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This study aimed to report mortality, risk factors, and burden of diseases in Spain. The Global Burden of Disease, Injuries, and Risk Factors 2019 estimates the burden due to 369 diseases, injuries, and impairments and 87 risk factors and risk factor combinations. Here, we detail the updated Spain 1990–2019 burden of disease estimates and project certain metrics up to 2030. In 2019, leading causes of death were ischaemic heart disease, stroke, chronic obstructive pulmonary disease, Alzheimer's disease, and lung cancer. Main causes of disability adjusted life years (DALYs) were ischaemic heart disease, diabetes, lung cancer, low back pain, and stroke. Leading DALYs risk factors included smoking, high body mass index, and high fasting plasma glucose. Spain scored 74/100 among all health-related Sustainable Development Goals (SDGs) indicators, ranking 20 of 195 countries and territories. We forecasted that by 2030, Spain would outpace Japan, the United States, and the European Union. Behavioural risk factors, such as smoking and poor diet, and environmental factors added a significant burden to the Spanish population's health in 2019. Monitoring these trends, particularly in light of COVID-19, is essential to prioritise interventions that will reduce the future burden of disease to meet population health and SDG commitments. [ABSTRACT FROM AUTHOR]

The needs of the aging populations are putting increasing burden on healthcare particularly in the Western Pacific Region (WPR), which is the home of aging economies such as Hong Kong and Japan alongside rapid increases in older people in low- and middle-income countries (LMICs). However, little is known about the associations between sociodemographic factors, disease burden, and life expectancy in WPR. The current study conducted secondary analysis on the Global Burden of Disease (GBD) estimates of populations aged 70 years and older in WPR countries between 1995 and 2019. Correlation tests, linear mixed regressions and generalized additive mixture models were run to examine the associations of interest. Unsupervised machine learning was conducted to segment the data automatically, at cluster analysis. The sociodemographic development index was found an important factor to the disease burden in terms of Years Lived with Disability (YLD) rate and mortality rate among older adults. YLD rate and mortality rate of non-communicable diseases (NCDs) attributable to different risk groups were significant contributors to higher expectation of Lost Healthy Years (LHE) and shorter life expectancy respectively in the context of rising YLD rate, particularly in LMICs. Three clusters of countries with similar characteristics were identified. NCDs were the most significant contributors to shorter life expectancy within which the time living in poor health did not improve. Better management of NCDs in aging populations should be emphasized in all countries. The country clusters may help in a more regional strategic planning. [ABSTRACT FROM AUTHOR]

Background: Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people. The aims of this study are to evaluate the temporal variations of pain rates among general populations for the period 1991–2015 and to project 10-year pain rates. Methods: We used the harmonized dataset of ATHLOS project, which included 660,028 valid observations in the period 1990–2015 and we applied Bayesian age–period–cohort modeling to perform projections up to 2025. The harmonized Pain variable covers the content "self-reported pain experienced at the time of the interview", with a dichotomous (yes or no) modality. Results: Pain rates were higher among females, older subjects, in recent periods, and among observations referred to cohorts of subjects born between the 20s and the 60s. The 10-year projections indicate a noteworthy increase in pain rates in both genders and particularly among subjects aged 66 or over, for whom a 10–20% increase in pain rate is foreseen; among females only, a 10–15% increase in pain rates is foreseen for those aged 36–50. Conclusions: Projected increase in pain rates will require specific interventions by health and welfare systems, as pain is responsible for limited quality of subjective well-being, reduced employment rates and hampered work performance. Worksite and lifestyle interventions will therefore be needed to limit the impact of projected higher pain rates. [ABSTRACT FROM AUTHOR]

Background: Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people, and with increasing trends in general populations. Different risk factors for pain have been identified, but generally from studies with limited samples and a limited number of candidate predictors. The aim of this study is to evaluate the predictors of pain from a large set of variables and respondents. Methods: We used part of the harmonized dataset of ATHLOS project, selecting studies and waves with a longitudinal course, and in which pain was absent at baseline and with no missing at follow-up. Predictors were selected based on missing distribution and univariable association with pain, and were selected from the following domains: Socio-demographic and economic characteristics, Lifestyle and health behaviours, Health status and functional limitations, Diseases, Physical measures, Cognition, personality and other psychological measures, and Social environment. Hierarchical logistic regression models were then applied to identify significant predictors. Results: A total of 13,545 subjects were included of whom 5348 (39.5%) developed pain between baseline and the average 5.2 years' follow-up. Baseline risk factors for pain were female gender (OR 1.34), engaging in vigorous exercise (OR 2.51), being obese (OR 1.36) and suffering from the loss of a close person (OR 1.88) whereas follow-up risk factors were low energy levels/fatigue (1.93), difficulties with walking (1.69), self-rated health referred as poor (OR 2.20) or average to moderate (OR 1.57) and presence of sleep problems (1.80). Conclusions: Our results showed that 39.5% of respondents developed pain over a five-year follow-up period, that there are proximal and distal risk factors for pain, and that part of them are directly modifiable. Actions aimed at improving sleep, reducing weight among obese people and treating fatigue would positively impact on pain onset, and avoiding vigorous exercise should be advised to people aged 60 or over, in particular if female or obese. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies have reported associations between levels of protein and carbohydrate intake with several health outcomes. Yet, their effect on successful (or healthy) aging remains unknown. The purpose of the present work was to investigate the association of protein and carbohydrate intake levels with successful aging. Methods: A cross-sectional analysis was carried out on the participants of two epidemiological studies; the ATTICA and the MEDIS studies. Anthropometrical, clinical and socio-demographic characteristics, dietary habits, and lifestyle parameters were derived through standard procedures. Successful aging was evaluated using a validated index (SAI) composed of 10 health-related social, lifestyle and clinical characteristics. Results: SAI levels were lower in low protein—high carbohydrate diet group (B = − 0.08, p = 0.04), but higher in high protein—high carbohydrate group (B = 0.06, p = 0.04), as compared to low protein and low carbohydrate diet, in participants living in insular areas. Protein—carbohydrate diet was not associated with SAI (all p's > 0.05) among participants living in urban areas (p for diet—study interaction < 0.001). Conclusions: A high protein diet seems to be beneficial for older islanders in terms of successful aging; stating a hypothesis for a potential diet–environmental interaction that may be related to the quality of foods consumed and, consequently the sources of nutrients. [ABSTRACT FROM AUTHOR]

