Dra. Troncoso-Pantoja, Claudia

Depressive disorders are recognized as one of the most common mental health conditions across different age groups. However, the risk factors associated with depression among older people from low-and middle-income countries remains unclear. This study aims to identify socio-demographic, health and psychosocial-related factors associated with depression in Chilean older adults. A cross-sectional study was carried out in a representative sample of 1,765 adults aged ≥60 years participants from the Chilean National Health Survey 2016–2017. Depression was assessed with the Composite International Diagnostic Interview (CIDI-SF). Associations between the exposure variables and depression were investigated using Poisson regression analyses. The main findings indicated that women showed higher likelihood of depression than men (Prevalence Ratio (PR) = 2.6 [95% CI: 1.40; 4.89]). An increased likelihood of depression was found in older adults with chronic pain, multimorbidity (≥2 diseases), previous diagnose of depression, high perception of stress, financial stress, and difficulties for social participation. In women, higher likelihood of depression was found for those with the frailty phenotype (PR:8.53 [95% CI: 1.68; 43.32]), rheumatoid arthritis (PR:2.41 [95% CI: 1.34; 4.34]), insomnia (PR:2.99 [95% CI: 1.74; 5.12]) and low self-rated well-being (PR:4.94 [95% CI: 2.26; 10.79]). Men who were divorced (PR:7.10 [95% CI: 1.44; 34.90]) or widowed (PR:10.83 [95% CI: 3.71; 31.58]), obese (PR:5.08 [95% CI: 1.48; 17.42) and who had asthma (PR: 7.60 [95% CI: 2.31; 24.99]) were associated with higher odds of depression. The current findings may have clinical implications for the early identification of older adults more susceptible to depression and also suggest the need to implement cultural and age-sensitive strategies to promote mental health in late life.

Background: The Frailty Index (FI) is used to quantify and summarize vulnerability status in people. In Chile, no development and assessment of a FI have been explored. Objective: To develop and evaluate a FI using representative data from Chilean adults aged 40 years and older stratified by sex. Design: Cross-sectional study. Setting: National representative data from the Chilean National Health Survey 2016–2017 (CNHS 2016–2017). Participants: 3,036 participants older than 40 years with complete data for all variables. Measurements: A 49-item FI was developed and evaluated. This FI included deficits from comorbidities, functional limitations, mental health status, physical activity, anthropometry, medications, and falls. A score between 0 and 1 was calculated for each person. Descriptive statistics and linear regression models were employed to evaluate the FI’s performance in the population. Comparative analyses were carried out to evaluate the FI score by age (<60 and ≥ 60 years). Results: The mean FI score was 0.15 (SD:0.09), with a 99% upper limit of 0.46. Scores were greater in women than men (0.17 [SD:0.09]) vs. 0.12 [0.08]); in people older than 80 years (0.22 [0.11]), and in people with ≤8 years of education (0.18 [0.10]) compared with those with >12 years (0.12 [0.08]). The average age-related increase in the FI was 2.3%. When a cut-off point ≥ 0.25 was applied, the prevalence of frail individuals was 11.8% (95% CI: 10.0 to 13.8) in the general population. The prevalence was higher in women 15.9% [95% CI: 13.3 to 18.9] than men 7.4% [95% CI: 5.3 to 10.1]. In a comparative analysis by age, higher FI mean scores and prevalence of frail were observed in people ≥ 60 than younger than 60. Conclusions: The mean FI score and frailty prevalence were higher in women than men, in people with fewer years of formal education, and incremented markedly with age. This FI can be used for early detection of frailty status focusing on women and middle-aged people as a strategy to delay or prevent frailty-related consequences.

Introduction: The average life expectancy, as well as the prevalence of Type 2 diabetes (T2D), is increasing worldwide. Population-based studies have demonstrated that the duration of T2D has been associated with cognitive impairment. However, despite the high prevalence of T2D and cognitive impairment in Chile, the association between years with T2D and suspicion of cognitive impairment has not yet been investigated. The objective of this study was to investigate the association between duration of T2D and suspicion of cognitive impairment in Chilean older adults. Material and Methods: 1,040 older adults aged ≥60 years from the Chilean National Health Survey (2009-2010) were included. Suspicion of cognitive impairment was assessed by the abbreviated Mini-Mental State Examination (MMSE). The number of years with T2D was self-reported and categorised into four groups. Poisson Regression analysis was used to assess the association between altered MMSE and the number of years with DM2, adjusted by potential confounders including socio-demographic, lifestyle, adiposity and health-related factors. Results: When the analyses were adjusted for socio-demographic factors, people who had T2D for 15 to 24 and ≥25 years had 2.2-times (95%CI: 1.07; 3.33) and 5.8-times (95%CI: 3.81; 11.0) higher relative risk (RR) of cognitive impairment, compared to those without T2D. When the analyses were additionally adjusted for lifestyle and health-related covariates, the RR for cognitive impairment was 1.76-times (95%CI: 1.02; 2.50) and 4.54-times (95%CI: 2.70; 6.38) higher for those who had T2D for 14-24 years and ≥25 years, respectively. Conclusions: Number of years with T2D was associated with suspicion of cognitive impairment. A longer duration of T2D was associated with a higher likelihood of cognitive impairment in the Chilean older population, independently of confounder factors included in the study.