Prevalence and associated factors of incident and persistent loneliness among middle-aged and older adults in Thailand.

BACKGROUND: The aim of the study was to assess the prevalence and associated factors of incident and persistent loneliness in a prospective cohort study among middle-aged and older adults (≥ 45 years) in Thailand. METHODS: Longitudinal data from the Health, Aging, and Retirement in Thailand (HART) study in 2015 and 2017 were analysed. Loneliness was assessed with one item from the Center for Epidemiological Studies Depression scale. Logistic regression was used to calculate predictors of incident and persistent loneliness. RESULTS: In total, at baseline 21.7% had loneliness, 633 of 3696 participants without loneliness in 2015 had incident loneliness in 2017 (22.2%), and 239 of 790 adults had persistent loneliness (in both 2015 and 2017) (30.3%). In adjusted logistic regression analysis, low income (aOR: 1.27, 95% CI: 1.03 to 1.57), poor self-rated physical health status (aOR: 1.64, 95% CI: 1.27 to 2.12), hypertension (aOR: 1.34, 95% CI: 1.09 to 1.65), depressive symptoms (aOR: 1.97, 95% CI: 1.11 to 3.49), and having three or chronic conditions (aOR: 1.76, 95% CI: 1.19 to 2.60) were positively associated and a higher education (aOR: 0.74, 95% CI: 0.55 to 0.98) and living in the southern region of Thailand (aOR: 0.43, 95% CI: 0.30 to 0.61) were inversely associated with incident loneliness. Poor self-rated physical health status (aOR: 1.91, 95% CI: 1.26 to 2.88), and having three or more chronic diseases (aOR: 1.78, 95% CI: 1.07 to 2.98), were positively associated, and living in the southern region (aOR: 0.40, 95% CI: 0.25 to 0.65) was inversely associated with persistent loneliness. CONCLUSION: More than one in five ageing adults had incident loneliness in 2 years of follow-up. The prevalence of incident and/or persistent loneliness was higher in people with a lower socioeconomic status, residing in the central region, poor self-rated physical health status, depressive symptoms, hypertension, and a higher number of chronic diseases.

A Cross-Sectional and Longitudinal Study of Pain among Middle-Aged and Older Adults in Thailand.

Objective: The present study aimed to assess the prevalence and risk factors of pain among ageing adults in Thailand. Methods: Cross-sectional and longitudinal data were analysed from two consecutive national waves of the Health, Aging, and Retirement in Thailand (HART) study in 2015 and 2017. The dependent variable pain was defined as moderate or severe pain in any of the 13 areas of the body over the past month. Independent variables included sociodemographic factors, health risk behaviour, physical and mental health conditions, and healthcare utilization. Results: The baseline or cross-sectional sample consisted of 5,616 participants (≥45 years), and the follow-up or incident sample consisted of 2,305 participants. The proportion of pain in the cross-sectional/baseline sample was 36.0%, and in the incident/follow-up sample 39.9%. In the cross-sectional/baseline multivariable model, poor self-reported mental health, sleep problem, arthritis or rheumatism, brain disease and/or psychiatric problems, lung disease, use of hospital in-patient, conventional out-patient, and traditional medicine practitioners were positively associated with pain. In the incident/follow-up multivariable model, older age, Buddhist religion, class I obesity, poor self-reported mental health, hospital in-patient, private clinic out-patient, and use of a practitioner of traditional medicine were positively associated with pain. Male sex and higher education were negatively associated with both cross-sectional and incident pain. Conclusions: More than one-third of older adults in Thailand had past month moderate or severe pain. Risk factors of pain from cross-sectional and/or incident analysis included older age, female sex, lower education, obesity, poor self-reported mental health, sleep problem, arthritis or rheumatism, brain disease and/or psychiatric problems, lung disease, and conventional and traditional healthcare utilization.

Chronic conditions and incident and persistent depressive symptoms among ageing adults in rural South Africa.

