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Huang B, Hua J, Liu S, Wang X, Sun Z, Bai R, Dong W. Temporal trends in disease burden and attributable risk factors for tracheal, bronchus, and lung cancer in Nepal, 1990-2019. Cancer Epidemiol 2024; 88:102497. [PMID: 38007840 DOI: 10.1016/j.canep.2023.102497] [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: 08/17/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Tracheal, bronchus, and lung (TBL) cancer is one of the most common cancers in Nepal. The aim of this study was to analyze the changing disease burden and risk factors for TBL cancer in Nepal from 1990 to 2019. METHODS TBL cancer burden data were obtained from the Global Burden of Disease Study 2019. A decomposition analysis was used to explore the impact of changes in population size, population age structure, age-specific prevalence, and disease severity on long-term trends of the TBL cancer burden in Nepal. RESULTS In 2019, TBL cancer resulted in the loss of 45.2 thousand (95% uncertainty interval [UI]: 32.3-59.2 thousand) disability-adjusted life years (DALYs) in Nepal, with the age-standardized incidence and prevalence rates increasing by 12.7% (95% UI: -21.0 to 63.9%) and 12.8% (95% UI: -21.1 to 62.0%), respectively, compared with 1990. The proportion of DALYs due to TBL cancer increased significantly among people aged 70 years and older from 1990 to 2019. However, the proportion of DALYs due to TBL cancer still dominated among males and females aged 50-69 years. Population growth, population aging, and increased age-specific prevalence led to an increased disease burden of TBL cancer, while disease severity led to a decreased burden. In 2019, smoking remained the major risk factor for TBL cancer in Nepal, while ambient particulate matter pollution exhibited the most significant rise. CONCLUSIONS The disease burden of TBL cancer in Nepal has continued to increase over the past three decades, and given the continuing population growth and aging process, TBL cancer is likely to have a considerable impact on health in Nepal in the future. There is a need to further establish effective TBL cancer prevention and control policies.
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Affiliation(s)
- Binfang Huang
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Jinchao Hua
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Shanshan Liu
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Xu Wang
- Department of Science and Technology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Zhonghe Sun
- Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
| | - Ruhai Bai
- School of Public Affairs, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Wanyue Dong
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing 210023, China.
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Shrestha A, Ghimire S, Kinney J, Mehta R, Mistry SK, Saito S, Rayamajhee B, Sharma D, Mehta S, Yadav UN. The role of family support in the self-rated health of older adults in eastern Nepal: findings from a cross-sectional study. BMC Geriatr 2024; 24:20. [PMID: 38178009 PMCID: PMC10768249 DOI: 10.1186/s12877-023-04619-1] [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: 08/15/2023] [Accepted: 12/17/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Nepal's low fertility rate and increasing life expectancy have resulted in a burgeoning older population. For millennia, filial piety shaped family cohesion and helped Nepali older adults achieve positive outcomes, but recently, it has been eroding. Furthermore, there are not enough institutional support options or alternatives to family-based care to deal with the biosocial needs of older adults. This study explored the association between family support and self-rated health among Nepali older adults. METHODS A community-based cross-sectional survey in eastern Nepal's two districts, Sunsari and Morang, interviewed 847 older adults (≥ 60 years). The final analytical sample was 844. Participants were asked whether they received assistance with various aspects of daily life and activities of daily living from their families. Multivariable logistic regression examined the association between family support and self-rated health. RESULTS Participants who received support with various aspects of daily life had 43% higher odds of good health, but after adjusting for control variables, the result only approached statistical significance (p = 0.087). Those who received family assistance with activities of daily living had nearly four times higher odds (OR: 3.93; 95% CI: 2.58 - 5.98) of reporting good health than participants who lacked this support. CONCLUSIONS Given the important role of family support in Nepali older adults' health, government programs and policies should create a conducive environment to foster family-based care until more comprehensive policies for older adults' care can be put into effect. The results of this study can also help shape the global aging environment by highlighting the need for family support in older care, particularly in low-income nations with declining traditional care systems and weak social security policies.
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Affiliation(s)
- Aman Shrestha
- Department of Sociology & Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, USA
| | - Saruna Ghimire
- Department of Sociology & Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, USA
| | - Jennifer Kinney
- Department of Sociology & Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, USA
| | - Ranju Mehta
- Little Buddha College of Health Sciences, Kathmandu, Bagmati, Nepal
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Shoko Saito
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Binod Rayamajhee
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
| | - Deepak Sharma
- School of Health Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Suresh Mehta
- Koshi Province Ministry of Health, Biratnagar, Koshi, Nepal
| | - Uday Narayan Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia.
