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Pengpid S, Peltzer K. Loneliness and associated factors among middle-aged and older adults: cross-sectional and longitudinal survey results from the HAALSI cohort in South Africa. Aging Ment Health 2024; 28:1179-1187. [PMID: 38726552 DOI: 10.1080/13607863.2024.2345777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/15/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVES Longitudinal studies on chronic loneliness and before and during the COVID-19 pandemic are lacking in Africa. The study aimed to estimate the prevalence and associated factors of loneliness and chronic loneliness using cross-sectional and longitudinal data from middle-aged and older adults from rural South Africa. METHOD The analysis utilized data from the South African 7-year longitudinal Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) (analytic sample: n = 3,418, aged 40 years and older). Loneliness was assessed with a single and 3-item measure. RESULTS The proportion of loneliness was 19.5% in the 2021/2022 survey, the incidence of chronic loneliness (having loneliness in wave 2 and 3, and free of loneliness in wave 1) was 18.9%, and the 7-year incidence of loneliness was 41.0%. Comparing the 2019 (pre-COVID-19) to 2021/2022 (during COVID-19 pandemic) surveys participants experienced a significant reduction of loneliness. In cross-sectional and/or longitudinal analyses, we found that younger age, living alone, food insecurity, lack of social engagement, depressed mood, poor life satisfaction, poor sleep quality, impaired cognition, poor self-rated health, functional disability, underweight, obesity, and not living with HIV were associated with a higher prevalence, incidence and/or increases in loneliness. CONCLUSION One in five aging adults had acute or chronic loneliness. Several social, mental, and physical health factors were identified as associated with loneliness.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Jennings EA, Mall S, Bassil DT, Kahn K. Exposure to Adversity and its Impact on Later Life Cognitive, Mental, and Physical Health. Int J Public Health 2024; 69:1606499. [PMID: 38961855 PMCID: PMC11219567 DOI: 10.3389/ijph.2024.1606499] [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: 08/10/2023] [Accepted: 05/29/2024] [Indexed: 07/05/2024] Open
Abstract
Objectives We aimed to assess later-life health responses to childhood and lifetime adversity in a cohort of rural, Black South African adults. Methods We performed ordinary least squares regression using two waves of data from Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) to estimate a decline in cognitive, mental, and physical health over approximately 3 years. Our analytic sample consisted of 1,993 women and 1,496 men. Results Associations between several types of adversity and health outcomes point to declines in health. At the same time, many adverse experiences are associated with improvements in cognitive, mental, and physical health in later life. The direction of the association varied by type of exposure, health outcome, and gender. Conclusion In populations exposed to many adversities during life, specific adverse experiences may sometimes be associated with greater improvements (and not just greater decline) in health in later life. Further research is needed to unpack the mechanisms at play in these populations.
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Affiliation(s)
- Elyse A. Jennings
- Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Sumaya Mall
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Darina T. Bassil
- Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Pengpid S, Peltzer K. Longitudinal Associations Between Food Insecurity and Mental Health in Aging Adults in South Africa. Clin Gerontol 2024:1-9. [PMID: 38600746 DOI: 10.1080/07317115.2024.2341328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
OBJECTIVES The aim of this study was to assess the longitudinal unidirectional and bidirectional associations between food insecurity and mental health among aging adults in South Africa. METHODS The analysis utilized data from the South African 7-year longitudinal Health and Ageing in Africa (HAALSI) study. RESULTS The proportion of food insecurity was 20.2% in 2015, 24.1% in 2019 and 18.4% in 2021/2022. Food insecurity was positively associated depressive symptoms, poor life satisfaction, poor sleep quality, PTSD, loneliness, impaired cognition, and current tobacco use. Compared to without food insecurity in all three study waves, having food insecurity in one wave and/or two to three