Lifestyle factors and psychological well-being: 10-year follow-up study in Lithuanian urban population.

BACKGROUND: Several lifestyle behaviours, including physical activity, smoking, alcohol consumption, nutrition habits, and social activity have been associated with psychological well-being (PWB). However, their effect on PWB prospectively has been less studied. The aim of the present study was to evaluate the influence of lifestyle factors on higher future PWB during the 10-year follow-up of middle-aged and elderly urban population. METHODS: In the baseline survey (2006 to 2008), 7115 men and women 45-72 years of age were examined within the framework of the international study Health, Alcohol and Psychosocial Factors in the Eastern Europe (HAPIEE). In the follow-up survey (in 2016), which was performed among all 6210 participants who survived till that year, 4266 individuals participated responding to postal questionnaires. PWB was assessed by a CASP-12 questionnaire. The lifestyle behaviours, including smoking and nutrition habits, alcohol consumption, social and physical activity, were evaluated by the questionnaire. Multivariable logistic regression models were applied for statistical data analysis. RESULTS: After accounting for several potential confounders, healthy levels of lifestyle behaviours were associated with higher PWB after 10-year follow-up. Never-smokers in men and former smokers in women had higher PWB by 43 and 67% odds respectively in comparison with smokers. Physical activity in women and high social activity both in men in women was positively related to higher PWB. More frequent fresh vegetable and fruit consumption was associated with higher odds of higher PWB (odds ratio 1.57 in men and 1.36 in women, p < 0.05) compared to less frequent consumption of such food groups. Dose-response relationship between increasing number of healthy lifestyle factors and higher PWB was determined both in men and women. CONCLUSIONS: Lifestyle factors such as never smoking and former smoking, high social activity, and more frequent fresh vegetable and fruit consumption increased the odds of higher PWB over 10 years of follow-up in men and women groups. The increase of the protective health behaviour score was directly associated with the odds of higher PWB.

Lowered cognitive function and the risk of the first events of cardiovascular diseases: findings from a cohort study in Lithuania.

BACKGROUND: The purpose of this prospective cohort study was to examine whether the level of cognitive function at the baseline expressed as a cognitive function composite score and score of specific domains predict the risk of first cardiovascular disease (CVD) events in middle-aged and older populations. METHODS: Seven thousand eighty-seven participants, men and women aged 45-72 years, were assessed in the baseline survey of the Health Alcohol Psychosocial Factors in Eastern Europe (HAPIEE) study in 2006-2008 in the city of Kaunas, Lithuania. During 10 years of follow-up, the risk of first non-fatal events of CVD and death from CVD (excluding those participants with a documented history of CVD and/or ischemic heart disease (IHD) diagnosed at the baseline survey) was evaluated. Cox proportional hazards regression models were applied to examine how cognitive function predicts the first events of CVD. RESULTS: During the follow-up, there were 156 deaths from CVD (49 women and 107 men) and 464 first non-fatal CVD events (195 women and 269 men) registered. The total number of first CVD events was 620 (11.5%). After adjustment for sociodemographic factors, biological and lifestyle risk factors and illnesses, a decrease per 1 standard deviation in different cognitive function scores significantly increased the risk of a first event of CVD (immediate verbal recall score - by 17% in men and 32% in women; delayed verbal recall score - by 17% in men and 24% in women; and a composite score of cognitive function - by 15% in men and 29% in women). Kaplan-Meier survival curves for the probability of a first cardiovascular event according to the categories of a composite score of cognitive function, revealed that a lowered cognitive function predicts a higher probability of the events compared to normal cognitive function (p < 0.05). CONCLUSIONS: The findings of this follow-up study suggest that men and women with lower cognitive functions have an increased risk for a first event of CVD compared to participants with a higher level of cognitive functions.

Psychological well-being and mortality: longitudinal findings from Lithuanian middle-aged and older adults study.

