The Experts below are selected from a list of 291642 Experts worldwide ranked by ideXlab platform

Paulo A. Lotufo - One of the best experts on this subject based on the ideXlab platform.

  • association between posterior segment eye diseases common mental disorders and depression cross sectional and longitudinal analyses of brazilian longitudinal study of Adult Health cohort
    Psychosomatics, 2021
    Co-Authors: Kallene Summer Moreira Vidal, Isabela M. Benseñor, Paulo A. Lotufo, Claudia K Suemoto, Arlinda B Moreno, Maria Carmen Viana, Andre R Brunoni
    Abstract:

    BACKGROUND Posterior segment eye diseases, such as glaucoma and retinal diseases (such as diabetic retinopathy, age-related macular degeneration, and retinal detachment), are chronic diseases that are among the major causes of visual impairment. OBJECTIVE We investigated the prevalence of anxiety disorders, depressive disorders, and common mental disorders in these patients and also the incidence of depression. METHODS We examined baseline (2008-2010) and follow-up (2012-2014) data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We used the Clinical Interview Schedule-Revised (CIS-R) to perform International Classification of Diseases-10-based diagnoses of anxiety and depressive disorders. Common mental disorder was defined as a Clinical Interview Schedule-Revised >11. We used multinomial logistic regression models to investigate associations between eye diseases and mental disorders, adjusted by age, gender, educational level, self-reported ethnicity, cardiovascular conditions, and self-reported quality of vision. RESULTS Out of 10,775 subjects, 249 (2.3%), 303 (2.8%), and 30 (0.3%) reported having retinal diseases, glaucoma, or both, respectively. Patients with retinal diseases and those with glaucoma and retinal diseases presented a higher prevalence of common mental disorders (relative-risk ratios of 1.7 and 3.7, respectively, P < 0.001). These patients also presented a higher incidence of depression at follow-up (relative-risk ratios of 3.0 and 5.9, respectively, P < 0.001). Patients with glaucoma presented neither a higher prevalence nor a higher incidence of mental disorders or depression. CONCLUSIONS Retinal diseases but not glaucoma were associated with mental disorders, indicating that patients with posterior segment eye diseases require distinct management of psychiatric morbidity according to the underlying pathology.

  • neck and waist circumference values according to sex age and body mass index brazilian longitudinal study of Adult Health elsa brasil
    Brazilian Journal of Medical and Biological Research, 2020
    Co-Authors: B A B Moura, Isabela M. Benseñor, Paulo A. Lotufo, Maria Ines Schmidt, Alessandra C Goulart, Itamar S Santos, Cristina Pellegrino Baena
    Abstract:

    Body fat distribution predicts cardiovascular events better than body-mass index (BMI). Waist circumference (WC) and neck circumference (NC) are inexpensive anthropometric measurements. We aimed to present the conditional distribution of WC and NC values according to BMI, stratified by age and sex, from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline data. We analyzed 15,085 ELSA-Brasil participants with complete data. We used spline quantile regression models, stratified by sex and age, to estimate the NC and WC quantiles according to BMI. To test a putative association between age and median NC or WC values, we built sex-specific median regression models using both BMI and age as explanatory variables. We present estimated 25th, 50th, 75th, and 90th percentiles for NC and WC values, according to BMI, age, and sex. Predicted interquartile intervals for NC values varied from 1.6 to 3.8 cm and, for WC values, from 5.1 to 10.3 cm. Median NC was not associated with age in men (P=0.11) nor in women (P=0.79). However, median WC increased with advancing age in both sexes (P<0.001 for both). There was significant dispersion in WC and NC values for a given BMI and age strata for both men and women. WC, but not NC values, were associated with increasing age. The smaller influence of advancing age on the relationship between BMI and NC (compared to WC) values may be useful in longitudinal studies.

  • religious service attendance educational attainment and hypertension at baseline of the brazilian longitudinal study of Adult Health elsa brasil
    American Journal of Hypertension, 2020
    Co-Authors: Ana C Varella, Isabela M. Benseñor, Maria J M Fonseca, Rosane Harter Griep, Alexandre C Pereira, Paulo A. Lotufo
    Abstract:

    BACKGROUND Some religious dimensions have been associated with different Health-related outcomes over many years. Attending religious services is one of these dimensions that were associated with hypertension, with inconsistent results. And religious involvement seems to be closely influenced by sociodemographic factors, such as education. Therefore, this study aimed to investigate the association between religious service attendance and hypertension according to levels of education. METHODS We analyzed baseline data of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Frequency of religious service attendance and presence of hypertension were assessed in all 15,105 participants at baseline. The analyses were stratified by two levels of education (less than high school and high school or more). Logistic regression models were used to obtain the association between religious service attendance and hypertension in both groups. RESULTS For those with high school or more, attending religious services was positively associated with hypertension (adjusted odds ratio [OR] = 1.14, 95% confidence interval [CI] 1.02-1.28). In contrast, for those with less than high school, attending services was inversely associated with presence of hypertension (adjusted OR = 0.73, 95% CI 0.55-0.96). CONCLUSIONS There seems to be a paradox in the association of religious service attendance and hypertension depending on the level of education.

