Association of Depression,Psycho-Social Stress and Acculturation with Respiratory Disease Among Puerto Rican Adults in Massachusetts

To assess associations between acculturation, depression, and self-reported stress score with reported diagnosis of respiratory disease (RD) in Puerto Rican adults, participants (N = 1,168) were identified from areas of high Hispanic density in the Boston, MA metropolitan area. Eligible participants were interviewed in the home by bilingual interviewers in either Spanish or English. Scales included topics ranging from general background to depressive symptomatology. Respiratory disease was self-reported and checked against prescribed medication. More than one-third (37.8%) of subjects reported doctor-diagnosed RD. A final binary logistical regression model (N = 850), which was adjusted for potential confounders (sex, age, education, poverty) showed that RD was significantly associated with psychological acculturation (OR = 1.97, P = 0.005), depressive symptomatology (OR = 1.52, P = 0.03) high perceived stress score (OR = 1.97, P = 0.009), and current smoking (OR = 1.61, P = 0.03). Significant inverse associations included a high level of language acculturation (OR = 0.65, P = 0.03), light (OR = 0.67, P = 0.01) and moderate to heavy physical activity versus sedentary physical activity (OR = 0.40, P = 0.03). We found self reported physician diagnosed RD was associated with high perceived stress and depression, as well as higher levels of psychological acculturation. Longitudinal research is needed to determine if there is a causal pathway for these associations.     

Diet,Physical Activity,and Cardiovascular Disease Risk Factors Among Older Chinese Americans Living in New York City

Cardiovascular disease (CVD) is the leading cause of death in the US and affects Chinese Americans disproportionately compared to other ethnic groups in the American population. However, few studies have examined CVD risk factors, including diet and physical activity, in Chinese Americans. This investigation used a cross-sectional design to evaluate the dietary intake, dietary supplement use, and physical activity of 125 older Chinese Americans aged 50–98 years, and to determine how these behaviors may be related to obesity and other CVD risk factors. Sociodemographic information, CVD risk factors, dietary intake, and physical activity were obtained from all participants recruited from health fairs conducted in New York City (NYC). The findings revealed that older Chinese American adults living in NYC had a high prevalence of overweight and obesity, borderline hypertension, pre-diabetes, and diabetes. Many participants did not meet their daily requirements calcium, potassium, folate, vitamin B6, and vitamin B12, several minerals and vitamins important for cardiovascular health. Although most participants consumed an adequate numbers of servings of foods from the main food groups, most did not meet the recommended number of servings of dairy foods and only one in four adults took a multivitamin supplement daily. After adjusting for potential confounders, daily consumption of oil/sweets and dairy foods was positively associated with waist circumference. Also, daily consumption of oils/sweets, meats, and grains was positively associated with systolic blood pressure. The majority of the participants reported at least 30 min of moderate intensity physical activity per day. Dietary intake or supplement use did not show protective effects but performing vigorous physical activity may reduce risk of CVD in this population.     

Prevalence of Cardiovascular Disease and Risk Factors Among Somali Immigrants and Refugees

Background

Cardiovascular disease (CVD) risks are of concern among immigrants and refugees settling in affluent host countries. The prevalence of CVD and risk factors among Somali African immigrants to the U.S. has not been systematically studied.

Methods

In 2015–2016, we surveyed 1156 adult Somalis in a Midwestern metropolitan area using respondent-driven sampling to obtain anthropometric, interview, and laboratory data about CVD and associated risk factors, demographics, and social factors.

Results

The prevalence of diabetes and low physical activity among men and women was high. Overweight, obesity, and dyslipidemia were also particularly prevalent. Levels of calculated CVD risk across the community were greater for men than women.

Conclusion

Though CVD risk is lower among Somalis than the general U.S. population, our results suggest significant prevalence of risk factors among Somali immigrants. Comparison with prior research suggests that CVD risks may be increasing, necessitating thoughtful intervention to prevent adverse population outcomes.