BACKGROUND: The study aimed to examine whether after confounding by possible socio-demographic and other risk factors, psychological well-being is independently associated with reduced all-cause and cardiovascular mortality. METHODS: Initial data were collected within the framework of the international project HAPIEE in 2006-2008. A random sample of 7115 individuals aged 45-72 years was screened. Deaths were evaluated by death register of Kaunas city (Lithuania) in a follow-up study till 2016. Psychological well-being was evaluated by a CASP-12 questionnaire. Socio-demographic, lifestyle, biologic factors and depressive symptoms were evaluated. RESULTS: Age-adjusted survival curves revealed that psychological well-being predicts longevity in men and women (p < 0.001). After adjustment for many possible confounders psychological well-being was independently associated with all-cause mortality in men (HR 0.77; 95% CI 0.62-0.94) and women (HR 0.73; 95% CI 0.56-0.96). However, psychological well-being association with cardiovascular mortality attained statistical significance only in the women's group (HR 0.53; 95% CI 0.33-0.87), but not in men (HR 0.98; 95% CI 0.72-1.33). CONCLUSIONS: Psychological well-being is an important predictor of longevity, controlling well-recognized risk factors such as age, education, cardiovascular diseases, social status, marital status, lifestyle and biological factors and depressive symptoms. Positive psychological well-being should be taken into account when screening older people to prevent negative health outcomes.

The relationship of green space, depressive symptoms and perceived general health in urban population.

AIMS: To assess the relationship between green space proximity, use of green space and depressive symptoms and perceived general health among a random sample men and women. METHODS: Cross-sectional study of a population-based sample of 6,944 45-72 year old Kaunas city residents. Self-reported questionnaires provided information on sociodemographic variables, health behaviours, depressive symptoms and poor and very poor perceived general health. Residential proximity to green spaces was defined as living less than 300 m, within interval of 300-999 m, and equal or more than 1 km from a park. The use of the park was divided into two categories: no park use or use <4hrs/week and use of the park ≥4 h/week. The study received approval from the Kaunas Regional Research Ethics Committee. Multiple logistic regression assessed the associations controlling for confounding variables. RESULTS: The prevalence of depressive symptoms and poor and or very poor perceived general health was higher in women than in men. The association between the use of the park and residential proximity to the park revealed that women living >300 m from a green space and who used the space ≥4 h/week showed higher odds 1.92 (1.11-3.3) and 1.68 (0.81-3.48) of depressive symptoms and poor and very poor perceived general health as compared to those who used the park <4 hrs/week and residential proximity was >300 m. CONCLUSIONS: The results of our study confirmed an association between use of the green space, residential proximity, and depressive symptoms and poor and very poor perceived general health among women only.

Correlates of depressive symptoms in urban middle-aged and elderly Lithuanians.

PURPOSE: The study aimed to examine the prevalence of depressive symptoms and their correlates in urban middle-aged and elderly Lithuanian adults. METHODS: Data from the survey was collected within the framework of the international project HAPIEE (Health, Alcohol and Psychosocial Factors in Eastern Europe). A random sample of 7,115 individuals aged 45-72 years was screened in 2006-2008. RESULTS: Depressive symptoms were differently associated with independent variables by sex. In men, deprivation (OR 1.85, 95 % CI 1.54-2.17), being divorced (OR 2.34, 95 % CI 1.61-3.39) or widowed (OR 3.64, 95 % CI 2.40-5.52), physical inactivity (OR 1.30, 95 % CI 1.02-1.65), having a history of spine and joint disease (OR 1.72, 95 % CI 1.36-2.17), average perceived health (OR 2.14, 95 % CI 1.55-2.95), poor perceived health (OR 5.13, 95 % CI 3.39-7.76), average quality of life (OR 2.0, 95 % CI 1.55-2.95), or poor quality of life (OR 8.86, 95 % CI 5.19-15.13) were significantly associated with depressive symptoms. In women, deprivation (OR 1.28, 95 % CI 1.15-1.43), being widowed (OR 1.52, 95 % CI 1.23-1.88), mean dose of alcohol per occasion 40-79.9 g (OR 1.65, 95 % CI 1.18-2.30) and more than 80 g (OR 2.09, 95 % CI 1.14-3.82), physical inactivity in leisure time (OR 1.27, 95 % CI 1.04-1.57), having a history of spine and joint disease (OR 1.26, 95 % CI 1.06-1.51), average perceived health (OR 2.56, 95 % CI 1.89-2.72), poor perceived health (OR 5.07, 95 % CI 3.62-7.11), average quality of life (OR 2.27, 95 % CI 1.89-2.72), or poor quality of life (OR 7.21, 95 % CI 4.73-11.00) were significantly associated with depressive symptoms. CONCLUSIONS: Health status and lifestyle factors are associated with depressive symptoms. Associations between depressive symptoms and long-term health problems are partially mediated by self-rated quality of life and self-rated health.