  • validating the framingham hypertension risk score a 4 year follow up from the brazilian longitudinal study of the Adult Health elsa brasil
    Journal of Clinical Hypertension, 2020
    Co-Authors: Danielli Haddad Syllos, Isabela M. Benseñor, Vinicius F Calsavara, Paulo A. Lotufo
    Abstract:

    The Framingham Heart Study published an equation that permits to estimate the 4-year incidence of hypertension among Adults. In Brazil, only the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) of 15 105 men and women aged 35-74 years enrolled in 2008-2010 has data that can validate the Framingham Risk Score for Hypertension and create a new equation according to the Brazilian population. We examined the predictive performance of the Framingham Risk Score for Hypertension in the ELSA-Brasil using as an outcome variable, the 4-year incidence of hypertension. We split randomly the 8027 participants who participated in the second visit (2012-2014) and without hypertension at baseline in derivation data set (n = 4825; 60%) and a validation data set (n = 3202 participants; 40%). The area under the curve for Framingham Risk Score for Hypertension and ELSA-Brasil Risk Score was relatively similar. Hosmer-Lemeshow chi-squared statistic applied for the Framingham Risk Score was 3.78 (P-value = .876) and for our model was 8.22 (P-value = .41), disclosing good discrimination and calibration for both models. Even with these classification intervals, our model presents more underestimation of the risk, classifying 15% of the participants with new onset of hypertension in low risk vs 9% of the Framingham model and less overestimation of the risk, classifying 17% of the participants without hypertension as high risk vs 24% of the Framingham model. We concluded that the Framingham Risk Score for Hypertension has an acceptable performance when applied in the ELSA-Brasil population with good discrimination and calibration.

  • association between posterior segment eye diseases common mental disorders and depression cross sectional and longitudinal analyses of brazilian longitudinal study of Adult Health cohort
    Psychosomatics, 2020
    Co-Authors: Kallene Summer Moreira Vidal, Isabela M. Benseñor, Paulo A. Lotufo, Claudia K Suemoto, Arlinda B Moreno, Maria Carmen Viana, Andre R Brunoni
    Abstract:

    Abstract Background Posterior segment eye diseases, such as glaucoma and retinal diseases (such as diabetic retinopathy, age-related macular degeneration, and retinal detachment), are chronic diseases that are among the major causes of visual impairment. Objective We investigated the prevalence of anxiety disorders, depressive disorders, and common mental disorders in these patients and also the incidence of depression. Methods We examined baseline (2008–2010) and follow-up (2012–2014) data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We used the Clinical Interview Schedule-Revised (CIS-R) to perform International Classification of Diseases-10–based diagnoses of anxiety and depressive disorders. Common mental disorder was defined as a Clinical Interview Schedule-Revised >11. We used multinomial logistic regression models to investigate associations between eye diseases and mental disorders, adjusted by age, gender, educational level, self-reported ethnicity, cardiovascular conditions, and self-reported quality of vision. Results Out of 10,775 subjects, 249 (2.3%), 303 (2.8%), and 30 (0.3%) reported having retinal diseases, glaucoma, or both, respectively. Patients with retinal diseases and those with glaucoma and retinal diseases presented a higher prevalence of common mental disorders (relative-risk ratios of 1.7 and 3.7, respectively, P  Conclusions Retinal diseases but not glaucoma were associated with mental disorders, indicating that patients with posterior segment eye diseases require distinct management of psychiatric morbidity according to the underlying pathology.

Sandhi Maria Barreto - One of the best experts on this subject based on the ideXlab platform.

  • consumption of ultra processed food and obesity cross sectional results from the brazilian longitudinal study of Adult Health elsa brasil cohort 2008 2010
    Public Health Nutrition, 2018
    Co-Authors: Fernanda Marcelina Silva, Bruce Bartholow Duncan, Luana Giatti, Maria Del Carmen Bisi Molina, Leticia De Oliveira Cardoso, Roberta Carvalho De Figueiredo, Sandhi Maria Barreto
    Abstract:

    Objective To verify if the intake of ultra-processed foods is associated with higher BMI and waist circumference (WC) among participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. Design Cross-sectional analysis of the ELSA-Brasil baseline (2008-2010). Dietary information obtained through an FFQ was classified according to characteristics of food processing (NOVA) and used to estimate the percentage energy contribution from ultra-processed foods (i.e. industrial formulations, elaborated from food processing, synthetic constituents and food additives) to individuals' total energy intake. BMI and WC and their respective cut-off points served as response variables. Associations were estimated through linear and multinomial logistic regression models, after adjusting for confounders and total energy intake. Setting Six Brazilian capital cities, 2008-2010. Subjects Active and retired civil servants, aged 35-64 years, from universities and research organizations (n 8977). Results Ultra-processed foods accounted for 22·7 % of total energy intake. After adjustments, individuals in the fourth quartile of percentage energy contribution from ultra-processed foods presented (β; 95 % CI) a higher BMI (0·80; CI 0·53, 1·07 kg/m2) and WC (1·71; 1·02, 2·40 cm), and higher chances (OR; 95 % CI) of being overweight (1·31; 1·13, 1·51), obese (1·41; 1·18, 1·69) and having significantly increased WC (1·41; 1·20, 1·66), compared with those in the first quartile. All associations suggest a dose-response gradient. Conclusions Results indicate the existence of associations between greater energy contribution from ultra-processed foods and higher BMI and WC, which are independent of total energy intake. These findings corroborate public policies designed to reduce the intake of this type of food.

