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Increasing physical activity (PA) and/or decreasing sedentary behaviors is important in the delay and prevention of long-term conditions. PA can help maintain function and independence and decrease the need for hospitalization/institutionalization. Activity rates often decline in later life resulting in a need for interventions that encourage uptake and adherence through the use of Behavior Change Techniques (BCTs). We conducted a systematic review of the evidence for interventions that included BCTs in community-dwelling adults with a mean age of 50–70. The review followed PRISMA guidelines. The interventions were psychosocial, nonpharmacological, and noninvasive interventions utilizing components based on BCTs that evaluated change in PA and/or sedentary behavior. Intervention Component Analysis (ICA) was used to synthesize effectiveness of intervention components. Twelve randomized controlled trials were included in this review. The mean sample age was 50–64. Thirteen BCTs were used across all studies, and the most commonly used techniques were goals and planning, feedback and monitoring, and natural consequences. Seven intervention components linked with BCTs were found: personalized goal setting, tailored feedback from facilitators, on-site and postintervention support, education materials and resources, reinforcing change on behavior and attitudes, self-reported monitoring, and social connectedness. All components, except for social connectedness, were associated with improved health behavior and PA levels. The interventions that use BCTs have incorporated strategies that reinforce change in behavior and attitudes toward PA. [ABSTRACT FROM AUTHOR]

Despite the well-known benefits of physical activity, less than half of adults aged 55–75 years participate in sufficient physical activity. Short bouts of vigorous intermittent lifestyle physical activity (VILPA) accumulated throughout the day can contribute toward the recommended volume of physical activity. A rich characterization of the barriers and facilitators to participation in VILPA is needed to develop targeted interventions. This scoping review aimed to identify barriers and facilitators to participation in different components of VILPA in adults aged 55–75 years, and to map barriers and facilitators to the Theoretical Domains Framework. Within the 18 eligible studies, the most prevalent barriers were related to a person's skills, environmental context, and social influences. Most facilitators were related to a person's goals, social influences, and environmental context. Interventions to promote VILPA should test the effectiveness of behavioral change measures related to the unique barriers and facilitators in this age group. [ABSTRACT FROM AUTHOR]

As rates of obesity continue to rise, so does the impact of obesity on cognitive function. Engaging in physical activity is one pathway through which individuals can help maintain cognitive function. This study examined whether any link between exercise and cognitive function was associated with weight characteristics. Data from 6,012 participants in the Health and Retirement Study were used. The association between participation in light or moderate physical activity and better cognitive function was particularly strong for overweight or obese adults and less so for those who were normal weight. Overall, the findings suggested that while being physically active is associated with better cognitive function regardless of weight, the associations were stronger for individuals who were overweight/obese compared with those who were normal weight. Given the results were particularly pronounced for waist circumference (relative to body mass index), further research should be conducted to examine if individuals with greater abdominal adiposity may benefit most from staying active in terms of their cognitive function. [ABSTRACT FROM AUTHOR]

BACKGROUND: Middle age is increasingly acknowledged as a critical window for prevention of Alzheimers disease and related dementia (ADRD) since research has shown that AD develops in the course of 20-30 years (1) but we know very little about middle-aged individuals perspectives on ADRD. Knowledge gaps are particularly large for Latinas living in regions typically underrepresented in ADRD research, such as rural and/or agricultural regions. This is important given that over the next 40 years Latinos are projected to have the largest increase in ADRD cases in the U.S. Therefore, this study aims to assess knowledge, perceptions, and feelings associated with ADRD among a sample of middle-age, Spanish-speaking Latina women. METHOD: Using qualitative methods involving semi-structured interviews, we examined knowledge, perceptions, and feelings associated with ADRD among a subsample of the Center for Health Assessment of Mothers and Children of Salinas (CHAMACOS) study. Participants are Latina women residing in an underserved agricultural community entering mid-life (mean = 46.5 years old). Interviews were conducted with 20 women and data was analyzed with inductive thematic content analysis. RESULTS: We identified themes regarding perceptions, knowledge, and feelings. First, participants perceive ADRD as involving (1) Loss of memory, (2) Getting lost; (3) Losing the person they once were. With regard to knowledge about ADRD, participants reported: (1) Some knowledge about protective and risk factors for ADRD, (2) No awareness of the links between cardiovascular risk factors and ADRD; (3) A desire to learn prevention methods alongside signs and symptoms of ADRD. Themes related to feelings about ADRD were: (1) Fear of developing ADRD and not being aware of reality or who they are; (2) Worry about losing relationships with loved ones and caretaking if diagnosed with ADRD; (3) Sadness about forgetting ones family and depending on others if diagnosed with ADRD. CONCLUSION: The knowledge gaps and negative feelings associated with ADRD highlighted in this study underscore the need for ADRD interventions to include CVD prevention, particularly for mid-life Latino populations residing in rural regions.