The study aimed to assess associations between chronic diseases and incident and persistent depressive symptoms (DSs) in a cohort study of ageing adults in South Africa. Participants in the baseline survey (in 2014/2015) were 5,059 persons (≥40 years) and at follow-up 4,176 (in 2018/2019). DSs were measured with the Center for Epidemiological Studies Depression scale. Logistic regression was used to estimate the associations between chronic conditions and incident and persistent DS. The prevalence of DS at baseline was 15.5%, incident DS (without DS and/or PTSD at baseline) was 25.1% and persistent DS (DS at both baseline and follow-up) was 4.8%. In unadjusted logistic regression analysis, diabetes had higher odds of incident DS. Participants with baseline heart attack/stroke/angina, dyslipidemia, tuberculosis, chronic bronchitis, kidney disease and three or more chronic conditions had a higher probability of persistent DS. In conclusion, of the eight chronic conditions evaluated, only diabetes (in unadjusted analysis) was associated with incident DS, and five chronic conditions (heart attack/stroke/angina, dyslipidaemia, tuberculosis, chronic bronchitis and kidney disease) and three or more chronic conditions were associated with persistent DS.

Clinicomics-guided distant metastasis prediction in breast cancer via artificial intelligence.

BACKGROUND: Breast cancer has become the most common malignant tumour worldwide. Distant metastasis is one of the leading causes of breast cancer-related death. To verify the performance of clinicomics-guided distant metastasis risk prediction for breast cancer via artificial intelligence and to investigate the accuracy of the created prediction models for metachronous distant metastasis, bone metastasis and visceral metastasis. METHODS: We retrospectively enrolled 6703 breast cancer patients from 2011 to 2016 in our hospital. The figures of magnetic resonance imaging scanning and ultrasound were collected, and the figures features of distant metastasis in breast cancer were detected. Clinicomics-guided nomogram was proven to be with significant better ability on distant metastasis prediction than the nomogram constructed by only clinical or radiographic data. RESULTS: Three clinicomics-guided prediction nomograms on distant metastasis, bone metastasis and visceral metastasis were created and validated. These models can potentially guide metachronous distant metastasis screening and lead to the implementation of individualized prophylactic therapy for breast cancer patients. CONCLUSION: Our study is the first study to make cliniomics a reality. Such cliniomics strategy possesses the development potential in artificial intelligence medicine.

Tobacco use and incident sleep parameters among a rural ageing population in South Africa.

INTRODUCTION: Tobacco use may be associated with incident insomnia. The aim of the study was to investigate the association between tobacco use and incident sleep parameters in a longitudinal study in South Africa. METHODS: Longitudinal data from two consecutive waves of middle-aged and older adults in 2014-2015 (n=5059) and 2018-2019 (n=4176) in rural South Africa were analyzed. Tobacco use and sleep parameters were assessed by self-report. The associations between tobacco use and incident sleep parameters were estimated with multivariable logistic regression. RESULTS: The prevalence of baseline sleep parameters was poor sleep quality 6.5%, sleep disturbance 13.6%, restless sleep 32.9%, and breathing stops 7.0%. In the fully adjusted model for people without poor sleep quality at baseline, daily tobacco smoking, smoking ≥10 units of tobacco products, current tobacco use and current smokeless tobacco use did not increase the odds of incident poor sleep quality. Smoking ≥10 units of tobacco products in a day (AOR=3.83; 95% CI: 1.77-8.28), current tobacco use (AOR=1.65; 95% CI: 1.09-2.51), and daily tobacco smoking (AOR=2.16; 95% CI: 1.15-4.07), were significantly positively associated with incident sleep disturbance. Furthermore, incident restless sleep was significantly positively associated with smoking ≥10 units of tobacco products in a day (AOR=3.97; 95% CI: 1.18-13.37), current smokeless tobacco use (AOR=2.78; 95% CI: 1.17-6.62) and current tobacco use (AOR=2.00; 95% CI: 1.00-4.00). Incident breathing stops were significantly positively associated with daily smoking tobacco (AOR=2.08; 95% CI: 1.11-3.34), smoking 1-9 units of tobacco products in a day (AOR=2.17; 95% CI: 1.20-3.94), and current tobacco use (AOR=1.77; 95% CI: 1.16-2.72). CONCLUSIONS: Higher tobacco use was independently associated with incident sleep disturbance, incident restless sleep, and incident breathing stops, but not with incident poor sleep quality.

