Prevalence, correlates, and health indicators associated with meal-skipping among middle-aged and older adults in Thailand: A national longitudinal study.

AIM: The purpose of this longitudinal study was to evaluate the prevalence and correlates of and the factors contributing to meal-skipping in middle-aged and older adults in Thailand. METHODS: We examined prospective cohort data from three consecutive waves of the Health, Aging and Retirement in Thailand (HART) study (analytic sample size = 2863) for participants 45 years of age and older. Meal-skipping was assessed with a one- and two-day recall of breakfast, lunch, and dinner. We used generalized estimating equations analysis to evaluate the longitudinal relationships between sociodemographic, lifestyle, and health indicators and meal-skipping between 2015 (wave 1), 2017 (wave 2), and 2020 (wave 3). Furthermore, binary logistic regression was used to establish the longitudinal association between meal-skipping and the incidence of multiple chronic conditions. RESULTS: The prevalence of meal-skipping was 6.2% in 2015, 16.2% in 2017, and 13.6% in 2020, and across study years the highest proportion of meal skipping was for lunch (6.0%), followed by breakfast (4.6%), and dinner (2.8%). In the final model, sociodemographic factors (higher education, urban residence, and lower subjective economic status), lifestyle factors (high alcohol use, current smoking, and obesity class II), and health indicators (probable depression and wearing dentures) were positively associated with meal-skipping. In the adjusted logistic regression models, compared with no meal-skipping, meal-skipping in 2-3 study waves was associated with incident obesity and incident probable depression. CONCLUSION: Skipping meals was linked to a number of lifestyle variables and indicators of physical and mental illness. Geriatr Gerontol Int 2024; ••: ••-••.

Adolescent health-risk behaviours in Uruguay: Patterns from national cross-sectional school surveys conducted in 2006, 2012 and 2019.

BACKGROUND: There are no trend studies on various health risk behaviours among adolescents in Uruguay. Therefore, this study looked at trends in a number of health-risky behaviours among adolescents in Uruguay from three separate surveys. METHODS: Data from 9272 adolescents (age range: 11-16 years), who took part in three cross-sectional national in-school surveys in Uruguay in 2006, 2012 and 2019 were analysed. A self-administered survey was used to evaluate 24 health risk behaviours. By using logistic regression analyses to treat the study year as a categorical variable and adjusting food insecurity and age, linear trends were examined. RESULTS: We found a significant increase in the prevalence of being overweight, having obesity, inadequate fruit intake, sedentary behaviour in leisure-time, physical inactivity, bullying victimisation, loneliness, suicidal ideation, and sexual activity. We found a significant decrease in current cigarette use, physical fighting and current alcohol use. Among males, a significant increase of non-condom use, and a decrease in current other tobacco use (other than cigarettes), being physically attacked and the number of sexual partners. Among females, we found an increase in food insecurity, trouble from alcohol use, multiple sexual partners, and sleep problems. CONCLUSION: Overall, from 2006 to 2019, there was a decrease in seven health risk behaviours among boys and/or girls. Among boys, there was an increase in 10 health risk behaviours and among girls, 15 health risk behaviours increased, highlighting adolescent girls' greater vulnerability, thereby perpetuating further gendered health inequalities. In Uruguay, school health programmes for adolescents are recommended.

Tobacco use and heavy episodic drinking among persons aged 18-69 years in Bolivia in 2019.

OBJECTIVES: The aim of this study was to estimate the prevalence and sociodemographic factors associated with tobacco use and heavy episodic drinking (TUHED), current tobacco use only (TU), and current heavy episodic drinking only (HED) among people 18-69 years in Bolivia in 2019. STUDY DESIGN: Cross-sectional study. METHODS: The analysis used cross-sectional data from Bolivia's STEPS 2019 survey; 4472 individuals answered questions about substance use and socio-demographic information. RESULTS: The sample included 50.2% women and 49.8% men, 52.1% had secondary or higher education, 48.6% were Mestizo and 28.0% Quechua. The prevalence of TUHD was 6.0% (10.5% for men, 1.6% for women), TU 12.2% (20.0% for men, 4.4% for women), and HED 11.2% (13.4% for men and 9.1% for women). Male sex increased the risk of TU, HED and TUHED and belonging to the Amara ethnic group decreased the risk of TU and TUHED. Higher education was increased the odds of HED and among women of TUHED. Urban residence increased the risk of TUHED and among women of HED. For women, unemployment was associated with TU and marriage or cohabitation was inversely associated with TU, and for men, belonging to another ethnic group (such as Castellano or Tacana) increased the risk of TU and TUHED. CONCLUSION: More than 10% of the general adult population in Bolivia participated in TU and HED, and among men in TUHED. Various factors associated with the different categories of substance use were identified.