We tested if a dance trial yielded improvements in physical function and cardiorespiratory fitness (CRF) in middle-aged/older Latino adults. Physical activity was assessed using the Community Healthy Activities Model Program for Seniors, physical function with the Short Physical Performance Battery (SPPB) protocol, and estimated CRF with the Jurca nonexercise test model. Multivariate analysis of covariance models found significant change in SPPB protocol total scores, F(1, 329) = 4.23, p =.041, and CRF, F(1, 329) = 5.16, p =.024, between the two study arms in favor of the dance group. Mediation models found moderate- to vigorous-intensity physical activity to mediate to mediate between group and SPPB scores (β = 0.054, 95% confidence interval [0.0142, 0.1247]). Moderate- to vigorous-intensity physical activity and total physical activity were found to partially mediate between group and CRF (β = 0.02, 95% confidence interval [−0.0261, 0.0751]), with the direct pathway no longer being significant (p >.05). This provides support for Latin dance programs to have an effect on SPPB protocol and CRF. [ABSTRACT FROM AUTHOR]

Knowledge of how the different types of sedentary behaviors (SB) are associated with functional limitations can guide professionals who work with older adults on better recommendations about the amount of daily time that should be encouraged in each type of SB. The objective was to estimate the associations between two SB typologies (SB television [TV] and SB computer/internet) and the presence of handgrip strength, lower limb strength, gait speed, and balance limitations in Brazilian community-dwelling older adults. This is a cross-sectional study with 1,298 community-dwelling older adults (≥60 years). SB was assessed by self-reporting daily time spent watching TV or using computer/internet (categorized into <2, 3–4, and ≥5 hr/day). Outcomes were handgrip strength, lower limb strength, gait speed, and balance limitations considering referenced cutoff points. Older adults in SB TV ≥5 hr/day had 1.75 (95% confidence interval [CI] [1.07, 2.86]) and 1.88 (95% CI [1.02, 3.46]) times more chances of handgrip strength and gait speed limitations, respectively. On the other hand, those who spent 3–4 and ≥5 hr/day in SB computer/internet had 0.45 (95% CI [0.20, 0.99]) and 0.37 (95% CI [0.15, 0.93]) had less chances of lower limb strength and balance limitations, respectively. In conclusion, functional limitations would be associated differently depending on the type of SB in the older adults sampled. [ABSTRACT FROM AUTHOR]

Many studies have shown that personalized exergames have a positive effect on promoting regular and proper exercise. However, there is no consensus on the design characteristics and evaluation of exergames. This systematic review of published research literature aimed to explore the general characteristics, personalization characteristics, and evaluation of personalized exergames for middle-aged and older people. We screened published studies in the Web of Science, Scopus, PubMed, ACM, and IEEE Xplore databases, extracted data, and performed a thematic analysis according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. Three main themes and nine subthemes were generated from 24 included papers. Moreover, a personalization model (FACTS) and evaluation system (PMSS) of exergames were developed. Personalized exergames had potential positive effects on motivating middle-aged and older people to exercise and improve their health, particularly physical, mental, and social health. However, more fine-grained studies on personalized exergames are necessary in the future. [ABSTRACT FROM AUTHOR]

The objective of this study was to estimate the extent to which motivational regulations influence physical activity behavior through role identity among people 55 years or older. Participants (N = 409; Mage = 66.29 years [SD = 7.06]) completed online questionnaires to measure motivational regulations, role identity, and the frequency of physical activity in a typical week and in the past month. Mediation analysis using ordinary least squares path analysis revealed that autonomous forms of motivational regulation (positively) and controlled forms of motivational regulation (negatively) influenced role identity, which then positively influenced physical activity behavior. Bootstrap confidence intervals (95%) for the indirect effects (a × b) based on 5,000 bootstrap samples were entirely above or below zero. These findings point to future experimental evaluations of interventions aiming at both increasing and decreasing autonomous and controlled motivational regulations, respectively, to promote physical activity behavior through role identity. [ABSTRACT FROM AUTHOR]

