The aim of the study was to assess the prevalence and associated factors of successful ageing (SA) among people 50 years and older in Thailand. We analyzed national cross-sectional data (5092 men and women 50 years or older) from the Health, Aging and Retirement in Thailand (HART) study in 2015. The SA measures included (1) life satisfaction, (2) social engagement, (3) no major illness, (4) no probable depression, and (5) absence of functional disability. The sample included 5092 participants (median age 67 years, interquartile range 60 to 78 years). The prevalence of SA was 60.0% in adults 50 years and older, ranging from 43.8% in Krabi province to 80.2% in Pathum Thani province, 58.1% (≥60 years), and 56.3% (≥65 years), and the prevalence of the components of SA was 92.3% without major illness, 96.1% without functional disability, 87.5% without probable depression, 91.3% social engagement, and 82.3% high life satisfaction. In multivariable Poisson regression analysis, Buddhist religion (adjusted Prevalence Ratio (aPR): 1.50, 95% Confidence Interval (CI): 1.25 to 1.79), high subjective economic status (aPR: 1.29, 95% CI: 1.11 to 1.49), and physical activity (≥150 min/week) (aPR: 1.11, 95% CI: 1.01 to 1.24) were positively associated and increasing age (aPR: 0.993, 95% CI: 0.989 to 0.997) was negatively associated with SA. Almost two in three older adults in Thailand were successfully ageing. Factors associated with SA included being Buddhist, younger age, higher subjective economic status, and higher engagement in physical activity. These identified factors should be incorporated into health promotion intervention programs in Thailand.
ObjectivesThe purpose of this study was to assess the bidirectional association between multimorbidity (MM) and functional disability among middle-aged and older adults in a longitudinal study in Thailand.MethodsWe analyzed longitudinal data of participants aged 45 years and older from two consecutive waves (in 2015 and 2017) of the Health, Aging, and Retirement in Thailand (HART). Functional disability was assessed with a 4-item activity of daily living (ADL) scale. Logistic regression analysis was conducted to assess the association between baseline functional disability and incident MM (≥2), and baseline morbidity and incident functional disability.ResultsThe results indicate that a total of 1,716 individuals without morbidity at baseline and 3,529 without functional disability at baseline were included. At follow-up, 16.7 and 20.0% of functional disability cases and 7.1 and 3.6% of nonfunctional disability cases developed 2 morbidities and 3 or more morbidities, respectively, and 6.6% of MM cases and 4.0% of non-MM cases developed a functional disability. In the final logistic regression model adjusted for education, income, age, marital status, sex, smoking tobacco, body mass index (BMI), alcohol use, physical activity, and social engagement, functional disability at baseline was positively associated with incident MM (≥2) (adjusted odds ratio [aOR]: 2.58, 95% CI: 1.42–4.72), and MM (≥3) at baseline was positively associated with incident functional disability (aOR: 1.97, 95% CI: 1.13–3.43).ConclusionMultimorbidity and functional disability were bidirectionally associated.
Introduction
The purpose of this study was to assess the bidirectional association between multimorbidity (MM) and probable depression in a longitudinal study in Thailand.
Methods
We analyzed longitudinal data of participants 45 years and older from two consecutive waves (in 2015 and 2017) of Health, Aging, and Retirement in Thailand (HART). Probable depression was assessed using the Center for Epidemiological Studies Depression scale. Logistic regression analysis was conducted to assess the association between baseline probable depression and incident physical MM, and baseline physical MM and incident probable depression.
Results
In all, 2712 participants without MM at baseline and 2684 without probable depression at baseline were included. At follow-up 15.6% of probable depression cases and 11.4% of nonprobable depression cases developed physical MM, and at follow-up 13.3% of physical MM cases and 8.9% of nonphysical MM cases developed probable depression. In the final logistic regression analysis, adjusted for age, sex, marital status, income, education, body mass index, physical activity, smoking tobacco, alcohol use, and social engagement, probable depression at baseline was positively associated with incident physical MM (aOR: 1.50, 95% CI: 1.09 to 2.06), and physical MM at baseline was positively associated with incident probable depression (aOR: 1.47, 95% CI: 1.07 to 2.02).
Discussion
Baseline physical MM increases the risk of incident probable depression and baseline probable depression increases the risk of incident physical MM among middle-aged and older adults in Thailand.
Economic instruments offer the potential to reach pre-determined environmental goals at a lower aggregate cost than less incentive-based measures, but administrative underpinnings crucial to the effective functioning of economic instruments may be lacking in developing countries. For this reason, pragmatic analysts and policymakers often advocate the use of so-called ‘mixed’ instruments that combine incentive mechanisms with improved administrative arrangements. This paper explores such possibilities with reference to intensive shrimp aquaculture, which dominates shrimp farming and is an important economic sector in Thailand. This activity has been cited as a major contributor to environmental degradation in Thailand and several other countries through destruction of mangrove forests, salinization of land, sludge disposal, and, in particular, water pollution. An analytical model is presented that highlights some of the key opportunities and limitations of mixed instruments applied to shrimp aquaculture. Mixed instruments are then proposed and evaluated.
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