Aperçu

Résumé (français)

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Résumé (anglais)

Mental illness and cognitive impairment are diseases that are of a substantial burden to Canada and the world at large. They are chronic and persistent conditions with considerable associated disability. The links between mental and physical health are well-established. Our main goal is to use population-based nationally representative datasets to establish both trends and risk factors for chronic conditions and multimorbidity in Canada. In order to develop effective public health intervention programs and policies there is the need to first of all generate the necessary evidence that will form the basis for intervention. This evidence can be generated through empirical research regarding predictors and trends in chronic diseases. Our current research is therefore grounded on the need to understand major determinants and trends in chronic diseases through the use of interdisciplinary population-based research which will provide evidence that will drive policy decision making and lead to better health and improved quality of life for Canadians. In the first study, our systematic review and meta-analysis found that diabetes was a risk factor for incident depression. Population attributable fractions (PAFs) showed a reduction in depression that could result from reducing diabetes. The second study examined the shared risk factors for diabetes and depression in a large-scale longitudinal cohort study. We found hypertension, daily smoking, physical inactivity and overweight or obesity were shared risk factors of major depressive disorder and diabetes. Sex differences existed in risk factors for the two debilitating conditions. The third study examined both the prevalence of cognitive impairment and modifiable risk factors for such impairment. We found that cognitive impairment was on the decline despite the aging population in Canada and that the modifiable risk factors of cognitive impairment changed over time. Age and sex differences exist in the association between predictor variables and cognitive impairment. We found that different experiences shared by successive generations may predispose them to different disease risk. Our final paper assessed prevalence and trends in chronic diseases and multimorbidity over a 36-year period. We found a significant decrease in the prevalence of chronic diseases in Canada. While at the same time there was an increase in the prevalence of multimorbidity. Our study suggests that other contributory factors aside from the aging of the population are responsible for the contrasting trends in the prevalence of chronic diseases and multimorbidity in Canada. The central message of our research findings is that to achieve an improved quality of life during old age there is a need for a better understanding of how individuals can age healthily without developing multiple chronic illnesses with substantial disability.