  • at the intersection of place race and Health in brazil residential segregation and cardio metabolic risk factors in the brazilian longitudinal study of Adult Health elsa brasil
    Social Science & Medicine, 2017
    Co-Authors: Sharrelle Barber, Sandhi Maria Barreto, Luana Giatti, Leticia De Oliveira Cardoso, Maria Ines Schmidt, Ana Diez V Roux, Simone M Santos, Veronica Toste, Sherman A James, Dora Chor
    Abstract:

    Residential segregation is the spatial manifestation of entrenched socioeconomic and racial inequities and is considered a fundamental cause of racial inequalities in Health. Despite the well-documented racialized spatial inequalities that exist in urban areas throughout Brazil, few empirical investigations have examined the link between residential segregation and Health and considered its implications for racial Health inequalities in this setting. In the present study, we used data from the Brazilian Longitudinal Study of Adult Health (2008–2010) to examine the association between economic residential segregation and two major cardio-metabolic risk factors—hypertension and diabetes. We also examined whether associations were stronger for historically marginalized racial groups in Brazil. Residential segregation was calculated for study-defined neighborhoods using the Getis-Ord Local Gi* statistic and was based on household income data from the 2010 IBGE demographic census. Multivariable logistic regression models were used to examine associations. In our sample, Blacks and Browns were more likely to live in economically segregated neighborhoods. After taking into account income, education, and other demographic characteristics we found that individuals living in the most economically segregated neighborhoods were 26% more likely to have hypertension and 50% more likely to have diabetes than individuals living in more affluent areas. Although Blacks and Browns living in highly segregated neighborhoods had higher prevalence of hypertension and diabetes compared to Whites, we observed no statistically significant racial differences in the associations with residential segregation. Our findings suggest that residential segregation may be an important structural determinant of cardio-metabolic risk factors in Brazil. Moreover, the systematic and disproportionate exposure of Blacks and Browns to highly segregated neighborhoods may implicate these settings as potential drivers of racial inequalities in cardio-metabolic risk factors in urban settings in Brazil.

  • lack of association between depression and c reactive protein level in the baseline of longitudinal study of Adult Health elsa brasil
    Journal of Affective Disorders, 2017
    Co-Authors: Sara Teles De Menezes, Isabela M. Benseñor, Maria Carmen Viana, Alessandra C Goulart, Maria Angelica Nunes, Roberta Carvalho De Figueiredo, Sandhi Maria Barreto
    Abstract:

    Abstract Background Depression has been linked to increased levels of inflammatory markers in clinical studies, but results from general population samples are inconsistent. We aimed to investigate whether depression was associated with serum CRP levels in a cross-sectional analysis of a large cohort from a middle-income country. Methods We analyzed baseline data from 14,821 participants (35–74 years) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Current depression (last 7 days) was assessed by the Clinical Interview Schedule-Revised (CIS-R). Because individuals on antidepressants could be negative on CIS-R due to their therapeutic effect, the explanatory variable had three categories: (1) negative on CIS-R and not using antidepressant (reference); (2) negative on CIS-R but using antidepressant; (3) positive on CIS-R with/without antidepressant use. Associations with CRP were investigated by general linear model (GLM). Results After adjustments for confounders, neither current depression, nor antidepressant use was statistically associated with elevated CRP levels. Additionally, analyzes stratified by gender, type and severity of depression did not change the results. Limitations The reference group in our analysis might include participants with a lifetime history of depression. Additionally, the exclusion of questions on weight fluctuation and appetite from the CIS–R applied in ELSA-Brasil may have slightly underestimated the prevalence of depression, as well as limited our ability to assess the presence of somatic symptoms. Conclusion This study found no association between current depression, use of antidepressants, and serum CRP levels.

  • sex specific associations of birth weight with measures of adiposity in mid to late Adulthood the brazilian longitudinal study of Adult Health elsa brasil
    International Journal of Obesity, 2016
    Co-Authors: G Rockenbach, Vivian Cristine Luft, Bruce Bartholow Duncan, M C Stein, Alvaro Vigo, Sheila Maria Alvim De Matos, Maria De Jesus Mendes Da Fonseca, Sandhi Maria Barreto, Noel T. Mueller, I Bensenor
    Abstract:

    Sex-specific associations of birth weight with measures of adiposity in mid-to-late Adulthood: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

  • common mental disorders and sociodemographic characteristics baseline findings of the brazilian longitudinal study of Adult Health elsa brasil
    Revista Brasileira de Psiquiatria, 2016
    Co-Authors: Maria Angelica Nunes, Sandhi Maria Barreto, Isabela M. Benseñor, Andre R Brunoni, Dora Chor, Andrea Poyastro Pinheiro, Marina Bessel, Andrew H Kemp, Maria Ines Schmidt
    Abstract:

    Objective: To assess the prevalence of common mental disorders (CMD) and the association of CMD with sociodemographic characteristics in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. Methods: We analyzed data from the cross-sectional baseline assessment of the ELSA-Brasil, a cohort study of 15,105 civil servants from six Brazilian cities. The Clinical Interview Schedule-Revised (CIS-R) was used to investigate the presence of CMD, with a score ≥ 12 indicating a current CMD (last week). Specific diagnostic algorithms for each disorder were based on the ICD-10 diagnostic criteria. Prevalence ratios (PR) of the association between CMD and sociodemographic characteristics were estimated by Poisson regression. Results: CMD (CIS-R score ≥ 12) was found in 26.8% (95% confidence intervals [95%CI] 26.1-27.5). The highest burden occurred among women (PR 1.9; 95%CI 1.8-2.0), the youngest (PR 1.7; 95%CI 1.5-1.9), non-white individuals, and those without a university degree. The most frequent diagnostic category was anxiety disorders (16.2%), followed by depressive episodes (4.2%). Conclusion: The burden of CMD was high, particularly among the more socially vulnerable groups. These findings highlight the need to strengthen public policies aimed to address Health inequities related to mental disorders.

