initially had no or one chronic condition developed multimorbidity during within five years. About 20% of working women had multimorbidity at age 55, about 10 years earlier than working men. A higher prevalence appeared in working women with school-age children, non-standard employment, no autonomy at work, or unskilled occupation. SES was significantly associated with a higher prevalence of multimorbidity in both gender after controlling for the effect of age and other covariates. Multimorbidity is a major health concern in the working population and prevention and control should be promoted in the workplace.
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Affiliation(s)
- Sukyong Seo
- College of Nursing, Eulji University, Seongnam 13135, Korea
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19
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Hussin NM, Shahar S, Yahya HM, Din NC, Singh DKA, Omar MA. Incidence and predictors of mild cognitive impairment (MCI) within a multi-ethnic Asian populace: a community-based longitudinal study. BMC Public Health 2019; 19:1159. [PMID: 31438929 PMCID: PMC6704715 DOI: 10.1186/s12889-019-7508-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 08/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Limited information is available from longitudinal studies regarding the predictors and incidence of MCI in older Asian adults. Thus, a community-based longitudinal study was conducted to determine the incidence of MCI among multi-ethnic older adults in Malaysia. The role of health and lifestyle as predictors of MCI was also examined. METHODS Analysis of data obtained from the Towards Useful Aging (TUA) study (2014-2016), wave 1 (baseline) and wave 2 (1½ years of follow-up) was conducted. For the baseline, comprehensive, interview-based questionnaires were administered to 1227 subjects who were 60 years old and above. MCI is a unique transitional state between normal ageing and dementia. MCI characteristics include a decline and disturbance of cognition, minimal impairment of complex activities, ability to perform regular daily functions, and absence of dementia. The incidence of MCI was assessed using comprehensive neuropsychological batteries. The study then performed a logistic regression analysis to examine the effect of each possible predictor of MCI. This analysis began with univariate analyses and a separate review of the effect of every variable. Binary logistic analyses followed hereafter. RESULTS During the follow-up after 1½ years, 179 (14.6%) of the participants who did not exhibit MCI at baseline were observed to have developed MCI. Among the participants who did not exhibit MCI at baseline, the incidence rate was 10.5 per 100 person-years. Male sex and lack of engagement in mental activities were predictors of MCI among participants without MCI at baseline. CONCLUSION After the 1½-year follow-up, the incidence rate for MCI was considerably high among the respondents. Being male and being less engaged in mental activities were predictors of the occurrence of MCI. Mental activities need to be promoted for the prevention of MCI incidence among older adults.
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Affiliation(s)
- Norlela Mohd Hussin
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia.
| | - Hanis Mastura Yahya
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Centre of Rehabilitation Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Mohd Azahadi Omar
- Institute of Public Health, Ministry of Health, Jalan Bangsar, Federal Hill, 59000, Kuala Lumpur, Malaysia
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Rosli TI, Chan YM, Kadir RA, Hamid TAA. Association between oral health-related quality of life and nutritional status among older adults in district of Kuala Pilah, Malaysia. BMC Public Health 2019; 19:547. [PMID: 31196031 PMCID: PMC6565524 DOI: 10.1186/s12889-019-6867-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Background Poor oral health has an impact on food choices and intake of important nutrients among older population. The use of oral health-related quality of life instruments along with the clinical dental indicators can help to assess the oral problems that lead to nutritional problems in this group. This study aims to determine the association between oral health-related quality of life (OHRQoL) and nutritional status among a group of older adults in Kuala Pilah district, Malaysia. Methods A cross-sectional study was carried out on 446 older adults aged 50 years and above from 20 randomly selected villages. Respondents were interviewed to collect information on their demographic characteristics and oral health perception, followed by physical examination to measure height, weight and body mass index (BMI) of respondents. The validated Malay version of General Oral Health Assessment Index (GOHAI) was used to measure OHRQoL. Results About one-third (35.8%) of the respondents had normal BMI. Majority of the respondents were overweight (40.4%) and obese (19.9%), while only a small proportion was underweight (3.9%). Mean GOHAI score was 53.3 (SD = 4.7), indicating low perception of oral health. About 81.6% respondents had moderate to low perception of oral health. Logistic regression analysis showed a statistically significant association between the GOHAI and BMI scores (OR = 2.3; p < 0.01). Conclusions Oral health-related quality of life was significantly associated with nutritional condition of respondents. Older adults with poor perception of their oral health were more likely to have unsatisfactory BMI compared to those who perceived their oral health to be good.
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Affiliation(s)
- Tanti Irawati Rosli
- Department of Dental Public Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Wilayah Persekutuan, Malaysia. .,Malaysian Research Institute on Ageing, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia.
| | - Yoke Mun Chan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia
| | - Rahimah Abdul Kadir
- Faculty of Dentistry, Lincoln University College, No 2, Jalan Stadium, SS 7/15 Kelana Jaya, 47301, Petaling Jaya, Selangor, Malaysia
| | - Tengku Aizan Abdul Hamid
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia
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