     

Multiple Point-of-Testing Nutrition Counseling Sessions Reduce Risk Factors for Chronic Disease Among Older Adults

The objectives of this study were to explore the relationships of baseline dietary intakes and frequency of attendance at point-of-testing nutrition counseling sessions to selected risk factors for chronic diseases during a 3-year intervention. This study was part of a large multidisciplinary, community-based health outreach project conducted in a rural community of northern Louisiana. Screenings, point-of-testing counseling, weekly group exercise sessions, and group nutrition education sessions were provided over a period of 3 years. Outcome variables assessed at 6-month intervals over 3 years were body mass index (BMI), systolic and diastolic blood pressure, fasting blood glucose, and total and LDL cholesterol and dietary intake. Repeated measure analysis of variance was used to investigate the impact of the frequency of counseling sessions on outcome variables. Paired t-tests were used to identify points at which significant changes occurred. A total of 159 subjects ages 65 years and older participated in this study. The majority of the participants were female (62%) and White (82%). Attending the point of testing counseling for more than two sessions was important for a significant improvement in BMI (p ≤ 0.001), LDL cholesterol (p ≤ 0.03), blood glucose (p ≤ 0.03), and diastolic blood pressure (p ≤ 0.045). Participants who attended at least three sessions had significant reductions in risk factors for obesity and related chronic diseases, underscoring the importance of follow-up sessions after health screening.     

Dietary Patterns Associated with the Prevalence of Cardiovascular Disease Risk Factors in Kuwaiti Adults

BackgroundKuwaiti adults have experienced a rapid increase in cardiovascular disease (CVD) and its risk factors. Dietary patterns in the Kuwaiti diet associated with the increasingly higher CVD burden have not been adequately evaluated.ObjectiveThe objective of this study was to identify the major dietary patterns in Kuwaiti adults and examine their associations with CVD risk factors.DesignThis cross-sectional study examined data from the 2008-2009 National Nutrition Survey of the State of Kuwait.Participants/settingThe study included 555 Kuwaiti adults aged ≥20 years who completed a 24-hour dietary recall.Main outcome measuresThe outcome measures included CVD risk factors such as obesity (body mass index), abdominal obesity (waist circumference), elevated blood pressure, dyslipidemia (blood lipid levels), diabetes (glucose and glycated hemoglobin levels), and metabolic syndrome.Statistical analysisDietary patterns were identified using principal component analysis. The associations between dietary patterns and CVD risk factors were analyzed using survey-weighted multivariable linear and logistic regression models.ResultsThree dietary patterns were identified: vegetable-rich, fast food, and refined grains/poultry. Younger adults had higher adherence to the fast-food or refined-grains/poultry dietary patterns, whereas older adults had higher adherence to the vegetable-rich dietary pattern. The fast-food dietary pattern was positively associated with body mass index (β=.94, 95% CI 0.08 to 1.79), waist circumference (β=2.05, 95% CI 0.20 to 3.90 cm), and diastolic blood pressure (β=1.62, 95% CI 0.47 to 2.77 mm Hg). The refined grains/poultry dietary pattern was positively associated with plasma glucose levels (β=1.02, 95% CI 1.002 to 1.04 mg/dL [0.056 to 0.058 mmol/L]). Individuals in the highest tertile of the fast-food or refined-grains/poultry dietary patterns had higher odds of metabolic syndrome than those in the lowest tertile.ConclusionsThe fast-food and refined grains/poultry dietary patterns were associated with high prevalence of CVD risk factors among Kuwaiti adults. The current findings underscore the need for prospective studies to further explore dietary pattern and CVD risk factor relationships among at-risk Kuwait adults.     

Factors Associated with Risk of Perinatal Depressive Symptoms Among Puerto Rican Women with Hyperglycemia

Maternal and Child Health Journal - Rates of perinatal depression and pregnancy hyperglycemia are higher in Hispanic women as compared to non-Hispanic white women. In turn, depressive symptoms may...     

