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Introduction: The Global Adult Tobacco Survey (GATS) shows a drop in tobacco use worldwide. Despite the drop, there still continues to be a significant number of tobacco users in India. Research on tobacco use among young persons is commonly prioritised in India, while studies on tobacco use among middle-aged (45–59 years) and elderly (≥ 60 years) adults are noticeably lacking. We have conducted this study with objective to estimate the distribution, determinants and socioeconomic inequalities of smoking (SM) and smokeless tobacco (SLT) consumption across Indian states and union territories. Methods: This study was based on 66,606 participants aged ≥ 45 years using Longitudinal Aging Study in India (LASI)-1 (2017–2018) data. Distribution of tobacco consumption (any form, smoking (SM), smokeless (SLT) and both) was documented as per Indian states and union territories with spatial distribution by Indian map. Demographic, socioeconomic, health related and behavioural determinants were established using nested multilevel regression modelling. Socioeconomic disparities were documented using concentration curve. P-value < 0.05 was considered as statistically significant. Results: Overall, 36.78% participants documented using any form of tobacco; with higher consumption of SLT (19.88%) than smoking/SM (13.92%). Only 2.98% consumed both. Mizoram had highest consumption of tobacco in any form (78.21%) and smoking (35.18%). Elderly participants had higher odds of consuming tobacco (any 1.23 (1.18–1.28), SM 1.99 (1.14–1.27), SLT 1.08 (1.03–1.14) and both 1.27 (1.14–1.40 times) than middle aged participants. Females, OBC (other backward castes), urban residence had lower odds in all the categories, while being widow/ separated/ divorced, belonging to Muslim community, having clerical and skilled occupation, poor self-rated health, comorbidity and multimorbidity had higher odds. With decrease in the wealth index, educational status and frequency of physical activity the odds of tobacco consumption increased. The odds of higher tobacco consumption were documented from northeast region (2.56 (2.37–2.76) higher than north). Alcohol consumption had the highest odds (4.94 (4.69–5.21)). Participants exposed to media had lower odds (11% lower) of consuming tobacco. The socioeconomic inequalities in tobacco consumption were significantly distributed more among the poorest (any -0.064 (-0.072 to -0.056) and SLT -0.069 (-0.072 to -0.056)). Conclusion: Prioritising tobacco prevention and increasing availability and accessibility of cessation programmes that are suited with unique requirements and circumstances, even for elderly population, are essential focusing on the higher determinants across poorest section in the country. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the effects of a 16-wk combined exercise training on body composition, and metabolic and inflammatory markers in sedentary middle-aged workers. We also assessed whether alterations in metabolic markers were associated with changes in health-related outcomes. Methods: This randomized controlled trial involved 46 participants randomly allocated into control and exercise groups. The exercise group performed 16-wk combined aerobic and resistance training for 75 min per session, 3 times a week. Fasting blood samples were collected at baseline and after 16-wk intervention to determine lipid profile, and metabolic and inflammatory markers as primary outcomes. Results: A total of 36 participants completed the intervention (53.70 ± 6.92 yr old; n = 18 in each group). Waist circumference (interaction effect: F = 7.423, P = 0.002), fat mass (interaction effect: F = 5.070, P = 0.011), and muscle mass (interaction effect: F = 5.420, P = 0.007) were improved in the exercise group compared with the control group. Fasting glucose increased after the 16-wk follow-up (time effect: F = 73.253, P < 0.001), without an intergroup difference. Insulin levels were greater in the control compared with exercise group (group effect: F = 6.509, P = 0.015). The control group tended to increase the homeostatic model assessment of insulin resistance index (interaction effect: F = 3.493, P = 0.070) and to decrease the QUICKI index (interaction effect: F = 3.364, P = 0.075) to a greater extent compared with the exercise group. Exercise group reduced leptin (interaction effect: F = 11.175, P = 0.002) and adiponectin (interaction effect: F = 4.437, P = 0.043) concentrations in a greater magnitude than the control group. Interleukin (IL)-6 (time effect: F = 17.767, P < 0.001) and tumor necrosis factor α (time effect: F = 9.781, P = 0.004) concentrations decreased after the intervention, without an intergroup difference. IL-17A levels increased in the control compared with exercise group (interaction effect: F = 5.010, P = 0.033). Effects on adiponectin, IL-6, and IL-17A levels seem to depend on baseline body mass index, age, and sex. Percentage changes in leptin correlated positively with changes in homeostatic model assessment of insulin resistance index in the exercise (r = 0.565, P = 0.015) and control (r = 0.670, P = 0.002) groups. Conclusions: A combined training program can be an effective strategy to improve body composition and inflammatory markers and prevent marked reductions in insulin sensitivity among middle-aged workers. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Methods Results Conclusions Compare different behavioural, environmental and socioeconomic factors for caries with transversal data to decompose the direct and indirect effects of body mass index (BMI) in relation to coronal and root caries.This cross‐sectional study used a representative sample of 1002 individuals aged ≥ 35 years living in Porto Alegre. Questionnaires recorded age, sex, educational level, tooth brushing frequency and access to dental services. Oral examination assessed gingival bleeding and recession, coronal and root caries. Height and weight were collected to calculate the BMI. The structural equation modelling approach was used, and standardised coefficients (SC) to direct, indirect and total effects were calculated.The prevalence of excessive body weight was 71.17%, of which 40.09% were overweight and 31.07% were obese. The overall prevalence of coronal and root caries was 99.83 and 36.95, respectively. No direct link between BMI and coronal or root caries was observed. For coronal caries, positive SC was found for age (0.56; p < 0.01) and sex (female) (0.14; p < 0.01). For root caries, positive SC was detected for age (0.34; p < 0.01), smoking exposure (0.17; p < 0.01) and gingivitis (0.08; p < 0.01).Overweight and obese adults should not be regarded at higher risk for dental caries. [ABSTRACT FROM AUTHOR]

Background: China's rapidly aging population presents challenges for cognitive health and mental well-being among the older adults. This study examines how the number of children affects cognitive function in middle-aged and older adults and whether depressive symptoms mediate this relationship. Methods: This study analyzed data from waves 1 to 5 (2011–2020) of the China Health and Retirement Longitudinal Study (CHARLS), involving 5932 participants aged 45 and older. Participants were grouped by the number of children: childless, only child and multiple children. We used Logarithmic Generalized Linear Models (LGLMs) to explore the relationships among the number of children, depressive symptoms, and cognitive function. Indirect effect coefficients and 95% bias-corrected and accelerated confidence intervals (BCaCI) were estimated using Simultaneous Equation Models (SEM) with three-stage least squares (3SLS) and the bootstrap method to assess the mediating effect of depressive symptoms. Results: In middle-aged and older adults, a negative association was observed between the number of children and overall cognitive functioning (all p < 0.01). This association remained significant even after adjusting for covariates in groups with three (β = −0.023, p < 0.05) and four or more children (β = −0.043, p < 0.001). Conversely, the positive association between the number of children and depression also persisted after adjusting for covariates, although it weakened as the number of children increased (all p < 0.01). Depressive symptoms consistently correlated negatively with overall cognitive function (p < 0.001) and partially mediated the relationship between the number of children and cognitive function (pMe = 20.36%, p < 0.05). The proportion of the mediating effect attributed to depression was more pronounced in middle-aged and older adults who had experienced the loss of children (pMe = 24.31%) or had two children (pMe = 25.39%), with stronger mediating effects observed in males (pMe = 48.84%) and urban residents (pMe = 64.58%). Conclusions: The findings indicate that depressive symptoms partially mediate the relationship between the number of children and cognitive function in middle-aged and older adults in China. These results highlight the significance of considering mental health factors when studying cognitive function in this demographic. Notably, in families without children and those with two children, depressive symptoms play a crucial role in explaining the decline in cognitive function. [ABSTRACT FROM AUTHOR]

Purpose: Colorectal cancer screening is recommended starting at age 45, but there has been little research on strategies to promote screening in patients younger than 50. Methods: An outreach program quasi-randomly assigned patients aged 45–50 without recent fecal immunochemical test (FIT), colonoscopy or contraindications to screening to two intervention arms: electronic outreach with email and text (electronic outreach only) versus electronic outreach plus mailed outreach with FIT, an instructional letter and a prepaid return envelope (mailed + electronic outreach). In response to known disparities in screening uptake, all Black patients were assigned to receive mailed + electronic outreach. Results: Among patients quasi-randomly assigned to an intervention (non-Black patients), the 180-day FIT completion rate was 18.8% in the electronic outreach only group (n = 1,318) and 25.0% in the mailed + electronic outreach group (n = 1,364) (difference 6.2% [95% CI 3.0, 9.4]). FIT completion was 16.6% among Black patients (n = 469), 8.4% (95% CI 4.1, 12.6) lower than among non-Black patients also assigned to mailed + electronic outreach. Conclusion: Among patients aged 45–50, mailed + electronic outreach had a greater effect on FIT completion than electronic outreach alone. Crossover between intervention groups likely lead to an underestimation of the effect of mailed outreach. [ABSTRACT FROM AUTHOR]

