The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities
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 adul...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-01-01
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| Series: | Journal of Primary Care & Community Health |
| Online Access: | https://doi.org/10.1177/21501319241228123 |
| _version_ | 1797347630910537728 |
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| author | Oscar H. Del Brutto Robertino M. Mera Denisse A. Rumbea Mark J. Sedler |
| author_facet | Oscar H. Del Brutto Robertino M. Mera Denisse A. Rumbea Mark J. Sedler |
| author_sort | Oscar H. Del Brutto |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T11:50:35Z |
| format | Article |
| id | doaj.art-972fda1ff9da4410a770aa6fcf38dcdd |
| institution | Directory Open Access Journal |
| issn | 2150-1327 |
| language | English |
| last_indexed | 2024-03-08T11:50:35Z |
| publishDate | 2024-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Primary Care & Community Health |
| spelling | doaj.art-972fda1ff9da4410a770aa6fcf38dcdd2024-01-24T11:03:30ZengSAGE PublishingJournal of Primary Care & Community Health2150-13272024-01-011510.1177/21501319241228123The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural CommunitiesOscar H. Del Brutto0Robertino M. Mera1Denisse A. Rumbea2Mark J. Sedler3Universidad Espíritu Santo—Ecuador, Samborondón, EcuadorFreenome, Inc., South San Francisco, CA, USAUniversidad Espíritu Santo—Ecuador, Samborondón, EcuadorStony Brook University, New York, NY, USABackground: 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.https://doi.org/10.1177/21501319241228123 |
| spellingShingle | Oscar H. Del Brutto Robertino M. Mera Denisse A. Rumbea Mark J. Sedler The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities Journal of Primary Care & Community Health |
| title | The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities |
| title_full | The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities |
| title_fullStr | The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities |
| title_full_unstemmed | The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities |
| title_short | The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities |
| title_sort | impact of biological and social factors on mortality in older adults living in rural communities |
| url | https://doi.org/10.1177/21501319241228123 |
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