Mild Cognitive Impairment and Suicidal Ideation Among Adults Aged 65 Years or Older From Low- and Middle-Income Countries.

OBJECTIVES: Mild cognitive impairment (MCI) is a unique indicator of underlying distress that may be strongly associated with suicide risk. Despite this, to date, no study has examined the association between MCI and suicidal ideation. Therefore, the present study aimed to examine the association between MCI and suicidal ideation among adults aged ≥65 years from 6 low- and middle-income countries (LMICs; China, Ghana, India, Mexico, Russia, and South Africa). METHODS: Cross-sectional, nationally representative data from the World Health Organization's Study on Global Ageing and Adult Health were analyzed. MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Self-reported information on past 12-month suicidal ideation was collected. Multivariable logistic regression and meta-analysis were conducted to assess associations. RESULTS: Data on 13,623 individuals aged ≥65 years were analyzed. The prevalence of suicidal ideation ranged from 0.5% in China to 6.0% in India, whereas the range of the prevalence of MCI was 9.7% (Ghana) to 26.4% (China). After adjustment for potential confounders, MCI was significantly associated with 1.66 (95% confidence interval [95% CI] = 1.12-2.46) times higher odds for suicidal ideation. DISCUSSION: Mild cognitive impairment was significantly associated with higher odds for suicidal ideation among older adults in LMICs. Future longitudinal studies from LMICs are necessary to assess whether MCI is a risk factor for suicidal ideation.

Association of handgrip strength with suicidal ideation among adults aged ≥50 years from low- and middle-income countries.

INTRODUCTION: This study aimed to investigate the association between handgrip strength and suicidal ideation in representative samples of adults aged ≥50 years from six LMICs (China, Ghana, India, Mexico, Russia, and South Africa). METHODS: Cross-sectional, community-based data from the World Health Organization's Study on Global Aging and Adult Health were analyzed. Handgrip strength quintiles by sex were created based on the average value of two handgrip measurements of the dominant hand. Self-reported information on past 12-month suicidal ideation was collected. Multivariable logistic regression analysis was conducted to assess associations. RESULTS: Data on 34,129 individuals were analyzed [mean (SD) age 62.4 (16.0) years; age range 50-114 years; 52.1% females]. After adjustment for potential confounders, in the overall sample, compared to the handgrip strength quintile with the highest values [Quintile 1 (Q1)], Q2, Q3, Q4, and Q5 were associated with significant 2.15 (95% CI = 1.05-4.39), 2.78 (95% CI = 1.06-7.32), 3.53 (95% CI = 1.68-7.42), and 6.79 (95% CI = 2.80-16.48) times higher odds for suicidal ideation. CONCLUSIONS: Lower handgrip strength was significantly and dose-dependently associated with higher odds for suicidal ideation in adults aged ≥50 years from LMICs. Future longitudinal studies are needed to understand the underlying mechanisms, and whether increasing general muscular strength and physical function may lead to reduction in suicidal ideation.

Temporal Trends in Bullying Victimization Among Adolescents Aged 12-15 Years From 29 Countries: A Global Perspective.

PURPOSE: Bullying victimization among adolescents is a major public health concern. However, multicountry studies investigating temporal trends of bullying victimization among adolescents are scarce, especially from a global perspective. Thus, we aimed to examine the temporal trends of bullying victimization among school-going adolescents between 2003 and 2017 in 29 countries from Africa (n = 5), Asia (n = 18), and the Americas (n = 6). METHODS: Data on 191,228 students aged 12-15 years [mean (standard deviation) age 13.7 (1.0) years; 48.9% boys] who participated in the Global School-based Student Health Survey were analyzed. Bullying victimization was based on self-report and referred to being bullied at least once in the past 30 days. The prevalence (95% confidence interval) of bullying victimization was calculated for each survey. Crude linear trends in bullying victimization were examined by linear regression models. RESULTS: The mean prevalence of bullying victimization across all surveys was 39.4%. There was a large variation in the trends of bullying victimization across countries with a significant increasing and decreasing trend being observed in 6 and 13 countries, respectively. Myanmar, Egypt, and the Philippines showed the sharpest increase. The decrease was modest in most countries which showed a decreasing trend. The remaining countries showed stable trends (n = 10) but some countries such as Seychelles showed consistently high prevalence over time (i.e., ≥ 50%). DISCUSSION: Decreasing trends of bullying victimization were more common than increasing or stable trends in our study including adolescents from 29 countries. However, a high prevalence of bullying was observed in most countries, and thus, further global efforts to combat bullying victimization are necessary.

Association of Fruit and Vegetable Consumption With Mild Cognitive Impairment in Low- and Middle-Income Countries.

BACKGROUND: Inadequate fruit and vegetable intake may be associated with cognitive decline but its association with mild cognitive impairment (MCI; a preclinical stage of dementia) is largely unknown. Therefore, we examined the association of fruit and vegetable consumption with MCI among middle-aged and older adults from low- and middle-income countries (LMICs). METHODS: Cross-sectional, nationally representative data from the WHO Study on global AGEing and adult health were analyzed. MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Quintiles of vegetable and fruit consumption were created based on the number of servings consumed on a typical day. Multivariable logistic regression analysis was conducted. RESULTS: Data on 32 715 individuals aged ≥50 years were analyzed (mean [standard deviation] age 62.1 [15.6] years; 51.7% females). Greater fruit consumption was dose-dependently associated with lower odds for MCI. For example, the highest quintile (vs lowest) had 47% lower odds for MCI (odds ratio [OR] = 0.53; 95% confidence interval [CI] = 0.43-0.66). For vegetable consumption, compared to the lowest quintile, the second to fourth quintiles had significant 38%-44% lower odds for MCI but there was no significant difference for the highest quintile (OR = 0.82; 95% CI = 0.59-1.15). CONCLUSIONS: Higher fruit and vegetable consumption was associated with lower odds for MCI among middle-aged and older adults from LMICs, but no significant differences were found between the highest and lowest quintiles of vegetable consumption. Future longitudinal studies are required to explore these findings in more depth, and mechanistic studies are required to elucidate on the observed possible U-shaped association between vegetable consumption and MCI.