Background Stress urinary incontinence (SUI) is one of the common diseases in middle-aged and elderly women, which seriously affects their quality of life and physical and mental health. Internet medicine has the advantages of flexibility, privacy and accessibility, which can be used as an effective approach of self-management intervention for urinary incontinence patients. However, its effectiveness on the clinical treatment of middle-aged and elderly female SUI patients is unclear. Objective To explore the effects of Internet-based self-management intervention on improving clinical symptoms, self-efficacy, and psychological status in middle-aged and elderly female SUI patients. Methods A total of 120 middle-aged and elderly female SUI patients treated in the Air Force 986 Hospital of PLA from January to December 2022 were recruited. They were randomly assigned into control group (n=60) and experimental group (n=60) by double-blind random number table method. Patients in both groups were given conventional pelvic floor muscle training (PFMT), with 20 minutes per day, once every other day for a course of 10 times of PFMT, and those in the experimental group were additionally given Internet-based self-management intervention for 6 months. Outpatient re-examination and follow-up visits were conducted before treatment and 3 and 6 months after treatment. Clinical symptoms of SUI in middle-aged and elderly female patients were evaluated by surveying the International Consultation on Incontinence Questionnaire Short Form (ICI-Q-SF) and 1-hour pad test, thus determining the clinical efficacy. The Broome Pelvic Muscle Self-efficacy Scale (BPMSES) was used to evaluate the self-management efficacy. The Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to evaluate the anxiety and depression status, respectively. Results The ICI-Q-SF scores of experimental group at 3 months [ (6.58±3.91) points vs. (9.27±3.11) points, P

Abstract Introduction The prevalence of important public health problems like road traffic accidents (RTA) and depression are surging. This study was aimed to estimate distribution and determine the association between RTA and depression among Indian population aged 45 years and above: overall and stratified into age group, gender and across states/union territories as aspirants, achievers, and front runners. Methods Using Longitudinal Aging Study in India (LASI) dataset (April 2017–December 2018), we have conducted this study among middle aged (45–59 years) and older adults and elderly (≥ 60 years) Indians. Bivariate analysis was conducted to estimate the prevalence of RTA and depression nationally and across aspirants, achievers, and front runner states. States and union territories were categorised as low, medium, and high as per RTA and depression prevalence, which were further cross tabulated. Spatial distribution maps were created using Microsoft Excel. We have documented the association of RTA with depression. To reduce the confounding effects of demographic and socioeconomic; health related and behavioural covariates; propensity score matching (PSM) was conducted. Nested multilevel regression modelling was analysed using STATA version 17. Results Prevalence of RTA was 1.84% (1.74–1.94) nationally, highest among achiever states [2.04% (1.82–2.30)]. Prevalence of depression was 6.08% (5.90–6.26) nationally, highest among aspirant states [7.02% (6.74–7.30)]. The adjusted odds of having RTA was significantly among depressed [aOR (95% CI) 1.76 (1.45–2.15)] than non-depressed participants; which was much higher among females [aOR (95% CI) 1.93 (1.43–2.62)] than in males [aOR (95%CI) 1.67 (1.29–2.16)] and much higher among middle aged [aOR (95%CI) 2.08 (1.63–2.65)]. Odds of RTA was highest across front runners [aOR (95%CI) 1.86 (1.26–2.72)] followed by aspirant states [aOR (95%CI) 1.79 (1.37–2.33)]. Conclusion This study established the positive association between depression and road traffic accidents among middle aged, older adults and elderly. Therefore, efforts must be taken to address mental health issues in them with proper policy implication more focused on females and middle aged. Front runner’s states should get the limelight followed by aspirant states.

Background With the acceleration of China's aging population, the prevalence of chronic diseases and comorbidity patterns pose significant challenges to global health. There is a close relationship between the prevalence of chronic diseases and individuals' self-related health (SRH) status. However, there is limited research on the prevalence of chronic diseases and comorbidity patterns among middle-aged and elderly populations in rural areas of Xinjiang, China, and their impact on SRH status. Objective To understand the prevalence of chronic diseases and comorbidity patterns among middle-aged and elderly populations in rural areas of Xinjiang and to explore the impact of chronic diseases and comorbidity patterns on SRH status, providing effective reference for improving the health level of this population. Methods The data for this study were derived from the survey database of the National Social Science Foundation project (17BRK030) from 2016 to 2019. A questionnaire survey was conducted on the demographic characteristics, chronic disease status, and self-rated health status of male and female heads of households. Ordered logistics regression analysis was used to screen the influencing factors of SRH status. SOM network training analysis and partial least squares method were employed to evaluate the interrelationships among 14 chronic diseases and the degree of their impact on SRH status. Results A total of 3 400 middle-aged and elderly individuals were surveyed. Residents' SRH status varied significantly by geographical distribution, gender, age, education level, occupation, marital status, illness or disability, and chronic disease status (P

Abstract Background Inappropriate prescribing (IP) is common in hospitalised older adults with frailty. However, it is not known whether the presence of frailty confers an increased risk of mortality and readmissions from IP nor whether rectifying IP reduces this risk. This review was conducted to determine whether IP increases the risk of adverse outcomes in hospitalised middle-aged and older adults with frailty. Methods A systematic review was conducted on IP in hospitalised middle-aged (45–64 years) and older adults (≥ 65 years) with frailty. This review considered multiple types of IP including potentially inappropriate medicines, prescribing omissions and drug interactions. Both observational and interventional studies were included. The outcomes were mortality and hospital readmissions. The databases searched included MEDLINE, CINAHL, EMBASE, World of Science, SCOPUS and the Cochrane Library. The search was updated to 12 July 2024. Meta-analysis was performed to pool risk estimates using the random effects model. Results A total of 569 studies were identified and seven met the inclusion criteria, all focused on the older population. One of the five observational studies found an association between IP and emergency department visits and readmissions at specific time points. Three of the observational studies were amenable to meta-analysis which showed no significant association between IP and hospital readmissions (OR 1.08, 95% CI 0.90–1.31). Meta-analysis of the subgroup assessing Beers criteria medicines demonstrated that there was a 27% increase in the risk of hospital readmissions (OR 1.27, 95% CI 1.03–1.57) with this type of IP. In meta-analysis of the two interventional studies, there was a 37% reduced risk of mortality (OR 0.63, 95% CI 0.40-1.00) with interventions that reduced IP compared to usual care but no difference in hospital readmissions (OR 0.83, 95% CI 0.19–3.67). Conclusions Interventions to reduce IP were associated with reduced risk of mortality, but not readmissions, compared to usual care in older adults with frailty. The use of Beers criteria medicines was associated with hospital readmissions in this group. However, there was limited evidence of an association between IP more broadly and mortality or hospital readmissions. Further high-quality studies are needed to confirm these findings.

Background & aim: The effectiveness of preventive interventions on osteoporosis have been already investigated, but there is little information on the impact of cognitive-behavioral counseling (CBC) on prevention of osteoporosis. The present study aimed to determine the effect of CBC, provided by a midwife, on preventive behaviors of osteoporosis in middle-aged women.Methods: This randomized controlled trial was conducted in 2020 (Feb - June) on 62 middle-aged women (45-60 years old) referring to the health centers in Dezful, south of Iran. The participants were allocated into intervention (n=31) and control group (n=31) using block randomization design. For the intervention group, eight weekly sessions of CBC based on preventive behaviors against osteoporosis were held by a midwife. The control group received routine care. Data were collected using demographic and obstetric data questionnaire, Food Frequency Questionnaire (FFQ), and International Physical Activity Questionnaire (IPAQ), before and eight weeks after the intervention. Data were analyzed by SPSS software (version 22).Results: Before the intervention, there was no significant difference between the two groups in terms of osteoporosis prevention behaviors. After the intervention, the frequency of consumption of dairy products (P=0.001), vitamin D (P=0.002), and calcium supplements (P=0.012); bone density measurement (P=0.001); and the amount of using sunlight (P=0.001) significantly increased in the intervention group compared to the control group. The mean index of energy consumed in the form of physical activity did not show a significant difference between the two groups (P=O.852).Conclusion: CBC, as a non-pharmacological and safe method, can be used to promote preventive behaviors against osteoporosis.