Sarcopenia and sarcopenic obesity research in low- and middle- income countries (LMICs) is limited. We investigated sarcopenia and sarcopenic obesity prevalence and sociodemographic, bio-clinical and lifestyle factors in LMICs settings. For the purposes of this study, the 10/66 Dementia Research Group follow-up wave information from individuals aged 65 and over in Cuba, Dominican Republic, Peru, Mexico, Puerto Rico, China, was employed and analysed (n = 8.694). Based on indirect population formulas, we calculated body fat percentage (%BF) and skeletal muscle mass index (SMI). Sarcopenia prevalence ranged from 12.4% (Dominican Republic) to 24.6% (rural Peru); sarcopenic obesity prevalence ranged from 3.0% (rural China) to 10.2% (rural Peru). Odds ratios (OR) with 95% confidence intervals (CI) for sarcopenia were higher for men 2.82 (2.22–3.57) and those with higher %BF 1.08 (1.07–1.09), whereas higher number of assets was associated with a decreased likelihood 0.93 (0.87–1.00). OR of sarcopenic obesity were higher for men 2.17 (1.70–2.76), those reporting moderate alcohol drinking 1.76 (1.21–2.57), and those with increased number of limiting impairments 1.54 (1.11–2.14). We observed heterogeneity in the prevalence of sarcopenia and sarcopenic obesity in the 10/66 settings. We also found a variety of factors to be associated with those. Our results reveal the need for more research among the older population of LMICs. [ABSTRACT FROM AUTHOR]

Projections show that the number of people above 60 years old will triple by 2050 in Mexico. Nevertheless, ageing is characterised by great variability in the health status. In this study, we aimed to identify trajectories of health and their associations with lifestyle factors in a national representative cohort study of older Mexicans. We used secondary data of 14,143 adults from the Mexican Health and Aging Study (MHAS). A metric of health, based on the conceptual framework of functional ability, was mapped onto four waves (2001, 2003, 2012, 2015) and created by applying Bayesian multilevel Item Response Theory (IRT). Conditional Growth Mixture Modelling (GMM) was used to identify latent classes of individuals with similar trajectories and examine the impact of physical activity, smoking and alcohol on those. Conditional on sociodemographic and lifestyle behaviour four latent classes were suggested: high-stable, moderate-stable, low-stable and decliners. Participants who did not engage in physical activity, were current or previous smokers and did not consume alcohol at baseline were more likely to be in the trajectory with the highest deterioration (i.e. decliners). This study confirms ageing heterogeneity and the positive influence of a healthy lifestyle. These results provide the ground for new policies. [ABSTRACT FROM AUTHOR]

Edentulism is associated with various adverse health outcomes but treatment options in low- and middle-income countries (LMICs) are limited. Data on its prevalence and its effect on mental health and overall-health is lacking, especially from LMICs. Self-reported data on complete edentulism obtained by standardized questionnaires on 201,953 adults aged ≥18 years from 50 countries which participated in the World Health Survey (WHS) 2002-2004 were analyzed. Age and sex-standarized edentulism prevalence ranged from 0.1% (95% CI = 0.0-0.3) (Myanmar) to 14.5% (95% CI = 13.1-15.9) (Zimbabwe), and 2.1% (95% CI = 1.5-3.0) (Ghana) to 32.3% (95% CI = 29.0-35.8) (Brazil) in the younger and older age groups respectively. Edentulism was significantly associated with depression (OR 1.57, 95% CI = 1.23-2.00) and poor self-rated health (OR 1.38, 95% CI = 1.03-1.83) in the younger group with no significant associations in the older age group. Our findings highlight the edentulism-related health loss in younger persons from LMICs. The relative burden of edentulism is likely to grow as populations age and live longer. Given its life-long nature and common risk factors with other NCDs, edentulism surveillance and prevention should be an integral part of the global agenda of NCD control. [ABSTRACT FROM AUTHOR]