The role of modifiable risk factors in the development of dementia in Central and Eastern Europe remains understudied. We aimed to examine the association between 12 risk factors and the incidence of dementia in the Czech Republic and estimate the proportion of new dementia cases that can be attributed to these risk factors. Data of 3805 Czech participants in the Survey of Health, Ageing, and Retirement in Europe (mean age: 70 years, median 6.5-year follow-up) were analyzed. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox hazard models for the association between the risk factors (low education, alcohol use, living alone, obesity, smoking, physical inactivity, high blood pressure, high cholesterol, diabetes mellitus, hearing loss, vision problem, and depression) and probable dementia diagnosis defined based on adapted Lang-Weir algorithm. We estimated the proportion of dementia cases attributable to each risk factor using weighted population attributable fractions (wPAFs). Four risk factors, low education (HR 1.72), depression (HR 1.42), diabetes mellitus (HR 1.53), and physical inactivity (HR 2.13), were significantly associated with dementia and accounted for the largest proportion of attributable risk. The total weighted PAF for all factors was 39.18%. If all risk factors for dementia were eliminated, almost 40% of dementia cases in the Czech Republic could be prevented. More systematic approach is essential for mitigating the adverse impact of risk factors on the incidence of dementia, such as improving education, preventing and treating depression and diabetes mellitus, and promoting physical.

• MeSH
• demence * epidemiologie   MeSH
• deprese epidemiologie   MeSH
• důchod statistika a číselné údaje   MeSH
• incidence MeSH
• lidé středního věku MeSH
• lidé MeSH
• proporcionální rizikové modely MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• zdravotnické přehledy MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

The aim of this study was to determine prevalence of smokers and ex-smokers in the older diabetes population in Europe and to evaluate the relationship with various sociodemographic and lifestyle risk factors. This epidemiological study used Wave 8 of the multidisciplinary and cross-national SHARE database, which includes cross-sectional data on health, socio-economic status and social and family networks of individuals aged 50 and over from 27 European countries. Among the 6,903 participants with diabetes, 12.2% were current smokers, 29.9% were former smokers and 57.9% had never smoked. Among countries' diabetes populations, the highest prevalence of ex-smokers (57.6%) with a low prevalence of smokers (9.5%) was seen in the Netherlands. The highest prevalence of never-smokers (84.2%) was found in Latvia, with the lowest prevalence of ex-smokers (7.9%). Austria had the highest prevalence of current smokers (17.9%) along with a below-average prevalence of ex-smokers (26.5%) was seen in Austria. Normal weight, being overweight, lower education, living without a partner, living in larger cities, drinking alcohol in the last 7 days, lower age, and being male were associated with a higher risk of being a current smoker. The study shows high prevalence of smoking among the older diabetes population in Europe and provides data on the association of smoking with several risk factors and country-specific differences in smoking prevalence.

• Klíčová slova
• Diabetes, European population, Risk factors, SHARE, Smoking, Smoking cessation,
• MeSH
• diabetes mellitus * epidemiologie   MeSH
• kouření * epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• odvykání kouření * statistika a číselné údaje   MeSH
• prevalence MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• životní styl MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

BACKGROUND: The inverse association between education and obesity was previously found in numerous studies. This study aims to assess several possible mediators in the educational disparities in adiposity. We hypothesize the potential mediating role of lifestyle, socioeconomic, and mental health factors in the association between education and adiposity. METHODS: Cross-sectional population-based sample from Czechia included 2,154 25-64 years old subjects (54.6% women). Education was classified as high, middle, and low. Adiposity was assessed as a latent variable based on body fat percentage, BMI, waist circumference, and visceral fat. The mediation potential of unhealthy dietary behavior, alcohol intake, smoking, sedentary behaviors, income, stress, depression, and quality of life was assessed in age-adjusted sex-specific multiple mediation models. RESULTS: The negative direct effect of education on adiposity was statistically significant at 5% level of significance in both sexes. For men, the indirect effect was statistically significant via sedentary behavior (β = 0.041; 95% CI [0.025-0.062]) with a mediation ratio of 23.7%. In women, the indirect effect was statistically significant via dietary risk (β = -0.023, 95% CI [-0.037, -0.013]), alcohol intake (β = -0.006; 95% CI [-0.014, -0.001]), sedentary behavior (β = 0.012, 95% CI [0.004,0.023]), income (β = -0.022; 95% CI [-0.041, -0.004]), and mental health (β = -0.007; 95% CI [-0.019, -0.001]). The total mediation ratio in women was 30.5%. CONCLUSIONS: Sedentary behaviors had mediating role in the association between education and adiposity in both sexes, with more important role in men. In addition, unhealthy diet and lower income partially mediated the educational gradient in adiposity in women.

