Suchergebnisse

Objectives: Our aim was to determine clusters of non-communicable diseases (NCDs) in a very large, population-based sample of middle-aged and older adults from low- and middle-income (LMICs) and high-income (HICs) regions. Additionally, we explored the associations with several covariates. Design: The total sample was 72¿140 people aged 50+ years from three population-based studies (English Longitudinal Study of Ageing, Survey of Health, Ageing and Retirement in Europe Study and Study on Global Ageing and Adult Health) included in the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project and representing eight regions with LMICs and HICs. Variables were previously harmonised using an ex-post strategy. Eight NCDs were used in latent class analysis. Multinomial models were made to calculate associations with covariates. All the analyses were stratified by age (50–64 and 65+ years¿old). Results Three clusters were identified: 'cardio-metabolic' (8.93% in participants aged 50–64 years and 27.22% in those aged 65+ years), 'respiratory-mental-articular' (3.91% and 5.27%) and 'healthy' (87.16% and 67.51%). In the younger group, Russia presented the highest prevalence of the 'cardio-metabolic' group (18.8%) and England the 'respiratory-mental-articular' (5.1%). In the older group, Russia had the highest proportion of both classes (48.3% and 9%). Both the younger and older African participants presented the highest proportion of the 'healthy' class. Older age, being woman, widowed and with low levels of education and income were related to an increased risk of multimorbidity. Physical activity was a protective factor in both age groups and smoking a risk factor for the 'respiratory-mental-articular'. Conclusion: Multimorbidity is common worldwide, especially in HICs and Russia. Health policies in each country addressing coordination and support are needed to face the complexity of a pattern of growing multimorbidity. ; This work was supported by the 5-year Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project and the Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM). The ATHLOS project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 635 316. DF's work has been supported by grant RTI2018-100927-J-I00 Retos Investigación from Ministerio de Ciencia e Innovación (MCI), by Marsden grant E2987-3648 (Royal Society of New Zealand), and by grant 2017 SGR 622 (GRBIO) from the Departament d'Economia i Coneixement de la Generalitat de Catalunya (Spain). This work, grant number RTI2018-100927-J-I00, is supported by the Ministerio de Ciencia e Innovación (MCI, Spain), by the Agencia Estatal de Investigación (AEI, Spain) and by the European Regional Development Fund FEDER (FEDER, UE). BO's work is supported by the PERIS programme 2016–2020 'Ajuts per a la Incorporació de Científics i Tecnòlegs' (grant number SLT006/17/00066), with the support of the Health Department from the Generalitat de Catalunya. ; Peer Reviewed ; Postprint (published version)

(1) Cognitive decline differs among individuals and cognition function domains. We sought to identify distinct groups of immediate and delayed verbal memory in two age subsamples(50–64, 65+years), and to analyze associated factors. (2) Latent class mixed models were used to identify verbal memory trajectories in a sample of Spanish community-dwelling individuals over 8 years' follow up. Chi-square and Kruskal–Wallis tests were used to assess differences among trajectories. (3) Different trajectories were identified. In the case of immediate verbal memory, these were: very low/decline (6.3%), low/stable (38.2%), medium/slow decline (43.4%), and high/slowdecline (12.2%) in the middle-aged group, and low/decline (20.4%), medium/slow decline (60.4%),and high/slow decline (19.2%) in the older subsample. In delayed verbal memory, more distinct patterns were found: very low/decline (12.4%), low/stable (51.4%), medium/accelerated decline (24.7%),and high/slow increase (11.4%) in the younger group, and low/slow decline (34.4%), medium/decline(52.7%), and high/slow decline (12.9%) in the older group. (4) Overall, low initial performance and decline were associated with older age, lower education, and higher diabetes/stroke prevalence.Differences found suggests heterogeneity in cognitive ageing. The high prevalence of cardiovascular diseases in those with worse cognition suggests that early interventions to prevent those conditions should be targeted in midlife to delay cognitive decline. ; This work was supported by the European Community's Seventh Framework Programme [grant number223071-COURAGE Study]; the Instituto de Salud Carlos III-FIS [grant numbers PS09/00295, PS09/01845, PI12/01490,and PI13/00059. Projects PI12/01490 and PI13/00059 have been co-funded by the European Union EuropeanRegional Development Fund (ERDF) "A Way to Build Europe"]; the European Union's Horizon 2020 Research andInnovation Programme [grant agreement 635316]; and the Centro de Investigación Biomédica en Red de SaludMental (CIBERSAM), Instituto de Salud Carlos III. NMM is supported by the programme 'Contratos predoctoralespara Formación de Personal Investigador, FPI-UAM', Universidad Autónoma de Madrid, Spain. EL's work issupported by the Sara Borrell postdoctoral program (CD18/00099) of the Instituto de Salud Carlos III (Spain)and co-funded by the European Union (ERDF/ESF, "Investing in your future"). DM's work is supported by theSpanish Ministry of Education, Culture, and Sports [grant number FPU15/02634]. DF's work has been supportedby grant RTI2018-100927-J-I00 administrated by Ministerio de Ciencia e Innovación (MCI, Spain), by the AgenciaEstatal de Investigación (AEI, Spain), and by the European Regional Development Fund (FEDER, UE), by Marsdengrant E2987-3648 administrated by the Royal Society of New Zealand), and by grant 2017 SGR 622 (GRBIO)administrated by the Departament d'Economia i Coneixement de la Generalitat de Catalunya (Spa ; Peer Reviewed ; Postprint (published version)