The Effect of Alexithymia, Attention, and Pain Characteristics on Mentalizing Abilities Among Adults With Chronic Pain.

Introduction: Impaired mentalizing abilities are found among persons with chronic pain, yet it is still unknown why. The current study focuses on mentalizing abilities and how these could be affected by different pain factors, alexithymia traits, and other aspects of psychological functioning (depression, anxiety, attention) in persons experiencing chronic pain.Methods: 71 participants (80.3% female; mean age 56.1 (SD = 13.1)) with subjectively reported chronic pain conditions participated in the study. Mentalizing abilities were assessed using an objective assessment of the Frith-Happé animations test. Alexithymia was measured using Toronto Alexithymia Scale. Subjectively reported data on various pain characteristics and other related psychological factors (depression, anxiety, attention) were collected. Bivariate linear regression analyses were used to identify variables that had statistically significant relationships with Frith-Happé test scores as dependent variables, which were then used to build multivariate models.Results: Mentalization task scores had no significant associations with alexithymia. However, in bivariate models, greater Frith-Happé animations categorisation score was associated with higher attention task scores (ßs = .332, p = .005), higher education (ßs = .317, p = .007), and lower level of depressiveness (ßs = -.234, p = .049). Greater animations feelings scores were associated with less severe pain intensity (ßs = -.322, p = .006), younger age (ßs = -.399, p = .001), and better attention (ßs = .383, p = .001). In multivariate analysis models predicting both animations categorisation and feelings scores, attention was found to be the only statistically significant factor (respectively, ßs = .257, p = .029 and ßs = .264, p = .035).Conclusions: No significant correlations were found between mentalizing abilities and alexithymic features in persons with chronic pain. Disruptions of attention was the most significant factor leading to lower mentalizing abilities in persons with chronic pain.

Cardiovascular risk factors and cognitive function in middle aged and elderly Lithuanian urban population: results from the HAPIEE study.

BACKGROUND: The purpose of this study was to examine associations between cardiovascular risk factors and cognitive ability in middle aged and elderly Lithuanian urban population. METHODS: Data from the survey performed in the framework of the HAPIEE (Health, Alcohol, Psychosocial Factors in Eastern Europe) study were presented. A random sample of 7,087 individuals aged 45-72 years was screened in 2006-2008. RESULTS: The scores of immediate recall and delayed verbal recall, cognitive speed and attention were significantly lower in men than in women; yet numerical ability scores were higher in men. Significant associations between lowered cognitive functions and previous stroke (in male OR = 2.52; 95% CI = 1.75-3.64; in female OR = 2.45; 95% CI = 1.75, 3.64) as well as ischemic heart disease history (among male OR = 1.28; 95% CI = 1.03-1.60) have been determined. Higher level of physical activity in leisure time (among female OR = 1.32; 95% CI = 1.03-1.69), poor self-rated health (among male OR = 1.57; 95% CI = 1.15-2.14) and poor quality of life (in male OR = 1.67; 95% CI = 1.07-2.61; in female OR = 2.81; 95% CI = 1.92-4.11) were related to lowered cognitive function. CONCLUSIONS: The findings of the study suggest that associations between cardiovascular risk factors and lowered cognitive function among healthy middle-aged and elderly adults strongly depend on gender.

Cognitive Function and Mortality: Results from Kaunas HAPIEE Study 2006-2017.