Prevalence and associated factors of cross-sectional and incident self-reported arthritis or rheumatism among a national community sample of middle-aged and older adults in Thailand.

Background: The study aimed to assess the prevalence and associated factors of cross-sectional and incident arthritis or rheumatism among a national community sample of middle-aged and older adults in Thailand. Methods: We analyzed cross-sectional and longitudinal data from two consecutive waves (2015 and 2017) of the Health, Aging, and Retirement in Thailand (HART) study. Arthritis or rheumatism (SRA) was assessed by self-reported health care provider diagnosis. Results: The cross-sectional (baseline) sample included 5,616 participants (≥45 years, median age 66 years, interquartile range 57 to 76 years) and the incident (follow-up) sample included 3,545 participants. The prevalence of SRA in the cross-sectional sample (baseline) was 4.0% and in the incident (follow-up) sample 5.3%. In the cross-sectional multivariable model, obesity class I (aOR: 1.78, 95% CI: 1.19 to 2.67), obesity class II (aOR: 1.82, 95% CI: 1.02 to 3.25), hypertension (aOR: 1.90, 95% CI: 1.35 to 2.66), brain disease and/or psychiatric problems (aOR: 4.79, 95% CI: 2.27 to 10.62), sleep problem (aOR: 1.45, 95% CI: 1.01 to 2.07) and prescription drug use (aOR: 1.63, 95% CI: 1.14 to 2.33) were positively associated, and not in the labor force (aOR: 0.53, 95% CI: 0.34 to 0.84), and employed (aOR: 0.63, 95% CI: 0.41 to 0.99) were negatively associated with SRA. In the incident multivariable model, obesity class I (aOR: 1.78, 95% CI: 1.17 to 3.61), obesity class II (aOR: 2.01, 95% CI: 1.12 to 3.61), poor mental health (aOR: 1.69, 95% CI: 1.19 to 2.41), and functional disability (aOR: 2.04, 95% CI: 1.01 to 4.13) were positively associated, and current alcohol use (aOR: 0.50, 95% CI: 0.25 to 0.99) was negatively associated with SRA. Conclusion: The middle and older Thai adults had a low prevalence and incidence of SRA, and several physical and mental risk factors for cross-sectional and/or incident SRA were identified.

Tridirectional association between probable depression, fear of falling and falls among middle-aged and older adults in Thailand.

PURPOSE: Depression is a major issue in the aging population, which may be related to fear of falling (FOF) and falls contributing to increased morbidity and mortality. The aim of the study was to assess the tridirectional associations between probable depression (PD), FOF and falls in a longitudinal study in Thailand. METHODS: Longitudinal data of participants (≥45 years; N = 3708) from two consecutive waves (in 2015 and 2017) of the Health, Aging and Retirement in Thailand (HART) study were analysed. PD was assessed with the Center for Epidemiologic Studies Depression Scale, self-reported FOF and history of falls. RESULTS: Having no PD in 2015 and PD in 2017 (aOR: 2.35, 95% CI: 1.67 to 3.30), and having both PD in 2015 and 2017 (aOR: 3.46, 95% CI: 1.92 to 6.23) were positively associated with incident FOF with activity avoidance, and no FOF in 2015 and FOF in 2017 (aOR: 2.29, 95% CI: 1.77 to 2.95), and both FOF in 2015 and 2017 (aOR: 2.38, 95% CI: 1.69 to 3.36) were positively associated with incident PD. Two or more falls in 2015 (aOR: 2.03, 95% CI: 1.29 to 3.19) was positively associated with incident PD, and both PD in 2015 and 2017 (aOR: 3.10, 95% CI: 1.40 to 6.48) were positively associated with incident multiple (≥2) falls. CONCLUSIONS: We found tridirectional associations between PD, FOF and falls. It is suggested to screen and manage older adults for PD, FOF and fall history simultaneously.

Bidirectional Association Between Probable Depression and Multimorbidity Among Middle-Aged and Older Adults in Thailand.

