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Di J, Bai J, Zhang J, Chen J, Hao Y, Bai J, Xiang C. Regional disparities, age-related changes and sex-related differences in knee osteoarthritis. BMC Musculoskelet Disord 2024; 25:66. [PMID: 38225636 PMCID: PMC10788997 DOI: 10.1186/s12891-024-07191-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/10/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND The objective of the study is to analyse the regions, age and sex differences in the incidence of knee osteoarthritis (KOA). METHODS Data were extracted from the global burden of diseases (GBD) 2019 study, including incidence, years lived with disability (YLD), disability-adjusted life-years (DALYs) and risk factors. Estimated annual percentage changes (EAPCs) were calculated to quantify the temporal trends in age standardized rate (ASR) of KOA. Paired t-test, paired Wilcoxon signed-rank test and spearman correlation were performed to analyze the association of sex disparity in KOA and socio-demographic index (SDI). RESULTS There were significant regional differences in the incidence of knee osteoarthritis. In 2019, South Korea had the highest incidence of knee osteoarthritis (474.85,95%UI:413.34-539.64) and Thailand had the highest increase in incidence of knee osteoarthritis (EAPC = 0.56, 95%CI = 0.54-0.58). Notably, higher incidence, YLD and DALYs of knee osteoarthritis were associated with areas with a high socio-demographic index (r = 0.336, p < 0.001; r = 0.324, p < 0.001; r = 0.324, p < 0.001). In terms of age differences, the greatest increase in the incidence of knee osteoarthritis was between the 35-39 and 40-44 age groups. (EAPC = 0.52, 95%CI = 0.40-0.63; 0.47, 95%CI = 0.36-0.58). In addition, there were significant sex differences in the disease burden of knee osteoarthritis (P < 0.001). CONCLUSIONS The incidence of knee osteoarthritis is significantly different with regions, age and sex.
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Affiliation(s)
- Jingkai Di
- Department of Orthopedics, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiang Bai
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Junrui Zhang
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiaoyang Chen
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yuxuan Hao
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiaqi Bai
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Chuan Xiang
- Department of Orthopedics, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
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RICHARDSON ROBINA, KEYES KATHERINEM, CHEN CYNTHIA, MAUNG GUANYUNKENWIN, ROWE JOHN, CALVO ESTEBAN. Societal Adaptation to Aging and Prevalence of Depression Among Older Adults: Evidence From 20 Countries. Milbank Q 2023; 101:426-456. [PMID: 37078302 PMCID: PMC10262389 DOI: 10.1111/1468-0009.12646] [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: 09/13/2022] [Revised: 01/18/2023] [Accepted: 02/06/2023] [Indexed: 04/21/2023] Open
Abstract
Policy Points Countries have adopted different strategies to support aging populations, which are broadly reflected in social, economic, and contextual environments. Referred to as "societal adaptation to aging," these factors affect countries' capacity to support older adults. Results from our study show that countries with more robust societal adaptation to aging had lower depression prevalence. Reductions in depression prevalence occurred among every investigated sociodemographic group and were most pronounced among the old-old. Findings suggest that societal factors have an underacknowledged role in shaping depression risk. Policies that improve societal approaches to aging may reduce depression prevalence among older adults. CONTEXT Countries have adopted various formal and informal approaches to support older adults, which are broadly reflected in different policies, programs, and social environments. These contextual environments, broadly referred to as "societal adaptation to aging," may affect population health. METHODS We used a new theory-based measure that captured societal adaptation to aging, the Aging Society Index (ASI), which we linked with harmonized individual-level data from 89,111 older adults from 20 countries. Using multi-levels models that accounted for differences in the population composition across countries, we estimated the association between country-level ASI scores and depression prevalence. We also tested if associations were stronger among the old-old and among sociodemographic groups that experience more disadvantage (i.e., women, those with lower educational attainment, unmarried adults). FINDINGS We found that countries with higher ASI scores, indicating more comprehensive approaches to supporting older adults, had lower depression prevalence. We found especially strong reductions in depression prevalence among the oldest adults in our sample. However, we did not find stronger reductions among sociodemographic groups who may experience more disadvantage. CONCLUSIONS Country-level strategies to support older adults may affect depression prevalence. Such strategies may become increasingly important as adults grow older. These results offer promising evidence that improvements in societal adaptation to aging-such as through adoption of more comprehensive policies and programs targeting older adults-may be one avenue to improve population mental health. Future research could investigate observed associations using longitudinal and quasi-experimental study designs, offering additional information regarding a potential causal relationship.