Knowledge of Viral Hepatitis Among Puerto Rican Adults: Implications for Prevention

Although primary prevention of HAV and HBV can be achieved through vaccination, the burden of HCV can only be reduced through behavioral interventions to reduce its risk factors. This study evaluated knowledge regarding transmission, clinical manifestations and prevention of viral hepatitis in Puerto Rico. We assessed the level of knowledge about HAV (six questions), HBV (12 questions) and HCV (eight questions) among non-institutionalized Puerto Rican adults aged 21-64?years. Demographic characteristics and self-reported knowledge of these infections were determined through a face-to-face interview. A mean knowledge score was computed by summing correct responses to each scale. Mean knowledge scores according to demographics were compared using ANOVA or the Kruskal-Wallis test. Mean knowledge scores for HAV, HBV and HCV infections were 2.6?±?1.5, 6.1?±?2.4, and 3.6?±?1.1, respectively. For HAV and HBV infections, the mean knowledge score significantly (P?相似文献   

The Prevalence of Frailty Among Older Adults Living With Dementia: A Systematic Review

ObjectivesTo investigate the prevalence of frailty in older adults living with dementia and explore the differences in medication use according to frailty status.DesignSystematic review of published literature from inception to August 20, 2020.Setting and ParticipantsAdults age ≥65 years living with dementia in acute-care, community and residential care settings.MethodsA systematic search was performed in Embase, Medline, International Pharmaceutical Abstracts, APA PscyInfo, CINAHL, Scopus, and Web of Science. Two reviewers independently screened records and conducted quality assessment using the Newcastle-Ottawa Scale.ResultsSixteen articles met the inclusion criteria, with 7 studies conducted in acute care setting and 9 studies in community-dwelling adults. Five studies recruited people with dementia exclusively, and 11 studies were conducted in older populations that included individuals with dementia diagnosis. Among studies conducted in acute care setting, the prevalence of frailty ranged from 50.8% to 91.8% compared with studies in community-dwelling setting, which reported a prevalence of 24.3% to 98.9%. With respect to medication exposure, 3 studies documented medication use according to frailty status but not dementia status. Higher medications use, measured as total number of medications was reported in frail [7.0 ± 4.0 (SD) ?12.0 ± 9.0 (SD)] compared with nonfrail participants [6.1 ± 3.1(SD) ?10.4 ± 3.8 (SD)].Conclusions and ImplicationsCurrent data suggests a wide range of frailty prevalence in individuals with dementia. Future studies should systematically document frailty in adults living with dementia and its impact on medication use.     

Prevalence of Masturbation and Associated Factors Among Older Adults in Four European Countries

Solitary sexual activity is a free, safe, and accessible way to experience sexual pleasure. Despite these advantages, research on masturbation in later life is highly understudied. Using data from a cross-sectional probability-based survey of 3816 European adults (mean age 67 years; range 60–75 years), we explored several sociodemographic, health, attitudinal, and sexual behavioral factors associated with reported masturbation frequency. Across all countries, between 41% and 65% of men and 27% and 40% of women reported any masturbation in the preceding month. Satisfaction with sexual activity and attitudes related to disapproval of sex without love were significant predictors of reported masturbation in almost all countries and in both genders. Age, education, self-perceived health, and depression were for the most part predictive of men’s reported masturbation, but not women’s. Generally, those believing sex is beneficial to older people were more likely to masturbate, while less permissive attitudes decreased the likelihood of reporting masturbation. To improve healthy sexual aging, misinformation about masturbation and sexual attitudes in older people need to be addressed.

     

Cognitive Function and Vascular Risk Factors Among Older African American Adults

To evaluate the association between vascular risk factors and cognitive impairment among older African American (AA) adults in a primary care clinic. Participants included 96 AA adults aged 60 years or older who were evaluated for global and domain-specific cognition. Participants were interviewed using the Computerized Assessment of Memory and Cognitive Impairment (CAMCI). The relationship between CAMCI cognitive domain scores and vascular risk factors were examined using hierarchical regression models. Patients who smoked, those with higher SBP/DBP values had lower accuracy rates on CAMCI cognitive domains (attention, executive, memory).Those with higher BMI had better attention scores. Patients with higher HbA1C values had worse verbal memory. Patients with higher blood pressure were significantly faster in responding to tasks in the executive domain. Primary care providers working with older AA adults with these VRFs could implement cognitive screening earlier into their practice to reduce barriers of seeking treatment.     

