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Wang Y, Wang X, Zhao L, Jones K. A case for the use of deep learning algorithms for individual and population level assessments of mental health disorders: Predicting depression among China's elderly. J Affect Disord 2024:S0165-0327(24)01637-9. [PMID: 39321977 DOI: 10.1016/j.jad.2024.09.147] [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] [Received: 03/30/2024] [Revised: 09/16/2024] [Accepted: 09/21/2024] [Indexed: 09/27/2024]
Abstract
BACKGROUND With the continuous advancement of age in China, attention should be paid to the mental well-being of the elderly population. The present study uses a novel machine learning (ML) method on a large representative elderly database in China as a sample to predict the risk factors of depression in the elderly population from both holistic and individual level. METHODS A total of participants met the inclusion criteria from the fourth waves of the China Health and Retirement Longitudinal Study (CHARLS) were analyzed with ML algorithms. The level of depression was assessed by the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). RESULTS The current study found top 5 factors that were important for predicting depression in the elderly population in China, including average sleep time, gender, age, social activities and nap time during the day. The results also provide reliable diagnostic likelihood at the individual level to support clinicians identify the most impactful factors contributing to patient depression. Our findings also suggested that activities such as interacting with friends and play ma-Jong, chess or join community clubs may have a positive collaborative effect for elderly's mental health. CONCLUSIONS Holistic approaches are an effective method of deriving and interpreting sophisticated models of mental health in elderly populations. More detailed information about a patient's demographics, medical history, sleeping patterns and social/leisure activities can help to inform policy and treatment interventions on a population and individual level. Large scale surveys such as CHARLS are effective methods for testing the most accurate models, however, further research using professional clinical input could further advance the field.
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Affiliation(s)
- Yingjie Wang
- Department of Social Work, Nanjing University of Finance & Economics, Nanjing, China
| | - Xuzhe Wang
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Li Zhao
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Kyle Jones
- School of Psychology, Swansea University, Swansea, UK
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Moreno X, Monsalves MJ, Rueda S, Dagnino P, Borghero F. Gender differences in life expectancy free of depressive symptoms in Chile between 2003 and 2016. Glob Ment Health (Camb) 2024; 11:e16. [PMID: 38390246 PMCID: PMC10882180 DOI: 10.1017/gmh.2024.9] [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] [Received: 08/12/2023] [Revised: 11/26/2023] [Accepted: 01/18/2024] [Indexed: 02/24/2024] Open
Abstract
The aim of the study was to analyze gender differences in life expectancy free of depressive symptoms among the adult population in Chile between 2003 and 2016. The Sullivan method was used to estimate the total and marginal life expectancy, based on prevalence data from the National Health Survey (2003, 2010 and 2016), and abridged life tables for the Chilean population. There was a compression of morbidity among middle-aged men during the first period and among younger and older women during the last one. Men at all ages could expect to live a higher proportion of their lives without depressive symptoms during the whole period. The gender gap in the proportion of life expectancy free of depressive symptoms reached 10 percent points or more, considering almost all ages and periods. Unemployment and lower education increased the probability of depressive symptoms, and these effects were more marked among women. Public policies should have a gender-sensitive approach to address the gap in depression and the disadvantage experienced by women in life expectancy free of depressive symptoms, considering those dimensions that intersect with gender, such as access to education, employment or income.
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Affiliation(s)
- Ximena Moreno
- Facultad de Psicología y Humanidades, Universidad San Sebastián, Santiago, Chile
| | | | - Sarahí Rueda
- Millennium Institute for Care Research (MICARE), Santiago, Chile
| | - Paula Dagnino
- Facultad de Psicología y Humanidades, Universidad San Sebastián, Santiago, Chile
- Millennium Institute for the Study of Personality and Depression (MIDAP), Santiago, Chile
| | - Francesca Borghero
- Núcleo Milenio para Mejorar la Salud Mental de Adolescentes y Jóvenes (IMHAY), Santiago, Chile
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Ceolin G, Antunes LDC, Moretti M, Rieger DK, Moreira JD. Vitamin D and depression in older adults: lessons learned from observational and clinical studies. Nutr Res Rev 2023; 36:259-280. [PMID: 35022097 DOI: 10.1017/s0954422422000026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Depression is a mental disorder triggered by the interaction of social, psychological and biological factors that have an important impact on an individual's life. Despite being a well-studied disease with several established forms of treatment, its prevalence is increasing, especially among older adults. New forms of treatment and prevention are encouraged, and some researchers have been discussing the effects of vitamin D (VitD) on depression; however, the exact mechanism by which VitD exerts its effects is not yet conclusive. In this study, we aimed to discuss the possible mechanisms underlying the association between VitD and depression in older adults. Therefore, we conducted a systematic search of databases for indexed articles published until 30 April 2021. The primary focus was on both observational studies documenting the association between VitD and depression/depressive symptoms, and clinical trials documenting the effects of VitD supplementation on depression/depressive symptoms, especially in older adults. Based on pre-clinical, clinical and observational studies, it is suggested that the maintenance of adequate VitD concentrations is an important issue, especially in older adults, which are a risk population for both VitD deficiency and depression. Nevertheless, it is necessary to carry out more studies using longitudinal approaches in low- and middle-income countries to develop a strong source of evidence to formulate guidelines and interventions.