Longitudinal Associations Between Food Insecurity and Mental Health in Aging Adults in South Africa.

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.

Rural-urban health differences among aging adults in India.

Background: The aim of this study was to determine the rural-urban health differences among aging adults in India. Methods: The national cross-sectional data of 67,489 individuals (≥45 years) in 2017-2018 from 35 states and union territories of India (excluding Sikkim) in 2017-2018 were analysed. Various sociodemographic data, well-being indicators, lifestyle factors and physical conditions were assessed by face-to-face interviews and physical measurement. Univariable and multivariable logistic regression was utilized to assess the predictors between residence status (rural dweller, urban migrant, and urban dweller) and various health indicator outcomes. Results: Majority (70.4 %) of the participants lived in rural areas, 10.3 % were urban migrants and 19.3 % urban dwellers. In the multivariable logistic regression analysis, urban migrants and urban dwellers had a higher self-rated health status, cognitive functioning, physical inactivity, overweight or obesity and abdominal obesity than rural dwellers, while urban migrants and/or urban dwellers had lower functional disability, insomnia symptoms, current smokeless tobacco use, current smoking, heavy episodic drinking and underweight than rural dwellers. Furthermore, urban migrants and/or urban dwellers had higher odds of diabetes, hypertension, heart disease, cancer, high cholesterol than rural dwellers, while urban migrants and/or urban dwellers had lower odds of persistent headaches, major injury, recurrent fall, physical pain, periodontal disease, vision impairment, and gastrointestinal problems than rural dwellers. Conclusion: Among 30 health indicators assessed, 16 had an urban migrant and/or urban dweller advantage, 8 had urban migrant and/or urban dweller penalty, and 6 did not differ between rural-urban groups. Public health promotion and health care should address differing health care needs of rural and urban middle-aged and older adults.

Suicidal behaviour among adults in Cabo Verde in 2020.

BACKGROUND: The aim of the investigation was to evaluate past 12-month suicidal behaviour (PSB) among adults in Cabo Verde. METHODS: Data from 4,563 adults (mean age 41.4 years) that participated in the 2020 Cabo Verde STEPS survey were analysed. RESULTS: Results indicate that the proportion of PSB (attempt 0.6%, plan 1.5% and ideation 3.3%) was 3.7% (2.4% men/5.0% women). In adjusted logistic regression analysis, younger age, female sex, unemployed, widowed or divorced, alcohol family problem, heart attack, angina or stroke, current smokeless tobacco use and low fruit/vegetable intake were associated with PSB. CONCLUSION: Almost 4% of participants had PSB and several associated factors were identified that can guide public health interventions.

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.

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.

Marital status, marital transition and health behaviour and mental health outcomes among middle-aged and older adults in Thailand: A national longitudinal study.

OBJECTIVES: The aim of this study was to assess the longitudinal association between marital status, marital transition, mental ill-health, and health risk behaviours among middle-aged and older adults in Thailand. METHODS: We analyzed prospective cohort data of participants 45 years and older from three consecutive waves in 2015, 2017, and in 2020 (analytic sample, n = 2863) of the Health, Aging and Retirement in Thailand (HART) study. Sociodemographic and health variables were assessed by self-report. RESULTS: Being single was positively associated with current smoking among men and transitioning to widowed or divorced was associated with incident current smoking among women. Divorced or separated was positively associated with current alcohol use among men and transitioning to marriage was associated with incident alcohol use among women. Being single or widowed was positively associated with underweight and negatively associated with obesity among women. Men who were divorced, single, or widowed had higher odds of having depressive symptoms and among women, transitioning to being widowed or divorced or separated was associated with incident depressive symptoms. Among both men and women, being divorced, single or widowed were positively associated with poor quality of life/happiness, and among men being divorced, single or widowed was positively associated with loneliness, and among women, being single or widowed was positively associated with loneliness. Among men, being single was positively associated with having an emotional or psychiatric disorder. CONCLUSION: We found among men and/or women that being unmarried was associated with several health risk behaviours and mental-ill health indicators.