The goal of the present study was to examine naturalistic associations between body satisfaction and physical activity (PA) among women in midlife. Women 40–60 years of age with cardiovascular risk factors (e.g., hypertension; N = 75; Mage = 51.63) responded to five surveys per day for 10 days while accelerometer-derived PA measurements were collected continuously. PA parameters included cognitive determinants (PA motivation and intentions) and accelerometer-measured PA behavior (sedentary behavior, light-intensity PA, and moderate to vigorous PA). Multilevel models indicated that associations between body satisfaction and everyday PA differed across PA determinants, time frames (concurrent and prospective), and levels (momentary, daily, and person). For example, positive bidirectional associations were identified between women's daily body satisfaction and PA motivation, whereas greater momentary light-intensity PA (but not moderate to vigorous PA) was unidirectionally associated with greater body satisfaction at a subsequent prompt. These findings provide insight into how associations between body satisfaction and PA unfold in the daily lives of women in midlife and highlight the complexities of these associations. [ABSTRACT FROM AUTHOR]

Physical activity is a leading determinant of health and well-being in older adults; however, participation is low. Social support can significantly influence physical activity uptake and maintenance; however, most research is cross-sectional and does not differentiate among types of support. The current study assessed four types of social support for physical activity reported over 9 years by adults aged 60–65 at baseline (n = 1,984). Data were collected using a mail survey at four time points. Data were analyzed using linear mixed models. The most common type of support was emotional, with 25% of participants reporting this often/very often. Total support for activity declined by 16% across the 9 years (p <.001). Companionship had the greatest decline among types (17%–18%, p <.001). More work is needed to understand the factors contributing to the decline in support and how to enable access to support for physical activity in older adults. [ABSTRACT FROM AUTHOR]