• MeSH
• adipozita * MeSH
• analýza mediace MeSH
• disparity zdravotního stavu MeSH
• dospělí MeSH
• duševní zdraví * MeSH
• lidé středního věku MeSH
• lidé MeSH
• obezita epidemiologie   psychologie   MeSH
• průřezové studie MeSH
• sedavý životní styl MeSH
• socioekonomické faktory * MeSH
• stupeň vzdělání * MeSH
• životní styl * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: Despite accessible diagnostics and treatment of hypertension, a high proportion of patients worldwide remain unaware of their diagnosis, and even more remain untreated. Several studies suggest that absence of comorbidities is a predictive factor for unawareness and consequently non-treatment of hypertension. There are only a few studies that have assessed the hypertension prevalence and management among apparently healthy individuals. OBJECTIVE: The aim of the study was to assess and compare hypertension prevalence, awareness, treatment and control among apparently healthy individuals, patients with internal diseases, and patients with non-internal diseases. METHODS: Data from standardised blood pressure measurements conducted during the Czech European Health Examination Survey 2014 and information on health status and health care use collected during the Czech European Health Interview Survey 2014 were analyzed. We focused on participants aged 25-64. Data were weighted on sex and age to ensure an appropriate sex and age structure of the population. The χ2-test and binary logistic regression analyses were used to compare distribution of cascade of care for hypertension between the health-status groups of respondents. RESULTS: The final eligible sample consisted of 1121 participants. The prevalence of hypertension was 32.8% in the healthy group, 29.8% in the non-internal disease group and 52.4% in the internal disease group, (p < 0.001). Awareness was 54.1%, 59.1% and 85.2% respectively, (p < 0.001). Treatment was 44.2%, 52.6% and 86.4%, respectively, (p < 0.001). Among apparently healthy respondents 62.6% had their blood pressure measured by a medical professional in the last year, compared to 71.1% in the non-internal disease group and 91.7% in the internal disease group, (p < 0.001). Differences in hypertension control were not statistically significant. CONCLUSIONS: Generally, our data show a discordance in hypertension management within the Czech population. Apparently healthy individuals are the least aware of their diagnosis and the highest proportion of them remain untreated.

• MeSH
• dospělí MeSH
• hypertenze * epidemiologie   terapie   diagnóza   MeSH
• krevní tlak MeSH
• lidé středního věku MeSH
• lidé MeSH
• prevalence MeSH
• zdraví - znalosti, postoje, praxe MeSH
• zdravotnické přehledy MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

• Klíčová slova
• Diabetes, Diabetes screening, HbA1c, Prediabetes,
• MeSH
• diabetes mellitus 2. typu * diagnóza   MeSH
• krevní glukóza MeSH
• lidé MeSH
• prediabetes * diagnóza   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH
• komentáře MeSH
• práce podpořená grantem MeSH
• Názvy látek
• krevní glukóza MeSH

BACKGROUND AND OBJECTIVES: HCV infection often remains untreated in people who inject drugs (PWID), albeit they may present with advanced liver fibrosis at a young age. We aimed to assess the rate of patients with significant fibrosis in PWID starting anti-HCV therapy and identify the factors associated with severe fibrosis. METHODS: The cohort of 200 patients was divided into two groups: F0-F2 (N = 154, 77%), patients with liver stiffness measurement (LSM) < 10.0 kPa, and F3-F4 (N = 46, 23%), with LSM ≥ 10.0 kPa, indicating significant liver fibrosis. RESULTS: In group F3-F4, there were significantly more males, and the patients were older, with a higher BMI. The number of long-term abstaining patients was significantly higher in group F3-F4 compared with group F0-F2, as well as the proportion of patients reporting harmful drinking. Obesity (OR 4.77), long-term abstinence from illicit drugs (OR 4.06), harmful drinking (OR 2.83), and older age (OR 1.17) were significant predictors of advanced fibrosis in PWID starting anti-HCV therapy. CONCLUSIONS: A quarter of PWID presented with significant liver fibrosis at treatment initiation. Obesity, long-term drug abstinence, harmful drinking, and older age contributed to significant liver fibrosis.

• Klíčová slova
• age, chronic hepatitis C, harmful drinking, obesity, people who inject drugs, significant liver fibrosis,
• Publikační typ
• časopisecké články MeSH

