Suchergebnisse

Εισαγωγή: Η πολυνοσηρότητα ορίζεται ως η συνύπαρξη δύο ή περισσότερων χρόνιων ασθενειών. Καθώς το προσδόκιμο ζωής αυξάνεται, το ίδιο ισχύει και για τον επιπολασμό της πολυνοσηρότητας. Ο εντοπισμός των παραγόντων που σχετίζονται είτε με υψηλή είτε με χαμηλή πολυνοσηρότητα στον πληθυσμό είναι σημαντικός. Υπάρχουν περιορισμένες ενδείξεις σχετικά με τη συσχέτιση της Μεσογειακής διατροφής με την ύπαρξη πολυνοσηρότητας σε ένα άτομο. Οι στόχοι αυτής της διδακτορικής διατριβής ήταν: α) να εκτιμηθεί ο επιπολασμός της πολυνοσηρότητας στην Κύπρο και να εντοπιστούν οι πιο συχνές χρόνιες ασθένειες, β) να εξεταστεί η απήχηση της Μεσογειακής διατροφής στον ενήλικο γενικό πληθυσμό της Κύπρου και η σχέση της με την πολυνοσηρότητα, και γ) να υπολογιστεί η ποιότητα του ύπνου στην Κύπρο και να αξιολογηθεί η σχέση της με την πολυνοσηρότητα. Μέθοδοι: Η μελέτη ήταν συγχρονική και εφαρμόστηκε στρωματοποιημένη δειγματοληψία. Ένα αντιπροσωπευτικό δείγμα ατόμων άνω των 18 ετών ερευνήθηκε κατά την περίοδο 2018-2019 στις πέντε επαρχίες της Κυπριακής Δημοκρατίας που βρίσκονται υπό τον έλεγχο της Κυπριακής κυβέρνησης. Δημογραφικά στοιχεία, πληροφορίες για τη διατροφή, δεδομένα για την ποιότητα του ύπνου, το κάπνισμα και τη σωματική δραστηριότητα, καθώς και η παρουσία χρόνιων, κλινικών και ψυχικών ασθενειών συλλέχθηκαν χρησιμοποιώντας ένα επικυρωμένο ερωτηματολόγιο. Οι ασθένειες ταξινομήθηκαν σύμφωνα με τη διεθνή ταξινόμηση των ασθενειών, 10η αναθεώρηση (ICD-10). Αποτελέσματα: Η μέση ηλικία των 1140 συμμετεχόντων ήταν 41 ± 17 έτη, 56% από αυτούς ήταν γυναίκες, 76% ήταν κάτοικοι αστικής περιοχής, 54% ήταν παντρεμένοι, 64% είχαν ανώτερη εκπαίδευση και το 50% είχαν ετήσιο μέσο εισόδημα €6,500- €19,500. Ο τυποποιημένος ως προς την ηλικία και το φύλο επιπολασμός της πολυνοσηρότητας ήταν 28.6%. Η πολυνοσηρότητα σχετίζεται με την ηλικία (p <0.01), με το υψηλότερο ποσοστό να παρατηρείται σε άτομα ηλικίας 65 ετών και άνω (68.9%). Η πολυνοσηρότητα ήταν υψηλότερη στις γυναίκες παρά στους άνδρες (28.2% έναντι 22.5%, p <0.01), ενώ τα ποσοστά ήταν παρόμοια στις αστικές και στις αγροτικές περιοχές (26.4% έναντι 23.8%, p = 0.40). Οι πιο διαδεδομένες χρόνιες ασθένειες μεταξύ ατόμων με πολυνοσηρότητα ήταν η υπερλιπιδαιμία (44.7%), ακολουθούμενη από υπέρταση (37.5%), γαστρική παλινδρόμηση (23.9%) και ασθένειες του θυρεοειδούς (22.2%), ενώ οι πιο συνηθισμένοι συνδυασμοί ασθενειών ήταν στο κυκλοφορικό και ενδοκρινολογικό σύστημα. Το προφίλ του ατόμου με πολυνοσηρότητα δείχνει ένα άτομο μεγαλύτερης ηλικίας, με υψηλότερο δείκτη μάζας σώματος, που είναι καπνιστής και έχει υψηλότερο μισθό. Η μέση βαθμολογία της Μεσογειακής Διατροφής ήταν 15.5 ± 4.0 με τους άνδρες και τους κατοίκους των αγροτικών περιοχών να έχουν μεγαλύτερη συμμόρφωση στη Μεσογειακή Διατροφή σε σύγκριση με τις γυναίκες και τους κατοίκους των αστικών περιοχών, αντίστοιχα (p<0.05). Το να έχει ένα άτομο μεγαλύτερη συμμόρφωση στη Μεσογειακή Διατροφή σχετίζεται με χαμηλότερες πιθανότητες πολυνοσηρότητας και αυτό το αποτέλεσμα ήταν στατιστικά σημαντικό ακόμη και μετά την προσαρμογή των αποτελεσμάτων για την ηλικία, το φύλο, τις συνήθειες καπνίσματος και τη σωματική δραστηριότητα (OR = 0.68, 95% CI: 0.46, 0.99). Η μέση βαθμολογία ποιότητας ύπνου των συμμετεχόντων ήταν 5 (q1=3, q3=7) με τη μέγιστη βαθμολογία να είναι 17. Οι γυναίκες, οι κάτοικοι της Πάφου και οι παντρεμένοι είχαν χαμηλότερη ποιότητα ύπνου (p <0.05). Η καλύτερη