waves was positively associated with incident depressive symptoms, incident poor life satisfaction, incident poor sleep quality, incident PTSD, incident loneliness, incident current tobacco use, and incident current heavy alcohol use. PTSD, impaired cognition, current tobacco use and current heavy alcohol use were positively associated with incident food insecurity. CONCLUSION We found that food insecurity was unidirectionally associated with depressive symptoms, poor life satisfaction, poor sleep quality and loneliness, and bidirectionally associated with PTSD, impaired cognition, current tobacco use and current heavy alcohol use. CLINICAL IMPLICATIONS Enhanced screening and management of food insecurity may reduce mental ill-health in South Africa.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Pengpid S, Peltzer K. Associations of history of intimate partner violence with mental ill-health and lifestyle factors in middle-aged and older men and women in South Africa. Arch Gerontol Geriatr 2024; 118:105286. [PMID: 38016354 PMCID: PMC10842886 DOI: 10.1016/j.archger.2023.105286] [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: 10/28/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVES The aim of this study was to assess the association between history of intimate partner violence (IPV) exposure and mental and lifestyle factors among middle-aged and older men and women in rural South Africa. METHODS The analysis utilized data from wave 3 of the longitudinal Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) (n = 3,707, median age 66 years, range 46-118 years). History of IPV was assessed with five questions on physical, sexual, psychological, and economic IPV. Logistic regression was used to assess the association between history of IPV exposure and mental and lifestyle factors. RESULTS Among men 7.8% and among women 10.9% reported a history of IPV. In terms of mental health outcomes, in the final adjusted model, among men, exposure to 1 and/or 2-4 types of IPV were associated with depressive symptoms, insomnia symptoms, PTSD, and loneliness, while among women, exposure to 1 and/or 2-4 types of IPV was associated with insomnia symptoms and PTSD. In terms of lifestyle outcomes, in the final adjusted model, among men, 2-4 types of IPV were associated current tobacco use, current heavy alcohol use, inadequate fruit intake, and food insecurity, and among women, 1 and/or 2-4 types of IPV were associated with soft drink intake, and food insecurity. CONCLUSION We found that lifetime exposure to IPV was associated with several mental and lifestyle factors in middle-aged and older men and women. Enhanced screening and treatment of IPV may reduce poor mental and health risk behavior among this aging male and female population in South Africa.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Department of Psychology, University of the Free State, Bloemfontein, South Africa; Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Kobayashi LC, Jones RN, Briceño EM, Rentería MA, Zhang Y, Meijer E, Langa KM, Lee J, Gross AL. Cross-national comparisons of later-life cognitive function using data from the Harmonized Cognitive Assessment Protocol (HCAP): Considerations and recommended best practices. Alzheimers Dement 2024; 20:2273-2281. [PMID: 38284801 PMCID: PMC10984496 DOI: 10.1002/alz.13694] [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: 07/31/2023] [Revised: 12/01/2023] [Accepted: 12/23/2023] [Indexed: 01/30/2024]
Abstract
The Harmonized Cognitive Assessment Protocol (HCAP) is a major innovation that provides, for the first time, harmonized data for cross-national comparisons of later-life cognitive functions that are sensitive to linguistic, cultural, and educational differences across countries. However, cognitive function does not lend itself to direct comparison across diverse populations without careful consideration of the best practices for such comparisons. This perspective discusses theoretical and methodological considerations and offers a set of recommended best practices for conducting cross-national comparisons of risk factor associations using HCAP data. Because existing and planned HCAP studies provide cognition data representing an estimated 75% of the global population ≥65 years of age, these recommended best practices will support high-quality comparative analyses of cognitive aging around the world. The principles described in this perspective are applicable to any researcher aiming to integrate or compare harmonized data on cognitive outcomes and their risk and protective factors across diverse populations.
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Affiliation(s)
- Lindsay C. Kobayashi
- Department of EpidemiologyCenter for Social Epidemiology and Population HealthUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
- Survey Research CenterUniversity of Michigan Institute for Social ResearchAnn ArborMichiganUSA
| | - Richard N. Jones
- Department of Psychiatry and Human BehaviorWarren Alpert Medical SchoolBrown UniversityProvidenceRhode IslandUSA
| | - Emily M. Briceño
- Department of Physical Medicine & RehabilitationUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Miguel Arce Rentería
- Taub Institute for Research on Alzheimer's Disease and the Aging BrainDepartment of NeurologyColumbia University College of Physicians and SurgeonsNew York CityNew YorkUSA
| | - Yuan Zhang
- Department of Sociomedical SciencesColumbia UniversityNew York CityNew YorkUSA
- Robert N. Butler Columbia Aging CenterColumbia UniversityNew York CityNew YorkUSA
| | - Erik Meijer
- Center for Economic and Social ResearchUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Kenneth M. Langa
- Survey Research CenterUniversity of Michigan Institute for Social ResearchAnn ArborMichiganUSA
- Department of Internal MedicineUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
- Veterans Affairs Center for Clinical Management ResearchAnn ArborMichiganUSA
| | - Jinkook Lee
- Center for Economic and Social ResearchUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of EconomicsUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Alden L. Gross
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Center on Aging and HealthJohns Hopkins UniversityBaltimoreMarylandUSA
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Westrick AC, Avila‐Rieger J, Gross AL, Hohman T, Vonk JMJ, Zahodne LB, Kobayashi LC. Does education moderate gender disparities in later-life memory function? A cross-national comparison of harmonized cognitive assessment protocols in the United States and India. Alzheimers Dement 2024; 20:16-24. [PMID: 37490296 PMCID: PMC10808282 DOI: 10.1002/alz.13404] [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] [Revised: 06/06/2023] [Accepted: 06/25/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION We compared gender disparities in later-life memory, overall and by education, in India and the United States (US). METHODS Data (N = 7443) were from harmonized cognitive assessment protocols (HCAPs) in the Longitudinal Aging Study of India-Diagnostic Assessment of Dementia (LASI-DAD; N = 4096; 2017-19) and US Health and Retirement Study HCAP (HRS-HCAP; N = 3347; 2016-17). We derived harmonized memory factors from each study using confirmatory factor analysis. We used multivariable-adjusted linear regression to compare gender disparities in memory function between countries, overall and by education. RESULTS In the United States, older women had better memory than older men (0.28 SD-unit difference; 95% CI: 0.22, 0.35). In India, older women had worse memory than older men (-0.15 SD-unit difference; 95% CI: -0.20, -0.10), which attenuated with increasing education and literacy. CONCLUSION We observed gender disparities in memory in India that were not present in the United States, and which dissipated with education and literacy.
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Affiliation(s)
- Ashly C. Westrick
- Department of EpidemiologyCenter for Social Epidemiology and Population HealthUniversity of Michigan: School of Public HealthAnn ArborMichiganUSA
| | - Justina Avila‐Rieger
- Gertrude H. Sergievsky Center and the Taub Institute for Research in Aging and Alzheimer's DiseaseColumbia UniversityNew YorkNew YorkUSA
| | - Alden L. Gross
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthCenter on Aging and HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Timothy Hohman
- Vanderbilt Memory & Alzheimer's CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Vanderbilt Genetics InstituteVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Jet M. J. Vonk
- Department of NeurologyMemory and Aging CenterUniversity of California San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Laura B. Zahodne
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Lindsay C. Kobayashi
- Department of EpidemiologyCenter for Social Epidemiology and Population HealthUniversity of Michigan: School of Public HealthAnn ArborMichiganUSA
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Hoang CT, Kohler IV, Amin V, Behrman JR, Kohler HP. Resilience, Accelerated Aging and Persistently Poor Health: Diverse Trajectories of Health in Malawi. POPULATION AND DEVELOPMENT REVIEW 2023; 49:771-800. [PMID: 38605849 PMCID: PMC11005366 DOI: 10.1111/padr.12590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Individuals age at vastly different rates resulting in significant within-population heterogeneity in health and aging outcomes. This diversity in health and aging trajectories has rarely been investigated among low-income aging populations that have experienced substantial hardships throughout their lifecourses. Utilizing 2006-2018 data from the Malawi Longitudinal Study of Families and Health (MLSFH) and estimating group-based trajectory models (GBTM), our analyses identified three distinct lifecourse health trajectories: (1) comparatively good initial mental and physical health that persisted throughout the lifecourse ("resilient aging"); (2) relatively good initial mental and physical health that started to deteriorate during mid-adulthood ("accelerated aging"); and (3) poor initial mental and physical health that further declined over the lifecourse ("aging with persistently poor health"). For both physical and mental health, men were more likely to enjoy resilient aging than women. Predictors other than gender of trajectory membership sometimes confirmed, and sometimes contradicted, hypotheses derived from high-income country studies. Our analyses highlight the long arm of early life conditions and gender in determining aging trajectories and show that a non-trivial sub-population is characterized by aging with persistently poor health. The study uncovers widening gaps in health outcomes between those who age with resilience and those who experience accelerated aging.
