Association between Happiness and Economic Status among Older Adults in Two Myanmar Regions.

Few studies have examined whether objective or subjective economic status (ES) has a greater association with the happiness of older adults, despite concerns regarding the growing economic cost of morbidity and their functional dependence in developing countries with aging populations. Thus, this study examined whether objective/subjective ES was associated with happiness in older adults in two Myanmar regions. A multistage random sampling procedure and face-to-face interviews were conducted in the urban and rural areas of Myanmar. The happiness of 1200 participants aged >60 years was evaluated using a single happiness score ranging from 0 (very unhappy) to 10 (very happy). The wealth index, used as an objective ES, was calculated from 17 household asset items, such as radio, washing machines, and television. Subjective ES was assessed by asking "Which of the following best describes your current financial situation in light of general economic conditions?" Responses ranged from "very difficult" to "very comfortable". Both low objective and subjective ES were negatively associated with happiness, after adjusting for confounding variables and stratification by region (urban and rural areas). Although objective and subjective ES had similar associations with happiness in urban areas, subjective ES had a stronger association in rural areas.

Association between depressive symptoms and objective/subjective socioeconomic status among older adults of two regions in Myanmar.

Low objective socioeconomic status (SES) has been correlated with poor physical and mental health among older adults. Some studies suggest that subjective SES is also important for ensuring sound physical and mental health among older adults. However, few studies have been conducted on the impact of both objective and subjective SES on mental health among older adults. This study examines whether objective or subjective SES is associated with depressive symptoms in older adults in Myanmar. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from two regions of Myanmar, for face-to-face interviews. The Geriatric Depression Scale (GDS) was used to evaluate the depressive symptoms. Participants were classified as having no depressive symptom (GDS score <5) and having depressive symptoms (GDS score ≥5). Objective and subjective SES were assessed using the wealth index and asking participants a multiple-choice question about their current financial situation, respectively. The relationship between objective/subjective SES and depressive symptoms was examined using a multivariable logistic regression analysis. The mean age of the 1,186 participants aged 60 years and above was 69.7 (SD: 7.3), and 706 (59.5%) were female. Among them, 265 (22.3%) had depressive symptoms. After adjusting for objective SES and other covariates, only low subjective SES was positively associated with depressive symptoms (adjusted odds ratio, AOR: 4.18, 95% confidence interval, CI: 2.98-5.87). This association was stronger among participants in the rural areas (urban areas, AOR: 2.10, 95% CI: 1.08-4.05; rural areas, AOR: 5.65, 95% CI: 3.69-8.64). Subjective SES has a stronger association with depressive symptoms than objective SES, among older adults of the two regions in Myanmar, especially in the rural areas. Interventions for depression in older adults should consider regional differences in the context of subjective SES by reducing socioeconomic disparities among the communities.

Cohort profile: healthy and active ageing in Myanmar (JAGES in Myanmar 2018): a prospective population-based cohort study of the long-term care risks and health status of older adults in Myanmar.

PURPOSE: Myanmar is rapidly ageing. It is important to understand the current condition of older adults in the country. To obtain such information, we conducted home-visit surveys to collect data for evaluating social determinants of health on older adults in Yangon (representative of an urban) and Bago (representative of a rural) regions of Myanmar. PARTICIPANTS: Overall, 1200 individuals aged 60 years or older and who were not bedridden or had severe dementia (defined as an Abbreviated Mental Test score ≤6) were recruited from Yangon and Bago in 2018. A population-proportionate random-sampling method was used for recruitment. FINDINGS TO DATE: Overall, 600 individuals from Yangon (222 men; 378 women) and 600 from Bago (261 men; 339 women) were surveyed. The average age of Yangon-based men and women was 69.4±7.6 and 69.4±7.3 years; in Bago, this was 69.2±7.1 and 70.6±7.5 years, respectively. Compared to their Yangon-based counterparts, Bago-based respondents showed significantly lower socioeconomic status and more commonly reported poor self-rated health (Bago-based men: 32.2%, women: 42.5%; Yangon: 10.8% and 24.1%, respectively). Meanwhile, some Yangon-based respondents rarely met friends (men: 17.1%, women: 27.8%), and Yangon-based respondents scored higher for instrumental activities of daily living and body mass index when compared to their Bago-based counterparts. For both regions, women showed higher physical-function decline (Yangon-based women: 40.7%, men: 17.1%; Bago: 46.3% and 23.8%, respectively) and cognitive-function decline (Yangon: 34.1% and 10.4%, respectively; Bago: 53.4% and 22.2%, respectively). Being homebound was more common in urban areas (urban-based men: 11.3%, rural-based men: 2.3%; urban-based women: 13.0%, rural-based women: 4.7%, respectively). FUTURE PLANS: A follow-up survey is scheduled for 2021. This will afford longitudinal data collection concerning mortality, becoming bedridden, and developing dementia and long-term care-related diseases. This will allow us to calculate long-term care risks for older adults in Myanmar.

