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 Open Access An umbrella review of systematic reviews with meta-analyses evaluating positive and negative outcomes of hydroxychloroquine and chloroquine therapy.(2020-12-11T00:00:00Z) Celotto, Stefano; Veronese, Nicola; Barbagallo, Mario; Ometto, Francesca; Smith, Lee; Pardhan, Shahina; Barnett, Yvonne; Ilie, Petre Cristian; Soysal, PINAR; Lagolio, Erik; Kurotschka, Peter Konstantin; Tonelli, Roberto; Demurtas, Jacopo; SOYSAL, PINARBackground & aims: Hydroxychloroquine (HCQ) and chloroquine (CQ) are anti-malarial drugs frequently used in the rheumatologic field. They were recently identified as potential therapeutic options for Coronavirus Disease (COVID-19). The present study aims to map and grade the diverse health outcomes associated with HCQ/CQ using an umbrella review approach. Methods: Umbrella review of systematic reviews of observational and intervention studies. For observational studies, random-effects summary effect size, 95% confidence interval, and 95% prediction interval were estimated. We also assessed heterogeneity, evidence for small-study effect, and evidence for excess significance bias. The quality of evidence was then graded using validated criteria from highly convincing to weak. The evidence from randomized controlled trials (RCTs) was graded using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool. Results: From 313 articles returned in the literature search, six meta-analyses were included (n = 25 outcomes). Among meta-analyses (MAs) of observational studies, HCQ/CQ are weakly associated with a reduced risk for cardiovascular events and diabetes when used for autoimmune diseases and with spontaneous abortion; they are also associated with a higher risk of death in COVID-19 patients. Among MAs of RCTs, HCQ/CQ are associated with an improvement of articular manifestations of rheumatic diseases. Conclusions: There is high evidence of the efficacy of HCQ/CQ in the rheumatologic field. The lack of evidence for efficacy and the risk of death associated with the use of HCQ/CQ for COVID-19 indicate the inappropriateness of their inclusion in recent COVID-19 therapy guidelines and the urgent need for RCTs to determine eventual appropriateness as a COVID-19 therapy. Keywords: COVID-19; Chloroquine; Hydroxychloroquine; umbrella review.Publication Open Access Physical activity and exercise in dementia: an umbrella review of intervention and observational studies(2020-12-26T00:00:00Z) Demurtas, Jacopo; Schoene, Daniel; Torbahn, Gabriel; Petrovic, Mirko; Maggi, Stefania; Marengoni, Alessandra; Cesari, Matteo; Lamb, Sarah; Soysal, Pınar; Sieber, Cornel; Shenkin, Susan; Grande, Giulia; Schwingshack, Lukas; Smith, Lee; Veronese, Nicola; SOYSAL, PINARObjectives The aim of this umbrella review was to determine the effect of physical activity/exercise on improving cognitive and noncognitive outcomes in people with MCI (mild cognitive impairment) and dementia. Design Umbrella review of systematic reviews (SR), with or without meta-analyses (MAs), of randomized controlled trials (RCTs) and observational studies. Settings and Participants People with MCI or dementia, confirmed through validated assessment measures. Any form of physical activity/exercise was included. As controls, we included participants not following any prespecified physical activity/exercise intervention or following the same standard protocol with the intervention group. Methods The protocol was registered in PROSPERO (CDR 164197). Major databases were searched until December 31, 2019. The certainty of evidence of statistically significant outcomes was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. SRs' findings, without a formal MA, were reported descriptively. Results Among 1160 articles initially evaluated, 27 SRs (all of RCTs, 9 without MA) for a total of 28,205 participants with MCI/dementia were included. In patients with MCI, mind-body intervention (standardized mean difference [SMD] = 0.36; 95% confidence intervals [CI] 0.20–0.52; low certainty) and mixed physical activity interventions (SMD = 0.30; 95% CI 0.11–0.49; moderate certainty) had a small effect on global cognition, whereas resistance training (SMD = 0.80; 95% CI 0.29–1.31; very low certainty) had a large effect on global cognition. In people affected by dementia, physical activity/exercise was effective in improving global cognition in Alzheimer disease (SMD = 1.10; 95% CI 0.65–1.64; very low certainty) and in all types of dementia (SMD = 0.48; 95% CI 0.22–0.74; low certainty). Finally, physical activity/exercise improved noncognitive outcomes in people with dementia including falls, and neuropsychiatric symptoms. Conclusions and Implications Supported by very low-to-moderate certainty of evidence, physical activity/exercise has a positive effect on several cognitive and noncognitive outcomes in people with MCI and dementia, but RCTs, with low risk of bias/confounding, are still needed to confirm these relationships.Publication 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 Multimorbidity and Anxiety Symptoms among Adults Aged 50 Years and Over from Six Low- and Middle-Income Countries(2021-10-01T00:00:00Z) Smıth, Lee; F. López Sánchez , Guillermo; Shin, Jae Il; Soysal, Pınar; Veronese, Nicola; 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 Metadata only Physical Activity and Exercise in Mild Cognitive Impairment and Dementia: An Umbrella Review of Intervention and Observational Studies(2020-10-01T00:00:00Z) Demurtas, Jacopo; Schoene, Daniel; Torbahn, Gabriel; Marengoni, Alessandra; Grande, Giulia; Zou, Liye; Petrovic, Mirko; Maggi, Stefania; Cesari, Matteo; Lamb, Sarah; Soysal, Pınar; Kemmler, Wolfgang; Sieber, Cornel; Mueller, Christoph; Shenkin, Susan D.; Schwingshackl, Lukas; Smith, Lee; Veronese, Nicola; SOYSAL, PINARObjectives: The aim of this umbrella review was to determine the effect of physical activity/exercise on improving cognitive and noncognitive outcomes in people with MCI (mild cognitive impairment) and dementia.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.Publication Open Access Mini Nutritional Assessment Scale-Short Form can be useful for frailty screening in older adults(2019-01-01T00:00:00Z) SOYSAL, PINAR; Veronese, Nicola; Arik, Ferhat; Kalan, Ugur; Smith, Lee; IŞIK, AHMET TURAN; SOYSAL, PINARAim: Mini Nutritional Assessment-Short Form MNA-SF) is used to assess nutritional status in older adults, but it is not known whether it can be used to define frailty. This study was aimed to investigate whether or not MNA-SF can identify frailty status as defined by Fried-s criteria.Publication Open Access Associations between sexual activity and weight status: Findings from the English Longitudinal Study of Ageing(2019-09-01T00:00:00Z) Smith, Lee; Yang, Lin; Forwood, Suzanna; Lopez-Sanchez, Guillermo; Koyanagi, Ai; Veronese, Nicola; SOYSAL, PINAR; Grabovac, Igor; Jackson, Sarah; SOYSAL, PINARObjective