ποιότητα ύπνου συσχετίστηκε με χαμηλότερες πιθανότητες πολυνοσηρότητας, ακόμη και μετά την προσαρμογή για δημογραφικούς και κοινωνικοοικονομικούς παράγοντες καθώς και τρόπο ζωής (OR = 2.21, 95% CI: 1.55, 3.16). Συμπεράσματα: Περισσότερο από το ένα τέταρτο του γενικού πληθυσμού της Κύπρου έχει πολυνοσηρότητα και το ποσοστό αυτό είναι σχεδόν 70% μεταξύ των ατόμων άνω των 65 ετών. Η πολυνοσηρότητα είναι σχετικά συχνή ακόμη και σε νεότερες ηλικίες. Η συμμόρφωση στη Μεσογειακή διατροφή και η καλύτερη ποιότητα του ύπνου σχετίζονται με χαμηλότερο κίνδυνο πολυνοσηρότητας. Τα αποτελέσματα της μελέτης υπογραμμίζουν την ανάγκη για στρατηγικές πρόληψης και προγράμματα ευαισθητοποίησης για την υγεία για ολόκληρο τον πληθυσμό. Προγράμματα πρόληψης και οδηγίες πρακτικής δημόσιας υγείας στην Κύπρο και αλλού θα πρέπει να λάβουν υπόψη τα παραπάνω αποτελέσματα και θα πρέπει να αναπτυχθούν κατευθυντήριες γραμμές για τη δημόσια υγεία υπογραμμίζοντας τη σημασία της τήρησης της Μεσογειακής διατροφής και της καλής ποιότητας του ύπνου και της συσχέτισης τους με την πολυνοσηρότητα. ; Introduction: Multimorbidity is defined as the co-existence of two or more chronic conditions. As life expectancy is increasing so does the prevalence of multimorbidity. Identifying the factors associated with the presence of multimorbidity is important. Furthermore, limited evidence exists on the association of Mediterranean Diet or of quality of sleep with the development of multimorbidity in an individual. The aim of this PhD dissertation work was: a) to estimate the prevalence of multimorbidity in Cyprus and identify the most prevalent diseases; b) to evaluate the level of adherence to the Mediterranean Diet in the adult general population of Cyprus and investigate its relationship with multimorbidity; and c) to assess the quality of sleep in Cyprus and examine its association with multimorbidity. Methods: This is a cross-sectional study and a stratified sampling procedure was implemented. A representative sample of individuals over 18 years old was surveyed during 2018-2019 in the five government-controlled municipalities of the Republic of Cyprus. Demographic data, dietary information, data on sleep quality, smoking, physical activity, stress, and quality of life, as well as the presence of chronic, clinical, and mental conditions were collected using a validated questionnaire. Diseases were classified according to the International Classification of Diseases, 10th Revision (ICD-10). Results: The mean age of the n=1140 participants was 41 ± 17 years old, 56% of them were women, 76% lived in an urban area, 54% were married, 64% had completed a higher education, and 50% had a yearly average income in the range €6,500 - €19,500. The age and sex standardized prevalence of multimorbidity was 28.6%. Multimorbidity was associated with age (p<0.01), with the highest rate observed among people aged 65 years old or older (68.9%). Multimorbidity was higher in women than men (28.2% vs. 22.5%, p<0.01) but similar in urban and rural regions (26.4% vs. 23.8%, p=0.40). The most prevalent chronic diseases among people with multimorbidity were hyperlipidemia (44.7%), followed by hypertension (37.5%), gastric reflux (23.9%), and thyroid diseases (22.2%), while the most common combinations of diseases were in the circulatory and endocrine systems. The profile of the multimorbid individual indicated this