Assessment of quality of life among elderly in urban and peri-urban areas, Yangon Region, Myanmar.

BACKGROUND: In the context of an aging population, quality of life (QOL) is an important consideration for the well-being of the elderly. However, there is limited information on the QOL of the elderly in Myanmar. This study aimed to explore the risk factors for low QOL among the elderly in urban and peri-urban areas of the Yangon Region, Myanmar. METHODS: A community-based, cross-sectional study was conducted among the elderly aged 60 years or older in two urban and two peri-urban townships in the Yangon Region from July to September 2019. A multi-stage sampling method was used to recruit study participants using a pre-tested questionnaire. A total of 616 (305 males and 311 females) elderly people were interviewed using a face-to-face interview technique. Multiple linear regression analysis was performed on the four domains (physical health, psychological health, social relationship, and environment) of QOL measured with the WHOQOL-BREF. RESULTS: Income level and having intimate friends influenced the QOL scores of the elderly in all domains, while education level and marital status influenced psychological health, social relationship, and environment domains. Social interaction with neighbors increased the QOL scores for physical health, social relationship, and environment domains. Living in peri-urban areas was associated with lower QOL scores for physical health, psychological health, and environment, while participation in group activities increased QOL scores in these domains. Having comorbidities affected the QOL for psychological health and environment domains, while the frequency of going out affected physical health, and the frequency of religious performance affected social relationship. CONCLUSION: Residential location, education level, marital status, income, comorbidities, social interactions with neighbors and friends, participation in group activities, and frequencies of going out and religious activities should be considered in planning and implementing programs for the elderly in Myanmar. Peri-urban development, strengthening healthcare and social security systems, and encouraging social interaction and participation in group activities play critical roles in improving the QOL for elderly residing in Myanmar.

Assessment of nutritional status and risk factors for malnutrition among the elderly in Loikaw, Myanmar.

OBJECTIVES: Malnutrition among the elderly is an important health concern in Myanmar. The country is challenged by both an aging population and poor nutritional status. The aim of this study was to estimate the prevalence of malnutrition and elucidate its associated factors among the elderly in Loikaw, Myanmar. METHODS: A cross-sectional study was conducted from July to August 2019. Using a multistage sampling method, 747 elderly individuals (313 men and 434 women) were recruited. The nutritional status of these participants was assessed using the Mini-Nutritional Assessment tool, with a face-to-face interview method. Body mass index, mid-upper arm and calf circumference, blood pressure, and random blood sugar levels were also assessed. Multinomial logistic regression analysis was performed. RESULTS: The prevalence of malnutrition and at risk for malnutrition were 21.7% and 59.4%, respectively. In the multivariate model, dental problem (adjusted odds ratio [aOR], 2.18; 95% confidence interval [CI], 1.24-3.83), low level of education (aOR, 3.13; 95% CI, 1.44-6.81), aged ≥70 y (aOR, 3.55; 95% CI, 1.83-6.88), current betel chewing (aOR, 2.82; 95% CI, 1.64-4.87), and having heart disease (aOR, 8.04; 95% CI, 2.29-18.13) were positively associated with malnutrition. CONCLUSION: One in five elderly study participants were malnourished and 50% were at risk for malnutrition. Malnutrition was associated with being ≥70 y of age, having a low educational level, chewing betel, having a history of heart disease, and having dental problems. These findings may alert policymakers to develop and implement effective interventions for improving nutritional status of the elderly population.