BACKGROUND: This paper describes the development of a mobile app for diabetes mellitus (DM) control and self-management and presents the results of long-term usage of this system in the Czech Republic. DM is a chronic disease affecting large numbers of people worldwide, and this number is continuously increasing. There is massive potential to increase adherence to self-management of DM with the use of smartphones and digital therapeutics interventions. OBJECTIVE: This study aims to describe the process of development of a mobile app, called Mobiab, for DM management and to investigate how individual features are used and how the whole system benefits its long-term users. Using at least 1 year of daily records from users, we analyzed the impact of the app on self-management of DM. METHODS: We have developed a mobile app that serves as an alternative form to the classic paper-based protocol or diary. The development was based on cooperation with both clinicians and people with DM. The app consists of independent individual modules. Therefore, the user has the possibility to use only selected features that they find useful. Mobiab was available free of charge on Google Play Store from mid-2014 until 2019. No targeted recruitment was performed to attract users. RESULTS: More than 500 users from the Czech Republic downloaded and signed up for the mobile app. Approximately 80% of the users used Mobiab for less than 1 week. The rest of the users used it for a longer time and 8 of the users produced data that were suitable for long-term analysis. Additionally, one of the 8 users provided their medical records, which were compared with the gathered data, and the improvements in their glucose levels and overall metabolic stability were consistent with the way in which the mobile app was used. CONCLUSIONS: The results of this study showed that the usability of a DM-centered self-management smartphone mobile app and server-based systems could be satisfactory and promising. Nonetheless, some better ways of motivating people with diabetes toward participation in self-management are needed. Further studies involving a larger number of participants are warranted to assess the effect on long-term diabetes management.

• Klíčová slova
• case study, diabetes mellitus, long-term data, mobile app, self-management,
• Publikační typ
• časopisecké články MeSH

This study examines the general health of consecrated persons (CP) in the Czech Republic (CZ) and in Slovakia (SK) compared to control samples of the Czech population. The sample of 293 CP participants (age: M = 47.52, SD = 9.57, females: 78.88%, 180 Czechs, 213 Slovaks) was compared with two control samples, one of which was nationally representative. Comparing CP with the general population, we measured the frequency of recent health complaints, the occurrence of chronic illnesses, general health and the individual chronotype. Compared to the representative sample, CP had a higher chance of suffering from pelvis minor pain and obesity but a lower chance of diabetes. Furthermore, CP had higher odds of having worse general health. Comparing "larks" with "night owls" among CP, the "night owls" had a significantly higher chance of suffering from worse general health. "Night owl" CP also seem to suffer more from backache and depression/anxiety and to have more problems with falling asleep. Compared to the overall society, CP in CZ and SK tend to have similar or worse general health. The results differ from the findings in the US, pointing to the positive health effects of the spiritual experience and structured daily routine of CP. Thus, this study shows the importance of more detailed research on the way of life of Czech and Slovak CP to determine the factors with the most negative health effects.

• Klíčová slova
• Czech, Slovak, consecrated person, health, religious institutes, spirituality,
• MeSH
• lidé MeSH
• náboženství * MeSH
• veřejné zdravotnictví * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Slovenská republika epidemiologie   MeSH

In contrast to the decreasing burden related to cardiovascular disease (CVD), the burden related to dysglycemia and adiposity complications is increasing in Czechia, and local drivers must be identified. A comprehensive literature review was performed to evaluate biological, behavioral, and environmental drivers of dysglycemia and abnormal adiposity in Czechia. Additionally, the structure of the Czech healthcare system was described. The prevalence of obesity in men and diabetes in both sexes has been increasing over the past 30 years. Possible reasons include the Eastern European eating pattern, high prevalence of physical inactivity and health illiteracy, education, and income-related health inequalities. Despite the advanced healthcare system based on the compulsory insurance model with free-for-service healthcare and a wide range of health-promoting initiatives, more effective strategies to tackle the adiposity/dysglycemia are needed. In conclusion, the disease burden related to dysglycemia and adiposity in Czechia remains high but is not translated into greater CVD. This discordant relationship likely depends more on other factors, such as improvements in dyslipidemia and hypertension control. A reconceptualization of abnormal adiposity and dysglycemia into a more actionable cardiometabolic-based chronic disease model is needed to improve the approach to these conditions. This review can serve as a platform to investigate causal mechanisms and secure effective management of cardiometabolic-based chronic disease.

• Klíčová slova
• adiposity, cardiometabolic risk, cardiovascular disease, chronic disease, dysglycemia, insulin resistance, nutrition, obesity, type 2 diabetes,
• MeSH
• adipozita etnologie   MeSH
• běloši statistika a číselné údaje   MeSH
• chronická nemoc epidemiologie   etnologie   MeSH
• diabetes mellitus 2. typu epidemiologie   etnologie   MeSH
• dieta škodlivé účinky   etnologie   MeSH
• disparity zdravotního stavu MeSH
• dospělí MeSH
• dyslipidemie epidemiologie   etnologie   MeSH
• hypertenze epidemiologie   etnologie   MeSH
• kardiometabolické riziko MeSH
• kardiovaskulární nemoci epidemiologie   etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• metabolický syndrom epidemiologie   etnologie   MeSH
• obezita epidemiologie   etnologie   MeSH
• porucha glukózové tolerance epidemiologie   etnologie   MeSH
• prediabetes epidemiologie   etnologie   MeSH
• prevalence MeSH
• sedavý životní styl etnologie   MeSH
• sociální determinanty zdraví etnologie   MeSH
• stravovací zvyklosti etnologie   MeSH
• zdravotní gramotnost MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH