Person: SOYSAL, PINAR
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Publication Open Access Association between physical multimorbidity and sleep problems in 46 low-and middle-income countries(2022-06-01T00:00:00Z) Smith, Lee; Il Shin, Jae; Jacob, Louis; Schuch, Felipe; Oh, Hans; Tully, Mark A.; Lopez Sanchez, Guillermo F.; Veronese, Nicola; SOYSAL, PINAR; Yang, Lin; Butler, Laurie; Barnett, Yvonne; Koyanagi, Ai; SOYSAL, PINARBackground: Little is known about the association between multimorbidity (i.e., two or more chronic conditions) and sleep problems in the general adult populations of low- and middle-income countries (LMICs). Thus, we aimed to assess this association among adults from 46 LMICs, and to quantify the extent to which anxiety, depression, stress, and pain explain this association. Methods: Cross-sectional, predominantly nationally representative, community-based data from the World Health Survey were analyzed. Nine chronic physical conditions (angina, arthritis, asthma, chronic back pain, diabetes, edentulism, hearing problems, tuberculosis, visual impairment) were assessed. To be included in the analysis, sleep problems had to have been experienced in the past 30 days and to have been severe or extreme; they included difficulties falling asleep, waking up frequently during the night or waking up too early in the morning. Multivariable logistic regression and mediation analyses were conducted to explore the associations. Results: Data on 237,023 individuals aged ≥18 years [mean (SD) age 38.4 (16.0) years; 49.2% men] were analyzed. Compared with no chronic conditions, having 1, 2, 3, and ≥4 conditions was associated with 2.39 (95%CI=2.14, 2.66), 4.13 (95%CI=3.62, 4.71), 5.70 (95%CI=4.86, 6.69), and 9.99 (95%CI=8.18, 12.19) times higher odds for sleep problems. Pain (24.0%) explained the largest proportion of the association between multimorbidity and sleep problems, followed by anxiety (21.0%), depression (11.2%), and stress (10.4%). Conclusions: Multimorbidity was associated with a substantially increased odds for sleep problems in adults from 46 LMICs. Future studies should assess whether addressing factors such as pain, anxiety, depression,Publication Metadata only Body mass index categories and anxiety symptoms among adults aged ≥ 50 years from low and middle income countries.(2021-10-18T00:00:00Z) Smith, Lee; Pizzol, Damiano; López-Sánchez, Guillermo F; Oh, Hans; Jacob, Louis; Yang, Lin; Veronese, Nicola; Soysal, PINAR; McDermott, Daragh; Barnett, Yvonne; Butler, Laurie; Koyanagi, Ai; SOYSAL, PINARPublication Metadata only Anxiety symptoms among informal caregivers in 47 low- and middle-income countries: a cross-sectional analysis of community-based surveys.(2021-11-14T00:00:00Z) Smith, Lee; Shin, Jae Il; Oh, Hans; López Sánchez, Guillermo F; Underwood, Benjamin; Jacob, Louis; Veronese, Nicola; Soysal, PINAR; Butler, Laurie; Barnett, Yvonne; Tully, Mark A; Koyanagi, Ai; SOYSAL, PINARPublication Metadata only Body Mass Index and Mild Cognitive Impairment Among Middle-Aged and Older Adults from Low- and Middle-Income Countries.(2021-12-10T00:00:00Z) Smith, Lee; Shin, Jae Il; Oh, Hans; Carmichael, Christina; Jacob, Louis; Stefanac, Sinisa; Lindsay, Rosie K; Soysal, PINAR; Veronese, Nicola; Tully, Mark A; Butler, Laurie; Barnett, Yvonne; Koyanagi, Ai; SOYSAL, PINARBackground: The effect of weight modification on future dementia risk is currently a subject of debate and may be modified by age. Objective: The aim of the present study was to investigate the association between body mass index (BMI) status with mild cognitive impairment (MCI) (a preclinical stage of dementia) in middle-aged and older adults residing in six low- and middle-income countries using nationally representative data. Methods: Cross-sectional data from the Study on Global Ageing and Adult Health (SAGE) were analyzed. MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. BMI (kg/m2) was based on measured weight and height and categorized as: underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9), and obese (≥30.0). Multivariable logistic regression analysis and meta-analysis were conducted to assess associations. Results: Data on 32,715 individuals aged ≥50 years with preservation in functional abilities were analyzed [mean (SD) age 62.1 (15.6) years; 51.7% females]. Among those aged 50-64 years, compared to normal weight, underweight (OR = 1.44; 95% CI = 1.14-1.81), overweight (OR = 1.17; 95% CI = 1.002-1.37), and obesity (OR = 1.46; 95% CI = 1.09-1.94) were all significantly associated with higher odds for MCI. In those aged ≥65 years, underweight (OR = 0.71; 95% CI = 0.54-0.95) and overweight (OR = 0.72; 95% CI = 0.55-0.94) were associated with significantly lower odds for MCI, while obesity was not significantly associated with MCI. Conclusion: The results of the study suggest that the association between BMI and MCI is likely moderated by age. Future longitudinal studies are required to confirm or refute the present findings before recommendations for policy and practice can be made.Publication Open Access Mild cognitive impairment is associated with fall-related injury among adults aged ≥65 years in low- and middle-income countries.(2020-12-29T00:00:00Z) Smith, Lee; Jacob, Louis; Kostev, Karel; Butler, Laurie; Barnett, Yvonne; Pfeifer, Briona; Soysal, PINAR; Grabovac, Igor; López-Sánchez, Guillermo F; Veronese, Nicola; Yang, Lin; Oh, Hans; Koyanagi, Ai; SOYSAL, PINARPublication Open Access The Association Between Sedentary Behavior and Sarcopenia Among Adults Aged >= 65 Years in Low- and Middle-Income Countries(2020-03-01T00:00:00Z) Smith, Lee; Tully, Mark; Jacob, Louis; Blackburn, Nicole; Adlakha, Deepti; Caserotti, Paolo; SOYSAL, PINAR; Veronese, Nicola; Lopez Sanchez, Guillermo F.; Vancampfort, Davy; Koyanagi, Ai; SOYSAL, PINARThe present study aimed to assess the association between sedentary behavior and sarcopenia among adults aged >= 65 years. Cross-sectional data from the Study on Global Ageing and Adult Health were analyzed. Sarcopenia was defined as having low skeletal muscle mass and either a slow gait speed or a weak handgrip strength. Self-reported sedentary behavior was assessed as a continuous variable (hours per day) and also as a categorical variable (0-= 11 hours/day). Multivariable logistic regression was conducted to assess the association between sedentary behavior and sarcopenia. Analyses using the overall sample and country-wise samples were conducted. A total of 14,585 participants aged >= 65 years were included in the analysis. Their mean age was 72.6 (standard deviation, 11.5) years and 55% were females. Compared to sedentary behavior of 0-= 11 hours/day was significantly associated with 2.14 (95% CI = 1.06-4.33) times higher odds for sarcopenia. The country-wise analysis showed that overall, a one-hour increase in sedentary behavior per day was associated with 1.06 (95% CI = 1.04-1.10) times higher odds for sarcopenia, while the level of between-country heterogeneity was low (I-2 = 12.9%). Public health and healthcare practitioners may wish to target reductions in sedentary behavior to aid in the prevention of sarcopenia in older adults.Publication Metadata only Physical multimorbidity predicts the onset and persistence of anxiety: A prospective analysis of the Irish Longitudinal Study on Ageing.(2022-04-19T00:00:00Z) Smith, Lee; Shin, Jae Il; Jacob, Louis; Schuch, Felipe; Pizzol, Damiano; López Sánchez, Guillermo F; Soysal, PINAR; Tully, Mark A; Butler, Laurie T; Barnett, Yvonne; Veronese, Nicola; Park, Seoyeon; Koyanagi, Ai; SOYSAL, PINARPublication Metadata only Physical multimorbidity and depression: A mediation analysis of influential factors among 34,129 adults aged ≥50 years from low- and middle-income countries.