Health-related quality of life among cancer survivors: pre-existing chronic conditions are to be given priority.

PURPOSE: This study aimed to describe the health-related quality of life (HRQoL) of cancer survivors in China by the five-level EuroQol-5-dimension (EQ-5D-5L) questionnaire and to explore the impact of the comorbidity of pre-existing chronic conditions on HRQoL in cancer survivors. METHODS: Data on cancer survivors were obtained from two cross-sectional surveys conducted in Shandong Province, China. The data of the Chinese general population, the Chinese diabetes population, the Chinese hypertension population, and the Chinese urban population from the published studies were used as the controls. The χ2 test was conducted to compare the incidence of five-dimensional problems between the study and control populations. The non-parametric Mann-Whitney U test and Kruskal-Wallis test were performed to examine the differences in EQ-5D-5L utility scores. Besides, the Tobit regression model was used to examine the variables influencing the EQ-5D-5L utility score. RESULTS: One thousand fifty-one adult cancer survivors were included. Cancer survivors had significantly lower EQ-5D-5L utility scores (Z = - 15.939, P < 0.001) and EQ-VAS scores (Z = - 11.156, P < 0.001) than the general adult population. The average EQ-5D-5L utility score of hypertensive cancer survivors was lower than that of the hypertensive population (Z = - 1.610, P = 0.107), but the difference was not statistically significant. CONCLUSION: Compared to the general population, the HRQoL of cancer survivors was extremely poor in all dimensions of the EQ-5D-5L. Pre-existing chronic conditions had significant antecedent effects on the HRQoL of cancer survivors. Therefore, more attention should be paid to chronic diseases, and effective interventions should be adopted based on this.

Internações por condições sensíveis à atenção primária à saúde: associação com a cobertura da atenção primária, 2015 ­ 2021 / Hospitalization for sensitive conditions in primary care: association with primary health care support, 2015-2021 / Hospitalizaciones por afecciones sensibles a la atención primaria: asociación con la cobertura de atención primaria, 2015 ­ 2021

Objetivo: Avaliar as tendências e associações relacionadas as coberturas e internações por condições sensíveis à atenção primária à saúde no município de Fortaleza/Ceará/Brasil, no período de 2015 a 2021. Métodos: Estudo transversal com dados secundários (Sistema de Informações Hospitalares do Sistema Único de Saúde, E- gestor atenção básica e o Instituto Brasileiro de Geografia e Estatística). Utilizou-se o coeficiente de correlação de Pearson para as associações. Resultados: Foram registrados 176.330 internações por condições sensíveis, totalizando 8 principais, correspondendo a 78.5% do total. Obteve-se correlação inversa significativa entre a cobertura de atenção primária e internações por condições sensíveis: r=-0.86, (IC95%: -0.91/-0.61); p<0.001, bem como uma correlação moderada com cobertura de agente comunitário e internações (r=-0.59 (IC95%: -0.68/-0.54); p<0.001) Conclusão: O aumento das internações por condições sensíveis está diretamente relacionado com a cobertura da atenção primária. Além disso, enfrenta-se uma dupla carga de doenças, coexistindo as doenças infecciosas/parasitárias em concomitância com as crônicas.

Objective: To assess trends and associations related to coverage and hospitalizations for conditions sensitive to primary health care in the city of Fortaleza/Ceará/Brazil, from 2015 to 2021. Methods: Cross-sectional study with secondary data (Hospital Information System of the National Unified Health System, E- manager for primary care and the Brazilian Institute of Geography and Statistics). Pearson's correlation coefficient was used to measure associations. Results: 176,330 hospitalizations for sensitive conditions were recorded, totaling 8 main ones, corresponding to 78.5% of the total. A significant inverse correlation was obtained between primary care coverage and hospitalizations for sensitive conditions: r=-0.86, (95%CI: -0.91/-0.61); p<0.001, as well as a moderate correlation with community agent coverage and hospitalizations (r=-0.59 (95%CI: -0.68/-0.54); p<0.001) Conclusion: The increase in hospitalizations for sensitive conditions is directly associated to the primary care coverage. In addition, there is a double burden of disease, with infectious/parasitic diseases coexisting with chronic ones.

