Mortality risk factors in the dependent population of Castilla-La Mancha (Spain) before and during the first COVID-19 wave.

The coronavirus disease pandemic has had an important impact worldwide. The population aged over 65 years and aged dependent persons are the population groups which have suffered in a highest level the consequences of the pandemic in terms of cases and death. In Spain, the situation is similar to other countries, but regional studies are needed because competencies on long-term care depend on regional public administration. Thus, the aim of this work is to analyse social and individual factors associated with the risk of mortality of legally recognised dependent people during the pandemic compared to a non-pandemic period. The data were extracted from the administrative database on individuals included in Castilla-La Mancha's long-term care system and it was merged with the information from the Spanish National Death Index administered by the Ministry of Health, Consumption and Social Welfare. The results show that the risk of mortality between March and June 2020 was positively associated with being male; being older than 65, with an especially high impact in the group aged over 90; having a higher level of dependency; living in a nursing home; and living in a place with more population density. Intraregional differences related to health areas also exists in both pandemic and non-pandemic periods. These findings are critical with a view to enhancing protocols for the care of the most vulnerable population groups.

Socioeconomic and Lifestyle Factors Related to Cost and Frequency of Hospitalization in European Older Adults.

Individuals' lifestyles play an important role in healthcare costs. A large part of these costs is derived from hospitalizations. With the aim of determine the relationship between lifestyle and the likelihood of hospitalization and associate costs in older adults, this study used the Survey of Health, Aging, and Retirement in Europe. Generalized regression models for panel data were developed and adjusted hospitalization costs derived from the length of hospital stay were also estimated. The average adjusted cost of hospitalization was I$ 9901.50 and the analyses showed that performing weekly physical activity significantly reduces the probability of hospitalization (OR: 0.624) and its costs (I$ 2594.5 less per person per year than subjects who never performed physical activity). Muscle strength plays an important role in this relationship and eating habits are not of great significance. Furthermore, we found interesting differences in the frequency and costs of hospitalization between subjects by country.

Calidad de la dieta en mayores de 65 años y factores socioeconómicos relacionados / Diet quality in a population aged over 65 and related socioeconomic factors

INTRODUCCIÓN: El consumo de ciertos alimentos y los hábitos saludables se relacionan con padecer o prevenir algunas enfermedades crónicas. Estos alimentos suelen estar recogidos en pirámides de alimentación, como las de la Sociedad Española de Nutrición Comunitaria. Una manera de analizar la calidad de la dieta es mediante índices que valoran la frecuencia de consumo de los diferentes alimentos. OBJETIVO: Analizar la calidad de la dieta en la población española mayor de 65 años mediante el índice de alimentación saludable y determinar cómo afectan los factores sociodemográficos al resultado final de la misma. DISEÑO: Se realizó un estudio transversal y descriptivo de la dieta de la población española mayor de 65 años en sus hogares a partir del índice de alimentación saludable, utilizando como información la Encuesta Europea de Salud en España de 2014. Mediante un análisis de regresión lineal múltiple se determinaron los factores socioeconómicos relacionados con la calidad de la dieta. RESULTADOS: El 89,6% de la población en estudio necesita cambios en la dieta, y tan solo un 8,2% sigue una dieta saludable. Padecer enfermedades crónicas, tener sobrepeso y realizar actividad física de forma ocasional se asocian con una mejor puntuación en el índice de alimentación saludable. CONCLUSIÓN: La mayor parte de la población de 65 o más años necesita realizar cambios en sus patrones alimentarios. Las personas con riesgos potenciales para la salud son las que cuidan más su alimentación. Estos resultados confirman la necesidad de promover pautas de alimentación saludable en la población sana

INTRODUCTION: The consumption of certain foods and healthy eating habits are related to preventing and suffering from a number of chronic diseases. These foods tend to be included in food pyramids, such as that proposed by the Spanish Society for Community Nutrition. One method of analysing diet quality is the use of indices that assess the frequency of consumption of different food groups. AIM: To analyse diet quality in a Spanish population of persons aged over 65 years using the Healthy Eating Index and to determine how sociodemographic factors affect scores on the index. DESIGN: A cross-sectional, descriptive study was conducted on the diet followed at home by Spanish population aged over 65years, using the Healthy Eating Index and taking information from the 2014 European Health Interview Survey in Spain. Multiple linear regression analysis was used to determine the socioeconomic factors associated with diet quality. RESULTS: Of the study population, 89.6% need to make changes in their diet, while only 8.2% follow a healthy diet. Suffering from chronic diseases, overweight and occasional physical exercise were associated with higher scores on the Healthy Eating Index. CONCLUSION: Most of the population aged 65 years or over need to make changes in their dietary patterns. Those with potential health risks are more careful about their diet. These findings confirm the need to promote guidelines for healthy eating in the non-clinical population

[Diet quality in a population aged over 65 and related socioeconomic factors]. / Calidad de la dieta en mayores de 65 años y factores socioeconómicos relacionados.