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Affiliation(s)
| | | | - CYNTHIA CHEN
- Saw Swee Hock School of Public HealthNational University of Singapore
| | | | - JOHN ROWE
- Mailman School of Public HealthColumbia University
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies
| | - ESTEBAN CALVO
- Mailman School of Public HealthColumbia University
- Society and Health Research CenterSchool of Public HealthUniversidad Mayor
- Laboratory on Aging and Social Epidemiology, Facultad de Ciencias Sociales y ArtesUniversidad Mayor
- Millennium Nucleus on Sociomedicine
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Yu DSF, Li PWC, Lin RSY, Kee F, Chiu A, Wu W. Effects of non-pharmacological interventions on loneliness among community-dwelling older adults: A systematic review, network meta-analysis, and meta-regression. Int J Nurs Stud 2023; 144:104524. [PMID: 37295285 DOI: 10.1016/j.ijnurstu.2023.104524] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND The highly prevalent late-life loneliness, together with its deleterious health impacts, calls for increasing attention to the need for effective interventions targeting on this growing public health problem. With the increasing evidence on interventions for combating loneliness, it is timely to identify their comparative effectiveness. OBJECTIVE This systematic review, meta-analysis and network meta-analysis was to identify and compare the effects of various non-pharmacological interventions on loneliness in community-dwelling older adults. METHODS Systematic search was conducted in nine electronic databases from inception to 30th March 2023 for studies investigating the effects of non-pharmacological interventions on loneliness among community-dwelling older adults. The interventions were categorized according to the nature and purpose of use. Pairwise meta-analysis and network meta-analyses were sequentially performed to identify the effects of each category of interventions and their comparative intervention effectiveness, respectively. Meta-regression was performed to examine any influence of study design and participants' characteristics on the intervention effectiveness. The study protocol was registered at PROSPERO (CRD42022307621). RESULTS A total of 60 studies with 13,295 participants were included. The interventions were categorized as psychological interventions, social support interventions (by digital and non-digital means), behavioral activation, exercise intervention with and without social engagement, multi-component intervention and health promotion. Pairwise meta-analysis identified the positive effect of psychological interventions (Hedges' g = -2.33; 95%CI [-4.40, -0.25]; Z = -2.20, p = 0.003), non-digital social support interventions (Hedges' g = -0.63; 95%CI [-1.16, -0.10]; Z = 2.33, p = 0.02) and multi-component interventions (Hedges' g = -0.28 95%CI [-0.54, -0.03]; Z = -2.15, p = 0.03) on reducing loneliness. Subgroup analysis provided additional insights: i) social support and exercise interventions which integrated active strategies to optimize the social engagement demonstrated more promising intervention effects; ii) behavioral activation and multicomponent interventions worked better for older adults who were male or reported loneliness, respectively, and iii) counseling-based psychological interventions was more effective than mind-body practice. Network meta-analysis consistently pointed to the greatest therapeutic benefits of psychological interventions, and this was followed by exercise-based interventions, non-digital social support interventions and behavioral activation. Meta-regression further suggested that the therapeutic effects of the tested interventions were independent of the various factors relating to study design and participants' characteristics. CONCLUSIONS This review highlights the more superior effects of psychological interventions in improving loneliness among older adults. Interventions which have an attribute to optimize social dynamic and connectivity may also be effective. TWEETABLE ABSTRACT Psychological intervention is the best to beat late-life loneliness, but increasing social dynamic and connectivity may add an impact.