Evaluar las tendencias y asociaciones relacionadas con la cobertura y hospitalizaciones por condiciones sensibles a la atención primaria de salud en la ciudad de Fortaleza/Ceará/Brasil de 2015 a 2021. Métodos: Estudio transversal con datos secundarios (Sistema de Informações Hospitalares do Sistema Único de Saúde, E-gestor atenção básica e Instituto Brasileiro de Geografia e Estatística). Se utilizó el coeficiente de correlación de Pearson para las asociaciones. Resultados: Hubo 176.330 hospitalizaciones por condiciones sensibles, totalizando 8 condiciones principales, correspondiendo a 78,5% del total. Se obtuvo una correlación inversa significativa entre la cobertura de atención primaria y las hospitalizaciones por afecciones sensibles: r=- 0,86, (IC 95%: -0,91/-0,61); p<0,001, así como una correlación moderada con la cobertura de agentes comunitarios y las hospitalizaciones (r=-0,59 (IC 95%: -0,68/-0,54); p<0,001) Conclusión: El aumento de las hospitalizaciones por afecciones sensibles está directamente relacionado con la cobertura de atención primaria. Además, se enfrenta a una doble carga de enfermedad, coexistiendo enfermedades infecciosas/parasitarias en concomitancia con enfermedades crónicas.

Use of health services and medication use, new comorbidities, and mortality in patients with chronic diseases who did not contract COVID-19 during the first year of the pandemic: a retrospective study and comparison by sex.

BACKGROUND: The restrictions introduced to stop the spread of the COVID-19 virus have also had a direct impact on people with chronic diseases and especially on diseases to which lifestyles are relevant in their control and management, such as diabetes, hypertension, chronic obstructive pulmonary disease (COPD), etc. The purpose of this paper is to conduct a longitudinal analysis of new comorbidities, mortality, medication use, and the use of health resources in patients with chronic diseases who did not contract COVID-19, comparing the six months before the strict lockdown to the 12 months following the end of the strict lockdown. METHOD: An observational real world data pre-post study of 668,974 people was undertaken. The patients studied were over 16 years of age, had been receiving care from the Aragon Health Service (Northeastern Spain), were diagnosed with one or more chronic diseases, and had not contracted COVID-19. Sociodemographic, comorbidity, pharmacological and health resource use variables were collected during the six months before the onset of the lockdown and during the six and 12 months following the end of the lockdown. The comparisons by sex were carried out using a Student T-test or chi-squared test to analyse differences. RESULTS: Dyslipidaemia (42.1%) followed by hypertension (35.1%) and anxiety and depression (34.6%) were the most prevalent chronic diseases among the study population. 78.% of patients had between one and four chronic illnesses. There was a decrease in new diagnoses of other chronic comorbidities in this population and a decrease in medications prescribed and the use of health services.  Although women received more diagnoses of chronic diseases, the number of medications dispensed was lower, but the use of health services was higher. These figures were maintained throughout the pandemic. CONCLUSION: Our results suggest an underdiagnosis of new chronic comorbidities and a decrease in mortality rates from causes unrelated to COVID-19 due to the closure of health centres in Aragón (Spain) during the lockdown. This trend was exacerbated in women. The underdiagnosis of new chronic comorbidities during confinement can cause the disease to worsen, with the consequent increase in symptoms and the worsening of chronic pathologies in patients with a severe evolution.

Prevalencia de enfermedades crónicas no transmisibles en las personas privadas de la libertad en Costa Rica / Prevalence of chronic noncommunicable diseases in persons deprived of liberty in Costa Rica

Mediante un estudio cuantitativo, descriptivo y de corte transversal se realiza una comparación entre la población penal de la Unidad de Atención Integral (UAI) 20 de diciembre y la población penal total costarricense. Hasta no hace mucho tiempo, en el ámbito penitenciario se ha experimentado un cambio importante en la morbimortalidad de las personas privadas de la libertad, pasando de un modelo casi unicausal de origen infeccioso, a procesos de etiología múltiple, con desarrollo poco predecible y alto porcentaje del gasto público sanitario. En el siguiente estudio se determina la similitud existente en prevalencia de enfermedades crónicas no trasmisibles tanto a nivel país, sistema penitenciario nacional y UAI 20 de diciembre.