Living Alone and Fall Risk Factors in Community-Dwelling Middle Age and Older Adults

As part of a larger study on fall-related risk factors, this study investigated the relationship between living alone status and fall-related variables among community-dwelling adults who lived in a rural county in eastern North Carolina. A convenience sample of 666 community-dwelling adults ages 50 and over participated in this 4-year study and completed a fall questionnaire. Significant findings were found in relation to living alone status and experiencing a fall, who they informed about their fall, injuries, safety equipment, ambulatory devices, and personal emergency response system usage. Three hundred thirty-eight participants stated they lived alone, compared to 300 who lived with others. The percentage reporting a fall was appreciably larger for those living alone (52%) than for those living with others (48%) in both genders in all age groups except for the 61–70 year old adults where the percentage was less. Findings from this research enhance knowledge about the prevalence and contributing fall-related factors in adults who live alone compared to those who live with others. Insights gained from this research will assist community and public health leaders and health care professionals in developing more efficacious intervention strategies to prevent or reduce falls, and associated psychological and physical consequences.     

永州市成人高血压患病情况及危险因素研究

目的了解永州市成人高血压患病率、知晓率及危险因素,为制定干预措施提供科学依据。方法采用多阶段分层随机抽样法,通过问卷调查和体检对永州市18～69岁成人进行高血压相关调查,应用SPSS13.0软件包进行单因素和多因素Logistic回归分析。结果共有效调查3780人,其中男性1638人,女性2142人;高血压患病率为25.1%,标化患病率为23.5%,其中男性为28.7%,女性为22.3%;知晓率为41.4%,其中男性为31.3%,女性为50.4%。进行单因素和多因素Logistic回归分析发现,高血压影响因素按作用大小依次为年龄、超重肥胖、精神状态、过量饮酒、中心性肥胖、血脂、性别、钙摄入。结论永州市成人高血压患病率高,针对高血压现况及危险因素采取控制体重、减少饮酒量、保持心理平衡、保持血脂正常及多摄入高钙食物等措施可以有效地减少永州市成人高血压的发生。抓好该市高血压及其相关疾病的综合防治是今后该市慢性病防治工作的重点。     

Physical Activity and Risk of Small-for-Gestational-Age Birth Among Predominantly Puerto Rican Women

To estimate the association between multiple domains of physical activity and risk of small-for-gestational-age (SGA) birth. We utilized data from 1,040 participants in the Latina Gestational Diabetes Mellitus Study, a prospective cohort of predominantly Puerto Rican prenatal care patients in Massachusetts. Physical activity was assessed by bilingual interviewers using a modified version of the Kaiser physical activity survey in early (mean = 15 weeks) and mid pregnancy (mean = 28 weeks). Physical activity (i.e., sports/exercise, household, occupational, and active living) in pre, early and mid pregnancy was categorized in quartiles. SGA was classified as <10th percentile of birth weight for gestational age. Pre- and early-pregnancy physical activity were not associated with SGA. In multivariable analyses, women with high total activity in mid-pregnancy had a decreased risk of SGA [risk ratio (RR) = 0.42; 95% confidence interval (CI) 0.21–0.82; p _trend = 0.003] as compared to those with low total activity. Findings were similar for high household activity (RR = 0.69; 95% CI = 0.34–1.40; p _trend = 0.26), active living (RR = 0.63; 95% CI = 0.35–1.13; p _trend = 0.04), and occupational activity (RR = 0.79, 95% CI = 0.47–1.34; p _trend = 0.26). High levels of sports/exercise were associated with an increased SGA risk without a significant dose–response association (RR = 2.14, 95% CI 1.04–4.39; p _trend = 0.33). Results extend prior studies of physical activity and SGA to the Hispanic population.     

