The Impact of the Financial Crisis on Lifestyle Health Determinants Among Older Adults Living in the Mediterranean Region: The Multinational MEDIS Study (2005-2015).
OBJECTIVE
By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands.


METHODS
From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity.


RESULTS
Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001).


CONCLUSIONS
A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Alexandra
A
Foscolou
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Stefanos
S
Tyrovolas
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
George
G
Soulis
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Anargiros
A
Mariolis
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Suzanne
S
Piscopo
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Giuseppe
G
Valacchi
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Foteini
F
Anastasiou
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Christos
C
Lionis
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Akis
A
Zeimbekis
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Josep-Antoni
JA
Tur
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Vassiliki
V
Bountziouka
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Dimitra
D
Tyrovola
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Efthimios
E
Gotsis
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
George
G
Metallinos
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Antonia-Leda
AL
Matalas
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Evangelos
E
Polychronopoulos
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Labros
L
Sidossis
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Demosthenes B
DB
Panagiotakos
D000367:Age Factors; D000368:Aged; D003863:Depression; D004032:Diet; D015444:Exercise; D005260:Female; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D008521:Mediterranean Islands; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D012923:Social Class
 Health status;  Lifestyle health determinant index;  Mediterranean islands;  Older adults;  Socioeconomic status; Financial crisis