Risk of dependence associated with health, social support, and lifestyle

OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors. METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered. RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women. CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence.OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors. METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered. RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women. CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence.OBJETIVO Analizar la prevalencia de personas en riesgo de dependencia y los factores asociados. MÉTODOS El estudio se basó en datos de la Encuesta de Salud de Cataluña, España, realizada de 2010 a 2011. A partir de una muestra aleatoria de 3.842 individuos, de 15 años o más, se llevaron a cabo modelos de regresión logística para clasificar a los individuos según el estado de su autonomía personal. Se plantearon modelos predictivos para identificar las variables susceptibles de intervención que permitieran distinguir a los individuos dependientes de aquellos en riesgo. Se consideraron variables acerca del estado de salud, apoyo social y estilos de vida. RESULTADOS El 18,6% de la población presentó riesgo de dependencia, con efecto más acusado a partir de los 65 años. En comparación con este colectivo, los individuos que se declararon dependientes (11,0%) manifestaron problemas para realizar las actividades cotidianas y obtuvieron apoyo para ello. Estilos de vida, como fumar, consumir alcohol en exceso y ser sedentario se asociaron con mayor probabilidad de dependencia, en particular para las mujeres. CONCLUSIONES Las dificultades para llevar a cabo las actividades cotidianas preceden a la aparición de dependencia. Preservar la propia autonomía y desenvolverse sin recibir apoyo aparecen como factores protectores. La adopción de un estilo de vida activo y saludable contribuye a reducir el riesgo de dependencia

ESCA

Enquesta de salut; ; Estadística mèdica; CatalunyaHealth survey; Medical statistics; CataloniaEncuesta de salud; Estadística médica; CataluñaLes enquestes de salut de Catalunya són un instrument del Departament de Salut que aporta informació poblacional rellevant per a l’establiment i les avaluacions de la política sanitària explicitades en el Pla de salut de Catalunya. A partir de la realització d'entrevistes domiciliàries, l’ESCA obté informació sobre l'estat de salut, els estils de vida i l’ús dels serveis sanitaris de la població de Catalunya. L'ESCA és una estadística oficial prevista en el Pla estadístic de Catalunya vigent, la qual cosa comporta una garantia de confidencialitat de les dades, que es troben emparades pel secret estadístic (Llei 23/1998, de 30 de desembre, d'estadística de Catalunya). Les microdades anònimes de l’ESCA es poden sol·licitar per a finalitats de recerca científica.Health surveys are an instrument of Catalonia Health Department that provides population data relevant to the establishment and evaluation of health policy spelled out in the Health Plan of Catalonia. After conducting home interviews, ESCA get information about the state of health, the lifestyle and the use of health services to the population of Catalonia. The ESCA is an official statistic provided in the Statistical Plan of Catalonia in force, which means a guarantee of confidentiality of data, which are protected by statistical secrecy (Law 23/1998 of 30 December, statistical Catalonia). ESCA anonymous microdata can be requested for purposes of scientific research.Las encuestas de salud de Cataluña son un instrumento del Departamento de Salud que aporta información poblacional relevante para el establecimiento y las evaluaciones de la política sanitaria explicitadas en el Plan de Salud de Cataluña. A partir de la realización de entrevistas domiciliarias, la ESCA obtiene información sobre el estado de salud , los estilos de vida y el uso de los servicios sanitarios de la población de Cataluña. La ESCA es una estadística oficial prevista en el Plan estadístico de Cataluña vigente, lo que conlleva una garantía de confidencialidad de los datos, que se encuentran amparadas por el secreto estadístico (Ley 23/1998, de 30 de diciembre, de estadística de Cataluña). Los microdatos anónimas de la ESCA se pueden solicitar para fines de investigación científica

Risk of dependence associated with health, social support, and lifestyle

The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered

Nuevo diseño de la Encuesta de Salud de Cataluña (2010-2014): un paso adelante en planificación y evaluación sanitaria

Se presenta la génesis de la Encuesta de Salud de Cataluña (2010-2014) con sus submuestras semestrales. Se detallan las características básicas de su diseño muestral polietápico. Entre las ventajas organizativas de esta nueva operación, en comparación con las anteriores, destacan la agilidad en la disponibilidad de datos y la capacidad de monitorización continuada de la población. Se señalan como beneficios la puntualidad en la obtención de indicadores y la posibilidad de introducir nuevos tópicos a través del cuestionario complementario, según las necesidades de información. Como limitación se apunta la mayor complejidad del diseño muestral y la falta de seguimiento longitudinal de la muestra. Se hace hincapié en la necesidad de utilizar ponderaciones adaptadas a las submuestras para el análisis estadístico que emplee microdatos, así como de acumular oleadas si se desea elevar el grado de desagregación del análisis, ya sea en el territorio o por subgrupos de población

Població ocupada i aturada: comparació d’indicadors de salut ESCA, 2006 i 2011-2012

Població activa; Població aturada; Indicadors de salut; Labor force; Unemployed; Health status indicators; Población activa; Población parada; Indicadores de saludAquest document forma part d’una sèrie d’estudis i anàlisis sobre l’efecte de la crisi econòmica i financera sobre la salut que es duen a terme des del Grup ESCA i crisi. En ell s'hi comparen els indicadors de salut de la població ocupada i aturada

Enquesta de salut a la població institucionalitzada de Catalunya, 2006: residències i centres de llarga estada