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Affiliation(s)
- Doris Sau-Fung Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong.
| | - Polly Wai-Chi Li
- School of Nursing, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Rose Sin-Yi Lin
- School of Nursing, University of Rochester, United States of America
| | - Frank Kee
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Alice Chiu
- Improving Health Outcomes Together Team, Alberta Health Services, Calgary, Alberta, Canada
| | - Wendy Wu
- School of Nursing, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
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Hallam L, McKenzie BL, Gong J, Carcel C, Hockham C. Contextualising sex and gender research to improve women's health: An early- and mid-career researcher perspective. Front Glob Womens Health 2022; 3:942876. [PMID: 35928054 PMCID: PMC9343614 DOI: 10.3389/fgwh.2022.942876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
The field of sex and gender research in health and medicine is growing, and many early- and mid-career researchers (EMCRs) are developing skills in this area. As EMCRs specialising in sex and gender research, we aim to better understand sex- and gender-based determinants of human health, challenge long-standing and pervasive gender biases, and contribute to improving the evidence base upon which clinical guidelines and policy interventions are developed. To effectively achieve these goals, we believe that EMCRs would benefit from understanding the challenges of working in this space and participate in driving change in three key areas. First, in creating greater links between the goals of sex and gender research and addressing systemic bias against women and gender minorities, to effectively translate knowledge about sex and gender differences into improved health outcomes. Second, in expanding the reach of sex and gender research to address women's health in an intersectional way and ensure that it also benefits the health of men, transgender and gender-diverse people and those who are intersex. Third, in working with others in the scientific community to improve methods for sex and gender research, including updating data collection practises, ensuring appropriate statistical analyses and shifting scientific culture to recognise the importance of null findings. By improving focus on these three areas, we see greater potential to translate this research to improve women's health and reduce health inequities for all.
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Affiliation(s)
- Laura Hallam
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- Australian Human Rights Institute, University of New South Wales, Sydney, NSW, Australia
- *Correspondence: Laura Hallam
| | - Briar L. McKenzie
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Jessica Gong
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Cheryl Carcel
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Carinna Hockham
- The George Institute for Global Health, Imperial College London, London, United Kingdom
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Kautzky-Willer A, Kaleta M, Lindner SD, Leutner M, Thurner S, Klimek P. Sex Differences in Clinical Characteristics and Outcomes of Patients with SARS-CoV-2-Infection Admitted to Intensive Care Units in Austria. J Pers Med 2022; 12:jpm12040517. [PMID: 35455633 PMCID: PMC9026885 DOI: 10.3390/jpm12040517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/04/2023] Open
Abstract
Importance: A male predominance is reported in hospitalised patients with COVID-19 alongside a higher mortality rate in men compared to women. Objective: To assess if the reported sex bias in the COVID-19 pandemic is validated by analysis of a subset of patients with severe disease. Design: A nationwide retrospective cohort study was performed using the Austrian National COVID Database. We performed a sex-specific Lasso regression to select the covariates best explaining the outcomes of mechanical ventilation and death using variables known before ICU admission. We use logistic regression to construct a sex-specific “risk score” for the outcomes using these variables. Setting: We studied the characteristics and outcomes of patients admitted to intensive care units (ICUs) in Austria. Participants: 5118 patients admitted to the ICU in Austria with a COVID-19 diagnosis in 03/2020–03/2021. Exposures: Demographic and clinical characteristics, vital signs and laboratory tests, comorbidities, and management of patients admitted to ICUs were analysed for possible sex differences. Main outcomes and measures: The aim was to define risk scores for mechanical ventilation and mortality for each sex to provide better sex-sensitive management and outcomes in the future. Results: We found balanced accuracies between 55% and 65% to predict the outcomes. Regarding outcome death, we found that the risk score for pre-ICU variables increases with age, renal insufficiency (f: OR 1.7(2), m: 1.9(2)) and decreases with observance as admission cause (f: OR 0.33(5), m: 0.36(5)). Additionally, the risk score for females also includes respiratory insufficiency (OR 2.4(4)) while heart failure for males only (OR 1.5(1)). Conclusions and relevance: Better knowledge of how sex influences COVID-19 outcomes at ICUs will have important implications for the ongoing pandemic’s clinical care and management strategies. Identifying sex-specific features in individuals with COVID-19 and fatal consequences might inform preventive strategies and public health services.
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Affiliation(s)
- Alexandra Kautzky-Willer
- Department of Internal Medicine III, Clinical Division of Endocrinology and Metabolism, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria; (A.K.-W.); (M.L.)