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Prynn JE, Davey C, Davis D, Kuper H, Mugisha J, Seeley J. Cognition in older adults in Uganda: Correlates, trends over time and association with mortality in prospective population study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001798. [PMID: 37922221 PMCID: PMC10624290 DOI: 10.1371/journal.pgph.0001798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 09/11/2023] [Indexed: 11/05/2023]
Abstract
Dementia is an important and growing issue in sub-Saharan Africa, but epidemiological data are lacking. Risk factors may differ from other regions due to high stroke incidence and HIV prevalence. Understanding the epidemiology of cognition in older adults in Africa is crucial for informing public health strategies to improve the lives of people with dementia and their carers. The Wellbeing of Older People Study in Uganda is an open cohort of adults aged 50+ with and without HIV, established in 2009. Detailed socio-demographic and health data have been collected at four waves spanning 10 years, including cognitive assessment using internationally validated WHO-recommended tests: verbal recall, digit span, and verbal fluency. Mortality data was collected until the end of the fourth wave (2019). We examined associations of low baseline cognition scores and changes in cognition score over time using random effects modelling, care needs of people with lower cognition scores, and the relationship between cognition score and mortality. Data were collected on 811 participants. Older age, lower educational attainment, lower socio-economic position, and extremes of BMI were associated with lower cognition scores. Cognition scores declined faster at older ages, but rate of decline was not associated with cardiovascular disease or HIV at baseline. People with lower cognition scores required more assistance with Activities of Daily Living, but mortality rates were similar across the range of cognition scores. The crucial next step will be to investigate types and presentation of clinical dementia in this cohort, so we can better understand the clinical relevance of these findings to inform public health planning.
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Affiliation(s)
- Josephine E. Prynn
- Institute of Cardiovascular Sciences, University College London, London, United Kingdom
| | - Calum Davey
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Daniel Davis
- MRC Unit for Lifelong Health and Ageing, University College London, London, United Kingdom
| | - Hannah Kuper
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Janet Seeley
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Pengpid S, Peltzer K. Health risk behaviour and persistent and incident depression among middle-aged and older adults in South Africa. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2023; 53:134-142. [PMID: 38106442 PMCID: PMC10723055 DOI: 10.1177/00812463221113413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
The aim of this study was to assess the association between five health risk behaviours and persistent and incident depressive symptoms in a longitudinal study in South Africa. The sample included 5059 men and women (≥40 years) in 2014/2015, and 4176 in 2018/2019 of the 'Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa'. Depressive symptoms were assessed with the Centre for Epidemiologic Studies Depression scale. Multivariable logistic regression analysis was conducted to assess the associations between five health risk behaviours and persistent and incident depressive symptoms. Results indicate that 5.0% of participants had depressive symptoms at both wave 1 and 2 (persistent depressive symptoms), and 27.9% had incident depressive symptoms in wave 2. Higher education and moderate baseline physical activity were negatively associated and those with cardiovascular disease were positively associated with persistent depressive symptoms. Middle wealth index was negative, and being HIV positive and baseline tobacco use were positively associated with incident depressive symptoms. In conclusion, of five health risk behaviours assessed (inadequate fruit/vegetable intake, alcohol dependence, tobacco use, physical activity, and sedentary behaviour), only moderate physical activity was protective against persistent depressive symptoms, and tobacco use was associated with incident depressive symptoms.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Research Administration and Development, University of Limpopo, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, South Africa
- Department of Psychology, College of Medical and Health Sciences, Asia University
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Peltzer K. Lifestyle factors, mental health, and incident and persistent intrusive pain among ageing adults in South Africa. Scand J Pain 2023; 23:161-167. [PMID: 35467093 PMCID: PMC10249480 DOI: 10.1515/sjpain-2022-0013] [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: 01/17/2022] [Accepted: 04/13/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate longitudinal associations with incident and persistent intrusive pain among rural South Africans. METHODS Longitudinal data from two consecutive waves in 2014/2015 and 2018/2019 in Agincourt, South Africa, were analysed. Pain was assessed with the Brief Pain Inventory. RESULTS In all, 683 adults of 3,628 participants without intrusive pain in Wave 1 (19.1%) had incident intrusive pain in Wave 2, 94 adults of 254 participants who had intrusive pain in Wave 1 (38.3%) had intrusive pain at both Wave 1 and 2 (persistent intrusive pain). Furthermore, 358 (7.2%) participants had intrusive pain at baseline. In the fully adjusted model for people without intrusive pain at baseline, the study found that obesity (AOR: 1.31, 95% CI: 1.05-1.63), depressive symptoms (AOR: 1.67, 95% CI: 1.34-2.08), PTSD (AOR: 1.71, 95% CI: 1.19-2.45), and poor sleep quality (AOR: 1.30, 95% CI: 1.04-1.62) were positively associated with incident intrusive pain. Older age was positively, and male sex and daily alcohol use were negatively associated with incident intrusive pain. Furthermore, in the final adjusted logistic regression model, this study found that older age was positively, and underweight, overweight, and high sedentary behavior were negatively associated with persistent intrusive pain. CONCLUSIONS Several modifiable risk factors for incident and/or persistent intrusive pain were identified.
