Loneliness Among Older Adults in Latin America, China, and India: Prevalence, Correlates and Association With Mortality.

Objectives: This study was designed to explore prevalence and correlates of self-reported loneliness and to investigate whether loneliness predicts mortality among older adults (aged 65 or above) in Latin America, China and India. Methods: The study investigated population-based cross-sectional (2003-2007) and longitudinal surveys (follow-up 2007-2010) from the 10/66 Dementia Research Group project. Poisson regression and Cox regression analyses were conducted to analyse correlates of loneliness and its association with mortality. Results: The standardised prevalence of loneliness varied between 25.3 and 32.4% in Latin America and was 18.3% in India. China showed a low prevalence of loneliness (3.8%). In pooled meta-analyses, there was robust evidence to support an association between loneliness and mortality across Latin American countries (HR = 1.13, 95% CI 1.01-1.26, I2 = 10.1%) and China (HR = 1.58, 95% CI 1.03-2.41), but there were no associations in India. Conclusion: Our findings suggest potential cultural variances may exist in the concept of loneliness in older age. The effect of loneliness upon mortality is consistent across different cultural settings excluding India. Loneliness should therefore be considered as a potential dimension of public health among older populations.

[Neuropsychiatric symptoms in older adults with dementia and their relationship to disease severity]. / Síntomas neuropsiquiátricos en adultos mayores con demencia y su relación con la severidad de la enfermedad.

UNLABELLED: Neuropsychiatric symptoms are the psychopathological dimension of dementia and they integrate a set of symptoms among those are: personality, behavioral and basic functions changes. OBJECTIVE: To analyze the prevalence of neuropsychiatric symptoms in elder people diagnosed with dementia, the association of symptoms with each other, their relationship with the severity of the disease and the stress generated by them in caregivers. MATERIAL AND METHODS: Secondary data analysis of 180 cases diagnosed with dementia from a population-based cross-sectional study of 2,003 older adults living in rural and urban areas of low to medium income in Mexico. RESULTS: Twelve symptoms were assessed using the Neuropsychiatric Inventory, with depression (47.8%), sleep disorders (37.2%) and irritability (34.4%) being the most prevalent ones. Statistically significant associations were found between severity of dementia and frequency of delusions, hallucinations, agitation, depression, euphoria, apathy, disinhibition, irritability and aberrant motor behavior. Anxiety, depression and sleep disorders were associated with mild/moderate caregivers stress levels. Three factors were identified by clustering technique Principal Components Analysis: the first conforming by delusions, disinhibition and euphoria; the second factor was integrated for disorders of appetite and apathy and the third factor included anxiety and aberrant motor behavior. CONCLUSIONS: As in samples from other countries neuropsychiatric symptoms are common in Mexican elderly with dementia in non-institutionalized population, they may be auxiliary as indicators of severity of dementia and their grouping is related to 1) behavioral disorders, 2) vegetative symptoms and apathy, and 3) symptoms of anxiety.