Isabela M. Benseñor - One of the best experts on this subject based on the ideXlab platform.

  • association between posterior segment eye diseases common mental disorders and depression cross sectional and longitudinal analyses of brazilian longitudinal study of Adult Health cohort
    Psychosomatics, 2021
    Co-Authors: Kallene Summer Moreira Vidal, Isabela M. Benseñor, Paulo A. Lotufo, Claudia K Suemoto, Arlinda B Moreno, Maria Carmen Viana, Andre R Brunoni
    Abstract:

    BACKGROUND Posterior segment eye diseases, such as glaucoma and retinal diseases (such as diabetic retinopathy, age-related macular degeneration, and retinal detachment), are chronic diseases that are among the major causes of visual impairment. OBJECTIVE We investigated the prevalence of anxiety disorders, depressive disorders, and common mental disorders in these patients and also the incidence of depression. METHODS We examined baseline (2008-2010) and follow-up (2012-2014) data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We used the Clinical Interview Schedule-Revised (CIS-R) to perform International Classification of Diseases-10-based diagnoses of anxiety and depressive disorders. Common mental disorder was defined as a Clinical Interview Schedule-Revised >11. We used multinomial logistic regression models to investigate associations between eye diseases and mental disorders, adjusted by age, gender, educational level, self-reported ethnicity, cardiovascular conditions, and self-reported quality of vision. RESULTS Out of 10,775 subjects, 249 (2.3%), 303 (2.8%), and 30 (0.3%) reported having retinal diseases, glaucoma, or both, respectively. Patients with retinal diseases and those with glaucoma and retinal diseases presented a higher prevalence of common mental disorders (relative-risk ratios of 1.7 and 3.7, respectively, P < 0.001). These patients also presented a higher incidence of depression at follow-up (relative-risk ratios of 3.0 and 5.9, respectively, P < 0.001). Patients with glaucoma presented neither a higher prevalence nor a higher incidence of mental disorders or depression. CONCLUSIONS Retinal diseases but not glaucoma were associated with mental disorders, indicating that patients with posterior segment eye diseases require distinct management of psychiatric morbidity according to the underlying pathology.

  • neck and waist circumference values according to sex age and body mass index brazilian longitudinal study of Adult Health elsa brasil
    Brazilian Journal of Medical and Biological Research, 2020
    Co-Authors: B A B Moura, Isabela M. Benseñor, Paulo A. Lotufo, Maria Ines Schmidt, Alessandra C Goulart, Itamar S Santos, Cristina Pellegrino Baena
    Abstract:

    Body fat distribution predicts cardiovascular events better than body-mass index (BMI). Waist circumference (WC) and neck circumference (NC) are inexpensive anthropometric measurements. We aimed to present the conditional distribution of WC and NC values according to BMI, stratified by age and sex, from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline data. We analyzed 15,085 ELSA-Brasil participants with complete data. We used spline quantile regression models, stratified by sex and age, to estimate the NC and WC quantiles according to BMI. To test a putative association between age and median NC or WC values, we built sex-specific median regression models using both BMI and age as explanatory variables. We present estimated 25th, 50th, 75th, and 90th percentiles for NC and WC values, according to BMI, age, and sex. Predicted interquartile intervals for NC values varied from 1.6 to 3.8 cm and, for WC values, from 5.1 to 10.3 cm. Median NC was not associated with age in men (P=0.11) nor in women (P=0.79). However, median WC increased with advancing age in both sexes (P<0.001 for both). There was significant dispersion in WC and NC values for a given BMI and age strata for both men and women. WC, but not NC values, were associated with increasing age. The smaller influence of advancing age on the relationship between BMI and NC (compared to WC) values may be useful in longitudinal studies.

  • religious service attendance educational attainment and hypertension at baseline of the brazilian longitudinal study of Adult Health elsa brasil
    American Journal of Hypertension, 2020
    Co-Authors: Ana C Varella, Isabela M. Benseñor, Maria J M Fonseca, Rosane Harter Griep, Alexandre C Pereira, Paulo A. Lotufo
    Abstract:

    BACKGROUND Some religious dimensions have been associated with different Health-related outcomes over many years. Attending religious services is one of these dimensions that were associated with hypertension, with inconsistent results. And religious involvement seems to be closely influenced by sociodemographic factors, such as education. Therefore, this study aimed to investigate the association between religious service attendance and hypertension according to levels of education. METHODS We analyzed baseline data of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Frequency of religious service attendance and presence of hypertension were assessed in all 15,105 participants at baseline. The analyses were stratified by two levels of education (less than high school and high school or more). Logistic regression models were used to obtain the association between religious service attendance and hypertension in both groups. RESULTS For those with high school or more, attending religious services was positively associated with hypertension (adjusted odds ratio [OR] = 1.14, 95% confidence interval [CI] 1.02-1.28). In contrast, for those with less than high school, attending services was inversely associated with presence of hypertension (adjusted OR = 0.73, 95% CI 0.55-0.96). CONCLUSIONS There seems to be a paradox in the association of religious service attendance and hypertension depending on the level of education.