Background: Reserves' mechanisms explain inconsistencies between accumulation of neuropathological damage and clinical manifestations. Leisure activities are believed to promote reserves. Objective: This study evaluates whether cognitive, social, and physical leisure activities performed over life-span predict current cognitive functioning in normal aging and Alzheimer's disease (AD) continuum. Methods: 35 AD, 24 amnestic-Mild Cognitive Impairment (a-MCI) patients, 21 individuals with subjective cognitive complaint (SCD), and 25 controls underwent a questionnaire developed to quantify leisure activities in different life periods, the Addenbrooke's Cognitive Examination-Revised (ACE-R), and T1-weighted 3T-MRI scans for brain volumetrics and cortical thickness quantification. Partial/total leisure activities' scores and demographic and brain variables were entered as predictors, while ACE-R scores as dependent variables in linear regression analyses. Results: Current level of cognition was predicted by (i) social and physical activities performed in middle age and current cognitive activity in AD; (ii) cognitive and social activities performed in middle age, current age and cortical thickness in a-MCI; (iii) recreational activities the set of lifetime, current age, and brain features in SCD; (iv) education and the set of lifetime leisure activities over lifespan in controls. Conclusions: This study shows a funnel effect due to gradual reduction of stimulatory activities in the transition from healthy aging to AD. Reserve indices taking into account different types of stimulatory activities allow to capture even smallest residual effects of reserves accumulated over lifespan, until their complete depletion at advanced AD stages. These results may help target tailored interventions during normal and pathological aging. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionsThis study aimed to examine factors associated with seogeulpeum (a feeling of loneliness and solitude) – including aging anxiety, menopausal symptoms, social support and self-efficacy – in middle-aged women to provide fundamental data for future research endeavors.One hundred and fifty-nine women aged 40–60 years were recruited from two cities in Gyeongnam Province and Busan City. Gu and Eun’s Seogeulpeum Scale was employed to evaluate seogeulpeum, alongside questionnaires to assess menopause status and symptoms, self-efficacy, social support and aging anxiety. To determine factors influencing seogeulpeum, a multiple stepwise regression analysis was conducted.The average seogeulpeum score was 2.4 ± 0.44, indicating a moderate level of seogeulpeum experienced by the participants. Seogeulpeum was positively correlated with aging anxiety and menopausal symptoms, and negatively with self-efficacy and social support, among which aging anxiety most significantly influenced seogeulpeum. Aging anxiety, menopausal symptoms and social support combined accounted for 60.9% of the variation observed in seogeulpeum.The findings indicate the importance of health interventions aimed at reducing aging anxiety and menopausal symptoms and enhancing social support for promoting well-being and facilitating a healthy menopausal transition among middle-aged women. Additionally, seogeulpeum can serve as a valuable process indicator during this stage of multiple transitions for women. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the association of Time In Range (TIR) obtained from Blood Glucose Monitoring (BGM) with Cognitive Impairment (CI) inpatients with middle-aged Type 2 Diabetes Mellitus (T2DM) and further explored whether a TIR goal for T2DM in adults with > 70% possess a protective effect on cognitive function. Research design and methods: A total of 274 inpatients with T2DM aged 40–64 years, who underwent seven-point BGM (pre meals and 120 min post meals and at bedtime) were recruited in this cross-sectional study. TIR was defined as the percentage of blood glucose within the target range of 3.9-10.0mmol/L. Subjects were divided into Normal Cognitive Function (NCF) (n = 160) and CI (n = 114) groups according to the results of the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). The association of TIR and other glycemic metrics, calculated from seven-point BGM data, with cognitive dysfunction was analyzed. Results: The prevalence of CI was 41.6% in patients with middle-aged T2DM (median age 58 years). TIR was lower in CI group than in NCF group (28.6% vs. 42.9%, P = 0.004). The prevalence of CI decreased with ascending tertiles of TIR (p for trend < 0.05). Binary logistic regression analysis showed a significant association between TIR and CI (odds ratio [OR] = 0.84, p < 0.001) after adjusting for confounders (age, education, marital status, age at Diabetes Mellitus (DM) onset, cerebrovascular disease). Further adjustment of Standard Deviation (SD)(OR = 0.84, p = 0.001) or Coefficient of Variation (CV)(OR = 0.83, p < 0.001), TIR was still associated with CI. While a TIR goal of > 70% probably possessed independent protective effect on cognitive function (OR = 0.25, p = 0.001) after controlling for confounders above. Conclusions: TIR obtained from BGM was related to CI in middle-aged T2DM individuals and a TIR goal of > 70% probably possessed a protective effect on cognitive function for middle-aged T2DM. [ABSTRACT FROM AUTHOR]

Background: The Developmental Origins of Health and Disease Hypothesis (DOHaD) suggests prenatal alcohol exposure (PAE) should have implications for adult physical and mental health. Since the health profile of older adults with PAE and diagnoses of fetal alcohol spectrum disorder (FASD) is unknown, the current study evaluates self‐reported health problems of midlife adults with and without a history of PAE to describe these outcomes. Methods: Participants (N = 357) recruited from longitudinal cohorts in Atlanta, GA and Seattle, WA completed a health survey assessing a range of physical conditions. Initial analysis compared the frequency of conditions between alcohol‐exposed and nonexposed groups. To identify patterns within groups, 10 problem areas were subjected to latent class analysis (LCA). Finally, the direct effect of PAE on health outcomes was evaluated using multilevel modeling, controlling for effects of other factors. Results: Compared with unexposed controls, individuals with PAE reported significantly higher frequencies of problems with hearing, dentition, heart, cancer, gastritis, kidney stones, bladder, diabetes, thyroid, skin, and seizures. LCA found that controls yielded two classes, with 45% reporting sleep and vision problems and 55% reporting sleep, vision, cardiovascular, endocrine, immune, and dental problems. The PAE group yielded three classes, with 13% endorsing few health problems, 43% reporting sleep, vision, immune, and dental problems, and 43% reporting sleep, vision, cardiovascular, urinary, endocrine, skin, immune, dental, and gastrointestinal problems. With multivariate analysis, controlling for other influences, PAE was associated directly with hearing, urinary, dental, and gastrointestinal problems. A similar pattern was found for alcohol‐exposed individuals who did and did not meet criteria for fetal alcohol syndrome (FAS). Discussion: Patients affected by alcohol may report greater frequency and range of health adversity. That PAE was only uniquely associated with a limited set of problems suggests that many health outcomes in midlife result from an initial vulnerability potentiated by postnatal stress resulting from other associated factors. [ABSTRACT FROM AUTHOR]