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Affiliation(s)
- Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa; and Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
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Kohler IV, Kämpfen F, Bandawe C, Kohler HP. Cognition and Cognitive Changes in a Low-Income Sub-Saharan African Aging Population. J Alzheimers Dis 2023; 95:195-212. [PMID: 37522209 PMCID: PMC10588811 DOI: 10.3233/jad-230271] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
BACKGROUND Cognition and its age-related changes remain vastly understudied in low-income countries (LICs), despite evidence suggesting that cognitive decline among aging low-income populations is a rapidly increasing disease burden often occurring at younger ages as compared to high-income countries (HICs). OBJECTIVE We examine patterns of cognition among men and women, 45 + years old, living in rural Malawi. We analyze how key socioeconomic characteristics predict levels of cognition and its changes as individuals get older. METHODS Utilizing the Mature Adults Cohort of the Malawi Longitudinal Study of Families and Health (MLSFH-MAC) collected during 2012-2017, we estimate standard regression models to analyze predictors of the age- and sex-specific levels and longitudinal changes in cognition. Cognition is assessed with a screening instrument that is adapted to this low-literacy context and measures different domains such as language, attention, or executive functioning. RESULTS Women have lower levels of cognition than men, a pattern in stark contrast to findings in HICs. Schooling and socioeconomic status increase the probability of having consistently high performance during the cognitive assessment. Cognitive decline accelerates with age and is detectable already at mid-adult ages (45-55 years). Despite lower levels of cognitive function observed among women, the pace of decline with age is similar for both genders. CONCLUSION Women are particularly affected by poor cognition in this context. The study emphasizes the importance of prioritizing cognitive health and research on cognition among older individuals in sub-Saharan Africa LICs, to which relatively little health care resources continue to be allocated.
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Affiliation(s)
- Iliana V Kohler
- Population Studies Center and Department of Sociology, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Chiwoza Bandawe
- Department of Psychiatry and Mental Health, Kamuzu University of Health Sciences (KUHeS), Blantyre, Malawi
| | - Hans-Peter Kohler
- Population Aging Research Center and Department of Sociology, University of Pennsylvania, Philadelphia, PA, USA
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Pengpid S, Peltzer K. Sleep duration and incident and persistent depressive symptoms among a rural ageing population in South Africa. Compr Psychiatry 2022; 119:152354. [PMID: 36308856 PMCID: PMC9671778 DOI: 10.1016/j.comppsych.2022.152354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 10/12/2022] [Accepted: 10/24/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The aim of the study was to assess the relationship between sleep duration and incident depressive symptoms (IDS) and persistent depressive symptoms (PDS) using longitudinal data from South Africa. METHODS This longitudinal community study enrolled 3891 adults (≥40 years) from the "Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI)". Sleep duration was assessed by self-report at wave 1, and depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale at wave 1 and 2. Outcomes were incident and persistent depressive symptoms at wave 2. Multivariable logistic regression analysis was conducted to assess the associations between sleep duration at wave 1 and incident, and persistent depressive symptoms. RESULTS The prevalence of IDS was 25.6% and PDS 30.8%. The prevalence of very short, short, normal, and long sleep duration at baseline was 3.6%, 10.1%, 60.9% and 25.4%, respectively. In the fully adjusted model, long sleep duration was positively associated with IDS among men (AOR: 1.37, 95% CI: 1.02-1.84), but not among women (AOR: 0.91, 95% CI: 0.67-1.23). No models among both men and women showed a significant association between short sleep and IDS. Long sleep duration was associated with PDS (AOR: 2.04, 95% CI: 1.20-3.48) among men but not among women (AOR: 1.26, 95% CI: 0.76-2.11). Short sleep showed among both sexes no significant associations with PDS. CONCLUSION Long but not short sleep duration was independently associated with IDS and PDS among men but not among women.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand,Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Department of Psychology, University of the Free State, Bloemfontein, South Africa; Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Emami Kazemabad MJ, Asgari Toni S, Tizro N, Dadkhah PA, Amani H, Akhavan Rezayat S, Sheikh Z, Mohammadi M, Alijanzadeh D, Alimohammadi F, Shahrokhi M, Erabi G, Noroozi M, Karimi MA, Honari S, Deravi N. Pharmacotherapeutic potential of pomegranate in age-related neurological disorders. Front Aging Neurosci 2022; 14:955735. [PMID: 36118710 PMCID: PMC9476556 DOI: 10.3389/fnagi.2022.955735] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/13/2022] [Indexed: 11/24/2022] Open