Through a quantitative, descriptive and cross-sectional study, a comparison is made between the prison population of the Unidad de Atención Integral (UAI) 20 de diciembre and the total Costa Rican prison population. Until recently, there has been an important change in the morbimortality of persons deprived of liberty in the penitentiary environment, going from an almost unicausal model of infectious origin, to processes of multiple etiology, with little predictable development and a high percentage of public health expenditure. The following study determines the existing similarity in the prevalence of chronic non-communicable diseases at the country level, the national prison system and the UAI December 20.

[Association between chronic diseases and possible sarcopenia in middle-aged and older Chinese men: A prospective cohort study].

OBJECTIVE: To investigate the association between chronic diseases and the risk of possible sarcopenia among middle-aged and older Chinese males. METHODS: This prospective cohort study included the data collected from the China Health and Retirement Longitudinal Study on 4 878 males aged over 45 years without possible sarcopenia as the baseline population in 2011 and 2013, and all were followed up until 2015. Possible sarcopenia was determined by measuring the grip strength and the time of five successive sit-ups. The Cox proportional risk model was used to analyze the relationship of the type and number of chronic diseases with the risk of possible sarcopenia in males. RESULTS: The risk of possible sarcopenia in the middle-aged and older men with prostatic disease, cognitive impairment or depression was increased by 16% (HR = 1.16, 95% CI: 1.01－1.33), 23% (HR = 1.23, 95% CI: 1.10－1.38) and 12% (HR = 1.12, 95% CI: 1.01－1.24), respectively. The risk in those with one, two or three or more chronic diseases was raised by 22% (HR = 1.22, 95% CI: 1.04－1.42), 20% (HR = 1.20, 95% CI: 1.02－1.42) and 46% (HR = 1.46, 95% CI: 1.25－1.71), respectively, compared with those without chronic diseases, and it was increased in a dose-dependent manner (P < 0.01) Conclusion: Prostatic disease, cognitive impairment and depression increase the risk of possible sarcopenia in middle-aged and older Chinese males, and the risk rises with the increased number of chronic comorbidities.

The Impact of Multimorbidity on All-Cause Mortality: A Longitudinal Study of 87,151 Thai Adults.

Objectives: To investigate associations between multimorbidity, socio-demographic and health behaviour factors, and their interactions (multimorbidity and these factors) with all-cause mortality among Thai adults. Methods: Associations between multimorbidity (coexistence of two + chronic diseases) and mortality between 2005 and 2019 were investigated among Thai Cohort Study (TCS) participants (n = 87,151). Kaplan-Meier survival curves estimated and compared survival times. Multivariate Cox proportional hazards models examined associations between risk factors, and interactions between multimorbidity, these factors, and survival. Results: 1,958 cohort members died between 2005 and 2019. The risk of death was 43% higher for multimorbid people. In multivariate Cox proportional hazard models, multimorbidity/number of chronic conditions, age, long sleep duration, smoking and drinking were all independent factors that increased mortality risk. Women, urbanizers, university education, over 20,000-baht personal monthly income and soybean products consumption lowered risk. The interactions between multimorbidity and these variables (except for female, urbanizers and soybeans intake) also had significant (p < 0.05) impact on all-cause mortality. Conclusion: The results emphasise the importance of healthy lifestyle and reduced intake of alcohol and tobacco, in reducing premature mortality, especially when suffering from multimorbidity.

Examining neighbourhood-level disparities in Black, Latina/o, Asian, and White physical health, mental health, chronic conditions, and social disadvantage in California.