Background In China, there is a significant prevalence of type 2 diabetes patients (T2DM) , who also have an increased risk of developing secondary hyperuricemia (HUA) . Patients with T2DM who develops HUA are at increased risk of developing further problems, which could have detrimental effects on their health. Consequently, it is crucial to promptly identify individuals who have a high risk of developing secondary HUA and to begin early prevention and therapy. Objective Exploring the predictive value of common insulin resistance (IR) surrogates for the HUA in middle-aged and elderly T2DM patients. And employ a subset of these metrics as predictive metrics for the occurrence and progression of HUA. Methods Using stratified random sampling, 479 individuals with type 2 diabetes mellitus (T2DM) and 1 528 patients with non-hyperuricemia (NHUA) were chosen from seven community health service centers in Shenzhen between January and March 2023. Multivariate Logistic regression analysis was used to evaluate the effects of various insulin resistance (IR) metrics and their quartiles on the incidence of HUA in middle-aged and older type 2 diabetic patients. Triglyceride-high density lipoprotein cholesterol (TG/HDL-C) index, non-high density lipoprotein cholesterol ratio (Non-HDL-C/HDL-C) index, triglyceride glucose (TyG) index, triglyceride glucose body mass (TyG-BMI) index, triglyceride glucose waist circumference (TyG-WC) index, and insulin resistance metabolism (METS-IR) index are some of these metrics. The predictive efficacy of several IR substitution measures for HUA in middle-aged and older T2DM patients was assessed using the ROC curve. The CHARLS database's cohort data from 2011 and 2015 were filtered in order to create a nested case-control that would validate the predictive power of different IR alternative indicators for the likelihood of HUA. Results Multivariate Logistic regression study revealed that the METS-IR index, TG/HDL-C index, Non HDL-C/HDL-C index, TyG index, TyG-BMI index, TyG-WC index, and TG/HDL-C index were independent influencing factors for the occurrence of HUA (P

To analyze the short-term (one month intervention and post-intervention) and long-term (six-month follow-up) effects of Jazz Dance on menopausal symptoms (somatic, psychological and urogenital), in addition to the psychological aspects in specific (anxiety, depression, mood, stress, and aging perspective), compared to the control group of menopausal women. Randomized clinical trial with early postmenopausal women divided into two groups: Jazz Dance Intervention Group (GIDJ) (n = 23), and control group (CG) (n = 24). The physical exercise group received interventions of two weekly sessions of 60 minutes each, for 16 weeks. The control group received monthly calls, educational lectures, and maintained their usual activities during the intervention period. Assessments with all participants occurred at baseline, after the 1st month, after the interventions, and at the six-month follow-up. The evaluations are assessed by questionnaires and include menopausal symptoms (Menopause Rating Scale), depressive and anxiety symptoms (Anxiety and Depression Scale), stress (Perceived Stress Scale), mood (Brunel Mood Scale), and aging perspective (Sheppard Inventory). There was a significant improvement in GIDJ outcomes post-intervention, such as menopausal symptoms (p = .001), psychological aspects (anxiety (p =  <.001), depression (p = .016) and stress (p = .030)); in the integrity domain (p = .011) for the aging perspective, and in the confusion (p = .028) and vigor (p = .044) domains for mood. Furthermore, the CG showed significant improvements in the happiness domain at one month of intervention (p = .043) from the perspective of aging. Jazz Dance is effective in treating symptoms of menopause, depression, anxiety and stress, especially with an intervention of at least 16 weeks duration. [ABSTRACT FROM AUTHOR]

Objective: Although menopausal symptoms are an important issue for female workers, their association with work-related factors is not well studied. Here, we explored the association between work-related factors and menopausal symptoms in Japan. Methods: A cross-sectional study was conducted in 2023 among all 1465 female employees of a large Japanese company. Associations between occupational factors and moderate or severe menopausal symptoms, as measured by the Menopause Rating Scale (MRS), were examined using logistic regression analysis. Results: Several workplace-related factors were significantly associated with moderate or severe menopausal symptoms, including company support and the number of night shifts. A marginally significant association was also seen for commuting time. Conclusions: Workplacemenopause interventions for the factors identified in this study may satisfy unmet needs. [ABSTRACT FROM AUTHOR]

Background: Inappropriate prescribing (IP) is common in hospitalised older adults with frailty. However, it is not known whether the presence of frailty confers an increased risk of mortality and readmissions from IP nor whether rectifying IP reduces this risk. This review was conducted to determine whether IP increases the risk of adverse outcomes in hospitalised middle-aged and older adults with frailty. Methods: A systematic review was conducted on IP in hospitalised middle-aged (45–64 years) and older adults (≥ 65 years) with frailty. This review considered multiple types of IP including potentially inappropriate medicines, prescribing omissions and drug interactions. Both observational and interventional studies were included. The outcomes were mortality and hospital readmissions. The databases searched included MEDLINE, CINAHL, EMBASE, World of Science, SCOPUS and the Cochrane Library. The search was updated to 12 July 2024. Meta-analysis was performed to pool risk estimates using the random effects model. Results: A total of 569 studies were identified and seven met the inclusion criteria, all focused on the older population. One of the five observational studies found an association between IP and emergency department visits and readmissions at specific time points. Three of the observational studies were amenable to meta-analysis which showed no significant association between IP and hospital readmissions (OR 1.08, 95% CI 0.90–1.31). Meta-analysis of the subgroup assessing Beers criteria medicines demonstrated that there was a 27% increase in the risk of hospital readmissions (OR 1.27, 95% CI 1.03–1.57) with this type of IP. In meta-analysis of the two interventional studies, there was a 37% reduced risk of mortality (OR 0.63, 95% CI 0.40-1.00) with interventions that reduced IP compared to usual care but no difference in hospital readmissions (OR 0.83, 95% CI 0.19–3.67). Conclusions: Interventions to reduce IP were associated with reduced risk of mortality, but not readmissions, compared to usual care in older adults with frailty. The use of Beers criteria medicines was associated with hospital readmissions in this group. However, there was limited evidence of an association between IP more broadly and mortality or hospital readmissions. Further high-quality studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: Research suggests a bidirectional relationship between food insecurity and stress, but few studies have examined associations of food insecurity with stress and other indicators of cardiometabolic health, including depression, diet quality, and body weight, among lower-income women in the U.S. Methods: This cross-sectional study analyzed data from lower-income women caregivers living in North Carolina (n = 100): 42% Black/African American, 25% Hispanic/Latina, and 33% White women. Multivariable linear regression models were used to determine associations of food insecurity status with perceived stress, depressive symptoms, diet quality, and body mass index (BMI). Multivariable logistic regression models were used to determine associations of food insecurity with clinical depression and BMI ≥ 30 kg/m2. Associations were examined with and without adjustment for perceived stress. Results: Forty-two percent of the sample were experiencing food insecurity. Compared to food secure caregivers, food-insecure caregivers had significantly higher perceived stress (β: +7.51; 95%CI: 4.19, 10.84) and depressive symptoms (β: +3.55; 95%CI: 0.54, 6.56) and lower diet quality (β: −9.10; 95%CI: −15.81, −2.40). Associations with BMI outcomes were not statistically significant. Conclusion: Findings support removing stigma in nutrition assistance programs and clinical interactions, motivate future longitudinal studies, and inform the development of destigmatizing interventions for health promotion or disease prevention. [ABSTRACT FROM AUTHOR]

This article explores the lay meaning(s) and understanding of depression among middle-aged and elderly patients in Uganda and its impact on treatment seeking. Through an interpretive phenomenological approach, data was collected using in-depth interviews with purposively selected participants and analyzed using thematic content analysis. The findings revealed that depression with disruptive behaviors is regarded as "clan illness," "witchcraft" or "madness" while depression with non – disruptive symptoms is perceived to be a "disease of thoughts" normative to life circumstances and aging. Conclusively, the cultural understanding of depression may imply that the western medical approach would be less recommended compared to traditional healing. [ABSTRACT FROM AUTHOR]

Objective: To systematically review the intervention effect of dance therapy on the physical and psychological health level of middle-aged and older adult with arterial hypertension. Methods: The databases including the Cochrane Library, PubMed, Web of Science, EBSCO, CNKI, VIP, WANFANG DATA, and Bailianyun Library, which were searched for the randomized controlled trials for identifying the effect of dance intervention on the blood pressure. The literature published from the establishment of the database to May 10, 2023, was collected for analysis. The quality of the literature was evaluated by the Cochrane bias risk assessment tool. Results: The blood pressure in the dance intervention group were significantly improved than those of patients in the control group. However, among the mediating variables that influence the effects of dance intervention, its intensity and frequency based on the improvement of aerobic capacity were found high and low respectively, while the research on dance intervention aimed at muscle strength, endurance, and flexibility remains lacking. The movement selection and arrangement of dance therapy could integrate the physical activities with local traditional cultural characteristics. Conclusions: It is worth noting that in the selection and arrangement of movements, dance therapy can skillfully integrate physical activities with local cultural characteristics. This unique combination not only enriches the content of dance therapy but also deepens people's understanding and recognition of traditional culture. Through this comprehensive dance intervention approach, we hope to comprehensively improve participants' physical and mental health, and promote the inheritance and development of culture.