Abstract
Age-related neurological disorders [AND] include neurodegenerative diseases [NDDs] such as Alzheimer's disease [AD] and Parkinson's disease [PD], which are the most prevalent types of dementia in the elderly. It also includes other illnesses such as migraine and epilepsy. ANDs are multifactorial, but aging is their major risk factor. The most frequent and vital pathological features of AND are oxidative stress, inflammation, and accumulation of misfolded proteins. As AND brain damage is a significant public health burden and its incidence is increasing, much has been done to overcome it. Pomegranate (Punica granatum L.) is one of the polyphenol-rich fruits that is widely mentioned in medical folklore. Pomegranate is commonly used to treat common disorders such as diarrhea, abdominal pain, wound healing, bleeding, dysentery, acidosis, microbial infections, infectious and noninfectious respiratory diseases, and neurological disorders. In the current review article, we aimed to summarize the data on the pharmacotherapeutic potentials of pomegranate in ANDs.
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Affiliation(s)
| | - Sara Asgari Toni
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Neda Tizro
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Parisa Alsadat Dadkhah
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hanieh Amani
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shima Akhavan Rezayat
- Student Research Committee, Faculty of Medicine, Islamic Azad University of Mashhad, Mashhad, Iran
| | - Zahra Sheikh
- Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Mohammadi
- Student Research Committee, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Dorsa Alijanzadeh
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnoosh Alimohammadi
- Student Research Committee, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Gisou Erabi
- Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran
| | - Masoud Noroozi
- Department of Biomedical Engineering, Faculty of Engineering, University of Isfahan, Isfahan, Iran
| | - Mohammad Amin Karimi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Honari
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Pengpid S, Peltzer K. Fruit and vegetable intake and incident and persistent poor sleep quality in a rural ageing population in South Africa: longitudinal study. BJPsych Open 2022; 8:e149. [PMID: 35900085 PMCID: PMC9380195 DOI: 10.1192/bjo.2022.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Fruit and vegetable intake may improve sleep. AIMS To assess the relationship between fruit and vegetable intake and sleep quality in a longitudinal study. METHOD We analysed longitudinal data from two consecutive population surveys of adults in Agincourt, South Africa (2014-2015 and 2018-2019). RESULTS In total, 331 of 2975 participants without poor sleep quality in Wave 1 (11.1%) had incident poor sleep quality in Wave 2, and 270 of 3546 participants who had poor sleep quality in Wave 1 (7.6%) had poor sleep quality in both Waves 1 and 2 (persistent poor sleep quality). The prevalence of poor sleep quality at baseline was 17.2%. In the fully adjusted model for people without poor sleep quality at baseline, higher fruit and vegetable consumption (≥5 servings/day) was positively associated with incident poor sleep quality among men (AOR = 1.43, 95% CI 1.51-2.01) but not among women (AOR = 1.09, 95% CI 0.78-1.46). Two or more servings of fruits were positively associated with incident poor sleep quality among men (AOR = 3.35, 95% CI 1.96-5.72) and among women (AOR = 1.84, 95% CI 1.15-2.94). No models among men and women showed a significant association between vegetable intake and incident poor sleep quality or between fruit and vegetable intake, vegetable intake and persistent poor sleep quality. Fruit intake (one serving) was positively associated with persistent poor sleep quality among men (AOR = 1.76, 95% CI 1.00-3.08) but not among women (AOR = 1.42, 95% CI 0.93-2.18). CONCLUSIONS Higher fruit and vegetable intake was independently associated with poorer sleep quality among men but not women, and higher fruit but not vegetable intake was associated with poorer sleep quality among both men and women.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; and Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa; and Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
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