Gender-specific factors associated with case complexity in middle-aged and older adults—Evidence from a large population-based study

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY International Journal of Geriatric Psychiatry Pub Date : 2024-06-14 DOI:10.1002/gps.6113

Cinara Paul, Ben Schöttker, Mechthild Hartmann, Hans-Christoph Friederich, Hermann Brenner, Beate Wild

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Abstract

Objectives

To investigate gender-specific factors associated with case complexity in a population-based sample of middle-aged and older adults using a holistic approach to complexity.

Methods

Data were derived from the 8-year follow-up home visits of the ESTHER study—a German population-based study in middle-aged and older adults. Cross-sectional analyses were conducted for 2932 persons (aged 57–84). Complexity was assessed by the well-established INTERMED for the elderly interview, which uses a holistic approach to the definition of case complexity. The association between various bio-psycho-social variables and case complexity was analyzed using gender-specific logistic regression models, adjusted for sociodemographic factors (age, marital status, education).

Results

Prevalence of complexity was 8.3% with significantly higher prevalence in female (10.6%) compared to male (5.8%) participants (p < 0.001). Variables associated with increased odds for complexity in both, women and men were: being divorced (odds ratio [OR] women: 1.86, 95% CI 1.05–3.30; OR men: 3.19, 1.25–8.12), higher total somatic morbidity (women: 1.08, 1.04–1.12; men: 1.06, 1.02–1.11), higher depression severity (women: 1.34, 1.28–1.40; men: 1.35, 1.27–1.44), and higher loneliness scores (women: 1.19, 1.05–1.36; men: 1.23, 1.03–1.47). Women (but not men) with obesity (Body mass index [BMI] ≥30) had higher odds (1.79, 1.11–2.89) for being complex compared to those with a BMI <25. High oxidative stress measured by derivatives of reactive oxygen metabolites in serum was associated with 2.02 (1.09–3.74) higher odds for complexity only in men.

Conclusions

This study provides epidemiological evidence on gender differences in prevalence and factors associated with case complexity in middle-aged and older adults. Moreover, this study adds to the holistic understanding of complexity by identifying novel variables linked to complexity among middle-aged and older individuals. These factors include loneliness for both genders, and high oxidative stress for men. These findings should be confirmed in future longitudinal studies.

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与中老年人病例复杂性相关的性别特异性因素--来自一项大型人口研究的证据。

目的在中老年人人群样本中，采用综合方法调查与病例复杂性相关的性别特异性因素：数据来源于 ESTHER 研究--德国中老年人人群研究--的 8 年随访家访。对 2932 人（57-84 岁）进行了横断面分析。复杂性通过成熟的 INTERMED 老年访谈进行评估，该访谈采用整体方法来定义病例的复杂性。在对社会人口学因素（年龄、婚姻状况、教育程度）进行调整后，采用性别特异性逻辑回归模型分析了各种生物-心理-社会变量与病例复杂性之间的关联：结果：复杂病例的发生率为 8.3%，女性（10.6%）的发生率明显高于男性（5.8%）（p 结论：该研究为流行病学提供了证据：这项研究提供了流行病学证据，说明中老年人在患病率和病例复杂性相关因素方面的性别差异。此外，本研究还发现了与中老年人病例复杂性相关的新变量，从而加深了对复杂性的全面理解。这些因素包括男女两性的孤独感和男性的高氧化应激。这些发现应在今后的纵向研究中得到证实。

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.