Background This study evaluated the usefulness of indices for metabolic syndrome, non-alcoholic fatty liver disease (NAFLD), and insulin resistance (IR), as predictive tools for cardiovascular disease in middle-aged Korean adults. Methods The prospective data obtained from the Ansan-Ansung cohort database, excluding patients with major adverse cardiac and cerebrovascular events (MACCE). The primary outcome was the incidence of MACCE during the follow-up period. Results A total of 9,337 patients were included in the analysis, of whom 1,130 (12.1%) experienced MACCE during a median follow-up period of 15.5 years. The metabolic syndrome severity Z-score, metabolic syndrome severity score, hepatic steatosis index, and NAFLD liver fat score were found to significantly predict MACCE at values above the cut-off point and in the second and third tertiles. Among these indices, the hazard ratios of the metabolic syndrome severity score and metabolic syndrome severity Z-score were the highest after adjusting for confounding factors. The area under the receiver operating characteristic curve (AUC) of the 10-year atherosclerotic cardiovascular disease (ASCVD) score for predicting MACCE was 0.716, and the metabolic syndrome severity Z-score had an AUC of 0.619. Conclusion The metabolic syndrome severity score is a highly reliable indicator and was closely associated with the 10-year ASCVD risk score in predicting MACCE in the general population. Given the specific characteristics and limitations of metabolic syndrome severity scores as well as the indices of NAFLD and IR, a more practical scoring system that considers these factors is essential to achieve greater accuracy in forecasting cardiovascular outcomes.

Background: This study compared the outcomes of surgical aortic valve replacement (AVR) in patients aged 50 to 70 years based on the type of prosthetic valve used. Methods: We compared patients who underwent mechanical AVR to those who underwent bioprosthetic AVR at our institution between January 2000 and March 2019. Competing risk analysis and the inverse probability of treatment weighting (IPTW) method based on propensity score were employed for comparisons. Results: A total of 1,580 patients (984 patients with mechanical AVR; 596 patients with bioprosthetic AVR) were enrolled. There was no significant difference in early mortality between the mechanical AVR and bioprosthetic AVR groups (0.9% vs. 1.7%, p=0.177). After IPTW adjustment, the risk of all-cause mortality was significantly higher in the bioprosthetic AVR group than in the mechanical AVR group (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.07–1.80; p=0.014). Competing risk analysis revealed lower risks of stroke (sub-distributional hazard ratio [sHR], 0.44; 95% CI, 0.28–0.67; p

Background Research on the utilization of outpatient and inpatient health services and its influencing factors has been well established, but there are few studies on the utilization of preventive medical services such as health checkup by residents in China. Objective To investigate the utilization of health checkup in Chinese residents aged 45 years and above and analyze its influencing factors. Methods Using data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), the population aged≥45 years was selected to calculate the rate of participation in health checkup and the number of health checkup items from 2015 to 2018. Zero-inflation negative binomial regression was used to analyze the influencing factors of the number of health checkup items attended by residents. Results A total of 17 203 samples were included in this study, with an average age of (62.4±10.0), and the participation rate of 47.73% (8 21/17 203). The top three in participation rate in health checkup were Xinjiang Uygur Autonomous Region (96.47%), Shanghai (83.67%) and Beijing (82.05%), while the bottom three were Liaoning Province (35.41%), Qinghai Province (36.55%) and Fujian Province (36.94%). Among the 8 211 people who had participated in health checkup, the average age was (64.1±9.9) years old, and the median number of health checkup items per capita was 9 (5, 12). The top three in the number of health checkup items were Beijing Municipality (14 items), Shanghai Municipality (14 items) city and Xinjiang Uygur Autonomous Region (13 items), and the bottom three were Gansu Province (7 items), Anhui Province (7 items) and Liaoning Province (7.5 items). Non-parametric test showed that the number of health checkup items in urban residents was significantly higher than that in rural areas (10 items vs. 8 items), the eastern region was significantly higher than the central (10 items vs. 8 items), western (10 items vs. 8 items) and northeast (10 items vs. 8 items) region, the western region was significantly higher than the central region (9 items vs. 8 items) (P

Background Recent studies have found that middle-aged individuals account for over 40% of patients with chronic disease comorbidities, and this percentage is still increasing. This comorbidity not only reduces the quality of life for these patients but can also lead to premature death. However, research on the distribution and influencing factors of chronic comorbidities in middle-aged adults is still limited. Objective To provide a scientific basis for managing such patients by retrospectively analyzing the disease distribution and influencing factors of chronic comorbidities among middle-aged inpatients. Methods From July 1, 2017 to February 28, 2023, a total of 5 931 inpatients were admitted to the Department of General Medicine, the Second Hospital of Lanzhou University. Among them, 1 650 middle-aged patients (aged 45 to 59 years) were included as subjects for this study. General information of the subjects was collected, and the comorbidity conditions of chronic diseases were statistically analyzed. Multifactorial Logistic regression analysis was employed to investigate the influencing factors associated with different chronic disease comorbidities. Results Among the 1 650 middle-aged patients attending the department of general practice, 79 (4.8%), 359 (21.8%), and 1 212 (73.4%) patients suffered from 0, 1, and ≥2 chronic diseases, respectively. Comparison of gender, age, ethnicity, occupation, and route of admission of patients with 0, 1, and ≥2 chronic diseases showed statistically significant differences (P

Aims: Prolonged loneliness and severe stress are increasingly recognised as public health concerns and considered risk factors for mental disorders, somatic illnesses and mortality. Loneliness and perceived stress also often co-occur; however, their longitudinal relation remains unclear. To the best of our knowledge, this is the first study aiming to investigate the longitudinal relation between loneliness and perceived stress independently of cross-sectional associations and time effects. Methods: Designed as a population-based cohort study with repeated measurements, the present study included individuals aged 16–80 years at baseline who participated in the Danish National Health Survey ('How are you?') in 2013 and 2017 (N = 10,159; response rate = 50%). Structural equation modelling was used to examine associations between loneliness and perceived stress in the total sample and across age groups (i.e., 16–29, 30–64 and 65–80 years). Results: The models indicated bidirectional relations between loneliness and perceived stress. The standardized cross-lagged path from loneliness to perceived stress (β: 0.12, 95% confidence interval (CI) (0.08, 0.16), p < 0.001) and from perceived stress to loneliness (β: 0.12, 95% CI (0.07, 0.16), p < 0.001) both corresponded to small effect sizes in the total sample. Additionally, the results indicated strong cross-sectional associations, especially among adolescents and young adults (16–29 years), and high temporal stability, especially among the elderly (65–80 years). Conclusions: Loneliness and perceived stress mutually predict each other over time. The finding of both substantial bidirectional and cross-sectional associations demonstrates an interdependence between loneliness and perceived stress that may be relevant to consider in future interventions. [ABSTRACT FROM AUTHOR]

Context Psychological distress has been linked to diabetes risk. Few population-based, epidemiologic studies have investigated the potential molecular mechanisms (eg, metabolic dysregulation) underlying this association. Objective To evaluate the association between a metabolomic signature for psychological distress and diabetes risk. Methods We conducted a nested case-control study of plasma metabolomics and diabetes risk in the Nurses' Health Study, including 728 women (mean age: 55.2 years) with incident diabetes and 728 matched controls. Blood samples were collected between 1989 and 1990 and incident diabetes was diagnosed between 1992 and 2008. Based on our prior work, we calculated a weighted plasma metabolite-based distress score (MDS) comprised of 19 metabolites. We used conditional logistic regression accounting for matching factors and other diabetes risk factors to estimate odds ratios (OR) and 95% confidence intervals (CI) for diabetes risk according to MDS. Results After adjusting for sociodemographic factors, family history of diabetes, and health behaviors, the OR (95% CI) for diabetes risk across quintiles of the MDS was 1.00 (reference) for Q1, 1.16 (0.77, 1.73) for Q2, 1.30 (0.88, 1.91) for Q3, 1.99 (1.36, 2.92) for Q4, and 2.47 (1.66, 3.67) for Q5. Each SD increase in MDS was associated with 36% higher diabetes risk (95% CI: 1.21, 1.54; P -trend <.0001). This association was moderately attenuated after additional adjustment for body mass index (comparable OR: 1.17; 95% CI: 1.02, 1.35; P -trend =.02). The MDS explained 17.6% of the association between self-reported psychological distress (defined as presence of depression or anxiety symptoms) and diabetes risk (P =.04). Conclusion MDS was significantly associated with diabetes risk in women. These results suggest that differences in multiple lipid and amino acid metabolites may underlie the observed association between psychological distress and diabetes risk. [ABSTRACT FROM AUTHOR]