  • validating the framingham hypertension risk score a 4 year follow up from the brazilian longitudinal study of the Adult Health elsa brasil
    Journal of Clinical Hypertension, 2020
    Co-Authors: Danielli Haddad Syllos, Isabela M. Benseñor, Vinicius F Calsavara, Paulo A. Lotufo
    Abstract:

    The Framingham Heart Study published an equation that permits to estimate the 4-year incidence of hypertension among Adults. In Brazil, only the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) of 15 105 men and women aged 35-74 years enrolled in 2008-2010 has data that can validate the Framingham Risk Score for Hypertension and create a new equation according to the Brazilian population. We examined the predictive performance of the Framingham Risk Score for Hypertension in the ELSA-Brasil using as an outcome variable, the 4-year incidence of hypertension. We split randomly the 8027 participants who participated in the second visit (2012-2014) and without hypertension at baseline in derivation data set (n = 4825; 60%) and a validation data set (n = 3202 participants; 40%). The area under the curve for Framingham Risk Score for Hypertension and ELSA-Brasil Risk Score was relatively similar. Hosmer-Lemeshow chi-squared statistic applied for the Framingham Risk Score was 3.78 (P-value = .876) and for our model was 8.22 (P-value = .41), disclosing good discrimination and calibration for both models. Even with these classification intervals, our model presents more underestimation of the risk, classifying 15% of the participants with new onset of hypertension in low risk vs 9% of the Framingham model and less overestimation of the risk, classifying 17% of the participants without hypertension as high risk vs 24% of the Framingham model. We concluded that the Framingham Risk Score for Hypertension has an acceptable performance when applied in the ELSA-Brasil population with good discrimination and calibration.

  • association between posterior segment eye diseases common mental disorders and depression cross sectional and longitudinal analyses of brazilian longitudinal study of Adult Health cohort
    Psychosomatics, 2020
    Co-Authors: Kallene Summer Moreira Vidal, Isabela M. Benseñor, Paulo A. Lotufo, Claudia K Suemoto, Arlinda B Moreno, Maria Carmen Viana, Andre R Brunoni
    Abstract:

    Abstract Background Posterior segment eye diseases, such as glaucoma and retinal diseases (such as diabetic retinopathy, age-related macular degeneration, and retinal detachment), are chronic diseases that are among the major causes of visual impairment. Objective We investigated the prevalence of anxiety disorders, depressive disorders, and common mental disorders in these patients and also the incidence of depression. Methods We examined baseline (2008–2010) and follow-up (2012–2014) data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We used the Clinical Interview Schedule-Revised (CIS-R) to perform International Classification of Diseases-10–based diagnoses of anxiety and depressive disorders. Common mental disorder was defined as a Clinical Interview Schedule-Revised >11. We used multinomial logistic regression models to investigate associations between eye diseases and mental disorders, adjusted by age, gender, educational level, self-reported ethnicity, cardiovascular conditions, and self-reported quality of vision. Results Out of 10,775 subjects, 249 (2.3%), 303 (2.8%), and 30 (0.3%) reported having retinal diseases, glaucoma, or both, respectively. Patients with retinal diseases and those with glaucoma and retinal diseases presented a higher prevalence of common mental disorders (relative-risk ratios of 1.7 and 3.7, respectively, P  Conclusions Retinal diseases but not glaucoma were associated with mental disorders, indicating that patients with posterior segment eye diseases require distinct management of psychiatric morbidity according to the underlying pathology.

Paul Kowal - One of the best experts on this subject based on the ideXlab platform.

  • prevalence socio demographic and environmental determinants of asthma in 4621 ghanaian Adults evidence from wave 2 of the world Health organization s study on global ageing and Adult Health
    PLOS ONE, 2020
    Co-Authors: Justice Moses K Aheto, Paul Kowal, Somnath Chatterji, George A Mensah, Emilia Asuquo Udofia, Eugene Kallson, Minicuci Nadia, Naidoo Nirmala, Richard B Biritwum
    Abstract:

    Background A previous multi-site study involving lower- and middle-income countries demonstrated that asthma in older Adults is associated with long-term exposure to particulate matter, male gender and smoking. However, variations may occur within individual countries, which are relevant to inform Health promoting policies as populations live longer. The present study estimates asthma prevalence and examines the sociodemographic characteristics and environmental determinants associated with asthma in older Adults in Ghana. Methods This study utilised data from the nationally representative World Health Organization Study on global AGEing and Adult Health (SAGE) Ghana Wave 2. A final sample of 4621 individuals residing in 3970 households was used in analytical modelling. Factors associated with asthma were investigated using single level and multilevel binary logistic regression models. Results Asthma was reported by 102 (2.2%) respondents. Factors associated with asthma in the univariate model were: those aged 60–69 (OR = 5.22, 95% CI: 1.24, 21.95) and 70 or more (OR = 5.56, 95% CI: 1.33, 23.26) years, Ga-Adangbe dialect group (OR = 1.65, 95% CI: 1.01, 2.71), no religion (OR = 3.59, 95% CI: 1.77, 7.28), having moderate (OR = 1.76, 95% CI: 1.13, 2.75) and bad/very bad (OR = 2.75, 95% CI: 1.58, 4.80) Health state, and severe/extreme difficulty with self-care (OR = 3.49, 95% CI: 1.23, 9.88) and non-flush toilet facility (OR = 0.62, 95% CI: 0.39, 0.99). Factors independently associated with asthma in the adjusted models were: those aged 60–69 (OR = 4.49, 95% CI: 1.03, 19.55) years, father with primary education or less (OR = 0.40, 95% CI: 0.17, 0.94), no religion (OR = 2.52, 95% CI: 1.18, 5.41), and households with non-flush toilet facility (OR = 0.58, 95% CI: 0.35, 0.96). Significant residual household-level variation in asthma was observed. Over 40% of variance in asthma episodes could be attributable to residual household-level variations. Conclusion Individual as well as household factors were seen to influence the prevalence of asthma in this national survey. Clinical management of these patients in Health facilities should consider household factors in addition to individual level factors.

  • the role of intergenerational educational mobility and household wealth in Adult obesity evidence from wave 2 of the world Health organization s study on global ageing and Adult Health
    PLOS ONE, 2019
    Co-Authors: Stella T Lartey, Costan G Magnussen, Paul Kowal, Richard B Biritwum, Barbara De Graaff, George A Mensah, Alfred Yawson, Nadia Minicuci
    Abstract:

    Background Obesity has emerged as a major risk factor for non-communicable diseases in low and middle-income countries but may not follow typical socioeconomic status (SES)-related gradients seen in higher income countries. This study examines the associations between current and lifetime markers of SES and BMI categories (underweight, normal weight, overweight, obese) and central adiposity in Ghanaian Adults. Methods Data from 4,464 Adults (2,610 women) who participated in the World Health Organization’s Study on global AGEing and Adult Health (SAGE) Wave 2 were examined. Multilevel multinomial and binomial logistic regression models were used to examine associations. SES markers included parental education, individual education, intergenerational educational mobility and household wealth. Intergenerational educational mobility was classified: stable-low (low parental and low individual education), stable-high (high parental and high individual education), upwardly (low parental and high individual education), or downwardly mobile (high parental and low individual education). Results The prevalence of obesity (12.9%) exceeded the prevalence of underweight (7.2%) in the population. High parental and individual education were significantly associated with higher odds of obesity and central adiposity in women. Compared to the stable low pattern, stable high (obesity: OR = 3.15; 95% CI: 1.96, 5.05; central adiposity: OR = 1.75; 95% CI: 1.03, 2.98) and upwardly (obesity: OR = 1.71; 95% CI: 11.13, 2.60; central adiposity: OR = 1.60; 95% CI: 1.08, 2.37) mobile education patterns were associated with higher odds of obesity and central adiposity in women, while stable high pattern was associated with higher odds of overweight (OR = 1.88; 95% CI: 1.11, 3.19) in men. Additionally, high compared to the lowest household wealth was associated with high odds of obesity and central adiposity in both sexes. Conclusion Stable high and upwardly mobile education patterns are associated with higher odds of obesity and central adiposity in women while the stable high pattern was associated with higher odds of overweight in men.

  • impact of informal caregiving on older Adults physical and mental Health in low income and middle income countries a cross sectional secondary analysis based on the who s study on global ageing and Adult Health sage
    BMJ Open, 2017
    Co-Authors: Sylvie D Lambert, Paul Kowal, Steven J Bowe, Patricia M Livingston, Leila Heckel, Selina Cook, Liliana Orellana
    Abstract:

    Objectives A high proportion of care stemming from chronic disease or disability in low-income and middle-income countries is provided by informal caregivers. The goal of this study was to determine the level of burden experienced by these caregivers, explore associated factors and assess whether caregivers’ and non-caregivers’ Health differed. Design and setting This cross-sectional study was a secondary analysis of data on caregivers’ burden, Health and Health risk factors in Ghana, India and the Russian Federation collected as part of the WHO’s Study on global AGEing and Adult Health (SAGE) Wave 1. Participants Caregivers in Ghana (n=143), India (n=490) and Russia (n=270) completed the measures. Outcome measures Factors associated (ie, demographics and caregiving profile variables) with burden were explored among caregivers. Then, quality of life (QOL), perceived stress, depression, self-rated Health (SRH) and Health risk factors were compared between caregivers and matched non-caregivers (1:2). Results The largest caregiving subgroups were spouses and Adult children. Caregivers mostly cared for one person and provided financial, social/emotional and/or physical support, but received little support themselves. Burden level ranged from 17.37 to 20.03. Variables associated with burden were mostly country-specific; however, some commonality for wealth, type of care and caregiving duration was noted. Caregivers with a moderate or high level of burden reported lower QOL and higher perceived stress than those experiencing low burden. Caregivers reported lower QOL and SRH than non-caregivers. Conclusion Given the lack of support received and consequences of the burden endured by caregivers, policy and programme initiatives are needed to ensure that caregivers in low- and middle-income countries can fulfil their role without compromising their own Health.

  • chronic noncommunicable diseases in 6 low and middle income countries findings from wave 1 of the world Health organization s study on global ageing and Adult Health sage
    American Journal of Epidemiology, 2017
    Co-Authors: Perianayagam Arokiasamy, Paul Kowal, Richard B Biritwum, Tamara Maximova, Benjamin D Capistrant, George A Mensah, Alfred Yawson, Theresa E Gildner, Elizabeth A Thiele, Yanfei Guo
    Abstract:

    In this paper, we examine patterns of self-reported diagnosis of noncommunicable diseases (NCDs) and prevalences of algorithm/measured test-based, undiagnosed, and untreated NCDs in China, Ghana, India, Mexico, Russia, and South Africa. Nationally representative samples of older Adults aged ≥50 years were analyzed from wave 1 of the World Health Organization's Study on Global Ageing and Adult Health (2007-2010; n = 34,149). Analyses focused on 6 conditions: angina, arthritis, asthma, chronic lung disease, depression, and hypertension. Outcomes for these NCDs were: 1) self-reported disease, 2) algorithm/measured test-based disease, 3) undiagnosed disease, and 4) untreated disease. Algorithm/measured test-based prevalence of NCDs was much higher than self-reported prevalence in all 6 countries, indicating underestimation of NCD prevalence in low- and middle-income countries. Undiagnosed prevalence of NCDs was highest for hypertension, ranging from 19.7% (95% confidence interval (CI): 18.1, 21.3) in India to 49.6% (95% CI: 46.2, 53.0) in South Africa. The proportion untreated among all diseases was highest for depression, ranging from 69.5% (95% CI: 57.1, 81.9) in South Africa to 93.2% (95% CI: 90.1, 95.7) in India. Higher levels of education and wealth significantly reduced the odds of an undiagnosed condition and untreated morbidity. A high prevalence of undiagnosed NCDs and an even higher proportion of untreated NCDs highlights the inadequacies in diagnosis and management of NCDs in local Health-care systems.

  • Health service use out of pocket payments and catastrophic Health expenditure among older people in india the who study on global ageing and Adult Health sage
    Journal of Epidemiology and Community Health, 2015
    Co-Authors: Ethel Mary Brinda, Paul Kowal, Jorn Attermann, Ulrika Enemark
    Abstract:

    Background Healthcare financing through out-of-pocket payments and inequities in Healthcare utilisation are common in low and middle income countries (LMICs). Given the dearth of pertinent studies on these issues among older people in LMICs, we investigated the determinants of Health service use, out-of-pocket and catastrophic Health expenditures among older people in one LMIC, India. Methods We accessed data from a nationally representative, multistage sample of 2414 people aged 65 years and older from the WHO9s Study on global Ageing and Adult Health in India. Sociodemographic characteristics, Health profiles, Health service utilisation and out-of-pocket Health expenditure were assessed using standard instruments. Multivariate zero-inflated negative binomial regression models were used to evaluate the determinants of Health service visits. Multivariate Heckman sample selection regression models were used to assess the determinants of out-of-pocket and catastrophic Health expenditures. Results Out-of-pocket Health expenditures were higher among participants with disability and lower income. Diabetes, hypertension, chronic pulmonary disease, heart disease and tuberculosis increased the number of Health visits and out-of-pocket Health expenditures. The prevalence of catastrophic Health expenditure among older people in India was 7% (95% CI 6% to 8%). Older men and individuals with chronic diseases were at higher risk of catastrophic Health expenditure, while access to Health insurance lowered the risk. Conclusions Reducing out-of-pocket Health expenditure among older people is an important public Health issue, in which social as well as medical determinants should be prioritised. Enhanced public Health sector performance and provision of publicly funded insurance may protect against catastrophic Health expenses and Healthcare inequities in India.

Luana Giatti - One of the best experts on this subject based on the ideXlab platform.

  • ultra processed foods incident overweight and obesity and longitudinal changes in weight and waist circumference the brazilian longitudinal study of Adult Health elsa brasil
    Public Health Nutrition, 2020
    Co-Authors: Vivian Cristine Luft, Bruce Bartholow Duncan, Sheila Maria Alvim De Matos, Maria De Jesus Mendes Da Fonseca, Luana Giatti, Dora Chor, Scheine Canhada, Maria Del Carmen Bisi Molina
    Abstract:

    Objective To evaluate the association of ultra-processed food (UPF) consumption with gains in weight and waist circumference, and incident overweight/obesity, in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. Design We applied FFQ at baseline and categorized energy intake by degree of processing using the NOVA classification. Height, weight and waist circumference were measured at baseline and after a mean 3·8-year follow-up. We assessed associations, through Poisson regression with robust variance, of UPF consumption with large weight gain (1·68 kg/year) and large waist gain (2·42 cm/year), both being defined as ≥90th percentile in the cohort, and with incident overweight/obesity. Setting Brazil. Participants Civil servants of Brazilian public academic institutions in six cities (n 11 827), aged 35-74 years at baseline (2008-2010). Results UPF provided a mean 24·6 (sd 9·6) % of ingested energy. After adjustment for smoking, physical activity, adiposity and other factors, fourth (>30·8 %) v. first ( 17·8 % of energy as UPF. Conclusions Greater UPF consumption predicts large gains in overall and central adiposity and may contribute to the inexorable rise in obesity seen worldwide.