Racial/ethnic minority individuals in the U.S. experience numerous health disparities versus Whites, often due to differences in social determinants. Yet, limited large-scale research has examined these differences at the neighbourhood level. We merged 2021 PLACES Project and 2020 American Community Survey data across 3,211 census tracts (neighbourhoods) defined as majority (>50%) Black, Latina/o, Asian or White. T-tests and hierarchical linear regressions were used to examine differences and associations between neighbourhoods on key health (general health, mental health, obesity, diabetes, cancer, coronary heart disease, chronic obstructive pulmonary disease, stroke), and social outcomes (income, unemployment, age, population density). Results indicated that minority neighbourhoods in California exhibited stark health and social disparities versus White neighbourhoods, displaying worse outcomes on nearly every social and health variable/condition examined; particularly for Black and Latina/o neighbourhoods. Moreover, regression findings revealed that, after considering income, unemployment, and population density, (1) fair/poor mental health and higher percentages of Black, Latina/o and Asian residents in neighbourhoods independently associated with greater neighbourhood fair/poor physical health, and (2) fair/poor mental health significantly associated with greater prevalence of obesity and COPD. This study thus underscores the need to address the profound health and social disparities experienced by minority neighbourhoods for more equitable neighbourhoods.

Características sociodemográficas, hábitos de vida y condiciones de salud de las personas privadas de libertad / Características sociodemográficas, hábitos de vida e condições de saúde de pessoas privadas de liberdade / Sociodemographic characteristics, life habits and health conditions of people deprived of liberty

La privación de la libertad, por sus características, impone a las personas hábitos y costumbres diferenciados que pueden influir en su salud. En ese sentido, el propósito de este estudio es describir las características sociodemográficas, hábitos de vida y condiciones de salud de las personas privadas de libertad. Se trata de un estudio transversal y descriptivo, realizado en cuatro centros penitenciarios de una ciudad del sur de Brasil. La recopilación de datos se realizó mediante un instrumento semiestructurado y se utilizó la estadística descriptiva para el análisis. Participaron 326 personas privadas de libertad, 90,8% eran hombres, 53,4% jóvenes, entre 18 y 29 años, 43,3% solteros, 55,8% con menos de nueve años de escolaridad, 61,3% realizaban alguna actividad en la unidad carcelaria, 63,2% eran fumadores o exfumadores, 28,2% ingerían bebidas alcohólicas y 60,4% eran usuarios o exusuarios de drogas ilícitas, 71,2% practicaban actividades físicas, 86,1% evaluaban positivamente su estado de salud y 52,5% reportaban alguna enfermedad crónica. Las enfermedades más frecuentes declaradas en sus relatos fueron las respiratorias, las gastrointestinales, las mentales, las cardiovasculares y las musculoesqueléticas. Las personas privadas de libertad tienen enfermedades crónicas y factores de riesgo prevalentes en la población general. Conocer el perfil epidemiológico de este grupo de población puede contribuir a las acciones de promoción de la salud, prevención y control de los factores de riesgo. (AU)

A privação de liberdade, por suas características, impõe as pessoas hábitos e costumes diferenciados que podem influenciar em sua saúde. Nesse sentido, o objetivo deste é descrever as características sociodemográficas, hábitos de vida e condições de saúde de pessoas privadas de liberdade. Trata-se de um estudo transversal, descritivo, realizado em quatro unidades penais de um município do sul do Brasil. A coleta de dados foi realizada por instrumento semiestruturado e utilizou-se estatística descritiva para análise. Participaram 326 pessoas privadas de liberdade, dessas 90,8% eram do sexo masculino, 53,4% jovens, com idade entre 18 e 29 anos, 43,3% solteiras, 55,8% com escolaridade inferior a nove anos, 61,3% realizavam alguma atividade na unidade penal, 63,2% eram fumantes ou ex-fumantes, 28,2% ingeriam bebida alcoólica e 60,4% usuários ou ex-usuários de drogas ilícitas, 71,2% praticavam atividades físicas, 86,1% avaliaram positivamente o estado de saúde e 52,5% relatou alguma doença crônica. As doenças que prevaleceram nos autorrelatos foram as respiratórias, gastrointestinais, psíquicas, cardiovasculares e osteomusculares. As pessoas privadas de liberdade possuem as doenças crônicas e fatores de risco prevalentes na população em geral. Conhecer o perfil epidemiológico desse grupo populacional pode contribuir com ações promotoras de saúde, prevenção e controle dos fatores de risco. (AU)

