Multimorbidity and perceived stress: a population-based cross-sectional study among older adults across six low- and middle-income countries.
Por:
Stubbs B, Vancampfort D, Veronese N, Schofield P, Lin PY, Tseng PT, Solmi M, Thompson T, Carvalho AF and Koyanagi A
Publicada:
1 ene 2018
Ahead of Print:
16 oct 2017
Resumen:
BACKGROUND: Stress in chronic conditions or multimorbidity (=2 chronic conditions) has been reported to affect clinical outcomes but there are no studies on the association between stress and chronic conditions/multimorbidity among older adults in low- and middle-income countries (LMICs). Thus, we investigated this association among adults aged =50 years across six LMICs. METHODS: A cross-sectional analysis using data from the World Health Organization's Study on Global Ageing and Adult Health (China, Ghana, India, Mexico, Russia, South Africa) was conducted. A perceived stress score [range 0 (lowest stress) -100 (highest stress)] was computed based on two questions from the Perceived Stress Scale. Thirteen chronic conditions were assessed. Multivariable linear regression analyses were conducted. RESULTS: 34,129 adults with a mean age of 62.4 (SD=16.0)years (52.1% females) were included. Overall, 56.6% (95% CI=55.0%-58.2%) had multimorbidity. In the adjusted model including all countries, compared with those with no chronic conditions, higher numbers of chronic conditions were significantly associated with higher stress levels, dose dependently. In a countrywide meta-analysis, multimorbidity was associated with significantly higher stress levels in all countries (especially India and Ghana) although characterized by moderate heterogeneity (I(2)=54.6%). For single chronic conditions, notably high stress scores were observed for depression, stroke, and hearing problems. CONCLUSION: Chronic conditions and multimorbidity are associated with higher levels of stress in older adults in LMICs. Given that perceived stress and chronic conditions are collectively associated with worse health outcomes, low-cost, population-level integrated interventions to address stress among those with chronic conditions are urgently needed.
Filiaciones:
Stubbs B:
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom
Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom
Faculty of Health, Social care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford CM1 1SQ, United Kingdom
Vancampfort D:
KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
KU Leuven, University Psychiatric Center KU Leuven, Leuven, Kortenberg, Belgium
Veronese N:
National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
Schofield P:
Faculty of Health, Social care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford CM1 1SQ, United Kingdom
Lin PY:
Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
Tseng PT:
Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Taiwan
Solmi M:
Department of Neurosciences, University of Padova, Padova, Italy
Thompson T:
Faculty of Education and Health, University of Greenwich, London, United Kingdom
Carvalho AF:
Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
Koyanagi A:
Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
Green Submitted, Green Accepted
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