Purpose Studies suggest that frequent contact with friends and relatives promote mental wellbeing in later life, but most evidence comes from Western populations. We investigated the prospective relationship between frequency of contact with friends and relatives and quality of life (QoL) among older Central and Eastern European (CEE) adults and whether depressive symptoms mediated the hypothesised longitudinal relationship. Methods Data from 6106 participants from the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study were used. Frequency of contact with friends and relatives was measured at baseline. QoL, at baseline and follow-up, was measured by the Control, Autonomy, Self-realisation, and Pleasure (CASP) 12-item scale. After assessing the prospective association using multivariable linear regression, the mediational hypothesis was tested using path analysis. Results There was a significant prospective association between frequency of contact with friends and relatives and CASP-12 score (0-36) in fully adjusted models. Per every one unit increase in frequency of contact, there was a 0.12 (95% CI 0.06, 0.17) increase in CASP-12 score at follow-up, accounting for sociodemographic, health-related and baseline QoL. Pathway results showed that 81% of the longitudinal effect of frequency of contact on QoL was mediated through depressive symptoms. Conclusions Frequent contact with friends and relatives improves QoL of older Central and Eastern European adults, partly through buffering against depressive symptoms. Interventions to improve QoL at older ages should incorporate effective management of common mental disorders such as depression.

Background: Post-lingual deafness represents a critical challenge for adults' well-being with substantial public health burdens. One treatment of choice has been cochlear implants (CI) for people with severe to profound hearing loss (HL). Since 2018, Chile has implemented a high-cost policy to cover CI treatment, the Ley Ricarte Soto (LRS) health policy. However, wide variability exists in the use of this device. To date, no study has been published on policy evaluation in Chile or other Latin American countries. Objectives: This study aimed to evaluate the impact of the LRS policy on the treatment success and labour market inclusion among deaf or hard of hearing (DHH) adults using CI. We examined and characterised outcomes based on self-reports about treatment success and occupation status between 2018 and 2020. Design: We performed a prospective study using hospital clinical records and an online questionnaire with 76 DHH adults aged >15 who had received CIs since the introduction of the LRS policy in 2018. Using univariate and multivariate regression models, we investigated the relationship between demographic, audiological, and social determinants of health and outcomes, including treatment success for social inclusion (International Outcome inventory for Hearing Aids and CIs assessment: IOI-HA) for social inclusion and occupation status for labour market inclusion. Results: Our study showed elevated levels of treatment success in most of the seven sub-scores of the IOI-HA assessment. Similarly, around 70% of participants maintained or improved their occupations after receiving their CI. We found a significant positive association between treatment success and market inclusion. Participants diagnosed at younger ages had better results than older participants in both outcomes (P=0.078 and P= 0.011, respectively). Regarding social determinants of health, finding suggested participants with high social health insurance and a shorter commute time to the clinic (p=0.070 and p=0.086, respectively) had better results in treatment success. For labour market inclusion, participants with high education levels and better pre- CI occupation (p=0.069 and p=0.021, respectively) had better post-CI occupation status, and findings suggested an impact of high education levels. Conclusions: In evaluating the LRS policy for providing CIs for DHH adults in Chile, we found positive effects relating to treatment success and occupation status. Our study supports the importance of age at diagnosis and social determinants of health, which should be assessed by integrating public services and bringing them near each beneficiary. Although evidence-based guidelines for candidate selection given by the LRS policy might contribute to good results, these parameters could limit the policy access to people who do not meet the requirements of the guidelines due to social inequalities

Purpose Depression is a prevalent disorder with effects beyond mental health. An association with mortality has been reported, however, evidence is mixed and limited to a few high-income countries. This study aims to assess the association between depressive symptoms and all-cause mortality in the Chilean population. Methods This prospective study used data from the Chilean National Health Survey (ENS). Data from 3,151 and 3,749 participants from the 2003 and 2010 ENS respectively were linked to mortality register data. Cox survival analysis was performed using days from interview as time-to-event. The main exposure was depressive symptoms, measured with CIDI-SF (cut-off ≥ 5), and the outcome was all-cause mortality. The study period was limited to 8.5 years to allow for the same length of follow-up in both cohorts. Results 10% and 8.5% of participants from the 2003 and 2010 cohort died during the follow-up. Adjusting for age and sex, those with depressive symptoms were 1.50 (95% CI 1.11–2.02) and 1.51 (95% CI 1.11–2.04) times more likely to die than those without symptoms in the 2003 and 2010 cohort, respectively. In fully adjusted models, participants with depressive symptoms were 1.38 (95% CI 1.02–1.86) and 1.38 (95% CI 1.02–1.88) times more likely to die compared to those without symptoms in the 2003 and 2010 cohort. Conclusion Addressing mental health in the Chilean population could contribute not only to healthier but longer lives as well. Future research should collect data on more points in time to assess the effect of trajectories of depressive symptoms on mortality.

Purpose Depression is a prevalent disorder with effects beyond mental health. A positive association with mortality has been mostly reported, however, evidence comes from a few high-income countries. This study aims to assess the association between depressive symptoms and all-cause mortality in the Chilean population and assess a potential secular effect in this association. Methods This prospective study used data from the Chilean National Health Survey (CNHS). Data from 3151 and 3749 participants from the 2003 and 2010 CNHS, respectively, were linked to mortality register data. Cox survival analysis was performed. The main exposure was depressive symptoms, measured with CIDI-SF (cut-off ≥ 5), and the outcome all-cause mortality. The study period was limited to 8.5 years to allow for the same length of follow-up. Results 10% and 8.5% of participants from the 2003 and 2010 cohort died during the follow-up. Adjusting for age and sex, those with depressive symptoms had 1.58 (95% CI 1.18–2.13) and 1.65 (95% CI 1.14–2.12) times the risk to die than those without symptoms in the 2003 and 2010 cohort, respectively. In models adjusted for demographic, socioeconomic, behavioural variables and comorbidities, participants with depressive symptoms had 1.42 (95% CI 1.05–1.92) and 1.46 (95% CI 1.07–− 1.99) times the risk to die compared to those without symptoms in the 2003 and 2010 cohort, respectively. Conclusion Chilean adults with depressive symptoms are at higher risk of all-cause mortality compared to those without symptoms. The effect size was similar regardless of the economic development of the country.