The deprivation of liberty, due to its characteristics, imposes on people differentiated habits and customs that can influence their health. In that sense, the objective of this is to verify the prevalence of chronic diseases in the prison population. This is a cross-sectional descriptive study, carried out in four prison unity in a city in southern Brazil. Data collection was performed by a semi-structured instrument and descriptive statistics were used for analysis. Participated 326 people deprived of freedom, 90.8% were male, 53.4% young, aged between 18 and 29 years, 43.3% single, 55.8% with less than nine years of schooling, 61.3% performed some activity in the penal unit, 63.2% were smokers or former smokers, 28.2% drank alcohol and 60.4% used or ex used illicit drugs, 71.2% practiced physical activities, 86.1% positively evaluated their health status and 52.5% reported some chronic disease. The most prevalent self-reported diseases were respiratory, gastrointestinal, mental, cardiovascular, and musculoskeletal. People deprived of freedom have chronic diseases and risk factors prevalent in the general population. Knowing the epidemiological profile of this population group can contribute to health-promoting actions, prevention, and control of risk factors. (AU)

Effect of chronic disease on racial difference in COVID-19-associated hospitalization among cancer patients.

BACKGROUND: Research indicates that Black cancer patients have higher rates of COVID-19 hospitalization than their White counterparts. However, the extent to which chronic diseases contribute to racial disparities remains uncertain. We aimed to quantify the effect of chronic diseases on racial disparity in COVID-19-associated hospitalization among cancer patients. METHODS: We linked Louisiana Tumor Registry's data with statewide COVID-19 data and hospital in-patient discharge data to identify patients diagnosed with cancer in 2015-2019 who tested positive for COVID-19 in 2020 and those with COVID-19-associated hospitalization. Multivariable logistic regression and mediation methods based on linear structural equations were employed to assess the effects of the number of chronic diseases (0, 1-2, ≥3) and individual chronic diseases. RESULTS: Of 6381 cancer patients who tested positive for COVID-19, 31.6% were non-Hispanic Black cancer patients. Compared with non-Hispanic White cancer patients, non-Hispanic Black cancer patients had a higher prevalence of chronic diseases (79.5% vs 66.0%) and higher COVID-19-associated hospitalization (27.2% vs 17.2%). The odds of COVID-19-associated hospitalization were 80% higher for non-Hispanic Black cancer patients than non-Hispanic White cancer patients (odds ratio = 1.80, 95% confidence interval = 1.59 to 2.04). After adjusting for age, sex, insurance, poverty, obesity, and cancer type, number of chronic diseases explained 37.8% of the racial disparity in COVID-19-associated hospitalization, and hypertension, diabetes, and chronic renal disease were the top 3 chronic diseases explaining 9.6%, 8.9%, and 7.3% of the racial disparity, respectively. CONCLUSION: Chronic diseases played a substantial role in the racial disparity in COVID-19-associated hospitalization among cancer patients, especially hypertension, diabetes, and renal disease. Understanding and addressing the root causes are crucial for targeted interventions, policies, and health-care strategies to reduce racial disparity.

Impact of Health Insurance Patterns on Chronic Health Conditions Among Older Patients.

