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      Association between depressive symptoms and objective/subjective socioeconomic status among older adults of two regions in Myanmar

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          Abstract

          Low objective socioeconomic status (SES) has been correlated with poor physical and mental health among older adults. Some studies suggest that subjective SES is also important for ensuring sound physical and mental health among older adults. However, few studies have been conducted on the impact of both objective and subjective SES on mental health among older adults. This study examines whether objective or subjective SES is associated with depressive symptoms in older adults in Myanmar. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from two regions of Myanmar, for face-to-face interviews. The Geriatric Depression Scale (GDS) was used to evaluate the depressive symptoms. Participants were classified as having no depressive symptom (GDS score <5) and having depressive symptoms (GDS score ≥5). Objective and subjective SES were assessed using the wealth index and asking participants a multiple-choice question about their current financial situation, respectively. The relationship between objective/subjective SES and depressive symptoms was examined using a multivariable logistic regression analysis. The mean age of the 1,186 participants aged 60 years and above was 69.7 (SD: 7.3), and 706 (59.5%) were female. Among them, 265 (22.3%) had depressive symptoms. After adjusting for objective SES and other covariates, only low subjective SES was positively associated with depressive symptoms (adjusted odds ratio, AOR: 4.18, 95% confidence interval, CI: 2.98–5.87). This association was stronger among participants in the rural areas (urban areas, AOR: 2.10, 95% CI: 1.08–4.05; rural areas, AOR: 5.65, 95% CI: 3.69–8.64). Subjective SES has a stronger association with depressive symptoms than objective SES, among older adults of the two regions in Myanmar, especially in the rural areas. Interventions for depression in older adults should consider regional differences in the context of subjective SES by reducing socioeconomic disparities among the communities.

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          Development and validation of a geriatric depression screening scale: A preliminary report

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            Estimating wealth effects without expenditure data—or tears: An application to educational enrollments in states of India

            Using data from India, we estimate the relationship between household wealth and children’s school enrollment. We proxy wealth by constructing a linear index from asset ownership indicators, using principal-components analysis to derive weights. In Indian data this index is robust to the assets included, and produces internally coherent results. State-level results correspond well to independent data on per capita output and poverty. To validate the method and to show that the asset index predicts enrollments as accurately as expenditures, or more so, we use data sets from Indonesia, Pakistan, and Nepal that contain information on both expenditures and assets. The results show large, variable wealth gaps in children’s enrollment across Indian states. On average a “rich” child is 31 percentage points more likely to be enrolled than a “poor” child, but this gap varies from only 4.6 percentage points in Kerala to 38.2 in Uttar Pradesh and 42.6 in Bihar.
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              Multimorbidity and depression: A systematic review and meta-analysis.

              Multimorbidity, the presence of two or more chronic conditions, is increasingly common and complicates the assessment and management of depression. The aim was to investigate the relationship between multimorbidity and depression.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: SupervisionRole: Writing – original draft
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: Supervision
                Role: ConceptualizationRole: Data curationRole: MethodologyRole: Project administrationRole: Supervision
                Role: ConceptualizationRole: Formal analysisRole: MethodologyRole: Project administrationRole: Validation
                Role: InvestigationRole: Project administrationRole: SupervisionRole: Validation
                Role: InvestigationRole: Project administrationRole: Supervision
                Role: ConceptualizationRole: InvestigationRole: Supervision
                Role: Project administrationRole: Supervision
                Role: Data curationRole: InvestigationRole: Resources
                Role: Data curationRole: Investigation
                Role: Data curationRole: Investigation
                Role: Funding acquisitionRole: Supervision
                Role: ConceptualizationRole: Data curationRole: Project administrationRole: Supervision
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                28 January 2021
                2021
                : 16
                : 1
                : e0245489
                Affiliations
                [1 ] National Institute of Public Health, Wako, Japan
                [2 ] Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
                [3 ] National Center for Global Health and Medicine, Tokyo, Japan
                [4 ] The University of Tokyo, Tokyo, Japan
                [5 ] Tokyo Medical and Dental University, Tokyo, Japan
                [6 ] Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
                [7 ] University of Medicine 1, Yangon, Myanmar
                [8 ] University of Public Health, Yangon, Myanmar
                National University of Singapore, SINGAPORE
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-5832-7001
                Article
                PONE-D-20-15915
                10.1371/journal.pone.0245489
                7842968
                33507963
                9866dbe6-2630-4d81-bb7d-403ec60db703
                © 2021 Sasaki et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 27 May 2020
                : 3 January 2021
                Page count
                Figures: 0, Tables: 4, Pages: 16
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/100009619, Japan Agency for Medical Research and Development;
                Award Recipient :
                Funded by: Grants in aid for Scientific Research from the Japan Society for the Promotion of Science
                Award ID: 19K19472
                Award Recipient :
                Funded by: Grants in aid for Health and Labor Administration Promotion Research (JP)
                Award ID: 20BA2002
                Award Recipient :
                Funded by: World Health Organization Kobe Centre
                Award ID: WKC:K18015
                Award Recipient :
                The research was funded by AMED (Japan Agency for Medical Research and Development), for the project titled, “Development of a Health-Equity Assessment Tool Based on Social Epidemiological Survey for Older Adults in Myanmar and Malaysia” (17934739), Grants in aid for Scientific Research from the Japan Society for the Promotion of Science, for the project titled, “Differences in Social Capital Influence on Depression among Older People—A Comparative Study of Three Asian Countries” (19K19472), and Grants in aid for Health and Labor Administration Promotion Research Project titled ‘Study on promotion of active and healthy aging in ASEAN (20BA2002)’. In addition, the World Health Organization for Health Development funded the research as research to accelerate universal health coverage in light of population ageing in ASEAN countries for research titled, “Development and Validation of Questionnaire Instrument for Evaluating the Determinants of Health Status and Universal Health Coverage in Older Adults in Selected Population in Myanmar and Malaysia (WHO Kobe Centre - WKC: K18015)”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Health Care
                Socioeconomic Aspects of Health
                Medicine and Health Sciences
                Public and Occupational Health
                Socioeconomic Aspects of Health
                People and Places
                Population Groupings
                Age Groups
                Adults
                Elderly
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                Geriatric Depression
                Medicine and Health Sciences
                Geriatrics
                Geriatric Psychiatry
                Geriatric Depression
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Geriatric Psychiatry
                Geriatric Depression
                People and Places
                Geographical Locations
                Asia
                Myanmar
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Social Sciences
                Anthropology
                Cultural Anthropology
                Religion
                Social Sciences
                Sociology
                Religion
                Social Sciences
                Sociology
                Education
                Schools
                Custom metadata
                An ethics committee has placed an ethical restriction on sharing de-identified data, since the data may contain sensitive information regarding the respondents’ physical and mental health. The following is the contact information of the individuals responsible for the dataset. Ethical Review Committee of the National Institute of Public Health, Japan TEL +81-48-458-6111 FAX +81-48-469-1573 2-3-6 Minami, Wako City, Saitama, Japan, 351-0197

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