to be a person at an older age, with a higher BMI, being a current smoker, and having a higher salary. The average Mediterranean Diet score was 15.5 ± 4.0 with men and residents of rural regions being more adherent to the Mediterranean Diet, compared to women and residents of urban regions, respectively (p<0.05). Being in the higher tertile of adherence to the Mediterranean Diet was associated with lower odds of multimorbidity, compared to the lower tertile, and this result was statistically significant even after adjusting for age, sex, smoking habits, and physical activity (adjusted OR=0.68, 95% CI: 0.46, 0.99). The median Pittsburgh Sleep Quality score of the participants was 5 (q1=3, q3=7) with the maximum score being 17. Women, residents of Paphos, and married people had a poorer quality of sleep (p<0.05). Having a better quality of sleep was associated with lower odds of multimorbidity, even after adjusting for demographics, socioeconomic and lifestyle factors (adjusted OR=2.21, 95% CI: 1.55, 3.16). Conclusions: More than one quarter of the general population of Cyprus has multimorbidity, and this rate is almost 70% among the elderly, with multimorbidity being relatively common even in younger ages too. Adherence to the Mediterranean Diet and better quality of sleep were associated with lower risk of multimorbidity. The results of the study underline the need for prevention strategies and health awareness programs for the entire population, including in relation to dietary and sleeping habits. Prevention programs and public health guidelines in Cyprus and elsewhere should take these results into account and public health guidelines should be developed in regards to the importance of adherence to the Mediterranean Diet and good quality of sleep, highlighting their association with multimorbidity. Further research on multimorbidity should be carried out, including in specific subgroups of the population. ; Completed

The COVID-19 pandemic is a serious global health emergency that could potentially have a significant impact on both somatic as well as psychological level. The aim of this study was to assess the prevalence of perceived stress in the general adult population of Cyprus during the first COVID-19 lockdown period. This was an internet-based cross-sectional study conducted between 6 April and 20 June 2020, one to two and a half months after the introduction of and the first mandatory lockdown on its entire territory imposed by the government of the Republic of Cyprus on 24 March 2020. Data collection was done using a self-administered questionnaire that included information about socioeconomic and demographic characteristics, physical activity, smoking habits, and stress level. A total of 1,485 adults participated in the study. The median perceived stress score was 10 (q1 = 6, q3 = 15). Linear regression models showed that having a medium monthly income (€501-1,500) and being a current smoker was positively associated with the perceived stress score, while being male and physically active was negatively associated with the perceived stress score (all p <0.05). People with medium average salary and current smokers were at a higher risk for perceived stress. Psychological interventions and/or psychological services provided in certain vulnerable groups would be beneficial in future lockdowns due to either COVID-19 or a new pandemic.