BACKGROUND: Patients have varying levels of chronic conditions and health insurance patterns as they become Medicare age-eligible. Understanding these dynamics will inform policies and reforms that direct capacity and resources for primary care clinics to care for these aging patients. This study 1) determined changes in chronic condition rates following Medicare age eligibility among patients with different insurance patterns and 2) estimated the number of chronically ill patients who remain inadequately insured post-Medicare eligibility among patients receiving care in community health centers. METHOD: We used retrospective electronic health record data from 45,527 patients aged 62 to 68 from 990 community health centers in 25 states in 2014 to 2019. Insurance patterns (continuously insured, continuously uninsured, uninsured/discontinuously insured who gained insurance after age 65, lost insurance after age 65, discontinuously insured) and diagnosis of chronic conditions were defined at each visit pre- and post-Medicare eligibility. Difference-in-differences Poisson GEE models estimated changes of chronic condition rates by insurance groups pre- to post-Medicare age eligibility. RESULTS: Post-Medicare eligibility, 72% patients were continuously insured, 14% gained insurance; and 14% were uninsured or discontinuously insured. The prevalence of multimorbidity (≥2 chronic conditions) was 77%. Those who gained insurance had a significantly larger increase in the rate of documented chronic conditions from pre- to post-Medicare (DID: 1.06, 95%CI:1.05-1.07) compared with the continuously insured group. CONCLUSIONS: Post-Medicare age eligibility, a significant proportion of patients were diagnosed with new conditions leading to high burden of disease. One in 4 older adults continue to have inadequate health care coverage in their older age.

Chronic wounds in a multiethnic Asian population: a cost of illness study.

OBJECTIVE: To estimate the 'cost of illness' arising from chronic wounds in Singapore. DESIGN: Incidence-based cost of illness study using evidence from a range of sources. SETTING: Singapore health services. PARTICIPANTS: We consider 3.49 million Singapore citizens and permanent residents. There are 16 752 new individuals with a chronic wound in 2017, with 598 venous ulcers, 2206 arterial insufficiency ulcers, 6680 diabetic ulcers and 7268 pressure injuries.Primary outcome measures expressed in monetary terms are the value of all hospital bed days lost for the population; monetary value of quality-adjusted life years (QALYs) lost in the population; costs of all outpatient visits; and costs of all poly clinic, use of Community Health Assist Scheme (CHAS) and emergency departments (EDs) visits. Intermediate outcomes that inform the primary outcomes are also estimated. RESULTS: Total annual cost of illness was $350 million (range $72-$1779 million). With 168 503 acute bed days taken up annually (range 141 966-196 032) that incurred costs of $139 million (range 117-161 million). Total costs to health services were $184 million (range $120-$1179 million). Total annual costs of lost health outcomes were 2077 QALYs (range -2657 to 29 029) valued at $166 million (range -212 to 2399 million). CONCLUSIONS: The costs of chronic wounds are large to Singapore. Costs can be reduced by making positive investments for comprehensive wound prevention and treatment programmes.

Association Between Daily Internet Use and Incidence of Chronic Diseases Among Older Adults: Prospective Cohort Study.

BACKGROUND: Chronic disease incidence among the elderly is increasing, which is correlated with the acceleration of population aging. Evolving internet technologies may help prevent and provide interventions for chronic diseases in an accelerating aging process. However, the impact of daily internet use on the incidence of chronic diseases is not well understood. OBJECTIVE: This study aims to investigate whether daily internet use by middle-aged and older adults may inhibit or promote the occurrence of chronic diseases. METHODS: We included participants from the China Health and Retirement Longitudinal Study (CHARLS), a longitudinal survey of Chinese residents aged ≥45 years. We assessed 8-year data from wave 1 (June 2011-March 2012) to wave 4 (July-September 2018) in CHARLS. Data from wave 4 were used for a cross-sectional study, and data from all 4 waves were used for a longitudinal study. Self-reported data were used to track variables, including internet use, use frequency, and the incidence of different chronic diseases. Cox proportional hazards modeling was applied in the longitudinal study to examine the relationship between daily internet use and chronic diseases among middle-aged and older adults, while adjusting for sociodemographic characteristics and health behaviors. In addition, longitudinal data were used to analyze internet usage trends, and cross-sectional data were used to analyze the factors influencing internet use. RESULTS: Among the 20,113 participants included in the longitudinal analyses, internet use increased significantly, from 2% to 12.3%, between 2011 and 2018. The adjusted model found statistically significant relationships between daily internet use and a lower incidence of the following chronic diseases: hypertension (hazard ratio [HR] 0.78, 95% CI 0.65-0.95, P=.01), chronic lung disease (HR 0.74, 95% CI 0.57-0.97, P=.03), stroke (HR 0.69, 95% CI 0.50-0.94, P=.02), digestive disease (HR 0.73, 95% CI 0.58-0.91, P=.005), memory-related disorders (HR 0.58, 95% CI 0.37-0.91, P=.02), arthritis or rheumatism (HR 0.60, 95% CI 0.48-0.76, P<.001), asthma (HR 0.52, 95% CI 0.33-0.84, P=.007), depression (HR 0.80, 95% CI 0.71-0.89, P<.001), and vision impairment (HR 0.83, 95% CI 0.74-0.93, P=.004). Moreover, our study also showed that with increasing frequency of internet use, the risk of some chronic diseases decreases. CONCLUSIONS: This study found that middle-aged and older adults who use the internet have a reduced risk of developing chronic diseases versus those who do not use the internet. The increasing prevalence of daily internet use among middle-aged and older adults may stimulate contemplation of the potential role of internet platforms in future research on chronic disease prevention.