Prevalence and correlates of psychological distress among national community-based adult populations in Nauru, Tukelau and Tuvalu.

AIMS: The aim of the study was to estimate the prevalence and correlates of psychological distress (PD) in three small Pacific Island countries. METHOD: National cross-sectional data (pooled sample N = 3,088, 18-69 years) of participants from the STEPS surveys in Nauru (2015/16; N = 1382), Tukelau (2014; N = 554) and Tuvalu (2015; N = 1152) were analysed. RESULTS: In the pooled sample 30.4% participants had PD (⩾20 scores), 18.1% mild (20-24 scores), 7.8% moderate (25-29 scores) and 4.4% severe (30-50 scores) PD. The prevalence of PD in Nauru was 41.5%, in Tukelau 5.0% and in Tuvalu 22.7%. In the adjusted logistic regression analysis with the pooled sample, younger age (18-39 years), alcohol family problems, heart attack/stroke, current smoking, high salt intake and high sedentary behaviour were positively associated with PD, while male sex and being from Tukelau and Tuvalu were negatively associated with PD. CONCLUSION: Almost one in three participants reported PD and several associated factors were found that can be targeted in population interventions.

Impact of Somatic Conditions and Lifestyle Behaviours on Depressive Symptoms and Low Life Satisfaction among Middle-Aged and Older Adult Men in South Africa.

Objective: The purpose of this study was to assess the association between somatic disorders, lifestyle factors, incident and persistent depressive symptoms, and low life satisfaction in a longitudinal study in South Africa. Methods: We analyzed longitudinal data from two consecutive waves, 2346 men aged 40 years or older in 2014/2015 in wave 1 and 1864 men of wave 1 in 2018/2019 in wave 2 of the "Health and Ageing in Africa: A Longitudinal Study of an International Network for the Demographic Evaluation of Populations and their Health (INDEPTH) Community in South Africa (HAALSI)". Results: In total, 360 of 1932 male participants without depressive symptoms in wave 1 (24.3%) had incident depressive symptoms in wave 2 and 77 of 349 men had depressive symptoms in both waves 1 and 2 (persistent depressive symptoms). In all, 457 of 1258 male participants without low life satisfaction in Wave 1 (47.6%) had incident low life satisfaction in Wave 2, and 360 of 998 men had low life satisfaction at both Wave 1 and 2 (persistent low life satisfaction). In the unadjusted logistic regression analysis, having kidney disease and living with HIV had greater odds of incident depressive symptoms. In adjusted analysis, alcohol dependence (Adjusted Odds Ratio-AOR: 4.54, 95% Confidence Interval-CI: 1.05-19.66) was positively correlated and 1-7 and 8-11 years of education (AOR: 0.45, 95% CI: 0.27-0.74, and AOR: 0.20, 95% CI: 0.07-0.54, respectively) were negatively associated with persistent depressive symptoms. Increasing age increased the odds (AOR: 1.03, 95% CI: 1.01-1.04), while higher education (≥12 years) (AOR: 0.50, 95% CI: 0.33-0.76), and high physical activity (AOR: 0.68, 95% CI: 0.52-0.89) decreased the odds of incident low life satisfaction. Increasing age (AOR: 1.03, 95% CI: 1.02-1.04) and tobacco use (AOR: 1.64, 95% CI: 1.23-2.19) increased the odds and high physical activity (AOR: 0.73, 95% CI: 0.56-0.96) decreased the odds of persistent low life satisfaction. Conclusions: Of the seven chronic conditions and five lifestyle factors evaluated, alcohol dependence increased the odds of persistent depressive symptoms and low physical activity, and tobacco use increased the odds of incident and/or persistent low life satisfaction among men in rural South Africa.