Background: This study evaluated the relationship between aging and tympanometric changes, specifically the incidence of type C tympanograms, using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: We analyzed data from the 2019–2022 KNHANES, including 26,738 ears from individuals aged 40 and older. Tympanometry at 226 Hz identified type C tympanograms based on peak pressure below −100 daPa. Multiple logistic regression evaluated the association between age and type C tympanograms, adjusting for confounders such as sex, smoking status, allergic rhinitis, chronic sinusitis, and lifestyle disease markers. Results: The incidence of type C tympanograms increased significantly with age (R2 = 0.953, p < 0.001). Age was the most significant factor associated with type C tympanograms (p < 0.001, odds ratio 1.052), while other factors were not statistically significant. Ears with type C tympanograms had significantly poorer hearing thresholds compared to those with type A tympanograms (p < 0.001). Conclusions: Aging is significantly associated with an increased incidence of type C tympanograms, indicating possible middle ear dysfunction in older adults. The correlation between type C tympanograms and poorer hearing thresholds suggests that age-related changes in middle ear function may contribute to hearing impairment. Tympanometric screening in older adults may facilitate early detection and management of middle ear dysfunction, potentially improving hearing outcomes and quality of life. [ABSTRACT FROM AUTHOR]

In this study, we examined rates of insomnia and co-occurring unhealthy alcohol use in a national sample of women Veterans age 50 years and older. We further explored associations between sociodemographic measures, insomnia-related clinical characteristics, and unhealthy alcohol use, and analyzed whether women with insomnia were more likely to report unhealthy alcohol use. Study aims were evaluated using national Veterans Health Administration (VA) electronic health records data from VA's Corporate Data Warehouse. Data were extracted for women Veterans ≥50 years old with ≥1 VA primary care visit in each study year (2018: 3/11/18–3/10/19; 2020: 3/11/20–3/10/21; 2022: 3/11/22–3/10/23). Cases of insomnia were identified via diagnostic codes and prescription medications for insomnia. Unhealthy alcohol use was identified via Alcohol Use Disorders Identification Test-Consumption screening scores indicating unhealthy alcohol use. Annual sample sizes ranged from 240,420–302,047. Over the study timeframe, insomnia rates (diagnosis or medication) among women ≥50 years old ranged from 18.11–19.29%; co-occurring insomnia and unhealthy alcohol use rates ranged from 2.02–2.52%. Insomnia and unhealthy alcohol use rates were highest among women aged 50–59 years old. Depression and physical health comorbidities were consistently associated with insomnia; associations by race and ethnicity were less consistent. Compared to women without insomnia, women Veterans with either concurrent or unremitting insomnia were more likely to endorse unhealthy alcohol use. Findings signal a potential need for assessment and preventative efforts aimed at addressing insomnia and unhealthy alcohol use among women Veterans. [ABSTRACT FROM AUTHOR]

As individuals transition into middle age, subtle declines in postural control may occur due to gradual reductions in neuromuscular control. The current study aimed to examine the effect of age on bipedal postural control across three support surfaces with varying degrees of instability: a firm surface, a foam pad, and a multiaxial balance board. The effect of surface stability was also assessed. Postural accelerations were recorded using a tri-axial accelerometer placed over the lumbar spine (L5) in 24 young female adults (23.9 ± 5.3 years) and 24 middle-aged female adults (51.4 ± 5.9 years). Sample entropy (SampEn) was used to analyze the complexity of postural control by measuring the regularity of postural acceleration. The main results show significant age-related differences in the mediolateral and anteroposterior acceleration directions (p ≤ 0.012). Young adults exhibit more irregular fluctuations in postural acceleration (high SampEn), reflecting greater efficiency or automaticity in postural control compared to middle-aged adults. Increased surface instability also progressively decreases SampEn in the mediolateral direction (p < 0.001), reflecting less automaticity with increased instability. However, no interaction effects are observed. These findings imply that incorporating balance training on unstable surfaces might help middle-aged adults maintain postural control and prevent future falls. [ABSTRACT FROM AUTHOR]