BACKGROUND: The purpose of the study is to evaluate the association between cognitive function and risk of all-cause and cardiovascular disease mortality during 10 years of the follow-up. METHODS: 7087 participants were assessed in the baseline survey of the Health Alcohol Psychosocial Factors in Eastern Europe (HAPIEE) study in 2006-2008. During 10 years of follow-up, all-cause and CVD mortality risk were evaluated. RESULTS: During 10 years of follow-up, 768 (23%) men and 403 (11%) women died (239 and 107 from CVD). After adjustment for sociodemographic, biological, lifestyle factors, and illnesses, a decrease per 1 standard deviation in different cognitive function scores increased risk for all-cause mortality (by 13%-24% in men, and 17%-33% in women) and CVD mortality (by 19%-32% in men, and 69%-91% in women). Kaplan-Meier survival curves for all-cause and CVD mortality, according to tertiles of cognitive function, revealed that the lowest cognitive function (1st tertile) predicts shorter survival compared to second and third tertiles (p < 0.001). CONCLUSIONS: The findings of this follow-up study suggest that older participants with lower cognitive functions have an increased risk for all-cause and CVD mortality compared to older participants with a higher level of cognitive function.

Changes in psychological well-being among older Lithuanian city dwellers: Results from a cohort study.

Background/Objective: The purpose of this study is to evaluate changes of psychological well-being (PWB) in older Lithuanian city dwellers during ten years of follow-up, and to establish factors associated with it. Method: 7,115 men and women of age 45-72 years participated in the initial survey in 2006-2008. In 2016 the follow-up survey was performed among all 6,210 participants who survived. 4,266 individuals responded to postal questionnaires. PWB was evaluated by using CASP-12 questionnaire. Depressive symptoms were evaluated by CES-D-10 scale. Quality of life, self-rated health, and social activity were evaluated.Socio-demographic, socio-economic factors were included into standard questionnaire. Results: PWB deteriorated in all age groups during 10-years follow-up. Poor quality of life, poor self-rated health, having depressive symptoms, and not being member of social organization are associated with lower PWB after 10 years in men and women. Employed-retired, retired, and not socially active women have higher possibility to have lower PWB over 10 years. Conclusions: PWB in older Lithuanian city dwellers deteriorates as many other socio-economic and psychosocial indicators during ten-year follow-up. Mostly psychosocial factors, but not the socio-demographic, and socio-economic ones predict PWB over 10 years. It is crucial to understand and promote predictors of PWB in older age.

Antecedentes/Objetivo: Evaluar los cambios en el bienestar psicológico (BP) de los habitantes de las ciudades lituanas más antiguas en un seguimiento de diez años e identificar factores asociados. Método: Inicialmente participaron 7.115 hombres y mujeres de 45-72 años de edad durante los años 2006-2008. En 2016, la encuesta de seguimiento se realizó entre 6.210 participantes. De ellos, 4.266 personas respondieron a los cuestionarios. El BP fue evaluado mediante el cuestionario CASP-12. Los síntomas depresivos mediante la escala CES-D-10. Se evaluó la calidad de vida, la salud y la actividad social. Resultados: El BP se deterioró en todos los grupos de edad a los 10 años de seguimiento. Mala calidad de vida, mala autoevaluación de la salud, síntomas depresivos y la no pertenencia a una organización social se asocian con BP más bajo. Mujeres jubiladas y socialmente inactivas tienen mayor probabilidad de peor BP. Conclusiones: El BP de los habitantes de las ciudades lituanas más antiguas se deteriora, al igual que otros muchos indicadores socioeconómicos y psicosociales a los diez años de seguimiento. La mayoría de los factores psicosociales, aunque no los sociodemográficos y socioeconómicos, predicen el BP. Es crucial promover predictores de bienestar psicológico en la vejez.

Link between healthy lifestyle and psychological well-being in Lithuanian adults aged 45-72: a cross-sectional study.