[Ethnic features of multipathology in elderly and senile patients of the Republic of Sakha suffering from chronic brain ischemia]. / Etnicheskie osobennosti mul'tipatologii u patsientov pozhilogo i starcheskogo vozrasta Respubliki Sakha (Yakutiya), stradayushchikh khronicheskoi ishemiei mozga.

OBJECTIVE: To study ethnic characteristics of multipathology in elderly and senile patients with chronic cerebral ischemia living in the Republic of Sakha (Yakutia). MATERIAL AND METHODS: The study included 522 inpatients, aged 60 to 89 years, who were divided into subgroups depending on the stage of chronic cerebral ischemia, ethnicity (Evens, Yakuts and Russians) and age (elderly and senile). RESULTS: In addition to vascular cerebral pathology, comorbidities were identified in patients of older age groups. At the same time, polymorbidity was less pronounced in the Evens, the indigenous inhabitants of the northern regions of Yakutia, than in the Yakuts and representatives of the non-indigenous population - Russians. CONCLUSION: The relatively rare occurrence of comorbid pathologies in Evens is presumably associated with greater adaptation to the extreme climatic conditions of the North.

Lifestyle factors related to prevalent chronic disease multimorbidity: A population-based cross-sectional study.

BACKGROUND: Multimorbidity is associated with poor quality of life, polypharmacy, health care costs and mortality, with those affected potentially benefitting from a healthy lifestyle. We assessed a comprehensive set of lifestyle factors in relation to multimorbidity with major chronic diseases. METHODS: This cross-sectional study utilised baseline data for adults from the prospective Lifelines Cohort in the north of the Netherlands (N = 79,345). We defined multimorbidity as the co-existence of two or more chronic diseases (i.e. cardiovascular disease, cancer, respiratory disease, type 2 diabetes) and evaluated factors in six lifestyle domains (nutrition, physical (in)activity, substance abuse, sleep, stress, relationships) among groups by the number of chronic diseases (≥2, 1, 0). Multinomial logistic regression models were created, adjusted for appropriate confounders, and odds ratios (OR) with 95% confidence intervals (95%CI) were reported. RESULTS: 3,712 participants had multimorbidity (4.7%, age 53.5 ± 12.5 years), and this group tended to have less healthy lifestyles. Compared to those without chronic diseases, those with multimorbidity reported physical inactivity more often (OR, 1.15; 95%CI, 1.06-1.25; not significant for one condition), chronic stress (OR, 2.14; 95%CI, 1.92-2.38) and inadequate sleep (OR, 1.70; 95%CI, 1.41-2.06); as expected, they more often watched television (OR, 1.70; 95%CI, 1.42-2.04) and currently smoked (OR, 1.91; 95%CI, 1.73-2.11), but they also had lower alcohol intakes (OR, 0.66; 95%CI, 0.59-0.74). CONCLUSIONS: Chronic stress and poor sleep, in addition to physical inactivity and smoking, are lifestyle factors of great concern in patients with multimorbidity.

Increased Morbidity, Mortality in People with Post-COVID-19 Condition.

According to this study: A case-control study showed that adults with post-COVID-19 condition (PCC) had elevated rates of adverse health outcomes and mortality during the one-year follow-up period.Continued monitoring of the PCC population is crucial.