(2022-03-21T00:00:00Z) Smith, Lee; Shin, Jae Il; Butler, Laurie; Barnett, Yvonne; Oh, Hans; Jacob, Louis; Kostev, Karel; Veronese, Nicola; Soysal, PINAR; Tully, Mark; López Sánchez, Guillermo F; Koyanagi, Ai; SOYSAL, PINARPublication Open Access The association of cooking fuels with depression and anxiety symptoms among adults aged ≥65 years from low- and middle-income countries(2022-05-21T00:00:00Z) Smith, Lee; Veronese, Nicola; López Sánchez, Guillermo F; Butler, Laurie; Barnett, Yvonne; Shin, Jae Il; Lee, San; Oh, Jae Won; Soysal, PINAR; Pizzol, Damiano; Oh, Hans; Kostev, Karel; Jacob, Louis; Koyanagi, Ai; SOYSAL, PINARBackground: We aimed to investigate associations of unclean cooking fuels with depression and anxiety symptoms in a large sample of adults aged ≥65 years from six low- and middle-income countries (LMICs). Methods: Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Unclean cooking fuel referred to kerosene/paraffin, coal/charcoal, wood, agriculture/crop, animal dung, and shrubs/grass. Depression referred to DSM-IV depression based on past 12-month symptoms or receiving depression treatment in the last 12 months. Anxiety symptoms referred to severe/extreme problems with worry or anxiety in the past 30 days. Multivariable logistic regression analysis and meta-analysis were conducted. Results: Data on 14,585 people aged ≥65 years were analyzed [mean (SD) age 72.6 (11.5) years; maximum age 114 years; 55.0% females]. After adjustment for potential confounders, unclean cooking fuel was associated with a significant 2.52 (95%CI = 1.66-3.82) times higher odds for depression with a low level of between-country heterogeneity (I2 = 0.0%). For anxiety symptoms, unclean fuel use was not significantly associated with anxiety symptoms (OR = 1.13; 95%CI = 0.77-1.68; I2 = 0.0%). Limitations: 1. Cross-sectional design. 2. Self-reported measures. 3. No information about outdoor pollution exposure, personal exposure, and smoke composition of different cooking fuels. Conclusions: Unclean cooking fuel was significantly associated with higher odds for depression, but not anxiety, with little observed variability between settings. Findings from the present study provide further support and call for action in appropriate implementation of the United Nations Sustainable Goal 7, which advocates affordable, reliable, sustainable, and modern energy for all.Publication Open Access Association between depression and subjective cognitive complaints in 47 low- and middle-income countries.(2022-07-07T00:00:00Z) Smith, Lee; Shin, Jae Il; Song, Tae-Jin; Underwood, Benjamin R; Jacob, Louis; López Sánchez, Guillermo F; Schuch, Felipe; Oh, Hans; Veronese, Nicola; Soysal, PINAR; Butler, Laurie; Barnett, Yvonne; Koyanagi, Ai; SOYSAL, PINARPeople with depression and subjective cognitive complaints (SCC) may be at particularly high risk for developing dementia. However, to date, studies on depression and SCC are limited mainly to single high-income countries. Thus, the aim of the present study was to investigate the association between depression and SCC in adults from low- and middle-income countries (LMICs). Cross-sectional, community-based data were analyzed from the World Health Survey. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). ICD-10 Diagnostic Criteria for Research was used for the diagnosis of subsyndromal depression, brief depressive episode, and depressive episode. Multivariable linear regression was conducted to explore the associations. Data on 237,952 individuals aged >= 18 years [mean (SD) age 38.4 (16.0) years; females 50.8%] were analyzed. After adjustment for potential confounders (age, sex, education, anxiety), compared to no depressive disorder, subsyndromal depression (b-coefficient 7.91; 95%CI = 5.63-10.18), brief depressive episode (b-coefficient 10.37; 95%CI = 8.95 11.78), and depressive episode (b-coefficient 13.57; 95%CI = 12.33 14.81) were significantly associated with higher mean SCC scores. The association was similar in all age groups (i.e., 18 44, 45 64, and >= 65 years), and both males and females. All depression types assessed were associated with worse SCC among adults in 47 LMICs. Future longitudinal studies are needed to investigate whether older people with depression and SCC are at higher risk for dementia onset in LMICs.