To date, little is known about body image and eating concerns among men in midlife. To bridge this gap in the literature, this study tested an adapted and integrated sociocultural model of body image and eating concerns among men in midlife. A sample of men (N = 213) between the ages of 45 and 60 years living in the United States completed an online survey and reported on sociocultural pressures from media, friends, family and partners, body image in younger years, internalization of a youthful lean and muscular ideal, appearance comparison, sexual objectification, body dissatisfaction, attitudes towards muscularity, drive for leanness and thinness, participation in muscularity-oriented behaviors, and restrictive eating. After modification, the final model revealed good fit to the data. Although not all predicted pathways were supported, overall, interpersonal and media pressures were related to internalization of ideals and appearance comparison. In turn, internalization and comparison were related to higher body dissatisfaction, drive for leanness and muscularity, and engagement in muscularity-oriented behaviors and restrictive eating. Findings support the usefulness of an adapted and integrated sociocultural model of body image and eating concerns in midlife men. The model suggests that the pressures that may increase body image and eating concerns in younger men may also be relevant in midlife men. Findings also highlight the usefulness of considering age-specific body-change behaviors and disordered eating in midlife men. [ABSTRACT FROM AUTHOR]

In about 400 Prudentius visited the shrine of St Cassian at Imola and wrote a poem describing his martyrdom. Cassian, a schoolmaster, had been killed by his own pupils using their styli and wax tablets. The story was popular throughout the Middle Ages and its medieval reception has attracted attention. In addition, and hitherto unnoticed, features of Cassian's death became motifs in narratives of violence in the medieval schoolroom, and this article explores these and reflects on what they can tell us about changes in the teacher–pupil relationship from Late Antiquity to the end of the twelfth century. [ABSTRACT FROM AUTHOR]

This article discusses a special type of narrative: encounters with named individuals in hell. The catchment is broad (Homer to Dante) but the focus is on the early Middle Ages. Philological and literary techniques elucidate and reinterpret a number of important visionary texts, Anglo‐Saxon, Merovingian, and Carolingian. Boniface, Ep. 115 re‐emerges as a woman's vision. Gregory of Tours, DLH 8.5 (Guntram's banquet of 585), where Chilperic is sighted, finds a place within the Roman tradition of the dark or terrifying banquet and the dangerous telling of dreams. In the Visio Pauperculae (terminus post quem = 3 October 818), Queen Irmengard's torture is reinterpreted by reference to the NT and to contemporary legal realia. An argument is made for an old emendation that required a romantic and courtly reading, including a fuzzy connection to Dante's Inferno 5. [ABSTRACT FROM AUTHOR]

Aim: This study aims to explore the association between declining lung function and depression in middle‐aged and older adults, with a special focus on the mediating role of cognitive function. Methods: This study utilizes self‐reported and physical examination data from 5345 individuals participating in the 2015 cycle of the China Health and Retirement Longitudinal Study (CHARLS) to explore the role of cognitive function changes in mediating the effects of diminished lung function on depression among middle‐aged and older adults. Results: Multivariate linear regression analysis revealed a positive correlation between pulmonary and cognitive functions (β = 0.003, 95% CI: 0.002∼0.003, P < 0.01) and a negative correlation between cognitive function and depression (β = −0.279, 95% CI: −0.330–0.228, P < 0.01). Cognitive function plays a mediating role in linking pulmonary function with depression, exhibiting a mediation effect of −0.0007 and a total effect of −0.0046, wherein the mediation effect contributes to 15.22% of the total effect. For females, the mediating effect of cognitive function was stronger (β = −0.0013, 95% CI: −0.0018∼–0.0008, P < 0.01) than it was for males (β = −0.0006, 95% CI: −0.0009∼–0.0003, P < 0.01). Conclusions: The study underscores the importance of monitoring lung and cognitive functions as interconnected factors contributing to the mental health of middle‐aged and older adults. It suggests that interventions aimed at improving pulmonary health and cognitive function may help mitigate depressive symptoms among middle‐aged and older adults. Further research is warranted to validate these findings across diverse cultural and demographic settings. Geriatr Gerontol Int 2024; 24: 1210–1217. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this longitudinal study was to evaluate the prevalence and correlates of and the factors contributing to meal‐skipping in middle‐aged and older adults in Thailand. Methods: We examined prospective cohort data from three consecutive waves of the Health, Aging and Retirement in Thailand (HART) study (analytic sample size = 2863) for participants 45 years of age and older. Meal‐skipping was assessed with a one‐ and two‐day recall of breakfast, lunch, and dinner. We used generalized estimating equations analysis to evaluate the longitudinal relationships between sociodemographic, lifestyle, and health indicators and meal‐skipping between 2015 (wave 1), 2017 (wave 2), and 2020 (wave 3). Furthermore, binary logistic regression was used to establish the longitudinal association between meal‐skipping and the incidence of multiple chronic conditions. Results: The prevalence of meal‐skipping was 6.2% in 2015, 16.2% in 2017, and 13.6% in 2020, and across study years the highest proportion of meal skipping was for lunch (6.0%), followed by breakfast (4.6%), and dinner (2.8%). In the final model, sociodemographic factors (higher education, urban residence, and lower subjective economic status), lifestyle factors (high alcohol use, current smoking, and obesity class II), and health indicators (probable depression and wearing dentures) were positively associated with meal‐skipping. In the adjusted logistic regression models, compared with no meal‐skipping, meal‐skipping in 2–3 study waves was associated with incident obesity and incident probable depression. Conclusion: Skipping meals was linked to a number of lifestyle variables and indicators of physical and mental illness. Geriatr Gerontol Int 2024; 24: 1196–1202. [ABSTRACT FROM AUTHOR]