Racial and Ethnic Disparities in Chronic Stress among Male Caregivers.

Whereas research on caregiving is well documented, less is known about gender inequalities in caregiver stress, coping mechanisms, and health outcomes, all of which may vary by race, ethnicity, and socioeconomic status. This scoping review investigated racial and ethnic disparities using the Stress Process Model among male caregivers. Several databases were searched including Academic Search Premier, Medline Complete, APA PsycInfo, CINHAL, Google, ProQuest, and Web of Science. Included were peer-reviewed articles in English, published from 1990 to 2022. A total of nine articles fulfilled inclusion criteria. Most of the articles indicated that compared to White male caregivers, African American male caregivers provided more hours of care, assisted with more activities of daily living (ADLs) and instrumental activities of daily living (IADLs), and experienced more financial stress. In terms of coping style, one study found African American male caregivers, compared to White male caregivers, held negative religious beliefs. Another study showed that they were at a higher risk for stroke than their White counterparts. The search revealed a dearth of studies on racial disparities in stress, coping, and health outcomes among male caregivers. Further research is needed on the experiences and perspectives of male minority caregivers.

Risky drinking and other drug use in adults with chronic conditions in the United States: differential associations by race/ethnicity.

Co-use of multiple drugs may prolong or increase heavy drinking, even for individuals with health conditions adversely affected by it. Patterns of alcohol and drug use may vary across racial/ethnic groups, with differential implications for health. This study examines racial/ethnic differences in the associations between risky drinking and other drug use in adults with diabetes, hypertension, heart disease, or cancer. Multiple logistic regression modeling, stratified by condition, was performed using a nationally representative sample of adults drawn from the 2015 to 2019 National Survey on Drug and Health. The outcome was risky drinking (consuming more than 7/14 drinks weekly). Other drugs considered were tobacco, marijuana, illicit drugs, and non-medical prescription drugs. Covariates included age, sex, education, income, marital/cohabitation status, health insurance coverage, and self-rated health status. Each drug category was positively associated with risky drinking across all four conditions. Racial/ethnic minority adults were less likely than White adults to engage in risky drinking, with this pattern most consistent for those with hypertension. Other drug use in minority adults (i.e. tobacco and illicit drug use in Black and Hispanic adults, and marijuana and prescription drug use in Asian adults) was associated with disproportionately greater odds of risky drinking compared with White adults. This pattern was more prominent for those with a heart condition, and not found for those with cancer. Future interventions might address co-use of alcohol and other drugs in adults with chronic conditions, with special attention to racial/ethnic minority adults.

Social Participation and Persistent Smoking Among Older Chinese With Smoking-Related Morbidity.

OBJECTIVES: Chronic diseases are common in midlife and old age and smoking can pose more health and longevity challenges for older people with chronic illnesses. In China where smoking is highly prevalent, older adults are likely to continue smoking even after developing severe chronic diseases. We examined the national prevalence of persistent smoking among older adults. We also investigated the sociodemographic characteristics of persistent smoking among ever-smokers with chronic diseases and its association with social participation (of various types). METHODS: We used data from a nationally representative sample of older adults aged 45-80 in the China Health and Retirement Longitudinal Study (2011-2018). Multinomial logistic and multilevel logistic models were fitted. RESULTS: The national prevalence of persistent smoking was around 24% of older men and 3% of older women. Among those with a history of smoking and chronic illness, younger, nonmarried/partnered, nonretired, or less educated individuals are more likely to continue smoking. Social participation is significantly associated with persistent smoking among those with chronic diseases, but the association differs across different forms of activities. Although the most popular but sedentary activities in China (playing Mahjong, chess, or cards) are associated with an elevated risk of persistent smoking, physical social activities (community-organized dancing, fitness, and qigong) are associated with a reduced risk of persistent smoking. DISCUSSION: Given the enormous burden of persistent smoking on individuals and society, public smoking cessation inventions should address sociocultural factors of persistent smoking and target older adults who participate in specific social activities.