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Nutrients Mar 2020Malnutrition in the elderly could be tackled by addressing socioeconomic factors. This study aimed to determine the magnitude of the relationship between socioeconomic... (Meta-Analysis)
Meta-Analysis
Malnutrition in the elderly could be tackled by addressing socioeconomic factors. This study aimed to determine the magnitude of the relationship between socioeconomic factors and the malnutrition or malnutrition risk (MR) in the elderly. The PubMed and SCOPUS databases were searched for observational studies that included assessment of malnutrition or/and MR and socioeconomic variables (educational level, living alone, marital status, income and occupational level, feeling of loneliness, place of residence, and food expenditure) in ≥60-year-old subjects, published in English among 2000-2018 (PROSPERO: CRD42019137097). The systematic review included 40 observational studies (34 cross-sectional and 4 cohort studies) and 16 cross-sectional studies in the meta-analysis (34,703 individuals) of malnutrition and MR in relation to low educational level (Odds Ratio (OR): 1.48; 95% Confidence Interval (CI): 1.33-1.64; < 0.001), living alone (OR: 1.92; 95% CI: 1.73-2.14; < 0.001), being single, widowed, or divorced (OR: 1.73; 95% CI: 1.57-1.90; < 0.001), and low income level (OR: 2.69; 95% CI: 2.35-3.08; < 0.001), and considering these four socioeconomic factors, malnutrition and MR is associated with them (OR: 1.83; 95% CI: 1.73-1.93; < 0.001). Malnutrition and MR could be reduced by increasing economic level, supporting people living alone or being single, widowed, and divorced, and improving lifelong learning.
Topics: Aged; Aged, 80 and over; Female; Geriatric Assessment; Humans; Loneliness; Male; Malnutrition; Marital Status; Nutrition Assessment; Nutritional Status; Publication Bias; Risk Assessment; Risk Factors; Socioeconomic Factors
PubMed: 32168827
DOI: 10.3390/nu12030737 -
Revista Brasileira de Psiquiatria (Sao... 2020Major depressive disorder (MDD) is one of the most disabling mental illnesses and it has a significant impact on society. This review aims to provide updated scientific...
OBJECTIVES
Major depressive disorder (MDD) is one of the most disabling mental illnesses and it has a significant impact on society. This review aims to provide updated scientific evidence about the epidemiology of MDD.
METHODS
A systematic literature review of the PubMed and MEDLINE databases was performed to identify articles on the prevalence of MDD and its correlates. The search was restricted to manuscripts published between January 2001 and December 2018.
RESULTS
Sixty-three articles were included in the review. The lifetime prevalence of MDD ranged from 2 to 21%, with the highest rates found in some European countries and the lowest in some Asian countries. The main sociodemographic correlates were separated/divorced marital status and female gender. Child abuse, intimate partner violence, and comorbidity with other physical and mental disorders also were consistently associated with MDD across the reviewed studies.
CONCLUSIONS
MDD is a highly prevalent condition worldwide. There are remarkable interregional differences in the disorder's prevalence, as well as in certain sociodemographic correlates. MDD is also highly comorbid with physical and mental health problems.
Topics: Child; Comorbidity; Depressive Disorder, Major; Female; Humans; Marital Status; Prevalence
PubMed: 32756809
DOI: 10.1590/1516-4446-2020-0650 -
JAMA Network Open Sep 2020The coronavirus disease 2019 (COVID-19) pandemic and the policies to contain it have been a near ubiquitous exposure in the US with unknown effects on depression...
IMPORTANCE
The coronavirus disease 2019 (COVID-19) pandemic and the policies to contain it have been a near ubiquitous exposure in the US with unknown effects on depression symptoms.
OBJECTIVE
To estimate the prevalence of and risk factors associated with depression symptoms among US adults during vs before the COVID-19 pandemic.
DESIGN, SETTING, AND PARTICIPANTS
This nationally representative survey study used 2 population-based surveys of US adults aged 18 or older. During COVID-19, estimates were derived from the COVID-19 and Life Stressors Impact on Mental Health and Well-being study, conducted from March 31, 2020, to April 13, 2020. Before COVID-19 estimates were derived from the National Health and Nutrition Examination Survey, conducted from 2017 to 2018. Data were analyzed from April 15 to 20, 2020.