OBJECTIVE: This study uses a cross-sectional study design to analyse the connection between psychological well-being (PWB) and components of a healthy lifestyle in the Lithuanian population aged 45-72. The purpose of our study is to establish the links between PWB and lifestyle factors such as physical activity, smoking, alcohol consumption and dietary patterns in people above the age of 44. PARTICIPANTS: A stratified sample of 10 940 urban citizens aged 45-72 years were randomly selected from the National Population Register. The response rate was 65%. METHODS: PWB was evaluated by using a Control Autonomy Self-realization and Pleasure (CASP-12) questionnaire. The standard questionnaire included questions regarding the respondent's sociodemographic, socioeconomic and social status. The lifestyle questionnaire evaluated behavioural factors as smoking status, alcohol consumption, nutrition habits and physical activity. Objective measurements of cardiovascular disease (CVD) risk factors were taken. RESULTS: Adjusted for sociodemographic, socioeconomic, social and biological CVD risk factors, the probability of higher PWB increased for physically active men and women and male former smokers. Higher PWB was directly associated with consumption of fresh vegetables and fruits. Responders who consumed potatoes, meat, boiled vegetables and eggs less frequently than average were more likely to have higher PWB. A direct association was ascertained between PWB and consumption of chicken and fish, as well as an inverse association between PWB and consumption of sweets in women. CONCLUSIONS: Healthy lifestyle education efforts should focus on increasing physical activity, controlling smoking and improving diversity in healthy food consumption including the consumption of fresh vegetables and fruits, particularly among older adults with lower PWB.

Changes in psychological well-being among older Lithuanian city dwellers: Results from a cohort study / Cambios en el bienestar psicológico de los habitantes de las ciudades más antiguas de Lituania: resultados de un estudio de cohorte

Background/Objective: The purpose of this study is to evaluate changes of psychological well-being (PWB) in older Lithuanian city dwellers during ten years of follow-up, and to establish factors associated with it. Method: 7,115 men and women of age 45-72 years participated in the initial survey in 2006-2008. In 2016 the follow-up survey was performed among all 6,210 participants who survived. 4,266 individuals responded to postal questionnaires. PWB was evaluated by using CASP-12 questionnaire. Depressive symptoms were evaluated by CES-D-10 scale. Quality of life, self-rated health, and social activity were evaluated. Socio-demographic, socio-economic factors were included into standard questionnaire. Results: PWB deteriorated in all age groups during 10-years follow-up. Poor quality of life, poor self-rated health, having depressive symptoms, and not being member of social organization are associated with lower PWB after 10 years in men and women. Employed-retired, retired, and not socially active women have higher possibility to have lower PWB over 10 years. Conclusions: PWB in older Lithuanian city dwellers deteriorates as many other socio-economic and psychosocial indicators during ten-year follow-up. Mostly psychosocial factors, but not the socio-demographic, and socio-economic ones predict PWB over 10 years. It is crucial to understand and promote predictors of PWB in older age

Antecedentes/Objetivo: Evaluar los cambios en el bienestar psicológico (BP) de los habitantes de las ciudades lituanas más antiguas en un seguimiento de diez años e identificar factores asociados. Método: Inicialmente participaron 7.115 hombres y mujeres de 45-72 años de edad durante los años 2006-2008. En 2016, la encuesta de seguimiento se realizó entre 6.210 participantes. De ellos, 4.266 personas respondieron a los cuestionarios. El BP fue evaluado mediante el cuestionario CASP-12. Los síntomas depresivos mediante la escala CES-D-10. Se evaluó la calidad de vida, la salud y la actividad social. Resultados: El BP se deterioró en todos los grupos de edad a los 10 años de seguimiento. Mala calidad de vida, mala autoevaluación de la salud, síntomas depresivos y la no pertenencia a una organización social se asocian con BP más bajo. Mujeres jubiladas y socialmente inactivas tienen mayor probabilidad de peor BP. Conclusiones: El BP de los habitantes de las ciudades lituanas más antiguas se deteriora, al igual que otros muchos indicadores socioeconómicos y psicosociales a los diez años de seguimiento. La mayoría de los factores psicosociales, aunque no los sociodemográficos y socioeconómicos, predicen el BP. Es crucial promover predictores de bienestar psicológico en la vejez