Objectives: We explored associations between mammographic features and risk of breast cancer death among women with small (<15 mm) and large (≥15 mm) invasive screen-detected breast cancer. Methods: We included data from 17,614 women diagnosed with invasive breast cancer as a result of participation in BreastScreen Norway, 1996–2020. Data on mammographic features (mass, spiculated mass, architectural distortion, asymmetric density, density with calcification and calcification alone), tumour diameter and cause of death was obtained from the Cancer Registry of Norway. Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI) for breast cancer death by mammographic features using spiculated mass as reference, adjusting for age, tumour diameter and lymph node status. All analyses were dichotomised by tumour diameter (small versus large). Results: Mean age at diagnosis was 60.8 (standard deviation, SD=5.8) for 10,160 women with small tumours and 60.0 (SD=5.8) years for 7454 women with large tumours. The number of breast cancer deaths was 299 and 634, respectively. Mean time from diagnosis to death was 8.7 (SD=5.0) years for women with small tumours and 7.2 (4.6) years for women with large tumours. Using spiculated mass as reference, adjusted HR for breast cancer death among women with small tumours was 2.48 (95% CI 1.67–3.68) for calcification alone, while HR for women with large tumours was 1.30 (95% CI 1.02–1.66) for density with calcification. Conclusions: Small screen-detected invasive cancers presenting as calcification and large screen-detected cancers presenting as density with calcification were associated with the highest risk of breast cancer death. Clinical relevance statement: Small tumours (<15 mm) presented as calcification alone and large tumours (≥ 15 mm) presented as density with calcification were associated with the highest risk of breast cancer death among women with screen-detected invasive breast cancer diagnosed 1996–2020. Key Points: • Women diagnosed with invasive screen-detected breast cancer 1996–2020 were analysed. • Small screen-detected cancers presenting as calcification alone resulted in the highest risk of breast cancer death. • Large screen-detected cancers presenting as density with calcification resulted in the highest risk of breast cancer death. [ABSTRACT FROM AUTHOR]

BACKGROUND: Several studies focus on the use of emerging technologies to support and monitor health but are centred around the elderly group of people. Meanwhile, the average elderly popularly known as the middle-aged have not been put into consideration regarding the subject matter. OBJECTIVE: This article focuses on the use behaviour and acceptance of emerging technologies that can assist in providing a middle-aged population with a healthy lifestyle. METHODS: This study collected the primary data through an online questionnaire survey to empirically evaluate final 169 respondents. The analysis for this study was done utilising SmartPLS software via partial least squares structural equation modelling. RESULTS: The results indicate that 9 out of 11 were tested as supported hypotheses. All supported hypotheses showed the strong relationship between acceptance and user behaviour with emerging technology. CONCLUSION: The experience of acceptance and behaviour of using emerging technology in a healthy lifestyle was found as an important determinant of outcome in preparing the middle-aged for their elderly age by adapting emerging technology as early as possible. [ABSTRACT FROM AUTHOR]

Objective To investigate the liver and renal function, blood lipids, and blood glucose at 3 months after blood donation in long-term blood donors aged 45-65 years, as well as the possibility of continuing to donate blood after exceeding the age for blood donation. Methods The long-term blood donors who donated blood at our station from September to December 2016 were selected, and according to the age, they were divided into group A (45-49 years of age), group B (50-54 years of age), group C (55-59 years of age), and group D (60-65 years of age). Liver and renal function, blood glucose, and blood lipid levels were measured at 3 months after the most recent blood donation and were compared between groups. Results There was a significant difference in the serum level of low-density lipoprotein cholesterol (LDL-C) at 3 months after blood donation between groups A/B/C and group D (t=2.45-4.61,P0.05). Conclusion The long-term blood donors, aged 45-59 years, tend to have stable liver and renal function, blood lipids, and blood glucose at 3 months after blood donation, and long-term blood donation does not affect the above indicators. The blood donors aged 60-65 years have a higher level of LDL-C after blood donation, with other indicators remaining stable, and therefore, they may be considered as potential blood donors.

Background Lifestyle is an important modifiable risk factor for dementia. Knowledge and beliefs are important factors affecting lifestyle. However, there is a lack of research on the types of knowledge, beliefs, behaviors of reducing dementia risk, and it remains unclear whether there are differences in dementia risk and cognitive function among residents with different types of knowledge, belief, and behavior. Objective To understand the current situation of knowledge, beliefs, behaviors of reducing dementia risk in the middle-aged and elderly adults in the community, explore and analyze the types of knowledge, beliefs and behaviors and the differences of cognitive function, and provide a basis for the development of targeted dementia prevention measures in the community. Methods From March 2021 to February 2022, middle-aged and elderly adults who participated in free health checkups at community health centers and established health management files in five communities in Shapingba District of Chongqing were selected as the survey objects by convenience sampling method. The general information questionnaire, Dementia Knowledge Assessment Scale (DKAS), Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction (MCLHB-DRR), Dementia Risk Reduction Lifestyle Scale (DRRLS), Beijing version of Montreal Cognitive Assessment (MoCA) and Cardiovascular Risk Factors, Aging and Dementia (CAIDE) scores were used for the investigation. K-means cluster analysis was used to classify the knowledge, beliefs, behaviors of reducing dementia risk of residents, and the differences in demographic characteristics, cognitive function and dementia risk among different types were compared and analyzed. Results A total of 232 questionnaires distributed and 211 valid questionnaires were recovered, with an effective recovery rate of 90.9%. The cluster analysis results showed that the knowledge, beliefs and behaviors of reducing dementia risk of the middle-aged and elderly adults in the community could be divided into three types of good knowledge, beliefs and behaviors type, low knowledge-poor behaviors type, low beliefs-poor behaviors type, which accounted for 39.8% (84/211), 37.4% (79/211), and 22.8% (48/211), respectively. The average years of education of middle-aged and elderly residents in good knowledge, beliefs and behaviors type were significantly higher than those in low knowledge-poor behaviors type (t=2.703, P

Background The 72nd World Health Assembly reviewed and adopted the International Classification of Diseases Eleventh Revision (ICD-11) , which for the first time included traditional medicine originating from traditional Chinese medicine (TCM) in its chapter coding, of which the code for wasting thirst disorder is SD71 (TM1) . At present, wasting thirst disorder is a high clinical prevalence disease, with middle-aged and older adults being the high incidence population, and TCM constitutions bias are risk factors for wasting thirst disorder. There was no research on the burden of TCM diseases and risk factors. Objective Based on the ICD-11 chapter on traditional medicine and the national standards of TCM, the burden of wasting thirst disorder among middle-aged and elderly in Guangzhou was calculated and attributed to the TCM constitutions. The role of TCM constitutions monitoring in health management was evaluated, providing reference for the prevention and treatment of wasting thirst disorder by TCM and the application of constitutions theory. Methods A cross-sectional survey was conducted in 2020 to investigate the prevalence of wasting thirst disorder and the distribution of TCM constitutions among middle-aged and elderly in Guangzhou. The comprehensive theory of Global Burden of Disease (GBD) , calculate the years of life lost (YLL) , years lived with disability (YLD) , and disability adjusted life year (DALY) of wasting thirst disorder in the middle-aged and elderly population in Guangzhou were used to evaluate the disease burden of wasting thirst disorder. Relative risk (RR) was used to assess the risk of different TCM constitutions for wasting thirst disorder in middle-aged and elderly people. Results A total of 1 576 middle aged and older adults in central Guangzhou were surveyed, 55 were lost, 1 521 valid questionnaires were recovered, and the effective response rate was 96.51%. Among them, 782 were male, aged 62 (56, 69) years; 739 were female, aged 62 (55, 70) years. The prevalence of wasting thirst disorder among middle-aged and elderly people in Guangzhou was 13.08%, with a standardized prevalence of 12.64%. The most distributed constitution among middle-aged and elderly people in Guangzhou were phlegm-dampness constitution, qi-deficiency constitution, and damp-heat constitution; among them, the most distributed constitutions in patients with wasting thirst disorder were phlegm-dampness constitution, yin-deficiency constitution, and qi-deficiency constitution. The DALY rate of wasting thirst disorder burden was 86.46‰, with a YLL rate of 4.86‰ and a YLD rate of 81.60‰. The proportion of single constitution and composite constitution was 48.98% and 51.02%, respectively. Yin-deficiency constitution was the risk constitution of wasting thirst disorder (RR=1.73, P

