Individual mental health patterns and the role of lifestyle among ageing adults over 20 years - the Doetinchem Cohort Study.

OBJECTIVE: We explored the prevalence of individual mental health patterns and the role of lifestyle factors over 20 years. STUDY DESIGN: We used data from the Doetinchem Cohort Study (1995-2019), a population-based study amongst adults (26-90 years) examined every five years in the Netherlands. Participants were classified in five pre-defined mental health patterns (persistent good, persistent poor, worsening, improving, varying) over 20 years (five rounds) using the MHI-5 questionnaire. BMI, sleep, smoking, alcohol consumption, and physical activity were dichotomised as healthy/unhealthy based on guidelines. The role of lifestyle at baseline (t1), 20 years later (t5), and longitudinally over 20 years (using pre-defined patterns) was explored using logistic regression. RESULTS: Most participants had good mental health at t1 (85 %) and t5 (88 %). Over 20 years, 67 % followed a persistent good mental health pattern, 30 % a changing pattern, and 3 % a persistent poor pattern. Persistent poor and changing patterns were associated with unhealthy sleep and smoking at t1, t5, and with the 20-year unhealthy patterns. Persistent poor mental health was associated with stable unhealthy and changing sleep (OR=5.58(2.48-12.54) and OR=2.07(1.14-3.74), respectively), and with stable unhealthy and changing smoking (OR=3.35(1.58-7.11) and OR=2.53(1.40-4.57), respectively). Changing mental health was associated with changing (OR=1.54(1.26-1.88) and OR=1.64(1.30-2.07), respectively) and stable unhealthy (OR=1.80(1.23-2.64) and OR=2.24(1.60-3.14), respectively) sleep and smoking, respectively. CONCLUSIONS: Persistent good and changing mental health patterns were more common than poor mental health in adults and were associated with smoking and sleep. Clarifying the underlying mechanisms and directionality between mental health and lifestyle could improve interventions.

Health interview surveys: towards international harmonization of methods and instruments

Monitoring health is an essential task of country systems for health information and of measuring the European Region’s progress towards health for all, the policy which includes internationally agreed indicators for countries to use. Health interview surveys provide the best means to collect data on some of the indicators that reflect more recent public health concerns such as health-related behaviour and quality of life. The surveys mirror the information that only properly approached individuals may be able to provide and ensure the coverage of all population subgroups. Yet they enjoy a long tradition in only a few countries. Moreover, information on indicators is sometimes not comparable. The methods and instruments of data collection have often been developed without international coordination or adapted from those in use in other countries, usually with substantial changes to meet local requirements. Also, countries lacking a tradition of health interviewing are often uncertain about the best way to conduct surveys. The WHO Regional Office for Europe and Statistics Netherlands organized meetings to tackle these problems, resulting in the internationally agreed methods and instruments for health interview surveys that are set out in this book. These are likely to become standards and thus improve the information comparability. The book provides practical guidance on health interview surveys, describes their role in health for all monitoring, the development and use of methods and instruments, and the prospects for harmonizing the surveys across the European Region.