Dietary Patterns and Their Association with Anxiety Symptoms among Older Adults: The ATTICA Study.

Abstract: By 2050, the global population aged 60 years and over is expected to reach nearly 2.1 billion and affective disorders might be also expected to increase. Although nutrition has been related with affective disorders, there is a lack of studies assessing the relation between dietary habits and anxiety among European and Mediterranean older populations. In the present study, we aimed to evaluate the association between dietary habits, energy intake, and anxiety symptoms using data from 1128 Greek older adults (>50 years) without pre-existing cardiovascular disease (CVD) or any other chronic disease who participated in the ATTICA study. Various socio demographic lifestyle, bio-clinical (e.g., blood pressure), and psychological (e.g., depression) characteristics were used, and dietary habits as well as energy intake were calculated using standard procedures. Older people with anxiety were more likely to be sedentary, to be smokers, and to show symptoms of depression. The saturated fat and added sugars (SFAS) dietary pattern was associated with higher anxiety levels (non-standardized b (95% CI): 5.82 (0.03 to 11.61)). No association between energy intake tertiles and anxiety levels pictured in the later regression model. Moreover, female gender, family status, and depression were positively related to anxiety. Therefore, promoting healthy dietary habits could reduce anxiety symptoms of the older adults.

La carga de enfermedad en España: resultados del Estudio de la Carga Global de las Enfermedades 2016 / The burden of disease in Spain: Results from the Global Burden of Disease 2016

Antecedentes y objetivo: El estudio de la carga global de las enfermedades, conocido como GBD por sus siglas en inglés (global burden of disease), mide la salud poblacional en todo el mundo de forma anual y sus resultados están disponibles por país. Utilizamos las estimaciones GBD para resumir el estado de salud poblacional en España en 2016 y describir las tendencias en morbimortalidad de 1990 a 2016. Material y métodos: GBD 2016 estima la carga debida a 333 enfermedades y lesiones, y a 84 factores de riesgo. La lista de causas de GBD es jerárquica e incluye 3 categorías de nivel superior: 1) enfermedades transmisibles, maternas, neonatales y nutricionales; 2) enfermedades no transmisibles (ENT), y 3) accidentes. Se presentan la mortalidad, los años de vida ajustados por discapacidad (AVAD), los factores de riesgo y el progreso hacia los objetivos de desarrollo sostenible (ODS) a partir de los datos de GBD 2016 en España. Resultados: En 2016 en España hubo 418.516 muertes, de una población total de 46,5 millones, y el 80,5% de ellas ocurrieron en personas de 70 años o más. Las ENT fueron la principal causa de muerte (92,8%), con 388.617 (intervalo de incertidumbre del 95% 374.959-402.486), seguidas de los accidentes (3,6%), con 15.052 (13.902-17.107), y de las enfermedades transmisibles (3,5%), con 14.847 (13.208-16.482) muertes. Las 5 principales causas específicas de muerte fueron la cardiopatía isquémica (CI), con el 14,6% de todas las muertes, la enfermedad de Alzheimer y otras demencias (13,6%), el accidente cerebrovascular (7,1%), la enfermedad pulmonar obstructiva crónica (6,9%) y el cáncer de pulmón (5,0%). Se observaron incrementos notables en la mortalidad de 1990 a 2016 en otros cánceres, infecciones respiratorias del tracto inferior, enfermedad renal crónica y otras enfermedades cardiovasculares, entre otros. Por el contrario, los accidentes de tráfico bajaron del puesto 8 al 32 y la diabetes del 6 al 10. Los dolores de espalda y cervicales se convirtieron en la causa principal de AVAD en España en 2016, superando a la CI, mientras que la enfermedad de Alzheimer pasó del puesto 9 al 3. Los mayores cambios en AVAD se observaron para accidentes de tráfico, que cayeron de la posición 4 a la posición 16, y los trastornos congénitos, de la 17 a la 35; por el contrario, los trastornos orales aumentaron, pasando del puesto 25 al 17. En general, fumar es, con mucho, el factor de riesgo más relevante en España, seguido de presión arterial alta, índice de masa corporal alto, consumo de alcohol y glucemia alta en ayunas. Finalmente, España obtuvo 74,3 sobre 100 puntos en la clasificación del índice ODS en 2016, y los principales determinantes de salud nacionales relacionados con los ODS fueron el consumo de alcohol, el tabaquismo y la obesidad infantil. Se proyecta un aumento a 80,3 puntos en 2030. Conclusión: Los dolores de espalda y cervical fueron el contribuyente más importante de discapacidad en España en 2016. Hubo un aumento notable de la carga poblacional debida a la enfermedad de Alzheimer y otras demencias. El tabaco sigue siendo el riesgo para la salud más importante que debe abordarse en España

