in Albania - Instituti i Shendetit Publik

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ALBANIAN MEDICAL JOURNAL SUPPLEMENTDepression and self reported mobility among olderpeople in five countries: IMIAS studyAlban Ylli 1,2 , Gentiana Qirjako 1,2 , Genc Burazeri 1,2 , Eduard Kakarriqi 1,21Institute of Public Health, Tirana, Albania;2Faculty of Public Health, University of Medicine, Tirana, Albania.Aim: The objective of this study was to assess theassociation of depression and self-reported mobilitycontrolling for socio-demographic characteristicsamong older people.Methods: The data for this presentation are basedon a pooled sample of 1993 older people fromBrazil (Natal), Canada (st. Hyacinte and Kingston),Columbia (Manizales) and Albania (Tirana). In allfive sites, all older people aged 65-74 years from aselected community were invited to participate. Astructured questionnaire and standard measurementswere used, including CES-D scale for depression,SPPB for physical performance, life spaceassessment instrument and Nagi s functionallimitation questionnaire.Results: overall, 27% of participants were classifiedas having a score of 16 or over in CES-D scale.There were significant variations between sites, withTirana exhibiting the highest proportion (39%) andKingston the lowest one (10%). Depression wassignificantly higher among females (33%), amongthose with lower education (31%) and among thepoor (37%). As it is documented elsewhere,depression was particularlyhigher with prevalencerates of over 70% among older people with poorphysical performance. Depression was significantlyhigher (42%) among people with lower mobility thatis difficulty walking 400 m or climbing stairs. Poormobility keeps predicting significantly well depressioneven after controlling for sex, education,income, study site and physical performance (OR2.2, 95%CI=1.7-2.9). Upon multivariable adjustment,only Tirana and st. Hyacinte display higherodds of depression compared to Kingston.Conclusion: People who feel difficulty in walkingor climbing stairs are likely to feel depressed,regardless of their measured physical performanceand socio-demographic characteristics.Keywords: aging, IMIA S study, mobility, older people.16 ALBANIAN MEDICAL JOURNAL SUPPLEMENT
INTERNATIONAL PUBLIC HEALTH CONFERENCE IN TIRANA, ALBANIAA primary health care based model for risk factorsof non-communicable diseases in AlbaniaJeta Lakrori 1 , Sonela Xinxo 1 , Alban Ylli 1,21Institute of Public Health, Tirana, Albania;2Faculty of Public Health, University of Medicine, Tirana, Albania.Context: Currently, non-communicable diseasesNCDs (cardiovascular, cancers and chronicobstructive pulmonary disease) account for 89% ofdeaths in Albania. Risk factors such as tobacco andalcohol use and poor diet are widespread in bothurban and rural settings in Albania. Metabolicconditions such as hypertension and diabetes affectthe population, but people are often unaware oftheir condition which may also be poorly managed.Under these circumstances, the prevention and earlydetection of the NCD risk factors is considered acrucial intervention. Primary Health Care (PHC) inAlbania has a traditionally good coverage of thepopulation.Methods: The Albanian Institute of Public Healthhas started an NCD prevention model based on thestandardization of simple techniques to identifyhigher risk persons and training of PHC staff.Selection of risk factors screening methods is basedin the review of the best practices recommended byGRADE working group. Risk factors included in thestandard manual include smoking, sedentary life,alcohol abuse, obesity, high blood pressure, high totalcholesterol, poor diet, and poor stress management.In addition, standardized strategies for dealing withpositively classified cases are recommended.Results: A two-day course on screening for NCDrisk factors is already accredited and four courses areprovided in Tirana and Durres. This model ofprevention of NCD risk factors, applied in theprimary health care settings, is considered a low-costapproach for identifying the high risk groups fordeveloping NCDs.Conclusion: The continuous capacity building of theprimary health care providers, and the systematicmonitoring and supervision of the program will becrucial for the long-term success of this model inAlbania.Keywords: non-communicablediseases, prevention, primaryhealth care.ALBANIAN MEDICAL JOURNAL SUPPLEMENT17
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