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Since battery systems typically account for over 40% of the cost of an electric vehicle, their mid-life replacements are exceptional. Therefore, the battery's lifespan must exceed that of the vehicle. To ensure long-term and safe use, accurate state-of-charge (SOC) estimation must be maintained throughout the battery's lifespan. This requires appropriate updates to parameters, such as capacity, in the battery model. In this context, dual extended Kalman filters, which simultaneously estimate both states and parameters, have gained interest. While existing reports on simultaneous estimators seemed promising, our study found that they performed well under low levels of battery aging but encountered issues at higher levels. Accurately reflecting the actual physicochemical changes of the parameters in aging cells is challenging for two reasons: the limited number of measurements of terminal voltage available for numerous parameters, and the weak observability of the capacity. Therefore, we combined the simultaneous estimator with a capacity estimator operated separately during charging and a sequential estimator specialized for an enhanced self-correcting model, achieving SOC accuracy within 5% even when the SOH decreased by 30%. However, there is still much work to be carried out to implement sequential estimators in battery management systems operating in real time with limited computational resources. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Design Setting Population Methods Main Outcome Measures Results Conclusions To determine the association between unilateral oophorectomy (UO) and age at natural menopause.Secondary analysis of survey data from Alberta's Tomorrow Project (2000–2022).Prospective cohort study in Alberta, Canada.23 630 women; 548 experienced UO and 23 082 did not experience UO.Flexible parametric survival analysis was used to analyse age at natural menopause, and logistic regression was used to analyse early menopause and premature ovarian insufficiency by UO status, controlling for birth year, parity, age at menarche, past infertility, hormonal contraceptive use and smoking.Age at natural menopause occurred by a final menstrual period without medical cause and sub‐classified as early menopause (< 45 years) and premature ovarian insufficiency (< 40 years).Compared to no UO, any UO was associated with elevated risk of earlier age at natural menopause, which was strongest in early midlife (adjusted HR at age 40 1.71, 95% CI 1.31–2.19) and diminished over time. Compared to age 55 years at UO, risks of earlier age at natural menopause were largest and uniform in magnitude when UO occurred between approximately ages 20–40 years (adjusted HR for UO at age 30 2.32, 1.46–3.54) and then diminished as age at UO approached the average age at natural menopause. Any UO was associated with higher odds of early menopause (adjusted OR 1.90, 1.30–2.79) and premature ovarian insufficiency (adjusted OR 3.75, 1.72–8.16).Unilateral oophorectomy is associated with earlier age at natural menopause, particularly when performed before 40 years of age. [ABSTRACT FROM AUTHOR]

Background: Long-term use of supraphysiologic doses of anabolic-androgenic steroids (AAS) has been associated with impaired visuospatial memory in young men but little is known about its cognitive effects in middle-aged men.Objectives: We compared cognition in middle-aged men with histories of long-term AAS use and age-matched non-users.Methods: We administered cognitive tests from the CANTAB battery to 76 weightlifters aged 37–60 years (mean [SD] 48.5 [6.5] years), of whom 51 reported at least 2 years of cumulative AAS use and 25 reported no AAS exposure.Results: We found no significant AAS user versus non-user group differences on visuospatial, verbal memory, emotional recognition, or executive function tasks (corrected p’s ≥ .00089; effect sizes ≤ .5).Conclusions: Our null visuospatial task findings contrast with our prior younger cohort study (mean age 37.1 [7.1] years), in which we found impaired visuospatial task performance in people who use AAS, and with other reports of cognitive impairments in younger men use AAS. Men who use AAS may develop early visuospatial memory deficits that stabilize by middle age while middle-aged non-users’ performance may “catch up” due to normal age-related visuospatial declines. Similar effects could contribute to our null findings on other tasks. Between-study cohort substance use differences or environmental factor differences that modify cognition, such as study geographical location and time of year, also could contribute to our discordant findings. Since young adult male AAS users experience increased mortality from unnatural causes, improving our understanding of AAS cognitive effects in this age group is important. [ABSTRACT FROM AUTHOR]

Background: Vaginal noise (VN) is a natural phenomenon that arises when air is forced into the vagina and then expelled as the vaginal wall muscles naturally contract. It has been described as involuntarily passing gas from the vagina. VN is a symptom of pelvic floor (PF) dysfunction and can cause social and psychological issues. Data on it is limited, and women rarely voluntarily report it. So, this study was conducted to determine the prevalence, bother, and relation between VN and PF muscle dysfunction. Material and methods: It was a cross-sectional study that included females with age ranges from 30 to 60 years old, body mass index (BMI) ranges from 18 to 30 kg/m2, married, single, virgin, nulliparous, and multiparous women; those with previous one or more vaginal deliveries or cesarean sections (CS) or history of anterior and/or posterior vaginal wall prolapses; and those who had undergone medical interventions such as vaginal surgeries (e.g., pelvic floor reconstruction, hysterectomy), stress urinary incontinence, urge incontinence, and fecal incontinence. The Vaginal Wind Questionnaire, Pelvic Floor Impact Questionnaire-Short Form 7 (PFIQ-7), and Pelvic Floor Bother Questionnaire were used as methods of evaluating the VN prevalence and bother and its relation to PF dysfunction. Results: It was noted that there was a 76.3% prevalence of VN and 75% bother among the study population. Eighty-eight percent of them did not seek any treatment, and VN occurred in 84.3% of females with pelvic floor muscle weakness. Conclusion: VN is common in middle-aged Egyptian women, most frequently occurring with sexual intercourse, vaginal delivery, and pelvic floor muscle weakness. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the longitudinal association between dynapenic abdominal obesity and new-onset arthritis among the middle-aged and older Chinese population. Methods: We included 6863 participants from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Dynapenia was defined as handgrip strength < 28 kg for males, and < 18 kg for females. Abdominal obesity was defined as a waist circumference ≥ 90 cm for males and ≥ 85 cm for females. Based on the definitions, all participants were divided into four groups: no dynapenia and no abdominal obesity (ND/NAO), abdominal obesity alone (ND/AO), dynapenia alone (D/NAO), and dynapenia and abdominal obesity (D/AO). The association between dynapenic abdominal obesity and new-onset arthritis was assessed by sex using the Poisson regression models. Results: After a four-year follow-up, 1272 (18.53%) participants reported new-onset arthritis. Those in the D/AO group had a significantly increased risk of new-onset arthritis compared to those in the ND/NAO group (adjusted relative risk (RR): 1.34, 95% confidence interval (CI): 1.01–1.77). In females, the ND/AO (RR: 1.21, 95% CI: 1.03–1.43) and D/AO (RR: 1.39, 95% CI: 1.01–1.93) groups were associated with a higher risk of arthritis. This significant association was not observed in males. Conclusions: Our results indicated that the combined effect of dynapenia and abdominal obesity significantly increased the risk of new-onset arthritis in females, but this association was not observed in males. [ABSTRACT FROM AUTHOR]

This paper presents the results of an adaptive thermal comfort field study conducted in the naturally ventilated residential buildings in the composite climate type of India over three main seasons i.e. monsoon, winter, and summer using ASHRAE's class II field measurements protocols. 768 measurements were collated wherein subjective thermal comfort sensation, preference, and acceptance for indoor environment variables were thoroughly explored along with the adaptive actions of the users for four different times during a day. Correlation analysis helped decipher the relationship between subjective votes and thermal comfort evaluation parameters. Thermal environment acceptance during monsoon season and morning time was highest however the same was found lower during summers and afternoons. The middle age group had the lowest acceptance and well-acclimatized non-native participants had a good thermal acceptance. Education also affects thermal acceptance and it decreases with increasing education level. The comfort temperature and adaptive comfort equation were also studied and results were compared with national and international thermal comfort standards. This study predicted a wider thermal comfort range of 12.23–34.45°C and indicated revising TSI, the first thermal comfort index for Indian Subjects. [ABSTRACT FROM AUTHOR]