INTRODUCTION: The consumption of certain foods and healthy eating habits are related to preventing and suffering from a number of chronic diseases. These foods tend to be included in food pyramids, such as that proposed by the Spanish Society for Community Nutrition. One method of analysing diet quality is the use of indices that assess the frequency of consumption of different food groups. AIM: To analyse diet quality in a Spanish population of persons aged over 65years using the Healthy Eating Index and to determine how sociodemographic factors affect scores on the index. DESIGN: A cross-sectional, descriptive study was conducted on the diet followed at home by Spanish population aged over 65years, using the Healthy Eating Index and taking information from the 2014 European Health Interview Survey in Spain. Multiple linear regression analysis was used to determine the socioeconomic factors associated with diet quality. RESULTS: Of the study population, 89.6% need to make changes in their diet, while only 8.2% follow a healthy diet. Suffering from chronic diseases, overweight and occasional physical exercise were associated with higher scores on the Healthy Eating Index. CONCLUSION: Most of the population aged 65years or over need to make changes in their dietary patterns. Those with potential health risks are more careful about their diet. These findings confirm the need to promote guidelines for healthy eating in the non-clinical population.

Correction: Social determinants of food group consumption based on Mediterranean diet pyramid: A cross-sectional study of university students.

[This corrects the article DOI: 10.1371/journal.pone.0227620.].

Socioeconomic, demographic and lifestyle-related factors associated with unhealthy diet: a cross-sectional study of university students.

BACKGROUND: Food habits are important to promote and maintain good health throughout life, and unhealthy diet is a modifiable and preventable risk factor. University students are a key group of adults among whom to promote healthy lifestyles. The aim of this study is to determine the factors associated with unhealthy diet in a sample of university students. METHODS: An electronic cross-sectional survey was conducted with university students (n=593) from inland Spain, during the 2016-2017 academic year. The survey collected information on the participants' food habits using an annual food frequency questionnaire. We also collected socioeconomic and demographic data and lifestyle-related information. A multivariate logistic regression was used for analysis. RESULTS: The multivariate logistic regression revealed that the factors associated with an unhealthy diet were: being male, being underweight compared to the reference category (normal weight), having a mother of low socioeconomic status, the family home not being in the university city and, finally, studying a non health-related course CONCLUSION: Among students of the University of Castilla-La Mancha, being male, being underweight, the family home not being in the university city, having a mother of low socioeconomic status, and, finally, not studying a health-related course are the factors associated with a lower quality diet. Following a healthy diet is key in reducing the health costs of non-communicable diseases, and ensuring an acceptable long-term quality of life in populations.

Mediterranean diet and health outcomes: a systematic meta-review.

Background: The Mediterranean diet (MeDi) is considered a healthy dietary pattern, and greater adherence to this diet may improve health status. It also may reduce the social and economic costs of diet-related illnesses. This meta-review aims to summarize, synthesize and organize the effects of MeDi pattern on different health outcomes. Methods: This meta-review was performed following the PRISMA guidelines. A systematic search was conducted in the electronic databases PubMed, Web of Science and Scopus. Two researchers screened all the records to eliminate any duplicate, and they selected the articles to be fully reviewed. A third researcher was consulted to resolve discrepancies and so reach a consensus agreement. Results: Thirty-three articles were included, nine were systematic reviews and twenty-four were meta-analyses. Most of the diseases analysed are catalogued as non-communicable diseases (NCD), and the impact of these in populations may have major financial consequences for healthcare spending and national income. The results showed that the MeDi may improve health status, and it also may reduce total lifetime costs. Conclusion: MeDi has been shown to be a healthy dietary pattern that may reduce risk related to NCD. The effect is larger if the pattern is combined with physical activity, and tobacco and excessive alcohol consumption are avoided. Promoting the MeDi as a healthy dietary pattern presents challenges which need the collaboration of all levels of society.