The COVID-19 pandemic is a serious global health emergency that could potentially have a significant impact on both somatic as well as psychological level. The aim of this study was to assess the prevalence of perceived stress in the general adult population of Cyprus during the first COVID-19 lockdown period. This was an internet-based cross-sectional study conducted between 6 April and 20 June 2020, one to two and a half months after the introduction of and the first mandatory lockdown on its entire territory imposed by the government of the Republic of Cyprus on 24 March 2020. Data collection was done using a self-administered questionnaire that included information about socioeconomic and demographic characteristics, physical activity, smoking habits, and stress level. A total of 1,485 adults participated in the study. The median perceived stress score was 10 (q1 = 6, q3 = 15). Linear regression models showed that having a medium monthly income (€501-1,500) and being a current smoker was positively associated with the perceived stress score, while being male and physically active was negatively associated with the perceived stress score (all p <0.05). People with medium average salary and current smokers were at a higher risk for perceived stress. Psychological interventions and/or psychological services provided in certain vulnerable groups would be beneficial in future lockdowns due to either COVID-19 or a new pandemic.

Poor sleep is a relatively common condition with possibly serious adverse health consequences. Lack of sleep affects the endocrine, immune, and nervous systems. In Cyprus, there is no information about the quality of sleep in the population. The goal of this study was to assess the quality of sleep in the Cypriot population and evaluate its association with multimorbidity. A representative sample of the adult population of Cyprus was selected in 2018–2019 among the five government-controlled municipalities of the Republic of Cyprus using stratified sampling. Data on sleep quality as well as on the presence of chronic, clinical, and mental health conditions were collected using a validated questionnaire. Diseases were classified according to the International Classification of Diseases, 10th Revision (ICD-10). A total of 1,140 Cypriot men and women over 18-years of age (range: 18–94) participated in the study. The median Pittsburgh sleep quality index score of the participants was 5 (first quartile = 3, third quartile = 7) with the maximum score being 17, which suggests that the Cypriot population has a relatively good quality of sleep overall, although, almost one-third of the study population had a poor quality of sleep. Women, residents of Paphos, and married people had a poorer quality of sleep (p < 0.05). Having a poor quality of sleep was associated with higher odds of multimorbidity (OR = 2.21, 95% CI: 1.55, 3.16), even after adjusting for demographics, socioeconomic, and lifestyle factors. Adopting good sleep habits could be beneficial and would potentially help reduce the risk of multimorbidity. Public health guidelines regarding the importance of sleep and its association with multimorbidity should be considered.

Objective To examine the adherence to the Mediterranean diet in the adult general population of Cyprus and assess its relationship with multi-morbidity. Design A representative sample of the adult population of Cyprus was selected in 2018-2019 using stratified sampling. Demographics, Mediterranean diet, smoking, and physical activity, as well as the presence of chronic, clinical, and mental conditions were collected using a validated questionnaire. Diseases were classified according to the International Classification of Diseases, 10th Revision (ICD-10). Setting The five government-controlled municipalities of the Republic of Cyprus. Participants A total of 1140 Cypriot men and women over 18-year old. Results The average Mediterranean Diet score was 15.5 ± 4.0 with males and residents of rural regions being more adherent to the Mediterranean Diet compared to females and residents of urban regions respectively (p<0.05). Being in the higher tertile of adherence to the Mediterranean diet was associated with lower odds of multi-morbidity compared to the lower tertile and this result was statistically significant even after adjusting for age, gender, smoking habits, and physical activity (OR= 0.68, 95% CI: 0.46, 0.99). Conclusions The study provides evidence of the adherence to Mediterranean diet in Cypriot population and its association with multi-morbidity. Adherence to the Mediterranean diet was associated with lower risk of multi-morbidity. Future research would attempt to replicate such results that could add solid pieces of evidence towards meeting some criteria of causality and severity tests, hence prevention programs and practice guidelines in Cyprus and elsewhere should take into account those beneficial effects.