Background and Aim: Social factors play a crucial role in the quality of life of + 50 adults. This study aimed to investigate the association between social support, depression, and loneliness and the health-related quality of life in + 50 adults of Ardakan. Methods: This was a cross-sectional study from the first phase of Ardakan Cohort Study on Aging (ACSA) in 2019. Health-Related Quality of Life (HRQoL, SF-16), Duke Social Support Index (DSSI), and Center for Epidemiologic Studies Depression Scale (CES-D10) were used to assess the variables of interest. Multivariable linear regression was used to model the associated factors with the score of the SF-16 tool in two dimensions; physical (PCS) and mental (MCS). Findings: A total of 5197 over 50 years individuals included in this study; The mean age was 62.2 ± 7.3 years old, and 52% were male. The mean score for PCS and MCS subscales was 45.6 (95% CI 45.4 to 45.9) and 49.3 (95% CI 49.0 to 49.5), respectively. Adjusted for other variables, having less feeling level of loneliness, and not having depressive symptoms were related to better PCS and MCS scores. Conclusion: The HRQoL for the mental aspect of HRQoL was better than the physical in elder populations. Also, much more focus should be paid to older adults who experience inadequate social support, higher levels of loneliness, and depressive symptoms. [ABSTRACT FROM AUTHOR]

Objectives: Mild behavioral impairment (MBI) is a dementia risk indicator in older adults characterized by later‐life emergent and persistent neuropsychiatric symptoms. Quality of life (QoL) is a multi‐dimensional concept encompassing physical, spiritual, and emotional well‐being. QoL aims to measure and quantify perceptions of individual health, well‐being, standard of living, personal fulfillment, and satisfaction. As MBI symptoms may arise from early‐stage neurodegenerative disease, MBI may contribute to declining QoL before dementia onset. In this study, we investigated the relationship between symptoms of MBI and QoL in older adults. Methods: The sample comprised 1107 individuals aged ≥ 50 years from the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behavior, Function, and Caregiving in Aging (CAN‐PROTECT). Multivariable linear regressions were used to model the associations between MBI symptom severity (exposure), measured using the MBI Checklist (MBI‐C), and QoL (outcome) assessed by the EuroQol‐5D (EQ‐5D, higher score = poorer QoL) and the novel Quality of Life and Function Five Domain Scale (QFS‐5) (QFS‐5, lower score = poorer QoL). Covariates were age, sex, cognition, education, ethnocultural origin, marital status, employment status, high blood pressure, heart disease, and diabetes. Moderation analysis explored potential sex differences. A sensitivity analysis was performed removing anxiety/depression items from the EQ‐5D score. Results: Across the sample (mean age = 64.4 ± 7.2, 79.4% female) every 1‐point increase in MBI‐C score was associated with a 0.06‐point standard deviation (SD) increase in EQ‐5D score (95% confidence interval (CI): 0.05–0.06, p < 0.001) and 0.08 SD decrease in QFS‐5 score (95% CI: −0.09 to −0.08, p < 0.001). Neither association depended on sex (p = 0.59 and p = 0.41, respectively). The association remained significant after removing anxiety/depression items from the EQ‐5D score (β = 0.04, 95% CI: 0.03– 0.04, p < 0.001). Conclusions: The study shows that MBI is associated with poorer QoL, independent of sex, on two QoL scales. We addressed depression/anxiety items in the EQ‐5D as a potential confounder for the observed MBI‐QoL association by conducting a sensitivity analysis that excluded those items from the EQ‐5D total score and by employing a novel measure of QoL (QFS‐5) that excludes psychiatric symptoms from measurement of QoL. Associations of MBI with the novel QFS‐5 were similar to associations between MBI and the EQ‐5D. Finding interventions to reduce the burden of MBI symptoms might improve quality of life. [ABSTRACT FROM AUTHOR]

Objective: We estimated, for women and men (1) the associations between psychological distress and the prevalences of presenteeism and absenteeism, (2) average hours lost annually per person, and (3) costs from the employers' economic perspective. Methods: Participants were 1292 Canadian white-collar workers. Psychological distress, presenteeism, and absenteeism were assessed with validated questionnaires. The average annual hours of productivity loss and related costs were estimated using generalized linear models with a negative binomial distribution and a log link. Results: High psychological distress in women and men was associated with presenteeism costs ($6944 and $8432) and absenteeism costs ($2337 and $2796 per person). The association between psychological distress and annual hours lost to presenteeism was twice stronger for men than women. Conclusions: Productivity losses associated with psychological distress are high in women and men older workers. [ABSTRACT FROM AUTHOR]

Purpose: Vitamin D has a crucial role in our metabolic health. We aimed to examine associations of vitamin D status and its related dietary pattern (DP) with prevalent risk of metabolic syndrome (MetS) in 9,237 Korean adults aged 19–64 years based on the National Health and Nutrition Examination Survey. Methods: Vitamin D status was examined by serum 25-hydroxyvitamin D (25(OH)D). A vitamin D-related DP associated with 25(OH)D levels was derived using reduced rank regression (RRR). Associations of vitamin D status and its related DP with MetS prevalence were examined using multivariable logistic regression models adjusted for potential confounders. Results: Men with sufficient vitamin D status had a 44% lower risk of MetS prevalence (OR: 0.56; 95%CI: 0.36–0.87) compared to those with deficiency. A vitamin D-related DP derived using RRR was characterized by high intakes of vegetables, fish, fruits, and nuts and low intakes of eggs, oils, and mushrooms in this study population. Among men, the DP was significantly associated with a lower risk of MetS prevalence, showing a 12% (95%CI: 4–20%) reduction in risk for a one-unit increase in the DP score. However, there was no significant association among women. Conclusion: The study's findings suggest that a sufficient vitamin D status and a related DP with high intakes of vegetables, fish, fruit, and nuts were associated with the risk of MetS, particularly in Korean male adults. [ABSTRACT FROM AUTHOR]

Purpose: Magnesium is one of the most common elements in the human body and plays an important role as a cofactor of enzymes required for DNA replication and repair and many other biochemical mechanisms including sensing and regulating one-carbon metabolism deficiencies. Low intake of magnesium can increase the risk of many diseases, in particular, chronic degenerative disorders. However, its role in prevention of DNA damage has not been studied fully in humans so far. Therefore, we tested the hypothesis that magnesium deficiency either on its own or in conjunction with high homocysteine (Hcy) induces DNA damage in vivo in humans. Methods: The present study was carried out in 172 healthy middle aged subjects from South Australia. Blood levels of magnesium, Hcy, folate and vitamin B12 were measured. Cytokinesis-Block Micronucleus cytome assay was performed to measure three DNA damage biomarkers: micronuclei (MN), nucleoplasmic bridges (NPBs) and nuclear buds (NBuds) in peripheral blood lymphocytes. Results: Data showed that magnesium and Hcy are significantly inversely correlated with each other (r = − 0.299, p < 0.0001). Furthermore, magnesium is positively correlated both with folate (p = 0.002) and vitamin B12 (p = 0.007). Magnesium is also significantly inversely correlated with MN (p < 0.0001) and NPB (p < 0.0001). Individuals with low magnesium and high Hcy exhibited significantly higher frequency of MN and NPBs compared to those with high magnesium and low Hcy (p < 0.0001). Furthermore, there was an interactive effect between these two factors as well in inducing MN (p = 0.01) and NPB (p = 0.048). Conclusions: The results obtained in the present study indicate for the first time that low in vivo levels of magnesium either on its own or in the presence of high Hcy increases DNA damage as evident by higher frequencies of MN and NPBs. [ABSTRACT FROM AUTHOR]

Purpose: Hyperglycemia is affected by lifestyle and genetic factors. We investigated if dietary patterns associate with glycemia in individuals with high or low genetic risk for type 2 diabetes (T2D). Methods: Men (n = 1577, 51–81 years) without T2D from the Metabolic Syndrome in Men (METSIM) cohort filled a food-frequency questionnaire and participated in a 2-hour oral glucose tolerance test. Polygenetic risk score (PRS) including 76 genetic variants was used to stratify participants into low or high T2D risk groups. We established two data-driven dietary patterns, termed healthy and unhealthy, and investigated their association with plasma glucose concentrations and hyperglycemia risk. Results: Healthy dietary pattern was associated with lower fasting and 2-hour plasma glucose, glucose area under the curve, and better insulin sensitivity (Matsuda insulin sensitivity index) and insulin secretion (disposition index) in unadjusted and adjusted models, whereas the unhealthy pattern was not. No interaction was observed between the patterns and PRS on glycemic measures. Healthy dietary pattern was negatively associated with the risk for hyperglycemia in an adjusted model (OR 0.69, 95% CI 0.51–0.95, in the highest tertile), whereas unhealthy pattern was not (OR 1.08, 95% CI 0.79–1.47, in the highest tertile). No interaction was found between diet and PRS on the risk for hyperglycemia (p = 0.69 for healthy diet, p = 0.54 for unhealthy diet). Conclusion: Our findings suggest that healthy diet is associated with lower glucose concentrations and lower risk for hyperglycemia in men with no interaction with the genetic risk. [ABSTRACT FROM AUTHOR]

Background: Acute total hip arthroplasty (THA) may be an alternative or an adjuvant to internal fixation for surgical treatment of acetabular fractures. We investigate recent trends in the operative management of acetabular fractures. We hypothesize that the incidence of acute THA for acetabular fractures has increased over time. Methods: 4569 middle-aged (45–64 years) and older adults (≥ 65 years) who received acute operative management of an acetabular fracture within 3 weeks of admission between 2010 and 2020 were identified from the United States Nationwide Inpatient Sample database. Treatment was classified as open reduction internal fixation (ORIF), THA, or combined ORIF and THA (ORIF + THA). Patients were stratified by age ≥ 65 years old. Associations between demographic factors and the incidence of each procedure over the study period were modeled using linear regression. Results: The relative incidence of treatments was 80.9% ORIF, 12.1% THA, and 7.0% ORIF + THA. Among patients aged 45–64 years old, THA increased 4.8% [R2 = 0.62; β1 = 0.6% (95% Confidence Interval (CI) 0.2–0.9%)] and ORIF + THA increased 2.6% [R2 = 0.73; β1 = 0.3% (95% CI 0.2–0.4%)], while the use of ORIF decreased 7.4% [R2 = 0.75; β1 = −0.9% (95% CI −1.2 to −0.5%)]. Among patients ≥ 65 years old, THA increased 16.5% [R2 = 0.87; β1 = 1.7% (95% CI 1.2–2.2%)] and ORIF + THA increased 5.0% [R2 = 0.38, β1 = 0.6% (95% CI 0.0–1.3%)], while ORIF decreased 21.5% [R2 = 0.75; β1 = −2.4% (95% CI −3.45 to −1.3%)]. Conclusion: The treatment of acetabular fractures with acute THA has increased in the last decade, particularly among older adults. [ABSTRACT FROM AUTHOR]

This study aimed to examine the risk and protective factors associated with depression in middle-aged and older Chinese adults with activity limitations. Data were obtained from the 2018 Wave 4 Survey of the China Health and Retirement Longitudinal Study. In the logistic regression analysis, health and functioning, losing a child, and a perceived lack of future assistance with daily activities increased the odds of depression. Conversely, receiving adequate assistance with daily activities lessened the depressive impacts of activity limitations, as indicated by a significant interaction effect. Enhanced long-term support for individuals with disabilities is necessary to improve mental health. [ABSTRACT FROM AUTHOR]

Findings have revealed a strong link between exposure to child maltreatment (CM) and later chronic pain. Concurrently, other findings have been grounded in the understanding that CM consequences may not end with the exposed individual, rather, they extend to their offspring. However, little is known regarding the possible intergenerational transmission of chronic pain following CM. This study examines whether chronic pain among parents and their young adult offspring may be associated with parental exposure to CM. Three hundred ninety‐three parent‐offspring dyads (parents' mean age = 58, SD = 5.91 years; offspring's mean age = 27, SD = 3.91 years) completed self‐report questionnaires, assessing CM (CTQ), posttraumatic stress (PTS) and disturbances in self‐organisation (DSO) symptoms (ITQ), and chronic pain. CM was associated with chronic pain mediated by DSO symptoms among parents (indirect effect = 0.77; p = 0.007) and PTS symptoms among offspring (indirect effect = 0.285; p = 0.005). Offspring chronic pain was significantly associated with parental CM through two intergenerational paths: the mediation of parents' DSO symptoms and chronic pain (indirect effect = 0.298; p = 0.011), and through parents' PTS symptoms and offspring's PTS symptoms (indirect effect = 0.077; p = 0.004). This study's findings support the relevance of the intergenerational transmission of chronic pain following parental exposure to CM. Furthermore, the findings reveal complex PTS symptoms as a possible underlying mechanism for the intergenerational associations of chronic pain following CM. [ABSTRACT FROM AUTHOR]

Background: Neighborhood poverty is associated with adiposity in women, though longitudinal designs, annually collected residential histories, objectively collected anthropometric measures, and geographically diverse samples of midlife women remain limited. Objective: To investigate whether longitudinal exposure to neighborhood concentrated poverty is associated with differences in body mass index (BMI) and waist circumference (WC) among 2,328 midlife women (age 42–52 years at baseline) from 6 U.S. cities enrolled in the Study of Women's Health Across the Nation (SWAN) from 1996 to 2007. Methods: Residential addresses and adiposity measures were collected at approximately annual intervals from the baseline visit through a 10-year follow-up. We used census poverty data and local spatial statistics to identify hot-spots of high concentrated poverty areas and cold-spots of low concentrated poverty located within each SWAN site region, and used linear mixed-effect models to estimate percentage differences (95% confidence interval [CI]) in average BMI and WC levels between neighborhood concentrated poverty categories. Results: After adjusting for individual-level sociodemographics, health-related factors, and residential mobility, compared to residents of moderate concentrated poverty communities, women living in site-specific hot-spots of high concentrated poverty had 1.5% higher (95% CI: 0.6, 2.3) BMI and 1.3% higher (95% CI: 0.5, 2.0) WC levels, whereas women living in cold-spots of low concentrated poverty had 0.7% lower (95% CI: −1.2, −0.1) BMI and 0.3% lower (95% CI: −0.8, 0.2) WC. Site-stratified results remained in largely similar directions to overall estimates, despite wide CIs and small sample sizes. Conclusions: Longitudinal exposure to neighborhood concentrated poverty is associated with slightly higher BMI and WC among women across midlife. [ABSTRACT FROM AUTHOR]

Background Despite persistent concerns about only children's disadvantage relative to individuals with siblings, existing health-related evidence is inconsistent. Recent evidence from Nordic countries about only children having poorer health outcomes may not apply elsewhere because selection processes differ across contexts. We investigate the midlife health of only children in the UK where one-child families tend to be socio-economically advantaged relative to large families. Methods Using the 1946, 1958 and 1970 British birth cohort studies, we examine various biomarkers and self-reported measures of chronic disease by sibship size when respondents are aged in their mid-40s, mid-50s and mid-60s. We estimate separate linear probability models for each cohort, age and outcome, adjusting for childhood and early adulthood circumstances. Results We found no evidence of only children differing from those with one, two or three or more siblings, at any age, in any of the cohorts, on: heart problems, hypertension, high triglycerides, high glycated haemoglobin or high C-reactive protein. However, compared with only children, the probability for cancer (0.019, 95% confidence interval [CI]: 0.002, 0.035; age 46/1970) and poor general health (0.060, CI: 0.015, 0.127; age 55/1958; and 0.110, CI: 0.052, 0.168; age 63/1946) was higher among those with three or more siblings. Conclusions There is no consistent pattern of only child health disadvantage for midlife chronic disease outcomes across ages or cohorts in the UK. Research should focus on better understanding how sibship size differentials are contingent on context. [ABSTRACT FROM AUTHOR]

Background: The association between arterial stiffness and alcohol consumption is still controversial. We investigated this relationship by performing continuous analysis in men drinking only beer/cider, and women drinking only red wine. Methods: This cross‐sectional study involved participants aged 40–69 years consisting of 9029 men who drank only beer/cider, and 6989 women drinking only red wine. Alcohol consumption was captured by self‐reported questionnaire and reported as units per week, where one unit is equal 10 mL pure ethanol. Arterial stiffness index (ASI) was estimated using photoplethysmography. Results: In men consuming a mean 17.8 (5th and 95th percentiles, 2.6–76.7) units/week, ASI increased by heptiles (sevenths) of alcohol captured from beer/cider consumption and after adjusting for age (9.14, 9.40, 9.51, 9.53, 9.80, 9.80, 10.00 m/s; p‐trend < 0.001) and after full adjustment (9.29, 9.46. 9.55, 9.55, 9.73, 9.73, 9.75 m/s; p‐trend = 0.013). Similarly, in women consuming a mean 8.1 (1.6–29.3) units/week, ASI increased by heptiles of alcohol captured from red wine consumption and after adjusting for age (8.05, 8.05, 8.05, 8.11, 8.17, 8.30, 8.45 m/s; p‐trend = 0.012) and borderline significant after full adjustment (8.05, 8.07, 8.05, 8.07, 8.11, 8.22, 8.43 m/s; p‐trend = 0.055). These associations were confirmed in multivariable‐adjusted regression analysis in all men, men younger and older than 50 years, and when consuming more than 14 units per week. Similarly, these associations were confirmed in all women, women older than 50 years, and in those consuming more than 14 units per week. Conclusions: Positive linear relationships exist between arterial stiffness and alcohol, irrespective of whether captured from beer/cider consumption in men or red wine consumption in women. No evidence existed to support the notion that our arteries benefit from any level of alcohol consumption. [ABSTRACT FROM AUTHOR]

This paper presents new isotopic, geochemical, and geochronological data on granitoids of the southeastern Voznesenka terrane of the Khanka block of the Amur paleocontinent. These granitoids are assumed to be a source of gold and tungsten mineralization in the host Late Paleozoic and Early Mesozoic strata and were initially considered to be of Late Cretaceous age. However, according to U-Pb isotopic data on zircons, their age is Middle Permian (~267 ± 3 Ma), which contradicts the idea of them being an ore-generating system that triggered the formation of mineralized zones in the associated younger volcanosedimentary and terrigenous formations of the Middle–Late Permian and Triassic age, respectively. [ABSTRACT FROM AUTHOR]

This paper explores a new perspective on middle‐aged migrant women. Midlife has long been presumed to be the most networked stage of life for sedentary populations, but it has not been examined critically in the context of migration. This is an empty space that warrants research attention, because middle‐aged migrants often have lives that are temporally and spatially distinctive. Drawing on ethnographic fieldwork in Latvia and the United Kingdom (2018–2023), I argue that the lifecourses of middle‐aged migrant women resemble the transitions that young people go through for work but differ in terms of care. Although strong ties relatives and friends have long been thought to be key for transnational care relations, weak ties also become instrumental through shared notions of self‐actualization in midlife. I provide a novel understanding of how the concepts of linked lives and networks can be applied to processes that are pertinent to middle‐aged women. [ABSTRACT FROM AUTHOR]

Background DNA methylation-derived epigenetic clocks and frailty are well-established biological age measures capturing different aging processes. However, whether they are dynamically linked to each other across chronological age remains poorly understood. Methods This analysis included 1 309 repeated measurements in 524 individuals aged 50–90 years from the Swedish Adoption/Twin Study of Aging. Frailty was measured using a validated 42-item frailty index (FI). Five epigenetic clocks were calculated, including 4 principal component (PC)-based clocks trained on chronological age (PCHorvathAge and PCHannumAge) and aging-related physiological conditions (PCPhenoAge and PCGrimAge), and a pace of aging clock (DunedinPACE). Using dual change score models, we examined the dynamic, bidirectional associations between each of the epigenetic clocks and the FI over age to test for potential causal associations. Results The FI exhibited a nonlinear, accelerated increase across the older adulthood, whereas the epigenetic clocks mostly increased linearly with age. For PCHorvathAge, PCHannumAge, PCPhenoAge, and PCGrimAge, their associations with the FI were primarily due to correlated levels at age 50 but with no evidence of a dynamic longitudinal association. In contrast, we observed a unidirectional association between DunedinPACE and the FI, where a higher DunedinPACE predicted a subsequent increase in the FI, but not vice versa. Conclusions Our results highlight a temporal order between epigenetic aging and frailty such that changes in DunedinPACE precede changes in the FI. This potentially suggests that the pace of aging clock can be used as an early marker of the overall physiological decline at system level. [ABSTRACT FROM AUTHOR]

Background and Objectives This study explores resilience factors among sexual and gender minority (SGM) midlife and older adults, identifying historical/environmental, psychological, social, and behavioral predictors, and examining variations across racial/ethnic subgroups. By adopting a resilience-focused perspective, this research contributes to understanding strengths in the SGM community in the context of aging. Research Design and Methods Using weighted survey data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study, this research investigates distinct risk and protective factors associated with resilience among SGM midlife and older adults. Subgroup variations were assessed using regression models. Factors moderated by race/ethnicity were integrated into final interaction models. Results Hispanic and Black individuals showed significantly higher resilience than non-Hispanic Whites. Lifetime victimization and day-to-day discrimination were negatively associated with resilience. Positive associations were found for higher income, identity affirmation, larger network size, greater social participation, increased physical activity, and sufficient food intake. Interaction models revealed nuanced patterns by subgroups; education negatively impacted resilience among Black individuals, while income positively influenced Hispanic individuals' resilience. The Other racial/ethnic group demonstrated unique associations between optimal sleep and resilience. Discussion and Implications This study shifts from a deficit-based to a resilience-focused approach among SGM midlife and older adults, revealing key strengths within diverse subgroups. Results underscore the significance of recognizing racial/ethnic differences in factors promoting resilience and posing risks for SGM midlife and older adults. Tailoring interventions to address the intersectional needs of SGM aging populations is essential for enhancing their abilities to bounce back from adverse events. [ABSTRACT FROM AUTHOR]

Introduction: Evidence on the early life risk factors of adult CRS, and the history of asthma and allergies across the life course, is limited. Aim: To investigate relationships between respiratory infective/allergic conditions in childhood, and asthma and allergies across the life course and CRS in middle age. Methods: Data were from the population‐based Tasmanian Longitudinal Health Study (TAHS) cohort, first studied in 1968 when aged 6–7 years (n = 8583) and serially followed into middle age (n = 3609). Using a well‐accepted epidemiological definition, participants were assigned a CRS‐severity subtype at age 53: no sinusitis/CRS (reference); past doctor diagnosis only; current symptoms without doctor diagnosis; and doctor‐diagnosed CRS with current symptoms. Relationships with infective/allergic respiratory illnesses at age 7, and previously published asthma‐allergy trajectories from 7 to 53 years, were examined using multinominal regression. Results: In middle age, 5.8% reported current CRS symptoms with 2.5% doctor‐diagnosed. Childhood conditions associated with symptomatic doctor‐diagnosed CRS included frequent head colds (multinomial odds ratio [mOR] = 2.04 (95% confidence interval [95% CI]: 1.24, 3.37)), frequent tonsillitis (mOR = 1.61 [95% CI: 1.00, 2.59]) and current childhood asthma (mOR = 2.23 [95% CI: 1.25, 3.98]). Life course trajectories that featured late‐onset or persistent asthma and allergies were associated with all CRS subtypes in middle age; early‐onset persistent asthma and allergies (mOR = 6.74, 95% CI: 2.76, 16.4); late‐onset asthma allergies (mOR = 15.9, 95% CI: 8.06, 31.4), and late‐onset hayfever (mOR = 3.02, 95% CI: 1.51, 6.06) were associated with symptomatic doctor‐diagnosed CRS. Conclusion: Current asthma, frequent head colds and tonsillitis at age 7 could signal a susceptible child who is at higher risk for CRS in mid‐adult life and who might benefit from closer monitoring and/or proactive management. Concurrent asthma and allergies were strongly associated and are potential treatable traits of adult CRS. [ABSTRACT FROM AUTHOR]

Objectives: Sarcopenia is prevalent in middle to old age. We aimed to investigate the association between muscle strength and the incident knee osteoarthritis (OA). Methods: 12,043 participants were collected from the China Health and Retirement Longitudinal Study. The effects of sarcopenic obesity (defined by obesity in combination with possible sarcopenia) on knee OA onset were calculated using Poisson regression models. Mediation analysis was fit to estimate mediating proportion of muscle strength on the association between obesity and incident knee OA. Results: The study all enrolled 12,043 participants with 2,008 progressed to knee OA. Poisson analyses demonstrated causal association of general obesity (RR:1.23, 95% CI: 1.08 to 1.39) and abdominal obesity (RR:1.23, 95% CI: 1.11 to 1.35) with knee OA onset. For the risk of incident knee OA, participants with the highest level of normalized grip strength had a decreased risk of incident knee OA by 0.33 (RR:0.67, 95% CI: 0.60 to 0.75) times compared to the control group, and chair-rising time was associated with increased risk of incident knee OA by 0.65 (RR:1.65, 95% CI: 1.17 to 2.33) times. Sensitivity analysis identified similar results. Participants with sarcopenic obesity were about 2 times risk of incident knee OA than reference group. Normalized grip strength and chair-rising time mediated the association between obesity and incidence of knee OA. Conclusions: Sarcopenic obesity is correlated with an increased risk of knee OA. Muscle strength recovery may alleviate the risk of incident knee OA in middle to old age with obesity. [ABSTRACT FROM AUTHOR]

Disordered eating refers to a range of eating behaviours and attitudes towards weight and food that can negatively influence physical and psychosocial well-being. The menopausal transition could be a vulnerable period for disordered eating due to major hormonal fluctuations, menopausal symptoms, common body composition shifts, and an increased risk of psychological challenges. This systematic review aimed to summarize evidence on the associations between the menopausal transition and disordered eating. Records published before October 2023 were identified through MEDLINE, PsycINFO, Scopus, Embase, and CINAHL. Studies investigating associations between menopausal status, menopausal symptoms, or reproductive hormone levels, and disordered eating during the menopausal transition were sought. A total of 1301 non-duplicate records were screened, with 10 studies deemed eligible for inclusion. Most included studies used a cross-sectional design (n = 9). Findings include potentially higher levels of binge eating during the perimenopausal stage, whereas restrictive eating behaviours appeared more common during postmenopause compared to premenopause. Both studies investigating menopausal symptoms found strong positive associations with disordered eating. Nonetheless, findings are equivocal with contrasting results and limited methodological quality across studies. Further research is needed to verify these findings and better assist health professionals in supporting healthy eating behaviours in menopausal women during this complex transition. (PROSPERO ID: CRD42021290736) [ABSTRACT FROM AUTHOR]

Parental age plays a major role in determining the life history attributes of an organism. Variation in parental age can have a big impact on offspring development, body mass and structure of population. To test the hypothesis that the increase in parental age has negative effects on offspring development of next generation, we observed the effect of parental age on the selected population of developmental variants (slow and fast developers) in a ladybird beetle, Propylea dissecta Mulsant (Coleoptera: Coccinellidae). The newly emerged adults were divided into two lines: Slow and Fast developers on the basis of their total developmental durations. Adult body mass, slow-fast emergence, sex-ratio, percentage of immature survival of newly emerged adults was recorded. Total developmental duration increased with the increase in age across generation and more fast developers were found in the offspring of young age groups; however, only slow developers were produced by old age groups. Offspring of older age showed higher immature mortality which supports slow-growth-higher mortality hypothesis. Thus, it can be concluded that young age beetles show better performance in terms of growth and developmental duration in P. dissecta in comparison to middle age and old age groups. [ABSTRACT FROM AUTHOR]

Migrants, along with youth, stand at the forefront of gig economy in many countries. Gig work intersects with other domains of migrants' post-migration life, including career development. To substantiate "plural systems of knowledges" [Sultana, R. G. (2021). For a postcolonial turn in career guidance: The dialectic between universalisms and localisms. British Journal of Guidance & Counselling, p. 5] required for understanding such intersecting boundaries, qualitative research that prioritises migrants' local knowledges is essential. This research systemically explores the career development of New Zealand immigrants working as rideshare drivers in Australia and considers the impact of gig work on their career development through the lens of the Systems Theory Framework (STF) of career development. Using a qualitative exploratory multiple case study design, interviews were conducted with four rideshare drivers. Findings highlight the role of systemic influences in the intersections of migration with gig work and career development. The role of the STF of career development in facilitating a systemic exploration through both stages of data collection and data analysis is highlighted. [ABSTRACT FROM AUTHOR]

Background: Older adults, an increasingly diverse segment of the United States population, are a priority population for prescription painkiller misuse. This study documents trends and correlates of prescription painkiller misuse among Hispanic and non-Hispanic adults ages 50 and older. Methods: A secondary analysis of adults 50 years and older across 5 cohorts using the 2015–2019 National Survey on Drug Use and Health (unweighted n = 16,181, 8.5% Hispanic, and 54% female). Logistic regression modeling with complex survey design was used to examine trends in prescription painkiller misuse. Results: Over time, the prevalence of past year painkiller misuse significantly decreased for Hispanic respondents (56.1% relative decrease, p = 0.02); elevated proportions were observed across strata of demographic characteristics. Conclusions: Variability in the prevalence of painkiller misuse may be explained by demographic characteristics. Further, these results emphasize the importance of addressing comorbid recreational marijuana use when designing interventions to address painkiller misuse for older adults. [ABSTRACT FROM AUTHOR]

The literature provides an incomplete picture of gender dynamics in later-life domestic work. This couple-level study examines the division of female-typed, gender-neutral, and male-typed housework among middle-aged and older Chinese couples, comparing working and non-working couples. It also explores the different relationships between education, income, and the division of housework in these two groups of couples. The findings derived from national time-use data reveal that, first, non-working couples exhibit a smaller gender gap in household labor compared to working couples, primarily because wives take on more gender-neutral tasks, while husbands assume more female-typed tasks. Second, female-typed housework exhibits the largest gender disparity, followed by gender-neutral housework. Third, educational and economic resources play distinct roles in shaping the division of household chores in the two groups. Furthermore, the time spent on paid work is a more significant factor in explaining gender differences in housework among working couples than education and income. [ABSTRACT FROM AUTHOR]

The purpose of this interventional experimental study was to determine the effect of health education program on physical activity and blood pressure in middle-aged women with pre-hypertension in Kohdasht. Eighty middle-aged women with pre-hypertension were selected and divided into two groups randomly. After the one-month online training program for intervention group, by conducting an interview, the data was completed using questionnaire and it was analyzed using spss 27 software (significance level of 0.05). Before the intervention, there was no significant difference between the two groups. After 3 months of follow-up, a significant increase in attitude, perceived behavioral control and behavioral intention related to physical activity was observed in the intervention group compared to the control group (P <.05). Also, the average blood pressure in the intervention group was higher than the control group. Considering the effect of the online health education program based on the theory of planned behavior in improving the stages of changing physical activity and reducing blood pressure, the use of these developed models with an emphasis on modifying the subjective norm related to physical activity in the field of prevention is recommended for high blood pressure. [ABSTRACT FROM AUTHOR]

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Purpose: This study aims to describe the experiences of critically ill elderly patients (CIEPs) who were treated using the high-flow nasal cannula (HFNC) after extubation. Design/methodology/approach: A descriptive phenomenological approach was conducted to interview eleven CIEPs using face-to-face semi-unstructured interviews. Participants were selected through purposive sampling. Data were analyzed using Giorgi's method. Findings: Experiences of CIEPs included their fears of failure, getting comfortable and uncomfortable, as well as asking for assistance. Fears of failure were described as involving worsening symptoms related to their diseases and failure of HFNC leading to the need for reintubation. While receiving HFNC, their breathing was comfortable, and they were free from intubation. However, they were uncomfortable because of the sensation of burning in the nasal passages. Additionally, they asked for assistance from nurses in managing their symptoms, and the alarms of HFNC oxygen therapy devices resulted in fears of HFNC failure. Originality/value: The paper indicates that CIEPs experienced physical and psychological impacts from HFNC oxygen therapy (e.g. burning sensation in the nose and fear of failure). Although they had comfortable breathing, being uncomfortable also occurred. Therefore, health-care professionals should support what CIEPs need and develop a program or guidelines for managing the complications of HFNC – neither burning noses nor psychological issues enhance the comfort of CIEPs – by considering age-related changes. [ABSTRACT FROM AUTHOR]

Objectives: To assess how cognitive trajectories from mid-to-later life relate to wealth change, overall and by mid-life income. Methods: Data were from participants (51–64 years) in the 2000–2018 U.S. Health and Retirement Study who were cognitively healthy at baseline (year 2000; unweighted n = 3821). Longitudinal latent class analyses generated cognitive and wealth trajectories, independently, and multinomial logistic regressions estimated the association between cognitive trajectories and wealth profiles, overall and by median income. Results: We identified three cognitive: cognitively healthy (CH), increasing cognitive impairment (ICI), and increasing dementia (ID) and four wealth profiles: stable wealth loss (SWL), delayed gradual wealth loss (DGWL), stable wealth gain (SWG), and gradual wealth gain (GWG). The ID group had higher probability of being in the SWL group and lower probability of SWG, which was more pronounced in respondents with greater median income. Discussion: Individuals with ID may be vulnerable to wealth loss, particularly for middle-class households. [ABSTRACT FROM AUTHOR]

Objectives: Sleep is an indispensable part of human health, which can help us to restore physical strength, enhance immunity and maintain nervous system stability. The relationship between sleep quality and cognitive dysfunction is unclear, especially at the community population level. This study aims to explore the association between sleep quality and cognitive dysfunction. Methods: A total of 5,224 community residents were enrolled in this crosssectional study. Cognitive function was assessed by the Mini-Mental State Examination (MMSE). Sleep quality was assessed by the multidimensional sleep questionnaire. Multivariate logistic regression was used to analyze the association between sleep quality and cognitive dysfunction. The adjusted models took into account relevant demographic, clinical, and sleep variables. Results: A total of 3,106 participants were enrolled in this study, of whom 463 (15%) had cognitive dysfunction. Total sleep duration, staying up, sleep latency, number of awakenings, and history of sleep medications were associated with cognitive dysfunction in unadjusted models, and these effects were consistent after adjustment. First, those who slept 6-7.9 h per day (OR = 0.57, 95% CI 0.40 to 0.80, p = 0.001) had a lower risk for cognitive dysfunction compared to those who slept less than 6 h per day. Second, participants who stayed up more than 10 times over the 3 months (OR = 1.90, 95% CI 1.20 to 3.00, p = 0.006) were more likely to suffer cognitive dysfunction than those who never stayed up. Third, we also found that participants with sleep latencies of 16-30 min were less likely to experience cognitive dysfunction than those with sleep latencies of less than 16 min after adjusting confounders (OR = 0.33, 95% CI 0.23 to 0.47, p < 0.001). Fourth, participants who woke up once (OR = 1.65, 95% CI 1.19 to 2.30, p = 0.003) and three or more times (OR = 2.34, 95% CI 1.25 to 4.36, p = 0.008) after falling asleep had a higher risk than those who did not wake up at night. Last, participants taking sleep medication (OR = 2.97, 95% CI 1.19 to 7.45, p = 0.020) were more vulnerable to cognitive dysfunction, relative to participants without taking any medications. Conclusion: Our results suggest that after adjustment for potential confounding variables, poor sleep quality is associated with cognitive dysfunction. [ABSTRACT FROM AUTHOR]

Objectives: The burden of pain in middle‐aged and older adults is considerable and significantly increases healthcare expenditures. We aimed to investigate the roles of handgrip strength (HGS) weakness and asymmetry in predicting pain across four nationally representative cohorts. Methods: This longitudinal study utilized data from four major surveys: the Health and Retirement Study (HRS); the English Longitudinal Study of Ageing (ELSA); the Survey of Health, Ageing and Retirement in Europe (SHARE); and the China Health and Retirement Longitudinal Study (CHARLS). Multivariable cubic regression splines were employed to visually explore the nonlinear associations between HGS and pain in each cohort. The Cox proportional hazard model was applied to analyze the independent and combined relationship between HGS weakness and asymmetry and pain risk. Results: We included 41,171 participants in the final analysis, with a mean follow‐up period of 4.68 ± 2.61 years (50.7% female, mean age 64.3 ± 9.3 years). No nonlinear relationship was found between HGS and pain incidence (nonlinear p < 0.05 in ELSA and SHARE; >0.05 in CHARLS and HRS). After adjustment, the highest quartile groups had a significantly reduced risk of pain compared to the lowest quartile groups across all cohorts, with hazard ratios of 0.81 (0.74, 0.89) in CHARLS, 0.86 (0.77, 0.97) in HRS, 0.88 (0.77, 0.98) in ELSA, and 0.78 (0.73, 0.84) in SHARE. Participants with normal HGS had approximately 20% lower risk of pain compared to those with weak HGS. Each 5 kg increase in HGS was associated with decreased hazard ratios for pain: 0.95 (0.93, 0.97) in CHARLS, 0.97 (0.94, 0.99) in HRS, 0.96 (0.94, 0.99) in ELSA, and 0.94 (0.92, 0.95) in SHARE. The association between HGS asymmetry and pain risk was significant only in a few cohorts (HRS at 10%, 1.10 (1.03, 1.18); SHARE at 30%, 1.12 (1.05, 1.21)). No interaction effect between HGS weakness and asymmetry on pain risk was observed (all p‐values for interaction >0.05). Conclusions: Our findings suggest that HGS can be used as an independent predictor of pain in middle‐aged and older European, American, and Chinese populations. However, our results do not support the use of HGS asymmetry as an independent predictor of pain risk. It is necessary to establish appropriate criteria for HGS asymmetry across different populations. The use of both weak HGS and asymmetry as predictors of health outcomes requires further validation in more diverse populations. [ABSTRACT FROM AUTHOR]

Objective: This study describes the 2010–2019 trend of cervical cancer (CC) in women over 55 by socio‐demographic index (SDI) and geographical regions. Methods: We obtained data on CC annually from 2010 to 2019 from the 2019 Global Burden of Disease Study (GBD) to analyze the incidence, death and prevalence rates, and disability‐adjusted life years (DALYs) associated with CC across different parameters such as global trend, age groups, SDI, continents, World Bank Regions, World Health Organization (WHO) regions, GBD regions, and National and territorial division. This analysis covers data from 204 countries and territories from 1990 to 2019. Results: There were 236,228 CC incidence cases worldwide in 2019, which is a 1.27‐fold increase from 2010. Global CC deaths also increased to 169,304 cases in 2019, reflecting a 1.24‐fold increase. CC prevalence increased to 769,925 cases in 2019, representing a 1.4‐fold rise. The number of CC DALYs globally increased to 3,835,979 cases in 2019, reflecting a 1.24‐fold increase. Incidence, death, prevalence, and DALY numbers of CC increased across all age groups females in the 65–69 years age group experienced the highest increase. Middle SDI countries had the highest incidence, death, prevalence, and DALY numbers, while low SDI countries showed increasing trends. Asia exhibited the highest incidence, death, prevalence, and DALY numbers of CC. Upper middle‐income countries had the highest incidence, death, prevalence, and DALY numbers, with the highest decreases in these rates except the prevalence rate. The Western Pacific Region showed the highest incidence, death, prevalence, and DALY numbers, with declining rate trends. The Republic of Kiribati showed the highest incidence, death, prevalence, and DALY numbers. Conclusion: Based on the study results, it is clear that although the global trend of epidemiological indicators of CC is decreasing, the largest proportion of the decreasing trend is related to developing countries. But in regions of Africa and Asia that have a lower level of development, sometimes these indicators show upward trends, which shows the worsening of the problem in these regions and the need for serious policies and plans to implement comprehensive vaccination, screening, and promotion interventions. People's awareness is necessary in the field of better disease control. [ABSTRACT FROM AUTHOR]

Background and Objectives: Telomere length (TL) has been acknowledged as biomarker of biological aging. Numerous investigations have examined associations between individual early life factors and leukocyte TL; however, the findings were far from consistent. Research Design and Methods: We evaluated the relationship between individual and combined early life factors and leukocytes TL in middle and late life using data from the UK Biobank. The early life factors (eg, maternal smoking, breastfeeding, birth weight, and comparative body size and height to peers at age 10) were measured. The regression coefficients (β) and 95% confidence interval (CI) were applied to assess the link of the early life factors and TL in adulthood. Flexible parametric survival models incorporated age to calculate the relationship between early life factors and life expectancy. Results: Exposure to maternal smoking, lack of breastfeeding, low birth weight, and shorter height compared to peers at age 10 were identified to be associated with shorter TL in middle and older age according to the large population-based study with 197 504 participants. Individuals who experienced more than 3 adverse early life factors had the shortest TL in middle and late life (β = −0.053; 95% CI = −0.069 to −0.038; p < .0001), as well as an average of 0.54 years of life loss at the age of 45 and 0.49 years of life loss at the age of 60, compared to those who were not exposed to any early life risk factors. Discussion and Implications: Early life factors including maternal smoking, non-breastfed, low birth weight, and shorter height compared to peers at age 10 were associated with shorter TL in later life. In addition, an increased number of the aforementioned factors was associated with a greater likelihood of shorter TL in adulthood, as well as a reduced life expectancy. [ABSTRACT FROM AUTHOR]

Objectives: Mental and cognitive health is crucial to ensure well-being in older age. However, prolonged periods of stress, grief, and bereavement might compromise mental health balance, leading to profound changes. This study investigated the sex-stratified associations between midlife bereavement experiences (e.g. sibling loss, spousal loss, and multiple losses) and late-life depression (LLD) and cognitive impairment. Method: Linked data from the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) were used. Multiple logistic regressions were performed to examine the associations between midlife bereavement and LLD (n = 1078) and cognitive impairment (n = 995), separately. Results: Sibling loss and multiple losses in midlife were associated with lower odds of LLD, especially among women. Among men, sibling loss in midlife was associated with lower odds of cognitive impairment, while the experience of two losses among women suggested an increased (but non-significant) risk of cognitive impairment. Interaction analyses did not show significant effects between bereavement and gender on LLD and cognitive impairment. Conclusion: Midlife bereavement might have gendered implications on LLD and cognitive impairment, but associations need to be confirmed by well-powered studies. Further research is warranted to elucidate the association between multiple midlife losses and reduced LLD risk. [ABSTRACT FROM AUTHOR]

Objectives: This study sought to (1) identify the percentage of high-risk substance use or substance use disorder (SUD) and (2) examine the factors associated with high-risk substance use or SUD in adults aged 50 years and older receiving mental health treatment with a primary delirium or dementia diagnosis. Method: This study used 7 years (2013–2019) of national administrative data on community mental health center patients aged 50 years and older with a primary delirium or dementia diagnosis receiving treatment in the United States (U.S.). To examine factors associated with the dependent variable (high-risk substance use or SUD), a multivariable binary logistic regression model was utilized. Results: The sample included 77,509 individuals who were mostly aged 65 years and older (69.7%), and did not have co-occurring high-risk substance use or SUD (90.1%). Receiving treatment in a U.S. region other than the Northeast, being younger, male, not non-Hispanic White, and having multiple mental health diagnoses had greater odds of co-occurring high-risk substance use or SUD. Conclusion: One in ten persons in this sample having high-risk substance use or SUD highlights the clinical necessity for screening and subsequent treatment for co-occurring high-risk substance use among persons receiving treatment for a neurocognitive disorder. [ABSTRACT FROM AUTHOR]

Although intergenerational solidarity with adult children has been considered to have a positive impact on older parents' well-being, less is known about the association between intergenerational solidarity and longevity. Based on this background, this study identified multidimensional constructs of intergenerational solidarity with adult children and employed them as a predictor of older parents' mortality outcomes in the United States. We used data from the 1988 wave of the Longitudinal Study of Generations, focusing on middle-aged parents when they averaged 60 years of age. We conducted a latent class analysis to identify typologies of intergenerational solidarity with adult children and included these results in a Cox proportional hazard model predicting age-related mortality risk between 1988 and 2020 using data from the National Death Index. We found that the best-fitting model revealed five intergenerational solidarity classes: tight-knit, intimate-but-distant, social, detached, and obligatory. Parents in the intimate-but-distant, social, and obligatory latent classes had a lower risk of subsequent death compared to the detached latent class. However, contrary to our expectations, parents' risk of subsequent death was not significantly different between tight-knit and detached latent classes. Our findings suggest that weak ties bordering on estrangement could raise the mortality risk of parents. However, full integration, which includes support exchange, may provide little benefit to parents' survival due to having a restricted family network. [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: This study aimed to determine the incidence of septic arthritis across adult age groups in Västra Götaland Region (VGR) of Sweden, while also comparing disease characteristics among different age groups with hematogenous septic arthritis. Methods: Using ICD-10 codes for septic arthritis from 2016 to 2019, we identified 955 patients in VGR. We reviewed the medical records of 216 adult patients with hematogenous septic arthritis and compared data across age groups. Results: The overall incidence of septic arthritis in adults was 4 per 100,000 persons annually, rising to 14 per 100,000 in those ≥80 years. The median age of the 216 patients was 71. The comparison across age groups (18–64, 65–79, and ≥80) showed significantly longer hospital stays and higher mortality rate in the older groups. CRP levels were higher in the middle age group, SF-WBC counts were lower in the youngest age group, and synovial fluid crystals were more common in the oldest. No differences were found in joint involvement or the organisms isolated. Conclusion: The incidence of septic arthritis is 6.5 times higher in patients aged ≥ 80 compared to those under 65, highlighting the need to consider age-related differences in disease management. [ABSTRACT FROM AUTHOR]

This study aims to explore the change of intimate relationship between people with Alzheimer's disease and their adult child caregivers as the disease progresses. Twelve adult child caregivers were recruited through purposive sampling. Explanatory phenomenological analysis was conducted to analyse data collected by semi-structured in-depth interviews. This study found a dynamically changing relationship between adult child caregivers and their parents with Alzheimer's disease during care giving that evolved with the progress of the disease. The relationship was the most intimate in the middle stage of the disease for most caregivers and a new reciprocal relationship developed due to caregiving. Caregivers experienced different degrees of self-growth when providing care, though caregiver burdens were common. The positive experience and perception of caregivers were important for improving the quality of life for adult child caregivers of people with Alzheimer's disease. [ABSTRACT FROM AUTHOR]

More than half of older people in long-term care facilities have dementia. Little is currently known about the methods and instruments which can be used to capture the perspectives of older people, including those with dementia, regarding the quality of care provided in such facilities. The main aims of this scoping review were two-fold. Firstly, to identify quality of care instruments that have been applied in long-term care settings. Secondly, to evaluate how these instruments have been developed and validated, particularly in terms of their applicability among older people with dementia. Seven databases (Medline, Web of Science, Scopus, ProQuest, Ageline, CINHAL and google scholar) were searched for relevant literature without any date limit. We used quality criteria adapted from COSMIN (Consensus-based Standards for the selection of health status Measurement Instruments) guidelines to assess the psychometric properties of the instruments. The search identified 16 quality of care instruments which had been used in long-term care settings. Of which, two (12.5%) were specifically designed for older people with dementia, and three instruments (18.7%) were modified for use with older people with mild to moderate dementia. A variety of methods were used to develop the identified instruments including literature reviews, qualitative interviews, expert panel reviews, pre-testing and piloting with older people. None of the identified instruments had been subjected to comprehensive psychometric assessment. Most instruments for assessing quality of care in long term care settings lack alternative communication techniques tailored to people with dementia. This review highlights the need for more rigorous psychometric testing of existing instruments for assessing quality of care in long-term care settings. Several existing measures show promise and may be taken forward for further testing and development for widespread application with older people, including those living with dementia, in long term care settings. [ABSTRACT FROM AUTHOR]

Introduction: People living with young-onset dementia and their care-partners are at risk of a range of adverse mental health outcomes and social isolation. There are few interventions aimed at supporting couples affected by young-onset dementia, which poses unique psychosocial challenges for younger people. Methodology: This pre-post interventional mixed methods pilot study aimed to assess the feasibility and acceptability of an online group program for people with young-onset dementia and their care-partners living at home in Australia. The Music And Psychology and Social connections (MAPS) program aimed to address: (1) the challenges and changes associated with young-onset dementia; and (2) coping and wellbeing. The program involved six weekly two-hour sessions co-facilitated by a psychologist and music therapist, and a private Facebook group. The primary outcomes of feasibility and acceptability were assessed through a post-program focus group, separate individual feedback sessions with each couple, and a program evaluation questionnaire. Thematic analysis was conducted on the focus group transcripts and field notes from couple feedback sessions. We also examined the preliminary utility of MAPS in improving mental health and social connectedness, using quantitative pre-post-measures. Results: Five couples completed the MAPS program. The most common dementia type was Alzheimer's Disease. Participant attendance was 87% across all sessions. Qualitative findings supported acceptability of the program with four emergent themes: being connected to others with shared experiences; reframing thoughts and feelings about dementia; music as a therapeutic tool; and benefits of MAPS. Conclusion: The high retention rate, qualitative findings and positive program evaluation suggest MAPS may be a promising, feasible and acceptable program for couples affected by young-onset dementia. [ABSTRACT FROM AUTHOR]

Little is known about the possibility of reversing age-related biological changes when they have already occurred. To explore this, we have characterized the effects of reducing insulin/IGF-1 signaling (IIS) during old age. Reduction of IIS throughout life slows age-related decline in diverse species, most strikingly in the nematode Caenorhabditis elegans. Here we show that even at advanced ages, auxin-induced degradation of DAF-2 in single tissues, including neurons and the intestine, is still able to markedly increase C. elegans lifespan. We describe how reversibility varies among senescent changes. While senescent pathologies that develop in mid-life were not reversed, there was a rejuvenation of the proteostasis network, manifesting as a restoration of the capacity to eliminate otherwise intractable protein aggregates that accumulate with age. Moreover, resistance to several stressors was restored. These results support several new conclusions. (1) Loss of resilience is not solely a consequence of pathologies that develop in earlier life. (2) Restoration of proteostasis and resilience by inhibiting IIS is a plausible cause of the increase in lifespan. And (3), most interestingly, some aspects of the age-related transition from resilience to frailty can be reversed to a certain extent. This raises the possibility that the effect of IIS and related pathways on resilience and frailty during aging in higher animals might possess some degree of reversibility. [ABSTRACT FROM AUTHOR]

Genetically heterogeneous UM-HET3 mice born in 2020 were used to test possible lifespan effects of alpha-ketoglutarate (AKG), 2,4-dinitrophenol (DNP), hydralazine (HYD), nebivolol (NEBI), 16α-hydroxyestriol (OH_Est), and sodium thiosulfate (THIO), and to evaluate the effects of canagliflozin (Cana) when started at 16 months of age. OH_Est produced a 15% increase (p = 0.0001) in median lifespan in males but led to a significant (7%) decline in female lifespan. Cana, started at 16 months, also led to a significant increase (14%, p = 0.004) in males and a significant decline (6%, p = 0.03) in females. Cana given to mice at 6 months led, as in our previous study, to an increase in male lifespan without any change in female lifespan, suggesting that this agent may lead to female-specific late-life harm. We found that blood levels of Cana were approximately 20-fold higher in aged females than in young males, suggesting a possible mechanism for the sex-specific disparities in its effects. NEBI was also found to produce a female-specific decline (4%, p = 0.03) in lifespan. None of the other tested drugs provided a lifespan benefit in either sex. These data bring to 7 the list of ITP-tested drugs that induce at least a 10% lifespan increase in one or both sexes, add a fourth drug with demonstrated mid-life benefits on lifespan, and provide a testable hypothesis that might explain the sexual dimorphism in lifespan effects of the SGLT2 inhibitor Cana. [ABSTRACT FROM AUTHOR]

Building on the rich array of literatures that explore women's ageing and employment, we conduct a comprehensive review of research on middle‐ and older‐age women and work (including menopause and post‐menopause). In reviewing these studies, we blend our interdisciplinary discussions across several domains. We reflect on the question: How are employed, middle‐ and older‐age women treated in organizations, and what are employers' perceptions of these workers? Through our analysis, we identify and critique two predominant, conflicting yet inter‐related themes. These are, namely, notions of constraint (and women's supposed/perceived reduced competencies as they age) versus ideas of flexibility (foregrounding assumptions that employed women experience fewer limitations as they age). As a theoretical lens for theorizing the constraints theme, we draw upon the concept of abjection, highlighting how employer perceptions of women's health as supposedly diminishing can lead to discriminatory treatment at work. In analysing theoretical assumptions regarding apparently enhanced flexibility among middle‐ and older‐age women, we note how women's differing circumstances and requirements might go unrecognized. We argue the need to deepen theoretical understandings about ideas of flexibility during women's middle and older age. Reflecting on the limitations of both themes, we consider the implications for future research agendas. [ABSTRACT FROM AUTHOR]

AbstractSocial changes in industrialized societies have prolonged adolescence, postponing entry into adult roles. We use U.S. age-arrest data to investigate whether this delay has contributed to higher crime rates among emerging adults, altering population age-arrest curves. We compare parameters for multiple offenses from 1980 to 2019 to answer: (1) Have there been recent shifts toward older, less adolescent-spiked curves; (2) If so, do emerging adults today exhibit higher offending levels than historical counterparts; or (3) Do proximate age-groups drive these distributional alterations? We find peak age remains in the late teens, but today’s age-curves for minor offenses are more symmetrical compared to preceding adolescent-spiked iterations. Given contemporary emerging adults’ relatively low offending levels, more symmetrical age curves are the product of precipitous declines in teen arrest rates coupled with higher mid-life adult rates. Tracking future age-arrest trends is important, but data collection challenges related to the UCR-NIBRS transition may hinder those efforts. [ABSTRACT FROM AUTHOR]