EXPOSURES
The COVID-19 pandemic and outcomes associated with the measures to mitigate it.
MAIN OUTCOMES AND MEASURES
Depression symptoms, defined using the Patient Health Questionnaire-9 cutoff of 10 or higher. Categories of depression symptoms were defined as none (score, 0-4), mild (score, 5-9), moderate (score, 10-14), moderately severe (score, 15-19), and severe (score, ≥20).
RESULTS
A total of 1470 participants completed the COVID-19 and Life Stressors Impact on Mental Health and Well-being survey (completion rate, 64.3%), and after removing those with missing data, the final during-COVID-19 sample included 1441 participants (619 participants [43.0%] aged 18-39 years; 723 [50.2%] men; 933 [64.7%] non-Hispanic White). The pre-COVID-19 sample included 5065 participants (1704 participants [37.8%] aged 18-39 years; 2588 [51.4%] women; 1790 [62.9%] non-Hispanic White). Depression symptom prevalence was higher in every category during COVID-19 compared with before (mild: 24.6% [95% CI, 21.8%-27.7%] vs 16.2% [95% CI, 15.1%-17.4%]; moderate: 14.8% [95% CI, 12.6%-17.4%] vs 5.7% [95% CI, 4.8%-6.9%]; moderately severe: 7.9% [95% CI, 6.3%-9.8%] vs 2.1% [95% CI, 1.6%-2.8%]; severe: 5.1% [95% CI, 3.8%-6.9%] vs 0.7% [95% CI, 0.5%-0.9%]). Higher risk of depression symptoms during COVID-19 was associated with having lower income (odds ratio, 2.37 [95% CI, 1.26-4.43]), having less than $5000 in savings (odds ratio, 1.52 [95% CI, 1.02-2.26]), and exposure to more stressors (odds ratio, 3.05 [95% CI, 1.95-4.77]).
CONCLUSIONS AND RELEVANCE
These findings suggest that prevalence of depression symptoms in the US was more than 3-fold higher during COVID-19 compared with before the COVID-19 pandemic. Individuals with lower social resources, lower economic resources, and greater exposure to stressors (eg, job loss) reported a greater burden of depression symptoms. Post-COVID-19 plans should account for the probable increase in mental illness to come, particularly among at-risk populations.
Topics: Adolescent; Adult; Betacoronavirus; COVID-19; Coronavirus Infections; Depression; Educational Status; Female; Humans; Income; Male; Marital Status; Middle Aged; Pandemics; Patient Health Questionnaire; Pneumonia, Viral; Prevalence; Risk Factors; SARS-CoV-2; Severity of Illness Index; Stress, Psychological; United States; Young Adult
PubMed: 32876685
DOI: 10.1001/jamanetworkopen.2020.19686 -
Respiratory Investigation Mar 2023Although studies have investigated the factors associated with psychological post-COVID-19 symptoms, the impact of marital status on symptom development has not been...
Although studies have investigated the factors associated with psychological post-COVID-19 symptoms, the impact of marital status on symptom development has not been fully determined. This study conducts a questionnaire survey to investigate the association between marital status and the proportion of patients with post-COVID-19 symptoms in 749 cases as valid responses. Depressive state and memory impairment were more frequently seen in the no-spouse group when each symptom was compared according to marital status. Particularly in individuals in the 40s who had minor COVID-19 illness, this trend was noted. Single patients with mild COVID-19 illness may need proactive psychological support.
Topics: Humans; COVID-19; Depression; Marital Status; Surveys and Questionnaires; Anxiety
PubMed: 36720183
DOI: 10.1016/j.resinv.2023.01.001 -
Indian Journal of Medical Ethics 2020The introduction of AETCOM (attitude, ethics and communication) (1) is seen as an effort at incorporating Medical Humanities (MH) within the medical curriculum. For the...
The introduction of AETCOM (attitude, ethics and communication) (1) is seen as an effort at incorporating Medical Humanities (MH) within the medical curriculum. For the first time, India's medical curriculum includes modules on the patient-doctor relationship, helping doctors to address ethical dilemmas that might arise during medical practice. Despite this progressive step, AETCOM has a number of drawbacks. Gayathri Prabhu (2) has analysed AETCOM as ossified, instrumental, lacking in a critical sensibility and failing to borrow from a humanities methodology. We would like to add to her excellent critique by examining other areas which have been overlooked within AETCOM. Our editorial addresses AETCOM's lack of sensibility towards the diversity of patients in India by focusing specifically on questions of gender, sexuality and marital status. While it is also important to understand how caste, religious, tribal and ethnic backgrounds of patients might be addressed within AETCOM, it is outside the scope of this editorial.
Topics: Curriculum; Education, Medical, Undergraduate; Female; Humanities; Humans; India; Marital Status; Sexuality
PubMed: 32393449
DOI: 10.20529/IJME.2020.039 -
Trends in Cardiovascular Medicine May 2020The national burden of cardiovascular disease (CVD) continues to impose significant risk of morbidity, mortality and increased costs. While traditional risk factors have... (Review)
Review
The national burden of cardiovascular disease (CVD) continues to impose significant risk of morbidity, mortality and increased costs. While traditional risk factors have been well-established, the evolving role of non-traditional risk factors, including socioeconomic and psychosocial factors, is increasingly being recognized. Several studies have acknowledged an association between marital status and the presence of CVD and its associated adverse outcomes. Across multiple U.S. and international cohorts, patients who are unmarried, including those who are divorced, separated, widowed, or never married, have an increased rate of adverse cardiovascular events when compared to their married counterparts. Some studies suggest that marriage may have a more protective role for men compared to women. Furthermore, dissatisfaction in a marriage and marriage quality have significant impact on cardiovascular risk. Psychosocial and socioeconomic factors, as well as other acute stressors, may contribute to the association between marital status and CVD outcomes, but the underlying mechanisms are not completely clear. Further investigation is required to identify potential targets for intervention and to determine whether more aggressive targeting of standard anti-atherosclerotic therapies can favorably impact CVD risk in unmarried patients.
Topics: Cardiovascular Diseases; Female; Humans; Male; Marital Status; Prognosis; Risk Assessment; Risk Factors; Sex Factors; Social Determinants of Health
PubMed: 31204239
DOI: 10.1016/j.tcm.2019.05.012 -
Journal of the American Heart... Jun 2022Background Data are limited on the association between marital status and subclinical coronary atherosclerosis. This study investigated the influence of marital status...
Background Data are limited on the association between marital status and subclinical coronary atherosclerosis. This study investigated the influence of marital status on subclinical coronary atherosclerosis detected by coronary computed tomographic angiography in an asymptomatic population. Methods and Results This retrospective study analyzed 9288 asymptomatic individuals (mean age, 53.7±8.0 years; 6041 [65%] men) with no history of coronary artery disease who voluntarily underwent coronary computed tomographic angiography during a general health examination. Marital categories were married (n=8481) versus unmarried (n=807), comprising never married (n=195), divorced (n=183), separated (n=119), and widowed (n=310) individuals. The degree and extent of subclinical coronary atherosclerosis were evaluated by coronary computed tomographic angiography; ≥50% diameter stenosis was defined as significant. Logistic regression and propensity score matching analyses were used to determine the association between marital status and subclinical coronary atherosclerosis. After adjustment for cardiovascular risk factors, no significant differences were observed in the adjusted odds ratio (OR) of unmarried status for any coronary plaque (OR, 1.077; 95% CI, 0.899-1.291), calcified plaque (OR, 1.058; 95% CI, 0.881-1.271), noncalcified plaque (OR, 0.966; 95% CI, 0.691-1.351), mixed plaque (OR, 1.301; 95% CI, 0.884-1.917), and significant coronary artery stenosis (OR, 1.066; 95% CI, 0.771-1.474). Similarly, in the 2:1 propensity-score matched population (n=2398), no statistically significant differences were observed for the OR of marital status for any subclinical coronary atherosclerosis (>0.05 for all). Conclusions In this large cross-sectional study, marital status was not associated with an increased risk of subclinical coronary atherosclerosis.
Topics: Asymptomatic Diseases; Coronary Angiography; Coronary Artery Disease; Cross-Sectional Studies; Female; Humans; Male; Marital Status; Middle Aged; Plaque, Atherosclerotic; Retrospective Studies; Risk Factors
PubMed: 35621225
DOI: 10.1161/JAHA.121.024942 -
Journal of Aging and Health Jan 2022To investigate whether the association between non-spousal support and mortality risk differs by marital status.