Costes asociados a la desnutrición previa a la enfermedad y la desnutrición relacionada con la enfermedad en ancianos: una revisión sistemática.

INTRODUCTION: Malnutrition is a health problem which affects a high percentage of old people since the physical and psychosocial changes common to this period of life favor it in this group. In addition, aging population has a high prevalence of chronic illnesses and acute pathologies which can affect their nutritional state negatively, leading to malnutrition related to illness. OBJECTIVE: The aim of this systematic revision was to analyze the economic costs related to malnutrition in old people and to discover whether there were differences between economic costs of pre-existing malnutrition prior to illness and malnutrition because of disease. METHOD: A bibliographic search was carried out in the databases of Pubmed, Web of Science and Scopus, for the period between 2000 and 2016. RESULTS: A total of 1,001 articles were found and 19 were selected using inclusion criteria. Of these, eleven analyzed the costs of pre-existing malnutrition prior to illness, seven analyzed the costs of malnutrition related to illness and one, both situations. CONCLUSIONS: In general, malnutrition increased health costs as a result of hospital admissions, greater number of readmissions and greater demand on health resources. Moreover, in the studies analyzed, pre-existing malnutrition prior to illness implied greater costs than those related to the actual illness; therefore, it would be convenient to establish selection and preventive policies on malnutrition in old people.

Costes asociados a la desnutrición previa a la enfermedad y la desnutrición relacionada con la enfermedad en ancianos: una revisión sistemática / Cost associated with malnutrition prior to disease and disease-related malnutrition in the elderly: a systematic review

Introducción: la desnutrición es un problema de salud que afecta en un elevado porcentaje al colectivo de ancianos, ya que los cambios físicos y psicosociales propios de esta etapa de la vida favorecen la aparición de la misma. Además, la población anciana presenta una elevada prevalencia en enfermedades crónicas y patologías agudas que pueden afectar negativamente al estado nutricional, provocando desnutrición relacionada con la enfermedad. Objetivo: el propósito de esta revisión sistemática fue analizar el coste económico relacionado con la desnutrición en personas mayores y si existen diferencias entre los costes de la desnutrición previa a la enfermedad y la desnutrición relacionada con la enfermedad. Método: se realizó una búsqueda bibliográfica en las bases de datos Pubmed, Web of Science y Scopus, para el periodo comprendido entre 2000 y 2016. Resultados: se encontraron un total de 1.001 artículos y, utilizando los criterios de inclusión, se seleccionaron 19. De ellos, once analizaron los costes de la desnutrición previa a la enfermedad; siete, los costes de la desnutrición relacionada con la enfermedad, y uno, ambas situaciones. Conclusiones: la desnutrición en general incrementa el gasto sanitario debido al aumento de estancias hospitalarias, al mayor número de reingresos y a la mayor demanda de recursos sanitarios. Además, en los estudios analizados, la desnutrición previa a la enfermedad implicó mayores costes que la relacionada con la enfermedad, por lo que sería conveniente establecer políticas de cribado y prevención de la desnutrición en los ancianos (AU)

Introduction: Malnutrition is a health problem which affects a high percentage of old people since the physical and psychosocial changes common to this period of life favor it in this group. In addition, aging population has a high prevalence of chronic illnesses and acute pathologies which can affect their nutritional state negatively, leading to malnutrition related to illness. Objective: The aim of this systematic revision was to analyze the economic costs related to malnutrition in old people and to discover whether there were differences between economic costs of pre-existing malnutrition prior to illness and malnutrition because of disease. Method: A bibliographic search was carried out in the databases of Pubmed, Web of Science and Scopus, for the period between 2000 and 2016. Results: A total of 1,001 articles were found and 19 were selected using inclusion criteria. Of these, eleven analyzed the costs of pre-existing malnutrition prior to illness, seven analyzed the costs of malnutrition related to illness and one, both situations. Conclusions: In general, malnutrition increased health costs as a result of hospital admissions, greater number of readmissions and greater demand on health resources. Moreover, in the studies analyzed, pre-existing malnutrition prior to illness implied greater costs than those related to the actual illness; therefore, it would be convenient to establish selection and preventive policies on malnutrition in old people (AU)