Abstract Background Continued proliferation of accelerometers in physical activity research has opened new avenues for understanding activity behaviours beyond simple aggregate measures of frequency and duration. This study explores the standing and stepping composition, and the temporal distribution, of upright events, and investigates their associations with sociodemographic and health factors. Methods Participants from the 1970 British Cohort Study wore activPAL3 accelerometers for seven days. Event-based analysis was used to extract a time series of upright, standing, and stepping events. Derived metrics included daily number of upright and stepping events, total upright and stepping time, the burstiness of upright events and burstiness of sedentary events (burstiness refers to the pattern of how physical activity and sedentary behaviour are distributed throughout a given time period), within-event stepping proportion, within-event step count, and stepping cadence. Generalized linear regression models, adjusted for total step count, were employed to explore associations between derived metrics and sociodemographic and health-related factors. Results A total of 4527 participants, provided 30992 valid days (≥ 10 h of waking wear) and 1.64 million upright events. Upright event composition and temporal distribution varied across a range of sociodemographic and health-related factors. Females had more upright events than males (4.39 [3.41,5.38] n), spent more time upright, and exhibited burstier patterns of upright events (0.05 [0.04,0.05] B n). Individuals with higher BMI had fewer upright events and a lower daily step count, but their temporal distribution of upright events was less bursty (overweight -0.02 [-0.02,-0.01] B n; obese -0.03 [-0.04,-0.02] B n), and upright events had a higher step count. People in active occupations were upright for longer, displayed burstier patterns of upright events (standing 0.04 [0.03,0.05] B n; physical work 0.05 [0.04,0.05] B n; heavy manual 0.06 [0.04,0.07] B n), with more variable durations and shorter, slower paced stepping events compared with sedentary occupations. Conclusions This study has revealed novel phenotypes of standing and sitting that go beyond simple aggregate measures of total steps, step event duration or time between events. People with the same volume of stepping and frequency of gaps between upright events can accumulate their steps in very different ways. These differences and associations with population sub-groups, which persisted after adjustment for total stepping volume, may have important relations with functional and health outcomes. The findings lay the groundwork for future studies to investigate how different sitting and standing phenotypes can add to our understanding of the relationship between physical activity and health.

Abstract Background Primary healthcare centers (PHCs) serve as the cornerstone of accessible medical services in society, playing a crucial role in screening, detecting, and treating various health issues. This study aimed to investigate the prevalence of psychiatric disorders in middle-aged individuals who refer to PHCs and the potential of PHCs in diagnosing mental disorders. Methods This cross-sectional study was implemented at PHCs under the supervision of Mashhad University of Medical Sciences (MUMS) in northeast Iran in 2018. The enrolled subjects were middle-aged adults who had electronic medical records in SINA, an integrated health management system, and the electronic medical records of MUMS. The prevalence of psychiatric disorders by type and their relationship with demographic information was evaluated by a Chi-square test using SPSS 22. Results This study involved 218,341 middle-aged participants. Prevalence of psychiatric disorders was 8.59%, and depression (53.72%) and anxiety (42.02%) were the most common psychiatric disorders in both males and females. The prevalence of mental disorders was significantly higher in females than in males (88.18% vs. 18.81%; P

Background The effects of childhood experiences on the health of middle-aged and older adults has become a research hotspot. However, the effects and pathways of childhood experiences on cognitive function in middle-aged and older adults still remain unclear. Objective To analyze the effect of childhood socioeconomic status on cognitive function in middle-aged and older adults from a whole life cycle perspective, and explore promotion strategies for cognitive function in middle-aged and older adults. Methods The China Family Panel Studies (CFPS) for 2010, 2012, and 2020 was used to construct a multiple mediated-effects model to investigate the mediating pathways of the effect of childhood socioeconomic status on cognitive function in middle-aged and older adults. Pearson correlation analysis was used to analyze the relationship between various indicators. Results A total of 1 034 middle-aged and older adults with an average age of (62.33±9.89) years were included in this study. The childhood socioeconomic status score was (0.000±0.797), education level score was (1.970±1.111), social participation score was (1.150±0.967), depression status score was (5.960±4.681), and cognitive score was (0.000±1.000). Childhood socioeconomic status was positively correlated with education level, social participation, and cognitive function in middle-aged and older adults (P

Background: Osteosarcoma is the most common primary malignant bone neoplasm in young people. Presentation in non-bone tissues comprises 2 to 5% of all osteosarcomas and less than 1% of all soft tissue sarcomas. On rare occasions it presents as a superficial tumor, making it necessary to make a differential diagnosis with benign entities, such as pyogenic granuloma ossificans, and malignant neoplasms, with sarcomatoid differentiation such as carcinosarcoma and dedifferentiated melanoma. Accurate diagnosis requires correlation of the histological, macroscopic and imaging characteristics of the neoplasm, which is of great relevance since the biological behavior and treatment differ from that of bone osteosarcoma and dedifferentiated neoplasms. Clinical case: We present the case of a 52-year-old man with superficial extraskeletal osteosarcoma, with radiological and pathological characteristics characteristic of this neoplasm. Conclusions: Superficial extraskeletal osteosarcoma is extremely rare, representing less than 10% of extraskeletal osteosarcomas, histological evaluation and imaging studies are mandatory for diagnosis, and clinical history is useful both to rule out differential diagnoses and to contribute to the diagnosis. definitive. Superficial extraskeletal osteosarcoma was diagnosed in this patient based on histological criteria. However, the few findings reported prevent us from knowing the prognostic factors. [ABSTRACT FROM AUTHOR]

Background: Currently, it is essential to adopt physical therapy strategies, such as resistance training, to enhance muscle strength and gait in middle-aged individuals (ages 45–65) suffering from Multiple Sclerosis. This is crucial in combating the typical symptoms of neurodegenerative diseases associated with functional loss. The objective of this study is to determine the effects of resistance training interventions on walking and muscle strength in middle-aged people with Multiple Sclerosis. Methods: A systematic review with meta-analysis was conducted by searching specific keywords in the PubMed, Scopus, Cochrane, and Web of Science databases. For inclusion, studies had to incorporate resistance training as a primary or significant component of the overall intervention for middle-aged patients with MS. Out of the 3675 articles identified, 12 randomized clinical trials met the criteria for inclusion in the review, with resistance training being a consistent feature in all of them. Results: Muscle strength and gait were evaluated as the main variables, with fatigue and the quality of life as secondary variables. This review reveals that resistance training significantly improves muscle strength. Resistance training achieves modest and non-significant improvements in gait. Notably, studies combining resistance training with motor control exercises achieve results of greater clinical significance in terms of gait. However, resistance training yields variable positive effects on perceived fatigue and the quality of life. Conclusion: Resistance training is useful for improving muscle strength; however, walking needs to be combined with motor control training. [ABSTRACT FROM AUTHOR]

Background and Aims: Coronary artery disease (CAD) is the most common cardiovascular disease worldwide. Nutrition and physical activity are recognized as the major lifestyle‐related behaviors to reduce the risk of noncommunicable diseases. It is essential to explain personal cognitive factors to identify potential ways to increase physical activity and improve nutritional behavior. Therefore, the present study aimed to explain the personal cognitive factors affecting physical activity and nutritional behavior in the middle‐aged population at risk of a CAD. Methods: The present qualitative study was conducted with a directed content analysis approach. A purposive sampling was used with maximum variety of sex, age, education, marital status, job, and risk factors of CAD. The data were collected through semistructured interviews with 20 middle‐aged participants at the risk of CAD visiting comprehensive health centers in Bandar Abbas city. The interviews continued until data saturation. Results: The present findings led to the identification of 4 main categories (i.e., self‐efficacy, collective efficacy, outcome expectations, knowledge) and 10 subcategories. Conclusion: It seems that to increase the self‐efficacy, attention should be paid to individuals' past experiences, self‐efficacy of action and maintenance and successful middle‐aged peers. Measures should be taken to improve and strengthen it. Peer support, networking, forming online groups (in social networks), and a comprehensive use of social media can help increase collective efficacy. Expectations of positive and negative outcomes and the public knowledge can also be modified through accurate and appropriate information provided in different campaigns for awareness‐raising. [ABSTRACT FROM AUTHOR]

Objectives: For older employees, a mismatch between work and nonwork roles can lead to work–family conflict (WFC) and stress. This paper examines whether the availability of social support from outside the workplace can assist these employees in coping with the stress‐related consequences of WFC. Methods: This study used data from Waves 16 (Time 1) and 17 (Time 2) of the Household, Income and Labour Dynamics in Australia (HILDA) survey (N = 2867). Sociodemographic characteristics were measured using age, sex and employment tenure. A moderated regression model was applied to the older employees in this sample using stress, WFC with external social support as the moderator. Analysis was additionally undertaken for the different aged employee cohorts, younger than 30 years and middle‐aged (30–50). Results: We found that external social support dampened the effect of WFC on employee stress for older employees. This effect was more powerful for older employees than for younger employees. Interestingly, older employees reported the same levels of external social support as employees between 30 and 50, but less than that of employees younger than 30 years. Conclusions: Following our hypothesised relationships based on conservation of resources (COR), selection, optimisation with compensation (SOC) and socio‐emotional selectivity theories (SST), this paper demonstrates that older employees benefit significantly from external social support. As external social support increased among older employees, the negative effect of WFC on stress decreased. However, this effect was only significant for employees up to the 68th percentile. Overall, this effect was less powerful for both groups of younger employees. Consistent with SOC and SST, older employees possessed different social motives (less reported external social support). Employer and government strategies assisting employees to develop social networks outside the workplace may provide significant benefits to organisations in addition to employees. [ABSTRACT FROM AUTHOR]

