High social risk and mortality. A prospective study in community-dwelling older adults living in a rural Ecuadorian village

Brutto, Oscar H. Del; Mera, Robertino M.; Rumbea, Denisse A.; Recalde, Bettsy Y.; Sedler, Mark J.

doi:10.1016/j.pmedr.2023.102146

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…This population-based study was based on results from distinct simultaneous longitudinal prospective studies conducted in the same population. 8 - 13 These combined results detailed the contribution of independent and joint risk factors on mortality risk among older adults living in rural settings of a LMIC.…”

Section: Discussionmentioning

confidence: 95%

“…During the past few years, several studies have demonstrated the contribution of certain risk factors that are independently associated with increased mortality risk in rural Ecuadorian villages. 8 - 13 This study aims to estimate the independent role of each of these factors on mortality risk among older adults living in these settings.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities

Del Brutto,

Mera,

Rumbea

et al. 2024

J Prim Care Community Health

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Background: Information on factors that increase mortality in remote settings is limited. This study aims to estimate the independent and joint role of several factors on mortality risk among older adults living in rural Ecuador. Methods: Participants were selected from community-dwelling older adults who were included in previous studies targeting mortality risk factors in the study population. Generalized structural equation modeling (GSEM) was utilized to evaluate prior causal assumptions, to redraw causal links, and to introduce latent variables that may help to explain how the independently significant variables are associated with mortality. Results: The study included 590 individuals (mean age: 67.9 ± 7.3 years; 57% women), followed for a median of 8.2 years. Mortality rate was 3.4 per 100 person-years. Prior work on separate multivariate Poisson and Cox models was used to build a tentative causal construct. A GSEM containing all variables showed that age, symptoms of depression, high social risk, high fasting glucose, a history of overt stroke, and neck circumference were directly associated with mortality. Two latent variables were introduced, 1 representing the impact of biological factors and another, the impact of social factors on mortality. The social variable significantly influenced the biological variable which carried most of the direct effect on mortality. Conclusions: Several factors contributed to mortality risk in the study population, the most significant being biological factors which are highly influenced by social factors. High social risk interact with biological variables and play an important role in mortality risk.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities

Del Brutto,

Mera,

Rumbea

et al. 2024

J Prim Care Community Health

Self Cite

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Does Escalating Violence and Associated Fear of Crime Worsen Psychological Well-Being in Community Dwellers Living in a Rural Setting? Results From the Atahualpa Project Cohort

Del Brutto,

Mera,

Rumbea

et al. 2024

J Prim Care Community Health

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Background: Escalating street violence and criminal homicides have an adverse impact on psychological well-being. However, these consequences have been difficult to evaluate. Using a recently validated scale, we aimed to assess the impact of fear of crime on the psychological status of middle-aged and older adults living in a rural setting afflicted by endemic violence. Methods: Participants were selected from Atahualpa residents included in previous studies targeting psychological distress in the population. A validated scale was used to objectively quantify fear of crime in participants. Differences in symptoms of depression and anxiety between baseline and follow-up were used as distinct dependent variables and the continuous score of the fear of crime scale was used as the independent variable. Linear regression models were fitted to assess the association between the exposure and the outcomes, after adjusting for relevant confounders. Results: A total of 653 participants (mean age = 53.2 ± 11.5 years; 57% women) completed the requested tests. We found a 13% increase in symptoms of depression and anxiety during the peak of violence in the village compared with previous years. Linear regression models showed a significant association between the total score on the fear of crime questionnaire and worsening symptoms of depression (β = .24; 95% CI = 0.14-0.35) and anxiety (β = .31; 95% CI = 0.24-0.37), after adjustment for relevant confounders. Conclusions: This study shows a significant aggravating effect of fear of crime on pre-existing symptoms of depression and anxiety and a deleterious effect of these conditions on overall well-being.

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High social risk and mortality. A prospective study in community-dwelling older adults living in a rural Ecuadorian village

Cited by 2 publications

References 23 publications

The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities

The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities

Does Escalating Violence and Associated Fear of Crime Worsen Psychological Well-Being in Community Dwellers Living in a Rural Setting? Results From the Atahualpa Project Cohort

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