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Affiliation(s)
- Gilciane Ceolin
- Postgraduate Program in Nutrition, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Translational Nutritional Neuroscience working Group, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Luciana da Conceição Antunes
- Department of Nutrition, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Translational Nutritional Neuroscience working Group, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Morgana Moretti
- Postgraduate Program in Biochemistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Débora Kurrle Rieger
- Department of Nutrition, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Translational Nutritional Neuroscience working Group, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Júlia Dubois Moreira
- Department of Nutrition, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Translational Nutritional Neuroscience working Group, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Du Y, Luo Y, Ren Z, Zheng X, Liu J. Impact of adverse childhood experiences on life expectancy with depression in the U.K. population: The mitigating role of educational attainment. CHILD ABUSE & NEGLECT 2023; 144:106383. [PMID: 37541093 DOI: 10.1016/j.chiabu.2023.106383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with depression in later life. OBJECTIVE This study aimed to measure the impact of ACEs on life expectancy with depression (DLE) and to assess how educational attainment affected expectations. PARTICIPANTS AND SETTING The study used data on 5597 participants from the English Longitudinal Study of Aging (2006-2013). METHODS Depression was assessed through the eight-item short version of the Centre for Epidemiologic Studies Depression. We used discrete-multistate life table models to estimate total life expectancy and life expectancy with depression. RESULTS Older adults with ACEs had longer DLE and a higher proportion of remaining life with depression compared with those without ACEs. For example, men aged 60 years with ACEs could expect to live 5.2 (95 % confidence interval (CI): 4.2, 6.2) years with depression compared with 2.8 (95 % CI: 2.3, 3.3) years for men without ACEs. Women aged 60 years who reported ACEs could expect to live 9.4 (95 % CI: 7.6, 11.1) years with depression compared with 6.0 (95 % CI: 5.1, 7.0) years for women without ACEs. With a high level of educational attainment, older adults from younger cohorts with ACEs lived fewer depression years and spent a higher proportion of their life being free of depression than adults with ACEs and had a low level of educational attainment. CONCLUSION Our results indicated that ACEs may increase years of life with depression among U.K. adults. Meanwhile, high educational attainment could mitigate the mental health burden associated with ACEs.
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Affiliation(s)
- Yushan Du
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Ziyang Ren
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Xiaoying Zheng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Jufen Liu
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
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Multidimensional evaluation of healthy life expectancy indicators based on mental health among the rural older population: A large-scale cross-sectional study. J Affect Disord 2022; 319:318-324. [PMID: 36116604 DOI: 10.1016/j.jad.2022.09.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/09/2022] [Accepted: 09/13/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND This study aimed to estimate healthy life expectancy (HLE) regarding anxiety, depression and their comorbidity among rural older adults. METHODS A total of 12,851 subjects (5790 men and 7061 women) enrolled from the Henan Rural Cohort Study were used to evaluate healthy status expectancy (HSE), and 10,096 (4475 men and 5621 women) of them were used to estimate health-adjusted life expectancy (HALE). The life expectancy was calculated using period life table, and HSE and HALE indicators were calculated via the Sullivan method. RESULTS For participants aged 60, the depression-free life expectancy (DFLE), anxiety-free life expectancy (AFLE), and depression- and anxiety-free life expectancy (DAFLE) were 23.0993, 23.3314, and 22.7206 years, respectively. The quality-adjusted life expectancy (QALE) of those with neither anxiety nor depression, with anxiety, with depression, and with comorbidity was 22.0727, 20.8751, 18.1484, and 17.0823 years, respectively. The ratio of DFLE (AFLE) to LE increased with age among both genders, while the DAFLE/LE showed a decreasing trend. Regardless of HSE or HALE indicators, women tended to have higher HLE, while HLE/LE was lower than men. Furthermore, all HLE indicators associated with anxiety were the largest in both genders compared to indicators regarding depression. LIMITATIONS The HLE may be overestimated ignoring institutional population in the study. CONCLUSION Anxiety and depression played essential roles in the quality of life among rural older adults, especially depression. Comorbidity would intensify the adverse effect in rural areas, especially for older men. More attention should be paid to the psychological problems among rural older population.