BACKGROUND: In the Netherlands, the fact that midlife women constitute a considerable segment of the working population is relatively new. Generally paid work contributes to midlife women's wellbeing, but they also report health challenges, such as work-related fatigue and the menopause. OBJECTIVE: The objective of this study is to understand how midlife women themselves perceive their health, wellbeing, and functioning in relation to paid work. METHODS: In this exploratory qualitative study, 28 women participated in five ethnically homogeneous focus group discussions (FGDs). De FGDs were recorded, transcribed verbatim, and thematically analyzed using MAXQDA. RESULTS: We identified exhaustion as central to our analysis. During midlife, exhaustion seems to occur once a certain limit has been reached, both physically and mentally, with women feeling to have reached the end of their rope. Besides obvious physiological challenges, we identified two major themes in which we discuss challenges both in paid work and private life: (1) work environment and working conditions, and (2) burdens in private life. Participants took various measures to manage and try to reduce exhaustion, including finding a new job or negotiating different job tasks, and reducing work hours. CONCLUSION: This study indicates that the extent to which women experience exhaustion is associated with challenges in both paid work and private life. The underlying processes do not seem to reflect individual problems, but reflect a complex set of factors at the structural level. Nevertheless, women take several individual measures to reduce their exhaustion, including reducing their participation in paid work. [ABSTRACT FROM AUTHOR]

The UK Biobank is a cohort study that collects data on diet, lifestyle, biomarkers, and health to examine diet–disease associations. Based on the UK Biobank, we reviewed 36 studies on diet and three health conditions: type 2 diabetes (T2DM), cardiovascular disease (CVD), and cancer. Most studies used one-time dietary data instead of repeated 24 h recalls, which may lead to measurement errors and bias in estimating diet–disease associations. We also found that most studies focused on single food groups or macronutrients, while few studies adopted a dietary pattern approach. Several studies consistently showed that eating more red and processed meat led to a higher risk of lung and colorectal cancer. The results suggest that high adherence to "healthy" dietary patterns (consuming various food types, with at least three servings/day of whole grain, fruits, and vegetables, and meat and processed meat less than twice a week) slightly lowers the risk of T2DM, CVD, and colorectal cancer. Future research should use multi-omics data and machine learning models to account for the complexity and interactions of dietary components and their effects on disease risk. [ABSTRACT FROM AUTHOR]

Aim: Investigating what is underlying late‐life depression is becoming increasingly important with the rapidly growing elderly population. Yet, the associations between plasma biomarkers of neuroaxonal damage and late‐life depression remain largely unclear. Therefore, we determined cross‐sectional and longitudinal associations of neurofilament light chain (NfL) with depression in middle‐aged and elderly individuals, and total tau, β‐amyloid 40 and 42 for comparison. Methods: We included 3,895 participants (71.78 years [SD = 7.37], 53.4% women) from the population‐based Rotterdam Study. Between 2002 and 2005, NfL, total tau, β‐amyloid 40 and β‐amyloid 42 were determined in blood and depressive symptoms were measured with the Center for Epidemiologic Studies Depression scale (CES‐D). Incident depressive events (clinically relevant depressive symptoms, depressive syndromes, major depressive disorders) were measured prospectively with the Center for Epidemiologic Studies Depression, a clinical interview and follow‐up of medical records over a median follow‐up of 7.0 years (interquartile range 1.80). We used linear and Cox proportional hazard regression models. Results: Each log2 pg./mL increase in NfL was cross‐sectionally associated with more depressive symptoms (adjusted mean difference: 0.32, 95% CI 0.05–0.58), as well as with an increased risk of any incident depressive event over time (hazard ratio: 1.22, 95% CI 1.01–1.47). Further, more amyloid‐β 40 was cross‐sectionally associated with more depressive symptoms (adjusted mean difference: 0.70, 95% CI 0.15–1.25). Conclusion: Higher levels of NfL are cross‐sectionally associated with more depressive symptoms and a higher risk of incident depressive events longitudinally. The association was stronger for NfL compared to other plasma biomarkers, suggesting a potential role of neuroaxonal damage in developing late‐life depression. [ABSTRACT FROM AUTHOR]

Background: The prevalence of short sleep duration is rising and is linked to chronic comorbidities, such as metabolic syndrome (MetS). Sleep extension interventions in adults with MetS comorbidities and short sleep duration are limited and vary widely in terms of approach and duration. Objectives: This pilot study aimed to test the feasibility and acceptability of a personalized 12-week systematic sleep time extension intervention on post-intervention sleep outcomes in middle-aged adults at risk forMetSwith actigraphy-estimated short sleep duration. Methods: A single-arm, 12-week, 12-session systematic sleep time extension intervention was delivered weekly via videoconferencing. Feasibility and acceptability were assessed using retention rates and mean sleep diary completions. Sleep was estimated for 14 consecutive days prior to and immediately following the 12-week intervention using wrist actigraphy. Daytime sleepiness was assessed using the Epworth Sleepiness Scale. Paired sample t-tests modeled changes in study outcomes. Results: Study participants (N = 41) had a mean age of 52 years and were mostly female and White; 86% attended >80% of sessions, and mean sleep diary completion was 6.7 diaries/week. Significant improvements in sleep from pre- to post-intervention included increased total sleep time, earlier sleep onsets, more regular sleep onsets, a higher sleep regularity index, and reduced daytime sleepiness. Extending sleep, as well as improving sleep timing and regularity in middle-aged adults with actigraphy-estimated short sleep duration and at risk for MetS, is feasible and acceptable. Discussion: Behavioral sleep characteristics may be modifiable and present a novel behavioral paradigm for mitigating MetS risk. This pilot study provides a proof of concept for the feasibility, acceptability, and preliminary effectiveness of a systematic sleep time extension for middle-aged adults at risk for MetS with actigraphy-estimated short sleep duration. [ABSTRACT FROM AUTHOR]

Background and Aims: Data on mild cognitive impairment (MCI) in low‐ to middle‐income countries are still being determined, despite the fact that most future older adults are expected to reside in these regions. This study aimed to investigate the prevalence and associated factors of MCI in Iran. Methods: A cross‐sectional study was conducted on 4938 community‐dwelling subjects aged 50 years or above in the first wave of the Ardakan Cohort Study on Aging. MCI was evaluated using the Mini‐Mental State Examination (MMSE) and the Abbreviated Mental Test Score (AMTS) in literate and illiterate individuals. The relationship between factors associated with the odds of MCI was assessed through logistic regression. Results: The prevalence of MCI among all participants, the literates and illiterates, was 15.8%, 6.3%, and 36.4%, respectively. It was found that failure to accomplish any of the MMSE or AMTS items was significantly related to MCI (p < 0.001). Age ([odds ratio (OR): 1.05; p < 0.001 in the literates], [OR: 1.06; p < 0.001 in the illiterates]), sex (OR: 0.13; p < 0.001 in the illiterates), history of stroke ([OR: 2.86; p = 0.006 in the literates], [OR: 2.04; p = 0.045 in the illiterates]), and depression ([OR: 1.87; p < 0.001 in the literates], [OR: 1.41; p = 0.008 in the illiterates]) were significantly associated with MCI. Conclusion: This study highlights the significant associations between age, education, depression, stroke, and MCI in Iranian participants. These findings emphasize the need for targeted interventions in low‐literacy populations, mental health screening, and stroke prevention strategies to mitigate the burden of MCI and enhance cognitive health. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the relationship between health checkups, cervical cancer screenings, and breast cancer screenings (collectively referred to as wellness examinations) of wives and health checkups of their husbands. We aimed to develop strategies to encourage wellness examinations among married individuals in Japan. Methods: This study used the 2019 Comprehensive Survey of Living Conditions, focusing on married couples aged 40–64. We analyzed the percentage of wives undergoing wellness examinations, grouped based on whether their husbands had undergone health checkups. Subsequently, multivariable modified Poisson regression analysis was performed considering sociodemographic and health-related factors. All analyses considered medical insurance of wives because wellness examination methods varied depending on medical insurance type. Results: The sample comprised 40,560 couples undergoing health checkups, 39,870 undergoing cervical cancer screening, and 39,895 undergoing breast cancer screening. Regardless of the medical insurance type of the wife, a significant positive association was observed between the wellness examination of wives and the health checkup of husbands across all age groups. After adjusting for covariates, prevalence ratios (95% confidence intervals) for wives whose husbands underwent health checkups were 2.24 (2.09–2.40) for national health insurance, 1.18 (1.16–1.21) for employee insurance (employee), and 1.53 (1.44–1.63) for employee insurance (family) for health checkups. Similar trends were observed in cervical and breast cancer screening. Conclusions: Wellness examinations of wives were associated with those of their husbands, suggesting that couples often share similar health-seeking behaviors. Hence, targeted interventions are important for couples who do not undergo wellness examinations.