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Acharya T, Dhungana GK, Traille K, Dhakal H. Senior Citizens in Nepal: Policy Gaps and Recommendations. Gerontol Geriatr Med 2023; 9:23337214231179902. [PMID: 37333481 PMCID: PMC10272673 DOI: 10.1177/23337214231179902] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/05/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Limited research has been conducted on the views of senior citizens in Nepal with regards to contemporary challenges and aging issues. To better understand their existing problems, it is important to talk to and survey senior citizens and reflect on their experiences and insights. The Senior Citizens Acts, 2063 in Nepal defines senior citizens as individuals who have reached the age of 60 years or above. With an increase in life expectancy rates, the senior citizen population in Nepal is on the rise. However, despite the guarantees of rights outlined in the policy, little attention has been paid to the needs of the elderly population. This knowledge can help inform policies and programs that improve their quality of life and well-being. Therefore, this study aims to collect the lived experiences of older generations across Nepal, including information about the society, culture, and hardships they faced. The research aims to contribute to existing literature on the experiences of the elderly and inform policies related to senior citizens. A mixed-methods approach was used for this study, incorporating both primary and secondary sources. The primary data was collected through an informal survey posted on Facebook targeting senior citizens in Nepal which generated 100 responses from senior citizens aged 65 years or older within a 2-week period.
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Affiliation(s)
- Tulasi Acharya
- Nexus Institute of Research and Innovation(NIRI), Nepal
- South Georgia State College, Douglas, GA, USA
| | | | - Kay Traille
- Kennesaw State University, Kennesaw, GA, USA
| | - Hemraj Dhakal
- Nexus Institute of Research and Innovation(NIRI), Nepal
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Briceño EM, Dhakal U, Sharma U, Adhikari N, Pradhan MS, Shrestha L, Jalan P, Rai J, Langa KM, Lee J, Ghimire D, Mendes de Leon CF. Neuropsychological Assessment of Older Adults in Nepal for Population-Based Dementia Ascertainment: Needs, Challenges, and Opportunities. J Alzheimers Dis 2023; 96:1339-1352. [PMID: 37980674 PMCID: PMC10739926 DOI: 10.3233/jad-230906] [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] [Indexed: 11/21/2023]
Abstract
The population of Nepal is rapidly aging, as in other low and middle-income countries, and the number of individuals living with Alzheimer's Disease and related dementias (ADRD) is expected to increase. However, information about the neuropsychological assessment of ADRD in Nepal is lacking. We first aimed to examine the needs, challenges, and opportunities associated with the neuropsychological assessment of older adults in Nepal for population-based ADRD ascertainment. Second, we introduce the Chitwan Valley Family Study-Study of Cognition and Aging in Nepal (CVFS-SCAN), which is poised to address these needs, and its collaboration with the Harmonized Cognitive Assessment Protocol (HCAP) international network. We reviewed the existing literature on the prevalence, risk factors, available neuropsychological assessment instruments, and sociocultural factors that may influence the neuropsychological assessment of older adults for ADRD ascertainment in Nepal. Our review revealed no existing population-based data on the prevalence of ADRD in Nepal. Very few studies have utilized formal cognitive assessment instruments for ADRD assessment, and there have been no comprehensive neuropsychological assessment instruments that have been validated for the assessment of ADRD in Nepal. We describe how the CVFS-SCAN study will address this need through careful adaptation of the HCAP instrument. We conclude that the development of culturally appropriate neuropsychological assessment instruments is urgently needed for the population-based assessment of ADRD in Nepal. The CVFS-SCAN is designed to address this need and will contribute to the growth of global and equitable neuropsychology and to the science of ADRD in low- and middle-income countries.
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Affiliation(s)
- Emily M. Briceño
- Departments of Physical Medicine & Rehabilitation and Neurology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Usha Dhakal
- Department of Sociology & Gerontology, Miami University, Oxford, Ohio, USA
| | - Uttam Sharma
- Institute for Social and Environmental Research-Nepal (ISER-N), Bharatpur-15, Chitwan, Nepal
| | - Nabin Adhikari
- Institute for Social and Environmental Research-Nepal (ISER-N), Bharatpur-15, Chitwan, Nepal
| | - Meeta S. Pradhan
- Institute for Social and Environmental Research-Nepal (ISER-N), Bharatpur-15, Chitwan, Nepal
| | | | | | - Janak Rai
- Central Department of Anthropology, Tribhuvan University, Nepal
| | - Kenneth M. Langa
- Survey Research Center, University of Michigan Institute for Social Research, Ann Arbor, MI, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Jinkook Lee
- Department of Economics, University of Southern California, Los Angeles, CA, USA
| | - Dirgha Ghimire
- Institute for Social and Environmental Research-Nepal (ISER-N), Bharatpur-15, Chitwan, Nepal
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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