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Tawiah R, Jagger C, Anstey KJ, Kiely KM. Lifecourse socioeconomic position and cohort differences in health expectancy in Australia: a longitudinal cohort study. THE LANCET PUBLIC HEALTH 2022; 7:e347-e355. [DOI: 10.1016/s2468-2667(22)00026-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 10/18/2022] Open
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Wu Y, Zheng H, Liu Z, Wang S, Chen X, Yu H, Liu Y, Hu S. Depression and Anxiety-Free Life Expectancy by Sex and Urban-Rural Areas in Jiangxi, China in 2013 and 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041991. [PMID: 33670818 PMCID: PMC7922042 DOI: 10.3390/ijerph18041991] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/10/2021] [Accepted: 02/13/2021] [Indexed: 11/29/2022]
Abstract
Objective: To quantitatively estimate life expectancy (LE) and depression and anxiety-free life expectancy (DAFLE) for the years 2013 and 2018 in Jiangxi Province, China, by sex and urban–rural areas. Additionally, to compare the discrepancy of DAFLE/LE of different sexes and urban-rural areas over various years. Methods: Based on the summary of the health statistics of Jiangxi Province in 2013 and 2018 and the results of the 5th and 6th National Health Service Surveys in Jiangxi Province, the model life table is used to estimate the age-specific mortality rate by sex and urban–rural areas. Sullivan’s method was used to calculate DAFLE. Results: Data from 2013 indicate that those aged 15 can expect to live 56.20 years without depression and anxiety for men and 59.67 years without depression and anxiety for women. Compared to 2013, DAFLE had not fluctuated significantly in 2018. The proportion of life expectancy without depression and anxiety (DAFLE/LE) declined between 2013 and 2018. DAFLE/LE in urban areas was higher than in rural areas. Men had higher DAFLE/LE than women. From 2013 to 2018, the DAFLE aged 15 decreased by 0.18 years for urban men and decreased by 0.52 years for urban women, rural areas also decreased to varying degrees. Conclusions: Even if women had a longer life span than men, they would spend more time with depression or anxiety. DAFLE did not increase with the increase in LE from 2013 to 2018, suggesting an absolute expansion of the burden, especially in rural areas. Depression and anxiety health services in Jiangxi, China will face more serious obstacles and challenges, which may lead to more disability. This requires more attention and more effective measures from the public, medical departments and the government.
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Oliveira EJP, Alves LC, Duarte YADO, Bof de Andrade F. Edentulism-free life expectancy among older Brazilian adults: SABE study, 2006-2016. Gerodontology 2021; 38:429-436. [PMID: 33565129 DOI: 10.1111/ger.12541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 01/08/2021] [Accepted: 01/17/2021] [Indexed: 12/23/2022]
Abstract
AIM To assess edentulism-free life expectancy (EFLE) and the related inequalities by sex and schooling among older Brazilian adults from 2006 to 2016. BACKGROUND Tooth loss is related to shortened longevity and unhealthy life expectancy in old age. MATERIALS AND METHODS The outcome of the study was EFLE, assessed by age, sex and schooling. EFLE was estimated using the Sullivan method, considering the years and proportion of remaining life and the prevalence of edentulism-assessed in the Health, Well-being, and Aging cohort study, as well as the official mortality data for adults aged 60 years or older living in São Paulo, Brazil. RESULTS EFLE increased from 10.9 (95% CI: 10.4-11.5) to 13.8 (95% CI: 13.2-14.5) years, considering data from 2006 to 2016, among 60-year-old individuals. In relative terms, these individuals expected to live 50.7% (95% CI: 48.1-53.2) of their remaining life free of edentulism in 2006, while this expectation was 62.8% (95% CI: 60.0-65.6) in 2016. Within both years, women and the less educated had lower EFLE than men and the higher educated. CONCLUSION EFLE increased from 2006 to 2016. However, inequalities concerning sex and education remained significant, thereby highlighting the need to continuously address inequalities in tooth loss throughout life to contribute to a healthy ageing.
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Affiliation(s)
| | - Luciana Correia Alves
- Department of Demography, Institute of Philosophy and Human Sciences, University of Campinas (UNICAMP), Campinas, Brazil
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Andrade JM, Andrade FCD, Oliveira EJP, Duarte YADO, de Andrade FB. Life expectancy with poor health-related quality of life among Brazilian older adults. Arch Gerontol Geriatr 2021; 94:104346. [PMID: 33493953 DOI: 10.1016/j.archger.2021.104346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 01/14/2021] [Accepted: 01/14/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Juliana Mara Andrade
- René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Av. Augusto de Lima, 1715, Barro Preto, Belo Horizonte, Brazil.
| | | | - Eduardo José Pereira Oliveira
- René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Av. Augusto de Lima, 1715, Barro Preto, Belo Horizonte, Brazil.
| | | | - Fabíola Bof de Andrade
- René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Av. Augusto de Lima, 1715, Barro Preto, Belo Horizonte, Brazil.
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Abstract
Objective: To examine whether we live healthier as we live longer in Hong Kong, which has one of the highest life expectancies in the world. Methods: Sullivan's method was used to evaluate the chronic disease-free life expectancy (CDFLE), life expectancy in good self-perceived health (GPHLE), and impairment-free life expectancy (IFLE) among population aged 50 years and older in Hong Kong in 2007-2016. Results: In spite of the marked improvement in life expectancy in Hong Kong, the increase in GPHLE was much smaller, while CDFLE and IFLE even declined for both genders. The situation was more severe among older population. Discussion: People in Hong Kong live longer but with worsening health. The expansion of chronic diseases, self-perceived poor health, and impairments among older adults calls for more fiscal investments, government attention, and public health policies.
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Affiliation(s)
- Yan Zheng
- Department of Social Work and Social Administration, Faculty of Social Sciences, 25809The University of Hong Kong, Hong Kong
| | - Karen Siu Lan Cheung
- Mindlink Research Centre, Hong Kong.,Sau Po Centre on Ageing, 25809The University of Hong Kong, Hong Kong
| | - Paul S F Yip
- Department of Social Work and Social Administration, Faculty of Social Sciences, 25809The University of Hong Kong, Hong Kong.,Hong Kong Jockey Club Centre for Suicide Research and Prevention, 25809The University of Hong Kong, Hong Kong
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Data Sources for Health Expectancy Research. INTERNATIONAL HANDBOOK OF HEALTH EXPECTANCIES 2020. [DOI: 10.1007/978-3-030-37668-0_5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Family status and later-life depression among older adults in urban Latin America and the Caribbean. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractRapid fertility declines in Latin American and Caribbean countries since the 1960s have contributed to smaller family sizes among the current cohorts of older adults. This may have mental health implications in these societies as the family unit is highly valued as a source of social support. Utilising data from the 2000 Survey of Health, Well-being and Aging in Latin America and the Caribbean (SABE), this study examines the association between parental status, marital status and the likelihood of experiencing depressive symptoms among adults 60 years and older in seven cities within Latin America and the Caribbean (N = 9,756): Buenos Aires, Bridgetown, São Paulo, Santiago, Havana, Mexico City and Montevideo. Results from multivariate logistic regressions indicate that parental status is not significantly associated with depressive symptoms. Nonetheless, unmarried older adults, both those living alone and those living with others, are more vulnerable to experiencing depressive symptoms than their married counterparts. Marriage is especially protective for older adults in Havana and Montevideo. Older adults’ perceived income adequacy significantly moderates the relationship between marital status and depressive symptoms. Other significant covariates, such as experiencing disability and comorbidity, showed positive associations with depressive symptoms. While families may still represent a critical component for the mental health of older adults, broader investments in health across the lifespan are needed to improve individual psychological wellbeing.