Introduction: The purpose of this study was to assess the bidirectional association between multimorbidity (MM) and probable depression in a longitudinal study in Thailand. Methods: We analyzed longitudinal data of participants 45 years and older from two consecutive waves (in 2015 and 2017) of Health, Aging, and Retirement in Thailand (HART). Probable depression was assessed using the Center for Epidemiological Studies Depression scale. Logistic regression analysis was conducted to assess the association between baseline probable depression and incident physical MM, and baseline physical MM and incident probable depression. Results: In all, 2712 participants without MM at baseline and 2684 without probable depression at baseline were included. At follow-up 15.6% of probable depression cases and 11.4% of nonprobable depression cases developed physical MM, and at follow-up 13.3% of physical MM cases and 8.9% of nonphysical MM cases developed probable depression. In the final logistic regression analysis, adjusted for age, sex, marital status, income, education, body mass index, physical activity, smoking tobacco, alcohol use, and social engagement, probable depression at baseline was positively associated with incident physical MM (aOR: 1.50, 95% CI: 1.09 to 2.06), and physical MM at baseline was positively associated with incident probable depression (aOR: 1.47, 95% CI: 1.07 to 2.02). Discussion: Baseline physical MM increases the risk of incident probable depression and baseline probable depression increases the risk of incident physical MM among middle-aged and older adults in Thailand.

Food insecurity and health outcomes among community-dwelling middle-aged and older adults in India.

The study assessed associations between food insecurity and mental, physical, and behavioural health outcomes in India. The study analysed national cross-sectional population-based data (N = 72,262; ≥ 45 years) from in India in 2017-2018. The overall prevalence of food insecurity was 9.7%. Food insecurity was significantly positively associated with poor mental health [low life satisfaction (AOR: 2.75, 95% CI 2.35-3.23), low self-reported health (AOR: 1.61, 95% CI 1.11-1.42), insomnia symptoms (AOR: 1.64, 95% CI 1.45-1.85), depressive symptoms (AOR: 2.21, 95% CI 1.97-2.48), major depressive disorder (AOR: 2.37, 95% CI 2.03-2.77), Alzheimer's/dementia (AOR: 1.75, 95% CI 1.13-2.69), and poorer cognitive functioning (AOR: 0.68, 95% CI 0.49-0.93)], poor physical health [bone or joint disease (AOR: 1.18, 95% CI 1.04-1.34), angina (AOR: 1.80, 95% CI 1.58-2.06), underweight (AOR: 1.28, 95% CI 1.16-1.40), chronic lung disease (AOR: 1.22, 95% CI 1.03-1.45), and functional disability (AOR: 1.68, 95% CI 1.47-1.92)], and health risk behaviour [tobacco use (AOR: 1.13, 95% CI 1.01-1.25), heavy episodic drinking (AOR: 1.45, 95% CI 1.10-1.91) and physical inactivity (AOR: 1.42, 95% CI 1.21-1.67)]. Furthermore, food insecurity was negatively associated with overweight/obesity (AOR: 0.80, 95% CI 0.73-0.88). Food insecurity was associated with seven poor mental health indicators, five poor physical health conditions, and three health risk behaviours. Programmes and policies that improve food availability may help improve mental and physical health among middle-aged and older adults in India.

Bidirectional association between functional disability and multimorbidity among middle-aged and older adults in Thailand.

Objectives: The purpose of this study was to assess the bidirectional association between multimorbidity (MM) and functional disability among middle-aged and older adults in a longitudinal study in Thailand. Methods: We analyzed longitudinal data of participants aged 45 years and older from two consecutive waves (in 2015 and 2017) of the Health, Aging, and Retirement in Thailand (HART). Functional disability was assessed with a 4-item activity of daily living (ADL) scale. Logistic regression analysis was conducted to assess the association between baseline functional disability and incident MM (≥2), and baseline morbidity and incident functional disability. Results: The results indicate that a total of 1,716 individuals without morbidity at baseline and 3,529 without functional disability at baseline were included. At follow-up, 16.7 and 20.0% of functional disability cases and 7.1 and 3.6% of nonfunctional disability cases developed 2 morbidities and 3 or more morbidities, respectively, and 6.6% of MM cases and 4.0% of non-MM cases developed a functional disability. In the final logistic regression model adjusted for education, income, age, marital status, sex, smoking tobacco, body mass index (BMI), alcohol use, physical activity, and social engagement, functional disability at baseline was positively associated with incident MM (≥2) (adjusted odds ratio [aOR]: 2.58, 95% CI: 1.42-4.72), and MM (≥3) at baseline was positively associated with incident functional disability (aOR: 1.97, 95% CI: 1.13-3.43). Conclusion: Multimorbidity and functional disability were bidirectionally associated.