  • consumption of ultra processed food and obesity cross sectional results from the brazilian longitudinal study of Adult Health elsa brasil cohort 2008 2010
    Public Health Nutrition, 2018
    Co-Authors: Fernanda Marcelina Silva, Bruce Bartholow Duncan, Luana Giatti, Maria Del Carmen Bisi Molina, Leticia De Oliveira Cardoso, Roberta Carvalho De Figueiredo, Sandhi Maria Barreto
    Abstract:

    Objective To verify if the intake of ultra-processed foods is associated with higher BMI and waist circumference (WC) among participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. Design Cross-sectional analysis of the ELSA-Brasil baseline (2008-2010). Dietary information obtained through an FFQ was classified according to characteristics of food processing (NOVA) and used to estimate the percentage energy contribution from ultra-processed foods (i.e. industrial formulations, elaborated from food processing, synthetic constituents and food additives) to individuals' total energy intake. BMI and WC and their respective cut-off points served as response variables. Associations were estimated through linear and multinomial logistic regression models, after adjusting for confounders and total energy intake. Setting Six Brazilian capital cities, 2008-2010. Subjects Active and retired civil servants, aged 35-64 years, from universities and research organizations (n 8977). Results Ultra-processed foods accounted for 22·7 % of total energy intake. After adjustments, individuals in the fourth quartile of percentage energy contribution from ultra-processed foods presented (β; 95 % CI) a higher BMI (0·80; CI 0·53, 1·07 kg/m2) and WC (1·71; 1·02, 2·40 cm), and higher chances (OR; 95 % CI) of being overweight (1·31; 1·13, 1·51), obese (1·41; 1·18, 1·69) and having significantly increased WC (1·41; 1·20, 1·66), compared with those in the first quartile. All associations suggest a dose-response gradient. Conclusions Results indicate the existence of associations between greater energy contribution from ultra-processed foods and higher BMI and WC, which are independent of total energy intake. These findings corroborate public policies designed to reduce the intake of this type of food.

  • at the intersection of place race and Health in brazil residential segregation and cardio metabolic risk factors in the brazilian longitudinal study of Adult Health elsa brasil
    Social Science & Medicine, 2017
    Co-Authors: Sharrelle Barber, Sandhi Maria Barreto, Luana Giatti, Leticia De Oliveira Cardoso, Maria Ines Schmidt, Ana Diez V Roux, Simone M Santos, Veronica Toste, Sherman A James, Dora Chor
    Abstract:

    Residential segregation is the spatial manifestation of entrenched socioeconomic and racial inequities and is considered a fundamental cause of racial inequalities in Health. Despite the well-documented racialized spatial inequalities that exist in urban areas throughout Brazil, few empirical investigations have examined the link between residential segregation and Health and considered its implications for racial Health inequalities in this setting. In the present study, we used data from the Brazilian Longitudinal Study of Adult Health (2008–2010) to examine the association between economic residential segregation and two major cardio-metabolic risk factors—hypertension and diabetes. We also examined whether associations were stronger for historically marginalized racial groups in Brazil. Residential segregation was calculated for study-defined neighborhoods using the Getis-Ord Local Gi* statistic and was based on household income data from the 2010 IBGE demographic census. Multivariable logistic regression models were used to examine associations. In our sample, Blacks and Browns were more likely to live in economically segregated neighborhoods. After taking into account income, education, and other demographic characteristics we found that individuals living in the most economically segregated neighborhoods were 26% more likely to have hypertension and 50% more likely to have diabetes than individuals living in more affluent areas. Although Blacks and Browns living in highly segregated neighborhoods had higher prevalence of hypertension and diabetes compared to Whites, we observed no statistically significant racial differences in the associations with residential segregation. Our findings suggest that residential segregation may be an important structural determinant of cardio-metabolic risk factors in Brazil. Moreover, the systematic and disproportionate exposure of Blacks and Browns to highly segregated neighborhoods may implicate these settings as potential drivers of racial inequalities in cardio-metabolic risk factors in urban settings in Brazil.

  • reliability of the macarthur scale of subjective social status brazilian longitudinal study of Adult Health elsa brasil
    BMC Public Health, 2012
    Co-Authors: Lidyane Do Valle Camelo, Luana Giatti, Josi Fernandes De Castro Rodrigues, Sandhi Maria Barreto
    Abstract:

    The MacArthur Scale of Subjective Social Status intend to measure the subjective social status using a numbered stepladder image. This study investigated the reliability of the MacArthur scale in a subsample of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Three scales were employed using different references: 1) the overall socioeconomic position; 2) the socioeconomic situation of the participant’s closer community; 3) the workplace as a whole. A total of 245 of the ELSA participants from six states were involved. They were interviewed twice by the same person within an interval of seven to fourteen days. The reliability of the scale was assessed with weighted Kappa statistics and intraclass correlation coefficient (ICC), with their respective 95% confidence interval (CI). Kappa values were 0.62(0.58 to 0.64) for the society ladder; 0.58(0.56 to 0.61) for the community-related ladder; and 0.67(0.66 to 0.72) for the work-related ladder. The ICC ranged from 0.75 for the work ladder to 0.64 for the community ladder. These values differed slightly according to the participants’ age, sex and education category. The three ladders showed good stability in the test-retest, except the community ladder that showed moderate stability. Because the social structure in Brazil is rapidly changing, future qualitative and longitudinal studies are needed to confirm and understand the construct underlying the MacArthur Scale in the country.