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Contribution of chronic conditions to functional limitations using a multinomial outcome: results for the older population in Belgium and Brazil. ACTA ACUST UNITED AC 2017; 75:68. [PMID: 29270292 PMCID: PMC5733874 DOI: 10.1186/s13690-017-0235-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 10/17/2017] [Indexed: 11/18/2022]
Abstract
Background The global phenomenon of population ageing is creating new challenges in both high and middle income countries, as functional limitations are expected to increase with age. The attribution method has been proposed to identify which conditions contribute most to disability using cross-sectional data. Although the original method was based on binary outcomes, we recently proposed an extension to multinomial responses, since different disability levels are often investigated in surveys. This is the first application of the extended method to evaluate differences in the contribution of chronic conditions to functional limitations in the older population of Brazil and Belgium. Methods Representative data from individuals aged ≥65 years who participated in the 2008 or 2013 Health Interview Surveys in Belgium (N = 4521) or in the 2008 National Household Sample Survey in Brazil (N = 28,437) were analysed. Individuals were classified as without, moderate or severe functional limitations, based on three activities of daily living: eating, showering, and toileting. Six chronic conditions common to the surveys – diabetes, heart diseases, musculoskeletal conditions, depression, chronic respiratory diseases, and cancer – were included in the analysis. Separate multinomial additive hazards models by gender for each country were fitted. Results The prevalence of moderate functional limitations was larger in men in Brazil (8.4%) compared to Belgium (6.0%) and similar in women (approximately 12.0%). Conversely, the severe prevalence in men was similar in the two countries (around 8.0%) and higher in women from Belgium (16.6%) than from Brazil (9.1%). Musculoskeletal conditions were the main contributors to the prevalence of functional limitations in men and women in Belgium but only in men and women with moderate functional limitations in Brazil. Depression and heart diseases contributed most to the severe prevalence of functional limitations in men and women in Brazil, respectively. Conclusions Our findings provide a better understanding of differences in the prevalence of different levels of functional limitations in Brazil and Belgium. These differences can be related to differences in socioeconomic conditions, health care access and quality, disease diagnosis, stage of epidemiology transition, life expectancy, and the prevalence of lifestyle risk factors in the two countries. Electronic supplementary material The online version of this article (10.1186/s13690-017-0235-3) contains supplementary material, which is available to authorized users.
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Quadra GR, Oliveira de Souza H, Costa RDS, Fernandez MADS. Do pharmaceuticals reach and affect the aquatic ecosystems in Brazil? A critical review of current studies in a developing country. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2017; 24:1200-1218. [PMID: 27734317 DOI: 10.1007/s11356-016-7789-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 09/27/2016] [Indexed: 05/25/2023]
Abstract
Pharmaceutical residues are not completely removed in wastewater treatment plants (WWTPs) becoming contaminants in aquatic ecosystems. Thereby, it is important to investigate their concentrations in the environment and the possible consequences of their occurrence, including for human health. Here, we briefly reviewed the paths of pharmaceuticals to reach the environment, their behavior and fate in the environment, and the possible consequences of their occurrence. Moreover, we synthetized all the studies about the detection of pharmaceuticals in Brazilian water bodies and the available ecotoxicological knowledge on their effects. In this study, when we compare the data found on these compounds worldwide, we observed that Brazilian surface waters present considerable concentrations of 17α-ethinylestradiol, 17β-estradiol, and caffeine. In general, concentrations found in aquatic systems worldwide seems to be low; however, ecotoxicological tests showed that even these low concentrations can cause sublethal effects in biota. The knowledge about the effects of continuous exposure and mixtures is sparse. In summary, new research is urgently required about the effects of these compounds in biota-including long-term exposition and mixture tests-and on specific technologies to remove these compounds in water bodies and WWTPs, besides the introduction of new policies for pharmaceutical use.
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Affiliation(s)
- Gabrielle Rabelo Quadra
- Universidade Federal de Juiz de Fora, Rua José Lourenço Kelmer, S/n-Martelos, Juiz de Fora, MG, 36036-330, Brazil.
| | - Helena Oliveira de Souza
- Universidade Federal do Rio de Janeiro, Campus Macaé, Av. Aluizio da Silva Gomes, 50-Novo Cavaleiros, Macaé, RJ, 27930-560, Brazil
| | - Rafaela Dos Santos Costa
- Universidade Federal Fluminense, Av. Gen. Tavares de Souza s/n°, Campus da Praia Vermelha, Niteroi, RJ, 24210-346, Brazil
| | - Marcos Antonio Dos Santos Fernandez
- Laboratório de Ecotoxicologia Marinha, Faculdade de Oceanografia, Universidade Estadual do Rio de Janeiro, Rua São Francisco Xavier, 524-Maracanã, Rio de Janeiro, RJ, 20550-900, Brazil
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