- Gender Institute, A-3571 Gars am Kamp, Austria
| | - Michaela Kaleta
- Section for Science of Complex Systems, CeMSIIS, Medical University of Vienna, Spitalgasse 23, A-1090 Vienna, Austria; (M.K.); (S.D.L.); (S.T.)
- Complexity Science Hub Vienna, Josefstädter Strasse 39, A-1080 Vienna, Austria
| | - Simon D. Lindner
- Section for Science of Complex Systems, CeMSIIS, Medical University of Vienna, Spitalgasse 23, A-1090 Vienna, Austria; (M.K.); (S.D.L.); (S.T.)
- Complexity Science Hub Vienna, Josefstädter Strasse 39, A-1080 Vienna, Austria
| | - Michael Leutner
- Department of Internal Medicine III, Clinical Division of Endocrinology and Metabolism, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria; (A.K.-W.); (M.L.)
| | - Stefan Thurner
- Section for Science of Complex Systems, CeMSIIS, Medical University of Vienna, Spitalgasse 23, A-1090 Vienna, Austria; (M.K.); (S.D.L.); (S.T.)
- Complexity Science Hub Vienna, Josefstädter Strasse 39, A-1080 Vienna, Austria
- Santa Fe Institute, 1399 Hyde Park Road, Santa Fe, NM 85701, USA
| | - Peter Klimek
- Section for Science of Complex Systems, CeMSIIS, Medical University of Vienna, Spitalgasse 23, A-1090 Vienna, Austria; (M.K.); (S.D.L.); (S.T.)
- Complexity Science Hub Vienna, Josefstädter Strasse 39, A-1080 Vienna, Austria
- Correspondence:
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Lewandowska J, Tomaczak M, Wilk I, Lwow F. Obesity and low levels of physical activity are associated with a decreased health-related quality of life
in postmenopausal women: a Wroclaw pilot study. MEDICAL SCIENCE PULSE 2021. [DOI: 10.5604/01.3001.0015.3944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Menopause is associated with numerous somatic dysfunctions, an increased risk of chronic
diseases, and complications in the mental and social components of health that lower the quality of life
(QoL). Obesity and related comorbidities affect over 60% of postmenopausal women in Poland. A significant
role for systematic physical activity (PA) in the prevention of dysfunctions and chronic diseases, including
obesity and mental disorders, has been observed previously. A low level of PA is observed across the Polish
population, especially in postmenopausal women.
Aim of the study: To examine QoL in postmenopausal women participating in a community health promotion
program as it relates to obesity and levels of PA.
Material and methods: The study sample consisted of 76 postmenopausal women (aged 65.75±5.14 years)
participating in the Active Wrocław 55+ program. Before starting the program, anthropometric measurements
were taken, and QoL and PA were assessed using the 36-Item Short Form Health Survey (SF-36) and
the International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively.
Results: Most women had a PA level above 600 MET -min/week (78.95%), and were overweight or obese
(86.84%). A waist circumference over 80 cm, indicating an increased risk for metabolic syndrome, was observed
in 85.89% of the participants. BMI and waist circumference negatively correlated with the level of PA
(p=0.001 and p=0.017, respectively). Women exhibiting low levels of PA and higher BMIs showed a significantly
lower QoL compared to those with higher PA and lower BMIs, particularly with regard to the physical
domains of QoL.
Conclusions: Obesity and a low level of PA are associated with a significant decline in the health-related QoL
(especially in the PF and PCS domains) of postmenopausal women an urban setting.
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Affiliation(s)
- Joanna Lewandowska
- Department of Physiotherapy, University School of Physical Education in Wroclaw, Poland
| | - Mateusz Tomaczak
- Department of Physiotherapy, University School of Physical Education in Wroclaw, Poland
| | - Iwona Wilk
- Department of Physiotherapy, University School of Physical Education in Wroclaw, Poland
| | - Felicja Lwow
- Department of Physiotherapy, University School of Physical Education in Wroclaw, Poland
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Why we need ageing research sensitive to age and gender. THE LANCET. HEALTHY LONGEVITY 2021; 2:e445-e446. [DOI: 10.1016/s2666-7568(21)00149-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 06/14/2021] [Indexed: 11/22/2022] Open
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