OBJECTIVE
To investigate whether the association between non-spousal support and mortality risk differs by marital status.
METHODS
Using data from the National Social Life, Health, and Aging Project (N = 2460), we estimate a series of logistic regression models to assess how non-spousal support moderates the relationship between marital status and mortality across a 5-year period.
RESULTS
Never married respondents who had minimal perceived access to non-spousal support had a greater probability of death compared to married respondents with similar levels of non-spousal support. The disparity in mortality risk between these two groups disappeared when non-spousal support was high.
DISCUSSION
Although family and friends play an important role in mortality risk in later life, these findings suggest that never married older adults exhibit a heightened dependence on support from non-spousal sources. Future research and policies should explore ways in which never married older adults can be integrated into a supportive social environment.
Topics: Aged; Aging; Humans; Marital Status; Marriage; Single Person; Social Support
PubMed: 34114491
DOI: 10.1177/08982643211025381 -
Cancer Medicine Jan 2023In recent years, authors have repeatedly reported on the significance of social support in cancer survival. Although overall the studies appear to be convincing, little... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
In recent years, authors have repeatedly reported on the significance of social support in cancer survival. Although overall the studies appear to be convincing, little is known about which types of social support promote better survival rates, and which subgroups of cancer patients are more susceptible to the benefits of it. The aim of this study was to identify, organize, and examine studies reporting on the significance of social support in cancer survival.
METHODS
The PubMed, CINAHL and EBSCO databases were searched using the keywords social support/marital status, cancer, and survival/mortality. Where possible we used a meta-analytical approach, specifically a random effect model, in order to combine the results of the hazard ratios in studies from which this information could be obtained. When interpreting clinical relevance, we used the number needed to treat (NNT).
RESULTS
Better survival was observed in married patients when compared to unmarried (single, never-married, divorced/separated, and widowed) in overall and cancer-specific survival. Gender group differences showed that the association was statistically significant only in cancer-specific survival when comparing divorced/separated male and female cancer patients (p < 0.001), thus confirming results from the previous meta-analysis.
CONCLUSIONS
Being unmarried is associated with significantly worse overall and cancer-specific survival. The most vulnerable group found in our study were divorced/separated men. The results of this review can motivate physicians, oncologists, and other healthcare professionals to be aware of the importance of patients' social support, especially in the identified sub-group.
Topics: Humans; Male; Female; Marital Status; Neoplasms; Divorce; Single Person; Proportional Hazards Models
PubMed: 35789072
DOI: 10.1002/cam4.5003 -
Proceedings of the National Academy of... Aug 2022Marital attachment plays an important role in maintaining intimate personal relationships and sustaining psychological well-being. Mate-selection theories suggest that...
Marital attachment plays an important role in maintaining intimate personal relationships and sustaining psychological well-being. Mate-selection theories suggest that people are more likely to marry someone with a similar personality and social status, yet evidence for the association between personality-based couple similarity measures and marital satisfaction has been inconsistent. A more direct and useful approach for understanding fundamental processes underlying marital satisfaction is to probe similarity of dynamic brain responses to maritally and socially relevant communicative cues, which may better reflect how married couples process information in real time and make sense of their mates and themselves. Here, we investigate shared neural representations based on intersubject synchronization (ISS) of brain responses during free viewing of marital life-related, and nonmarital, object-related movies. Compared to randomly selected pairs of couples, married couples showed significantly higher levels of ISS during viewing of marital movies and ISS between married couples predicted higher levels of marital satisfaction. ISS in the default mode network emerged as a strong predictor of marital satisfaction and canonical correlation analysis revealed a specific relation between ISS in this network and shared communication and egalitarian components of martial satisfaction. Our findings demonstrate that brain similarities that reflect real-time mental responses to subjective perceptions, thoughts, and feelings about interpersonal and social interactions are strong predictors of marital satisfaction, reflecting shared values and beliefs. Our study advances foundational knowledge of the neurobiological basis of human pair bonding.
Topics: Brain; Communication; Humans; Interpersonal Relations; Marriage; Personal Satisfaction; Personality; Spouses
PubMed: 35981139
DOI: 10.1073/pnas.2202515119