Background and objectives: The global burden of disease (GBD) project measures the health of populations worldwide on an annual basis, and results are available by country. We used the estimates of the GBD to summarise the state of health in Spain in 2016 and report trends in mortality and morbidity from 1990 to 2016. Material and methods: GBD 2016 estimated disease burden due to 333 diseases and injuries, and 84 risk factors. The GBD list of causes is hierarchical and includes 3 top level categories, namely: 1) communicable, maternal, neonatal, and nutritional diseases; 2) non-communicable diseases (NCDs), and 3) injuries. Mortality and disability-adjusted life-years (DALYs), risk factors, and progress towards the sustainable development goals (SDGs) are presented based on the GBD 2016 data in Spain. Results: There were 418,516 deaths in Spain in 2016, from a total population of 46.5 million, and 80.5% of them occurred in those aged 70 years and older. Overall, NCDs were the main cause of death: 388,617 (95% uncertainty interval 374,959-402,486), corresponding to 92.8% of all deaths. They were followed by 3.6% due to injuries with 15,052 (13,902-17,107) deaths, and 3.5% communicable diseases with 14,847 (13,208-16,482) deaths. The 5 leading specific causes of death were ischaemic heart disease (IHD, 14.6% of all deaths), Alzheimer disease and other dementias (13.6%), stroke (7.1%), chronic obstructive pulmonary disease (6.9%), and lung cancer (5.0%). Remarkable increases in mortality from 1990 to 2016 were observed in other cancers, lower respiratory infections, chronic kidney disease, and other cardiovascular disease, among others. On the contrary, road injuries moved down from 8th to 32nd position, and diabetes from 6th to 10th. Low back and neck pain became the number one cause of DALYs in Spain in 2016, just surpassing IHD, while Alzheimer disease moved from 9th to 3rd position. The greatest changes in DALYs were observed for road injuries dropping from 4th to 16th position, and congenital disorders from 17th to 35th; conversely, oral disorders rose from 25th to 17th. Overall, smoking is by far the most relevant risk factor in Spain, followed by high blood pressure, high body mass index, alcohol use, and high fasting plasma glucose. Finally, Spain scored 74.3 of 100 points in the SDG index classification in 2016, and the main national drivers of detrimental health in SDGs were alcohol consumption, smoking and child obesity. An increase to 80.3 points is projected in 2030. Conclusion: Low back and neck pain was the most important contributor of disability in Spain in 2016. There has seen a remarkable increase in the burden due to Alzheimer disease and other dementias. Tobacco remains the most important health issue to address in Spain

The burden of disease in Spain: Results from the Global Burden of Disease 2016. / La carga de enfermedad en España: resultados del Estudio de la Carga Global de las Enfermedades 2016.

BACKGROUND AND OBJECTIVES: The global burden of disease (GBD) project measures the health of populations worldwide on an annual basis, and results are available by country. We used the estimates of the GBD to summarise the state of health in Spain in 2016 and report trends in mortality and morbidity from 1990 to 2016. MATERIAL AND METHODS: GBD 2016 estimated disease burden due to 333 diseases and injuries, and 84 risk factors. The GBD list of causes is hierarchical and includes 3 top level categories, namely: 1) communicable, maternal, neonatal, and nutritional diseases; 2) non-communicable diseases (NCDs), and 3) injuries. Mortality and disability-adjusted life-years (DALYs), risk factors, and progress towards the sustainable development goals (SDGs) are presented based on the GBD 2016 data in Spain. RESULTS: There were 418,516 deaths in Spain in 2016, from a total population of 46.5 million, and 80.5% of them occurred in those aged 70 years and older. Overall, NCDs were the main cause of death: 388,617 (95% uncertainty interval 374,959-402,486), corresponding to 92.8% of all deaths. They were followed by 3.6% due to injuries with 15,052 (13,902-17,107) deaths, and 3.5% communicable diseases with 14,847 (13,208-16,482) deaths. The 5 leading specific causes of death were ischaemic heart disease (IHD, 14.6% of all deaths), Alzheimer disease and other dementias (13.6%), stroke (7.1%), chronic obstructive pulmonary disease (6.9%), and lung cancer (5.0%). Remarkable increases in mortality from 1990 to 2016 were observed in other cancers, lower respiratory infections, chronic kidney disease, and other cardiovascular disease, among others. On the contrary, road injuries moved down from 8th to 32nd position, and diabetes from 6th to 10th. Low back and neck pain became the number one cause of DALYs in Spain in 2016, just surpassing IHD, while Alzheimer disease moved from 9th to 3rd position. The greatest changes in DALYs were observed for road injuries dropping from 4th to 16th position, and congenital disorders from 17th to 35th; conversely, oral disorders rose from 25th to 17th. Overall, smoking is by far the most relevant risk factor in Spain, followed by high blood pressure, high body mass index, alcohol use, and high fasting plasma glucose. Finally, Spain scored 74.3 of 100 points in the SDG index classification in 2016, and the main national drivers of detrimental health in SDGs were alcohol consumption, smoking and child obesity. An increase to 80.3 points is projected in 2030. CONCLUSION: Low back and neck pain was the most important contributor of disability in Spain in 2016. There has seen a remarkable increase in the burden due to Alzheimer disease and other dementias. Tobacco remains the most important health issue to address in Spain.

