Cost-effective analysis of genotyping using oral cells in the geriatric population.

We evaluated the cost-effectiveness of using buccal swab brushes in comparison with blood samples for obtaining DNA for large epidemiological studies of the elderly population. The data reported here are from the third phase of the Integral Study of Depression among the Elderly in Mexico City's Mexican Institute of Social Security, conducted in 2007. The total cost of the two procedures was determined. The measurement of effectiveness was the quality and quantity of DNA measured in ng/µL and the use of this DNA for the determination of apolipoprotein E (APO E) polymorphism by PCR. Similar rates of amplification were obtained with the two techniques. The cost of the buccal swab brushes, including sample collection and DNA extraction, was US$16.63, compared to the cost per blood sample of US$23.35. Using the buccal swab, the savings was US$6.72 per patient (P < 0.05). The effectiveness was similar. Quantity and quality of DNA obtained were similar for the oral and blood procedures, demonstrating that the swab brush technique offers a feasible alternative for large-scale epidemiological studies.

Early alcohol or tobacco onset and transition to other drug use among students in the state of Morelos, Mexico.

UNLABELLED: In this study, we explored if patterns in the transition from alcohol/tobacco in the Mexican State of Morelos, Mexico are similar to those observed in other countries. METHODS: The data were from a representative sample of youth age 11-21 years (n = 13,105), who participated in a paper-and-pencil survey in middle schools, high schools, and colleges in the State of Morelos, Mexico. Drug use was assessed via the standardized instrument mostly used in Mexican student surveys. Cox's models for discrete time-survival analyses, stratified by school and age group were used to estimate the risk of drug use in relation to age of alcohol and tobacco use initiation by gender, while accommodating the complex survey design. RESULTS: About 5% of the students were estimated to have used drugs in their life. Male early users of alcohol or tobacco were more likely to use other drugs, compared to students who did not have an early alcohol or tobacco onset. COMMENT: Further studies on social mechanisms might help to account for observed similarities in patterns of drug involvement in different countries, even in the context of important differences in rates of drug use.

The relationship of tobacco smoking with depressive symptomatology in the Third Mexican National Addictions Survey.

BACKGROUND: While an association between cigarette smoking and depression has been established in Anglo populations, replication of tobacco-depression associations in countries where smoking is growing may provide important new insights. The objectives of this study were to estimate the association of depressive symptomatology with tobacco smoking, number of cigarettes smoked daily, and smoking cessation in a representative sample of the Mexican population. METHOD: The data come from the Third National Addictions Survey (1998) conducted by the Mexican Ministry of Health, representative of Mexico's civilian population residing in cities and towns with 2500+ inhabitants, aged 18-64. Part of a multi-stage, stratified, probability sample, 1935 men and women answered a version of the survey that also included the CES-D depression scale. Analyses addressed the survey's complex design and controlled for income and educational evel. RESULTS: Among women only, current smokers had twice the odds of elevated depressive symptomatology than never smokers (OR 2.1, 95% CI 1.3-3.5, p = 0.002). For men, only those smoking a pack or more a day had greater odds of depressive symptomatology (OR 5.9, 95% CI 1.6-21.9, p = 0.008). Overall, former smokers who ceased smoking within 6 months had lower odds of depressive symptomatology than current smokers (OR 0.4, 95% CI 0.1-1.0, p = 0.042). CONCLUSIONS: These findings add to the accumulating evidence for the association between smoking and depression in different cultures and populations.

Early onset and recent drug use among children of parents with alcohol problems: data from a national epidemiologic survey.

There is good evidence that children of parents with alcohol problems have more drug involvement, plus related mental health and behavioral problems. In this study, we sought to estimate the degree to which these children might be more likely to initiate drug use precociously. A sample of 2888 parent-child pairs was identified within public data files of the National Household Survey on Drug Abuse (NHSDA), 1995-1997. Alcohol dependence of one parent was assessed by that parent's report of three or more dependence manifestations. Independently, one randomly selected 12-17 year-old child of the parent answered self-report survey questions on age at first use of tobacco, alcohol, and marijuana. In analyses contrasting 114 children of alcohol dependent parents (AD+) with 2774 other children (AD-), youths with alcohol dependent parents had higher odds than other kids to have used tobacco in the past year (odds ratio, OR=3.2, 95% confidence interval, CI=2.05-4.98), as well as alcohol (OR=1.6, 95% CI=1.05-2.50), and marijuana (OR=2.9, 95% CI=1.71-4.90). Survival analyses were used to clarify excess risk of early-onset drug use. For example, by age 17, an estimated 73% of AD+ children had smoked tobacco cigarettes, 70% had started drinking, and 41% had smoked marijuana, versus 44%, 57%, and 26% of AD- children, respectively. This new evidence helps build a case that children of parents with alcohol problems experience precocious drug use.

Depression in late life: a hidden public health problem for Mexico?

Depression is one of the most important causes of disability in the world, causes considerable suffering, and problems associated with depression are extremely costly to society. Depression is one of the most common and debilitating illnesses of older people that is frequently overlooked. The most recent epidemiological study in Mexico estimated the lifetime prevalence of major depressive episodes among people 18 to 54 years old to be 7.8%, only second to alcohol dependence (8.2%). A previous study found that older adults tend to have higher levels of depression than younger adults. There are important gaps of information about depression among the elderly. Along with refined measurement approaches, further research is needed on risk and protective factors for depression as these factors might highlight the areas that need to be targeted. Addressing depression among the elderly can significantly contribute in reduced health care costs, lowered disability, morbidity and mortality. This could yield important savings, freeing resources that might become available for the attention of important health carè needs.