Prevalence and associated factors of undiagnosed hypertension among adults in the Central African Republic.

The study aimed to estimate the prevalence and associated factors of undiagnosed hypertension (HTN) among adults in the Central African Republic (CAR). In the cross-sectional 2017 CAR (Bangui and Ombella M'Poko) STEPS survey, 3265 persons aged 25 to 64 years (non-pregnant and with complete blood pressure measurement), responded to an interview, biomedical and physical, including blood pressure, measurements. Undiagnosed HTN was classified as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg among adults who had never been told by a doctor or other health worker that they had raised blood pressure or hypertension and had not been taking antihypertensive medication. Binary logistic regressions are used to estimate factors associated with undiagnosed HTN. Among those with HTN (N = 1373), the proportion of undiagnosed HTN was 69.8% and 30.2% diagnosed HTN. In the adjusted logistic regression analysis, male sex (AOR: 2.12, 95% CI 1.39-3.23), current tobacco use (AOR: 1.58, 95% CI 1.03-2.42), and high physical activity (AOR: 1.93, 95% CI 1.00-3.71) were positively associated, and age (AOR: 0.75, 95% CI 0.59-0.96), and underweight (AOR: 0.58, 95% CI 0.37-0.90) were inversely associated with undiagnosed HTN. In addition, among men, ever screened for glucose (AOR: 0.07, 95% CI 0.02-0.27) was negatively associated with undiagnosed HTN, and among women, married or cohabiting (AOR: 1.20, 95% CI 1.00-1.44), current heavy drinking (AOR: 1.41, 95% CI 1.04-1.91) were positively associated with undiagnosed HTN. Seven in ten of the adult population with HTN had undiagnosed HTN in CAR. Efforts should be reinforced to screen for HTN in the general population.

Longitudinal correlates of fruit and vegetable consumption with depressive symptoms among middle-aged and older adults in South Africa.

BACKGROUND: Fruit and vegetable intake may influence mental well-being. The aim of this study was to assess longitudinal associations between fruit and vegetable intake and depressive symptoms among rural South Africans. METHODS: This longitudinal community study enrolled 3,891 adults (≥ 40 years) from the "Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI)". Fruit and vegetable intake was assessed by self-report at wave 1, and depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale at wave 1 and 2. Outcomes were incident and persistent depressive symptoms at wave 2. Logistic regression was used to assess the associations between fruit and vegetable intake at wave 1 and incident, and persistent depressive symptoms. RESULTS: Results indicate that in the fully adjusted model for individuals with no depressive symptoms at baseline, we found no significant association between frequency of fruit or vegetables intake and incident depressive symptoms. We also found no significant association between frequency of fruit or vegetable intake and persistent depressive symptoms. CONCLUSION: Fruit and vegetable intake was not significantly associated with incident and persistent depressive symptoms.

Prevalence and correlates of multiple non-communicable diseases risk factors among male and female adults in Sudan: results of the first national STEPS survey in 2016.

Background: Non-communicable diseases (NCDs) are on the rise in low- and middle-income countries. The aim of this study was to assess the prevalence and correlates of multiple NCD risk factors (inadequate fruit and vegetable intake, low physical activity, tobacco use, heavy alcohol use, diabetes, hypertension, raised total cholesterol and overweight/obesity) among adults in Sudan. Methods: We conducted a cross-sectional study using nationally representative data. The analytic cohort included 7,722 participants who were between the ages of 18-69 years old individuals (median age=36 years) that took part in the "2016 Sudan STEPS survey." Results: In all, 34.2% had 0-1 NCD risk factor, 33.5% 2 risk factors, and 32.4% 3 or more NCD risk factors. In adjusted ordinal logistic regression analysis, the odds of having a higher count of NCD risk factors increased from 2.04 to 3.52 from the age group of 35-49 years to age group of 50-69 years when compared to the younger people aged 18-34 years. Men had higher odds (1.21) of higher NCD risk factor count than women. Individuals residing in urban areas had higher odds (1.86) of higher NCD risk factor count than individuals residing in rural areas. Conclusion: Almost one in three participants had three or more NCD risk factors and several associated variables were identified for men and women that can facilitate in designing intervention programmes.

Factors affecting face mask-wearing behaviors to prevent COVID-19 among Thai people: A binary logistic regression model.

Objectives: Face mask wearing is a standard preventive measure, in addition to handwashing and physical distancing. Individuals may find that wearing a face mask protects their physical health and prevents viral transmission. However, none of the studies in Thailand identified factors associated with face mask-wearing behaviors among Thai people. Therefore, this study aims to determine factors affecting face mask-wearing behaviors to prevent COVID-19. Methods: This research is analytical survey research. The data used in this study were under the project title "The assessment of psychosocial and behavioral response and compliance to restriction measures to prevent and control COVID-19: A series of the rapid survey." A total of 6,521 people participated in an online survey by multi-stage sampling. Bivariate logistic regression analysis was used to examine the factors associated with face mask-wearing behaviors. Results: After adjusting for independent variables (i.e., gender, age, education, career, smoking, and comorbidity disease), the bivariate logistic regression analysis revealed that gender, age, and career were statistically significant to the face mask-wearing behaviors (p < 0.05). Level of education, smoking, and comorbidity disease were not statistically significant with face mask-wearing behaviors among Thai people. Conclusion: Further study should explore broader on individual face mask perceptions and wearing in the continuing of COVID-19 across gender, age, and careers to better understand their health behaviors and to inform further policy. In addition, the development of an intervention to promote face mask wearing should target men who age below 30 yrs. and did not work in government services careers as this group of the population was likely not to wear a face mask outside the home.

Prevalence and factors associated with undiagnosed type 2 diabetes among adults in Iraq: analysis of cross-sectional data from the 2015 STEPS survey.

OBJECTIVE: The purpose of the study was to assess the prevalence and correlates of undiagnosed type 2 diabetes (UT2D) among adults (aged 18 years and older) in Iraq. DESIGN: Cross-sectional, population-based study. SETTING: Nationally representative sample of general community-dwelling adult population in Iraq from the 2015 Iraq STEPS survey. PARTICIPANTS: The sample included 3853 adults (mean age 41.8 years, SD=15.8), with complete fasting blood glucose values, from the 2015 Iraq STEPS survey. OUTCOME MEASURES: Data collection included: (1) social and behavioural information, (2) physical parameters and blood pressure measurements and (3) biochemical measurements. UT2D was classified as not being diagnosed with T2D and fasting plasma glucose level ≥126 mg/dL. Multivariable multinomial and logistic regression was used to identify factors associated with UT2D. RESULTS: The prevalence of UT2D was 8.1% and the prevalence of diagnosed T2D (DT2D) was 8.9%. Participants aged 50 years and older (adjusted relative risk ratio (ARRR): 2.11, 95% CI 1.30 to 3.43) and those with high cholesterol (ARRR: 1.54, 95% CI 1.05 to 2.24) had a higher risk of UT2D. Older age (≥50 years) (ARRR: 17.90, 95% CI 8.42 to 38.06), receipt of healthcare advice (ARRR: 2.15, 95% CI 1.56 to 2.96), history of cholesterol testing (ARRR: 2.17, 95% CI 1.58 to 2.99), stroke or heart attack (ARRR: 1.81, 95% CI 1.13 to 2.92), and high cholesterol (ARRR: 1.55, 95% CI 1.17 to 2.06) were positively associated with DT2D, and high physical activity (ARRR: 0.57, 95% CI 0.38 to 0.84) was negatively associated with DT2D. Higher than primary education (adjusted OR (AOR): 2.02, 95% CI 1.21 to 3.37) was positively associated with UT2D versus DT2D, while older age (≥50 years) (AOR: 0.12, 95% CI 0.06 to 0.25), healthcare advice (AOR: 0.45, 95% CI 0.29 to 0.70), and history of cholesterol screening (AOR: 0.37, 95% CI 0.24 to 0.58) were inversely associated with UT2D versus DT2D. CONCLUSION: Almost one in ten adults in Iraq had UT2D, and various associated factors were identified that could be useful in planning interventions.

Mental distress and incident functional disability among a rural ageing population in South Africa.

OBJECTIVES: The aim of the study was to investigate the association between mental symptoms and incident functional disability among middle-age and older adults in South Africa. METHODS: Longitudinal data from two consecutive population surveys (2014/2015-2018/2019) in Agincourt, South Africa, were analysed. RESULTS: In total, 298 of 3813 participants without functional disability in wave 1 (8.8%) had functional disability in wave 2. The prevalence of baseline functional disability was 9.1%. In the fully adjusted models for people without functional disability at baseline, depressive symptoms (AOR: 1.74, 95% CI: 1.08-2.80) among men and lower life satisfaction among men (AOR: 0.86, 95% CI: 0.80-0.93) and among women (AOR: 0.90, 95% CI: 0.83-0.98) increased the odds of incident functional disability. Posttraumatic stress disorder symptoms, poor sleep quality, restless sleep, and loneliness were not significantly associated with incident functional disability. CONCLUSIONS: Depressive symptoms among men and lower life satisfaction among both sexes were independently associated with incident functional disability in ageing rural South Africans.

Combined victimization of face-to-face and cyberbullying and adverse health outcomes among school-age adolescents in Argentina.

Face-to-face bullying victimization (FBV) and cyber bullying victimization (CBV) are of global concern, including in Latin America. The aim of this study was to evaluate the associations between combined FBV and CBV relative to single victimization (FBV or CBV) and no victimization with a wide range of adverse health outcomes among school-aged adolescents from Argentina. National cross-sectional school data from 56,981 adolescents that responded to questions on FBV, CBV, and adverse health outcomes were analyzed. The results showed a prevalence of 18.7% FBV alone, 8.1% CBV alone and 13.6% combined FBV and CBV. Combined FBV and CBV had higher odds than single victimization (FBV or CBV) in 18 negative health outcomes, including anxiety, suicidal ideation, loneliness, suicide plan and attempt, smoking, smokeless tobacco use, history of intoxication, alcohol-related problems, current cannabis use, ever use of amphetamine, school truancy, participation in physical fighting, physically attacked, injury, ever sex, multiple sexual partners and sedentary behaviour. In conclusion, combined FBV and CBV had higher odds than single BV or no BV in most adverse health outcomes.

Undiagnosed hypertension in Sudan: results of the cross-sectional national STEPS survey in 2016.

Introduction: the rate of hypertension has been increasing in Africa. The study aimed to estimate the prevalence and associated factors of undiagnosed hypertension (HTN) among adults in Sudan. Methods: cross-sectional data were analyzed from 7,226 persons (18-69 years, median 37 years, interquartile range 27-49 years, 4557 were females) who participated in the 2016 Sudan STEPS survey, had complete blood pressure measurement and non-pregnant, and responded to a questionnaire, physical measures, and biomedical tests. Logistic regression was used to determine the predictors of undiagnosed HTN. Results: the prevalence of undiagnosed HTN was 26.2% (n=2057) (79.2% of total HTN), diagnosed HTN 6.9% (n=690) and total HTN 33.1% (n=2747). In multivariable analysis older age (50-69 years) (adjusted risk ratio-aRR: 2.49, 95% CI: 2.02-3.09; p<0.001), obesity (aRR: 2.51, 95% CI: 1.97-3.21; p<0.001), diabetes (aRR: 1.59, 95% CI: 1.17-2.16; p=0.002) and elevated total cholesterol (aRR: 1.48, 95% CI: 1.19-1.84; p<0.001) were positively associated and health care advice (aRR: 0.79, 95% CI: 0.64-0.98; p=0.036) was negatively associated with undiagnosed HTN versus no HTN. Male sex (adjusted odds ratio-aOR: 2.22, 95% CI: 1.63-3.01; p<0.001) was positively associated, and older age (50-69 years) (aOR: 0.31, 95% CI: 0.21-0.46; p<0.001), married (aOR: 0.45, 95% CI: 0.33-0.62; p<0.001), urban residence (aOR: 0.70, 95% CI: 0.51-0.96; p=0.022), health care advice (aOR: 0.32, 95% CI: 0.22-0.45; p<0.001), ever cholesterol measured (aOR: 0.43, 95% CI: 0.27-0.67; p<0.001), overweight (aOR: 0.63, 95% CI: 0.47-0.85; p=0.003) and heart attack or stroke (aOR: 0.31, 95% CI: 0.17-0.55; p<0.001) were negatively associated with undiagnosed HTN versus diagnosed HTN. Conclusion: one in four adults in Sudan had undiagnosed HTN (eight in ten of total HTN) and several associated factors that can help guide interventions were identified.

Sleep duration and incident and persistent depressive symptoms among a rural ageing population in South Africa.

BACKGROUND: The aim of the study was to assess the relationship between sleep duration and incident depressive symptoms (IDS) and persistent depressive symptoms (PDS) using longitudinal data from South Africa. METHODS: This longitudinal community study enrolled 3891 adults (≥40 years) from the "Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI)". Sleep duration was assessed by self-report at wave 1, and depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale at wave 1 and 2. Outcomes were incident and persistent depressive symptoms at wave 2. Multivariable logistic regression analysis was conducted to assess the associations between sleep duration at wave 1 and incident, and persistent depressive symptoms. RESULTS: The prevalence of IDS was 25.6% and PDS 30.8%. The prevalence of very short, short, normal, and long sleep duration at baseline was 3.6%, 10.1%, 60.9% and 25.4%, respectively. In the fully adjusted model, long sleep duration was positively associated with IDS among men (AOR: 1.37, 95% CI: 1.02-1.84), but not among women (AOR: 0.91, 95% CI: 0.67-1.23). No models among both men and women showed a significant association between short sleep and IDS. Long sleep duration was associated with PDS (AOR: 2.04, 95% CI: 1.20-3.48) among men but not among women (AOR: 1.26, 95% CI: 0.76-2.11). Short sleep showed among both sexes no significant associations with PDS. CONCLUSION: Long but not short sleep duration was independently associated with IDS and PDS among men but not among women.

Trends in concurrent tobacco use and heavy drinking among individuals 15 years and older in Mongolia.

The study aimed to evaluate trends in the prevalence and correlates of current tobacco use only (= CT), current heavy drinking only (= CHD), and current tobacco use and current heavy drinking (= CTHD) in people 15 years and older from 2009 to 2019 in Mongolia. Cross-sectional data were analyzed from 5,438 individuals (15-64 years) of the Mongolia STEPS 2009 survey, 6,013 (15-69 years) of the Mongolia STEPS 2013 survey, and 6,654 persons (15-69 years) of the Mongolia STEPS 2019 survey and responded to questions about substance use, other health risk behaviours and physical measurements. Trend analysis shows that the prevalence of CT increased from 14.4% in 2009 to 15.3% in 2019, and the prevalence of CHD significantly decreased from 13.3% in 2009 to 10.3% in 2019, and the prevalence of CTHD significantly decreased from 14.2% in 2009 to 9.4% in 2019. Middle and older age, male sex (13 times higher for CT, 3.4 times higher for CHD, and 28 times higher for CTHD) and high physical activity significantly increased the odds of CT, CHD and CTHD. Higher education decreased the odds of CT but increased the odds of CHD. Urban residence was positively associated with CT, and among women with CTHD. Underweight decreased the odds of CT, CHD, and CTHD, and obesity decreased the odds of CT and CTHD and increased the odds of CHD. Hypertension was positively associated with CHD and CTHD, while sedentary behaviour was positively associated with CT and CTHD. Being Khalkh by ethnicity increased the odds of CT and inadequate fruit and vegetable intake increased the odds of CHD. More than one in six persons 15 years and older engaged in CT and more than one in ten engaged in CHD and CTHD. Several sociodemographic factors, such as male sex and middle and/or older age, and health variables, such as obesity and hypertension for CHD, were identified associated with CT, CHD, and CTHD that can help in guiding public interventions.