Bidirectional association between functional disability and multimorbidity among middle-aged and older adults in Thailand

ObjectivesThe purpose of this study was to assess the bidirectional association between multimorbidity (MM) and functional disability among middle-aged and older adults in a longitudinal study in Thailand.MethodsWe analyzed longitudinal data of participants aged 45 years and older from two consecutive waves (in 2015 and 2017) of the Health, Aging, and Retirement in Thailand (HART). Functional disability was assessed with a 4-item activity of daily living (ADL) scale. Logistic regression analysis was conducted to assess the association between baseline functional disability and incident MM (≥2), and baseline morbidity and incident functional disability.ResultsThe results indicate that a total of 1,716 individuals without morbidity at baseline and 3,529 without functional disability at baseline were included. At follow-up, 16.7 and 20.0% of functional disability cases and 7.1 and 3.6% of nonfunctional disability cases developed 2 morbidities and 3 or more morbidities, respectively, and 6.6% of MM cases and 4.0% of non-MM cases developed a functional disability. In the final logistic regression model adjusted for education, income, age, marital status, sex, smoking tobacco, body mass index (BMI), alcohol use, physical activity, and social engagement, functional disability at baseline was positively associated with incident MM (≥2) (adjusted odds ratio [aOR]: 2.58, 95% CI: 1.42–4.72), and MM (≥3) at baseline was positively associated with incident functional disability (aOR: 1.97, 95% CI: 1.13–3.43).ConclusionMultimorbidity and functional disability were bidirectionally associated

Time-varying lifestyle and mental-ill health risk factors for the longitudinal development of daily activity limitations among middle-aged and older adults in Thailand

The aim of this study was to assess the longitudinal association between lifestyle factors, mental ill-health indicators and activities of daily living (ADL) disability among ageing adults in Thailand. We analyzed the cohort data of participants (5616 in 2015, 3600 in 2017 and 2863 in 2020) over the age of 45 from three consecutive waves of HART (health, age, retirement) in Thailand. ADL disability was assessed with a 4-item ADL scale. In order to evaluate the longitudinal correlation between measurement of lifestyle factors, mental health indicators, and ADL disability between three survey waves, we conducted a Generalized Estimate Equation Analysis (GEE). The proportion of ADL disability increased from 3.8 % in 2015 to 7.0 % in 2020. In the final GEE logistic regression model, adjusted for various confounding factors, probable depression (aOR: 1.95, 95 % CI: 1.47–2.59), self-reported poor mental health (aOR: 1.28, 95 % CI: 1.45–2.27), poor quality of life/happiness (aOR: 1.28, 95 % CI: 1.03–1.61), loneliness (aOR: 1.66, 95 % CI: 1.33–2.08), brain disease/dementia (aOR: 4.84, 95 % CI: 2.70–8.67), physical inactivity (aOR: 6.91, 95 % CI: 4.41–10.84) and having underweight (AOR: 1.33, 95 % CI: 1.00–1.76) were positively associated with ADL disability. Current smoking (aOR: 0.39, 95 % CI: 0.24–0.64) was negatively associated with ADL disability.We found that lifestyle factors (physical inactivity and having underweight) and loneliness, poor quality of life/happiness, probable depression, self-reported poor mental health, and brain disease/dementia were associated with ADL disability. Enhancing lifestyle factors relating to physical activity and healthy diet, and screening and treatment of mental ill-health indicators may reduce ADL disability in Thailand

Longitudinal associations between living alone, childlessness and mental health and mortality in ageing adults in Thailand

Background: This study aimed to evaluate the longitudinal relationships between living alone, being childless, and six mental health indicators and mortality in older adults in Thailand between 2015 and 2020. Methods: We examined prospective cohort data from the Health, Aging and Retirement in Thailand (HART) study, which included participants 45 years of age and older (N = 2863) from three successive waves in 2015, 2017, and 2020. Mental health indicators were assessed by self-report. We used Generalized Estimating Equations analysis (GEE) to evaluate the longitudinal relationships between measures of living alone, childlessness and six mental health indicators and mortality. Results: The proportion of living alone was 6.3 % and childlessness 9.9 % in 2015, while living alone only was 3.9 %, childlessness only 7.5 % and both living alone and childlessness 2.4 % in 2015. In the adjusted model, living alone only was among men positively associated with depressive symptoms, loneliness, poor quality of life and mortality, and among women only positively associated with poor quality of life. Childlessness only was among women positively associated with depressive symptoms, insomnia symptoms, loneliness, poor quality of life, poor self-rated mental health, and mortality, and among men with depressive symptoms, loneliness, poor quality of life and poor self-rated mental health. Both living alone and childlessness was among men associated with four mental health indicators (depressive symptoms, insomnia symptoms, loneliness, and poor quality of life), and among women two mental health indicators (loneliness and poor quality of life), all with higher odds ratios than in living alone only and childlessness only. Conclusions: Living alone only, childlessness only and/or both living alone and childlessness were associated with several poor mental health indicators and/or mortality. Enhanced screening and management of living alone and being childless may improve mental health in Thailand