Població institucionalitzada; Indicadors de salut; ESPI; Institutionalized population; Health Status Indicators; Catalonia; Población institucionalizada; Indicadores de salud; CataluñaL’ESPI és una enquesta dirigida a les persones de 65 anys i més que viuen a residències i centres de llarga estada (població institucionalitzada). Per primera vegada es disposa d’informació sobre el seu estat de salut, els hàbits i estils de vida i la utilització dels serveis sanitaris. L’ESPI ha entrevistat 1.379 persones de 65 anys i més amb permanència indefinida a residències i centres de llarga estada de més de 15 places de capacitat. La selecció de la mostra s’ha realitzat mitjançant un disseny mostral aleatori en dues etapes que ha tingut en compte el tipus d’institució (residència i centre de llarga estada) i la representativitat per regió sanitària

Prevalencia y condicionantes de la obesidad en la población infantojuvenil de Cataluña, 2006-2012

Estimar la prevalencia de obesidad y sobrepeso en la población catalana de 2 a 14 años, conocer su evolución durante los períodos 2006 y 2010-2012 y evaluar los determinantes sociales y estilos de vida relacionados con la obesidad

Effects of APOE-ε4 allele load on brain morphology in a cohort of middle-aged healthy individuals with enriched genetic risk for Alzheimer's disease

INTRODUCTION: Apolipoprotein E (APOE)-ε4 is the major genetic risk factor for Alzheimer's disease. However, the dose-dependent impact of this allele on brain morphology of healthy individuals remains unclear. METHODS: We analyzed gray matter volumes (GMvs) in a sample of 533 healthy middle-aged individuals with a substantial representation of ε4-carriers (207 heterozygotes and 65 homozygotes). RESULTS: We found APOE-ε4 additive GMv reductions in the right hippocampus, caudate, precentral gyrus, and cerebellar crus. In these regions, the APOE genotype interacted with age, with homozygotes displaying lower GMv after the fifth decade of life. APOE-ε4 was also associated to greater GMv in the right thalamus, left occipital gyrus, and right frontal cortex. DISCUSSION: Our data indicate that APOE-ε4 exerts additive effects on GMv in regions relevant for Alzheimer's disease pathophysiology already in healthy individuals. These findings elucidate the mechanisms underlying the increased Alzheimer's disease risk in ε4-carriers, suggesting a dose-dependent disease vulnerability on the brain structure level

Interactive effect of age and APOE-ε4 allele load on white matter myelin content in cognitively normal middle-aged subjects

The apolipoprotein E gene (APOE) ε4 allele has a strong and manifold impact on cognition and neuroimaging phenotypes in cognitively normal subjects, including alterations in the white matter (WM) microstructure. Such alterations have often been regarded as a reflection of potential thinning of the myelin sheath along axons, rather than pure axonal degeneration. Considering the main role of APOE in brain lipid transport, characterizing the impact of APOE on the myelin coating is therefore of crucial interest, especially in healthy APOE-ε4 homozygous individuals, who are exposed to a twelve-fold higher risk of developing Alzheimer's disease (AD), compared to the rest of the population. We examined T1w/T2w ratio maps in 515 cognitively healthy middle-aged participants from the ALFA study (ALzheimer and FAmilies) cohort, a single-site population-based study enriched for AD risk (68 APOE-ε4 homozygotes, 197 heterozygotes, and 250 non-carriers). Using tract-based spatial statistics, we assessed the impact of age and APOE genotype on this ratio taken as an indirect descriptor of myelin content. Healthy APOE-ε4 carriers display decreased T1w/T2w ratios in extensive regions in a dose-dependent manner. These differences were found to interact with age, suggesting faster changes in individuals with more ε4 alleles. These results obtained with T1w/T2w ratios, confirm the increased vulnerability of WM tracts in APOE-ε4 healthy carriers. Early alterations of myelin content could be the result of the impaired function of the ε4 isoform of the APOE protein in cholesterol transport. These findings help to clarify the possible interactions between the APOE-dependent non-pathological burden and age-related changes potentially at the source of the AD pathological cascade

Genotypic effects of APOE-epsilon 4 on resting-state connectivity in cognitively intact individuals support functional brain compensation

The investigation of resting-state functional connectivity (rsFC) in asymptomatic individuals at genetic risk for Alzheimer's disease (AD) enables discovering the earliest brain alterations in preclinical stages of the disease. The APOE-ε4 variant is the major genetic risk factor for AD, and previous studies have reported rsFC abnormalities in carriers of the ε4 allele. Yet, no study has assessed APOE-ε4 gene-dose effects on rsFC measures, and only a few studies included measures of cognitive performance to aid a clinical interpretation. We assessed the impact of APOE-ε4 on rsFC in a sample of 429 cognitively unimpaired individuals hosting a high number of ε4 homozygotes (n = 58), which enabled testing different models of genetic penetrance. We used independent component analysis and found a reduced rsFC as a function of the APOE-ε4 allelic load in the temporal default-mode and the medial temporal networks, while recessive effects were found in the extrastriate and limbic networks. Some of these results were replicated in a subsample with negative amyloid markers. Interaction with cognitive data suggests that such a network reorganization may support cognitive performance in the ε4-homozygotes. Our data indicate that APOE-ε4 shapes the functional architecture of the resting brain and favor the idea of a network-based functional compensation