ABSTRACT. Given the importance of dementia syndrome and its impacts on the population, interest in studying modifiable risk factors for dementia is growing. Objective: To compare the prevalence of risk factors for dementia in middle-aged and older adults over a two-year period and to identify what variables in baseline were predictive of cognitive decline in the follow-up. Methods: Longitudinal and quantitative study, with follow-up evaluation after two years, conducted with 200 participants aged 45 years or more, registered in Primary Care Units. In the baseline (2018/2019) and follow-up (2021) assessments, sociodemographic data were collected, and cognitive performance and risk factors for dementia were evaluated (education, hearing loss, head trauma, high blood pressure, alcohol use, obesity, smoking, depressive symptoms, social isolation, physical inactivity, and diabetes mellitus). Data were compared using the McNemar’s test. Individual multinomial logistic regression models were performed to identify the factors associated with cognitive decline after two years. Results: The percentages of low education, traumatic brain injury, and smoking remained the same in both assessments. There was a significant increase in the prevalence of high blood pressure (from 55.0 to 62.0%) and physical inactivity (from 58.5 to 74.5%) and a significant reduction in social isolation (from 25.0 to 18.0%). Participants with depressive symptoms in baseline had a higher risk of cognitive decline in follow-up. Conclusion: There was an increase in the prevalence of high blood pressure and physical inactivity and a reduction in social isolation after two years. Depressive symptoms predict cognitive decline.

Abstract Purpose It is important for middle-aged patients who have undergone acute treatment for coronary artery disease to voluntarily improve their lifestyle and risk factors based on their recognition as patients with chronic diseases. This study conducted individual education to improve risk factors and tried to verify its effectiveness. Methods The hypothesis was verified by applying a randomized controlled pre- and post-test design through random assignment of two groups. Middle-aged (40–64 years) patients who underwent percutaneous coronary intervention for the first time were recruited from a university hospital in Seoul, Korea. For the experimental group, based on the Self-Determination Theory, risk factor- tailored counseling and education were provided individually for one hour based on the education booklet, and telephone counseling was conducted twice for 12 weeks. Differences in autonomous motivation, resilience, self-care compliance and biochemical indicators measured after 12 weeks in the experimental group and the control group were compared. Data were analyzed using SPSS/WIN ver. 22.0. Results The autonomous motivation, resilience, and self-care compliance of the experimental group were significantly higher than those of the control group (p

Background Triglyceride-glucose (TyG) index is an index to evaluate insulin resistance (IR) and obesity-related metabolic diseases, which is closely related to the high risk of cardiovascular disease (CVD). However, TyG index may be different from the high risk of CVD in middle-aged obese people of different genders. Objective To investigate the relationship between TyG index and the high risk of CVD in middle-aged obese people of different genders, and to evaluate its role in the prevention and treatment of CVD. Methods A total of 30 425 middle-aged obese residents were selected from 10 early screening and comprehensive intervention projects of high-risk CVD population in Anhui Province and investigated by investigators who were trained and qualified, using the preliminary screening questionnaire and basic information registration form designed by the National Cardiovascular Center. The main survey contents included gender, age, hypertension, dyslipidemia, diabetes, smoking and alcohol consumption, etc, and perform a CVD high-risk assessment. The included residents were divided into the male group (n=11 566) and female group (n=18 859). The male group was divided into T1 (7.417-8.870) (n=2 892), T2 (8.871-9.204) (n=2 891), T3 (9.205-9.578) (n=2 892) and T4 (9.579-11.435) (n=2 891) subgroups, the female group was divided into F1 (7.579-8.876) (n=4 715), F2 (8.877-9.183) (n=4 720), F3 (9.184-9.526) (n=4 710) and F4 (9.527-11.647) (n=4 714) subgroups according to the quartiles of TyG index. Binary Logistic regression analysis was used to explore the relationship between TyG index and the high risk of CVD, and Z-test was used to compare the differences in effect values among subgroups. Results The high risk rate of CVD was 28.4% (3 280/11 566) in the male group and 26.0% (4 909/18 859) in the female group. Binary Logistic regression analysis showed that TyG index T2 (F2), T3 (F3), T4 (F4) in male group (female group) were correlated with the high risk of CVD (P

Objectives To identify factors associated with general and abdominal obesity in middle-aged and older Korean women based on the biopsychosocial model. Methods Data from 4,076 women aged ≥45 years who participated in the Korea National Health and Nutrition Examination Survey from 2015 to 2020 were analyzed. Complex sampling analysis was performed using IBM SPSS ver. 26.0. Results The combination of general and abdominal obesity was positively associated with age ≥65 years, postmenopausal status, and without breastfeeding experience among biomedical factors; depressive symptoms and prolonged (≥8 hours a day) sedentary behavior among psychosocial factors; and an educational level lower than middle or high school graduation and the first and second income quantiles among biosocial factors. Conclusion Healthcare providers in communities and public societies should screen for risk factors for the combination of general and abdominal obesity while considering non-modifiable biomedical (e.g., age) and biosocial factors (e.g., educational level). In addition, intervention strategies should be developed by considering modifiable psychosocial factors such as sedentary behavior.

Background: Living wills regulate medical decisions in emergency situations. Those who create a living will can have it registered voluntarily in the Central Register of Lasting Powers of Attorney. Little is known about the general prevalence of living wills. Methods: The German Ageing Survey is an ongoing, population-representative study. 4,185 people aged 50 and older were surveyed about living wills in 2020/2021. Results: 44.8 % of people aged 50 and older have a living will, women more often than men (50.1 % vs. 39.2 %), older people more often than middle-aged people. Educational differences do not exist. Conclusions: Living wills increase the autonomy in medical emergency situations because the patient’s wishes are specified in written form. People of all age groups should inform themselves about the significance of living wills and should seek advice about the contents, for example from the general practitioner or one’s own health insurance.

Background and Objectives: Social participation involves playing a role by expressing opinions, making decisions, and accepting responsibilities in society. The use of online health services can promote people’s perception of health. This study aims to determine the relationship of social participation with the ability to use online health services in middle-aged people of Kashan, Iran. Methods: This is a cross-sectional study that was conducted on 280 middle-aged people referred to comprehensive health service centers in Kashan City in 2020-2021. A social participation questionnaire and a researcher-made questionnaire of the ability to use online health services were used for data collection. chi-square and Fisher’s exact test, independent t-test, analysis of variance, and Pearson correlation test were used. Results: Of 280 participants, 154(55%) were female and 243(86.8%) were married. The mean score of social participation was 43.8±57.21 (on a scale from 14 to 70), indicating a moderate level. The mean score of ability to use online health services was 65.73±16.20 (on a scale from 20 to 100). Social participation had a positive significant correlation with the ability to use online health services (r=0.14, P=0.024) and attitude towards technology (r=0.26, P0.05). Conclusion: Social participation of middle-aged people in Kashan City is correlated with their ability to use online health services. This result can help the health system policymakers in designing educational programs for maintaining or improving the health and social participation of middle-aged people in society.

Abstract Background and Aims Coronary artery disease (CAD) is the most common cardiovascular disease worldwide. Nutrition and physical activity are recognized as the major lifestyle‐related behaviors to reduce the risk of noncommunicable diseases. It is essential to explain personal cognitive factors to identify potential ways to increase physical activity and improve nutritional behavior. Therefore, the present study aimed to explain the personal cognitive factors affecting physical activity and nutritional behavior in the middle‐aged population at risk of a CAD. Methods The present qualitative study was conducted with a directed content analysis approach. A purposive sampling was used with maximum variety of sex, age, education, marital status, job, and risk factors of CAD. The data were collected through semistructured interviews with 20 middle‐aged participants at the risk of CAD visiting comprehensive health centers in Bandar Abbas city. The interviews continued until data saturation. Results The present findings led to the identification of 4 main categories (i.e., self‐efficacy, collective efficacy, outcome expectations, knowledge) and 10 subcategories. Conclusion It seems that to increase the self‐efficacy, attention should be paid to individuals' past experiences, self‐efficacy of action and maintenance and successful middle‐aged peers. Measures should be taken to improve and strengthen it. Peer support, networking, forming online groups (in social networks), and a comprehensive use of social media can help increase collective efficacy. Expectations of positive and negative outcomes and the public knowledge can also be modified through accurate and appropriate information provided in different campaigns for awareness‐raising.