Mediterranean diet and depression among older individuals: The multinational MEDIS study.

BACKGROUND: Depression has been linked to a large and growing economic and societal burden worldwide. In Europe, depression is one of the most frequent mental disorders across all age groups, but particularly in people aged 65 years and over, and higher depressive symptoms have been reported among individuals with chronic diseases (e.g., diabetes and heart disease). AIM: To evaluate the role of adherence to the Mediterranean diet (MedDiet) in depression in a sample of older people living in the Mediterranean basin. METHODS: Standard procedures were used to determine socio-demographic, lifestyle, and clinical characteristics of the participants, as well as their dietary habits, and depressive symptoms were evaluated using the Geriatric Depression Scale (GDS). Multi-adjusted logistic and linear regression analyses were carried out to evaluate the associations between participants' characteristics and depression. RESULTS: Participants classified as having mild or severe depression were less educated and physically active, and more diabetic, and they reported less adherence to the MedDiet. Adherence to the MedDiet was associated with the absence of depression [(OR, 95% CI): 0.65, 0.50-0.85]. In addition, daily tea drinking was also related to the absence of depression [(OR, 95% CI): 0.51, 0.40-0.65]. CONCLUSIONS: Greater adherence to the MedDiet and daily tea drinking seem to have a beneficial effect on depressive symptoms in older adults.

Depression and metabolic syndrome in the older population: A review of evidence.

BACKGROUND: Metabolic syndrome (MetS) has been shown to be associated with depression in older adults but the results are mixed. We summarized and evaluated the association between depression and MetS in people aged 60 years or over. METHODS: Relevant published studies from January 1997 to July 2017 were identified by searching two electronic databases: PubMed/Medline and EMBASE. Observational studies were considered. RESULTS: Twelve studies were included in the systematic review. Depression seemed to be related with MetS in the majority of the studies (10/12 = 83.3%). As far as the longitudinal studies are concerned, the onset of depression was related to MetS in 2 out of 3 studies (66.6%), while a relation between chronicity of depression and MetS was reported (1 study). Regarding cross-sectional studies, 7 out of 9 (77.7%) concluded that there was a positive association between depression and MetS. Mixed evidence was found among studies concerning the association between depression and the individual components of MetS. Four out of ten studies (40%) reported that depression was significantly associated with the waist circumference, a component of MetS. LIMITATIONS: There was a high degree of heterogeneity between studies regarding their design. Only studies written in English, from peer-reviewed journals were included. CONCLUSIONS: Depression seemed to be significantly associated with MetS in people aged 60 years or over. Among the components of MetS, abdominal obesity seemed to be associated more strongly and consistently with depression. The direction of the causality and mechanisms underlying the relationship are still largely unknown.

n-3 Fatty acids, Mediterranean diet and cognitive function in normal aging: A systematic review.

BACKGROUND: Intake of n-3 fatty acids and adherence to the Mediterranean diet (MedDiet) have been shown to slow the progression of age-related cognitive decline, but the results are mixed. We summarized and evaluated the effect of n-3 fatty acids and MedDiet on cognitive outcomes in a cognitively healthy aged population. METHODS: Relevant published studies from January 2000 to May 2015 were identified by searching three electronic databases: Pubmed, Web of Science/MEDLINE, and CINHAL. Observational studies and randomized controlled trials (RCTs) were considered. RESULTS: Twenty-four studies were included for the systematic review. n-3 fatty acids were associated with better global cognition and some specific cognitive domains though some results were conflicting. Adherence to the MedDiet was also significantly associated with better cognitive performance and less cognitive decline. Finally, better cognitive performance was observed in men compared to women and mixed results were also found for the influence of APOE4 genotype on the association between n-3 fatty acids or MedDiet and cognition. CONCLUSIONS: Studies suggest that n-3 fatty acids in the diet and adherence to the MedDiet are beneficial in slowing age-related cognitive decline. However, more high-quality RCTs would be useful to clarify the effect of n-3 fatty acid supplements on cognition.