儿童期心血管病危险因素现状研究

为了解城市儿童心血管病危险因素现状，作者在北京８～１１岁儿童中，进行了血压、血脂谱、肥胖、膳食状况及心血管病家族史等主要心血管病危险因素目前水平的小样本调查。主要结果为：以收缩压＞１６．０ｋＰａ（１２０ｍｍＨｇ）和／或舒张压＞１０．７ｋＰａ（８０ｍｍＨｇ）为诊断标准，血压偏高检出率为７．２％；２１．９％的儿童血脂水平超过膳食干预推荐值；单纯性肥胖患病率为１１．７％。膳食状况中最突出的问题是摄入高胆固醇，平均日胆固醇摄入量为４８３．４ｍｇ，有７２％的儿童超过３００ｍｇ。与以往资料相比，这一儿童人群有较高的心血管病危险因素暴露水平。本结果提示，加强儿童期心血管病危险因素的监测与干预是十分必要的。     

Prevalence and Incidence of Frailty Among Community-dwelling Older Adults in Slovenia

IntroductionFrailty is recognized as one of the most important global health challenges as the population is aging. The aim of this study was to evaluate prevalence and incidence of frailty, and associated factors, among the population of older adults in Slovenia compared to other European countries.MethodsThe prevalence and 4-year incidence of frailty among older adults (≥65 years) were evaluated using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Frailty was defined by the SHARE operationalization of Frailty phenotype. Multiple logistic regression model was used to explore factors associated with frailty.ResultsAge-standardized prevalence (95% CI) of frailty and pre-frailty in Slovenia were 14.9% (13.3-16.5) and 42.5% (39.8-45.2), respectively. Factors (OR, 95% CI) associated with increased frailty in Slovenia included age (7584 years: 5.03 (3.08-8.22); ≥85 years 21.7 (10.6-44.7) vs. 65-74 years), self-rated health (fair: 4.58 (2.75-7.61), poor: 54.6 (28.1-105.9) vs. excellent/very good/good), number of chronic diseases (1.20 (1.03-1.40)), and polypharmacy (yes: 3.25 (1.93-5.48) vs. no). Female gender and lower education were significantly associated with pre-frailty, but not frailty, in the adjusted model. Independently of these characteristics, age-standardized prevalence of frailty varied among geographical regions. Age-standardized 4-year incidence of frailty and pre-frailty in Slovenia were 6.6% (3.0-10.1) and 40.2% (32.7-47.6), respectively.ConclusionAmong the Slovenian population of older adults aged 65 years and older, the age-standardized prevalence of frailty is 15% and 4-year incidence of frailty is 7%. Regional differences in Slovenia show the lowest prevalence in central Slovenian regions and the highest in northeastern Slovenian regions.     

Predicting Resting Energy Expenditure in Healthy Puerto Rican Adults

Equations to predict resting energy expenditure (REE) can be influenced by cultural and climatic factors. The purpose of this cross-sectional study was to evaluate the validity of the Harris-Benedict and Mifflin-St Jeor equations to predict REE in 48 healthy Puerto Rican adults (23 men, 25 women; aged 21 to 60 years, tested between January and March 2007) using indirect calorimetry as the criterion method for comparison. Weight, height, and skinfold thickness were measured. One-way analysis of variance was used to determine differences between the REE measured and predicted with the two equations, and independent t tests were used to detect differences between men and women. Linear and multiple regressions were conducted to determine relationships between the measured and predicted REE and to evaluate factors influencing REE. The REE predicted with Harris-Benedict and Mifflin-St Jeor were not statistically different from the REE measured with indirect calorimetry (mean±standard deviation: 1,555±268, 1,500±285, and 1,633±299 kcal/day, respectively; P=0.08). There was a strong correlation between the REE measured and predicted with Harris-Benedict and Mifflin-St Jeor (r=0.83, 0.87, respectively; P=0.0001). Mean REE was higher in men compared to women, and fat-free mass was the most influencing factor on REE. The Harris-Benedict and Mifflin-St Jeor are both valid equations for the prediction of REE in healthy Puerto Rican adults living in a tropical climate such as Puerto Rico. Both equations are appropriate for dietetics practitioners to use in assessing energy requirements in this population.     

Findings From a Randomized Trial of Weight Gain Prevention Among Overweight Puerto Rican Young Adults

Objective

Assess impact of multimodality weight gain prevention intervention.