Chronic diseases have become one of the most important factors threatening human health. Subjective life expectancy (SLE) describes an individual's expectation or subjective perception of lifespan. This article aims to explore the relationship between chronic diseases and SLE, as well as the differences among different age groups and different types of chronic diseases in this relationship. China Health and Retirement Longitudinal Study (CHARLS) is a nationwide longitudinal study that evaluates the social, economic, and health conditions of middle‐aged and older adult families and individuals aged 45 and above in China. In this study, CHARLS used probability proportional to size sampling (PPS sampling) to ensure the breadth and representativeness of the sample. This study selected cross‐sectional data from CHARLS 2018, removed missing values, and obtained a valid sample of 10,658 middle‐aged and older individuals, of whom 8564 had chronic diseases. After controlling demographic, health behavior, socioeconomic, psychological, and social security factors, an ordered logistic regression was performed to explore the relationship between chronic disease and SLE in middle‐aged and older adults. The results show that chronic diseases negatively correlate with SLE in middle‐aged and older adults. Middle‐aged and older adults with chronic diseases are 36.2% less likely to have high life expectancy than those without chronic diseases. Many different types of chronic diseases are negatively correlated with SLE. Cancer is most negatively correlated with SLE, far exceeding other chronic diseases. Chronic disease and SLE of middle‐aged and older adults have age‐heterogeneous differences. For middle‐aged people aged 45–59 and young older adults aged 60–79, there is a significant correlation between chronic diseases and SLE. However, there is no correlation between chronic diseases and subjective life expectancy in the older population aged 80 and above. The government and society should pay close attention to the prevention and treatment of chronic diseases among middle‐aged and older adults and adjust policies and measures according to the population's age structure. In addition, the government and society should pay attention to the spiritual needs of middle‐aged and older adults. The government and society should pay more attention to cancer patients. Finally, the scientific research team should also strengthen research on chronic diseases, research and development of specific drugs and vaccines, improve the cure rate of chronic diseases, promote people's health, and make people no longer afraid of diseases. [ABSTRACT FROM AUTHOR]

Objectives Later life is often categorized by higher-than-average levels of loneliness, but individual differences are vast and not well understood. Emerging evidence indicates that broad-based contextual factors such as the coronavirus disease 2019 (COVID-19) pandemic—and the use of the internet throughout—are differentially associated with the experience of loneliness. We, therefore, target internet usage and loneliness among middle-aged and older adults during the pandemic and examine the moderating role of age, gender, and limiting illness therein. Methods We applied hierarchical regression models to data from the COVID-19 substudy Wave 1 (June/July 2020) of the English Longitudinal Study of Ageing (N  = 4,790; M age = 70.2; standard deviation = 9.0; range: 50–90; 43.5% male). Results Infrequent internet use was associated with less loneliness compared with very frequent users—an association that strengthened with age. Conversely, the purpose of internet use was associated with more loneliness, with higher levels exhibited by those searching for health-related information—an effect stronger among those with a limiting illness. Discussion Findings imply that infrequent internet use may reduce loneliness, while health-related internet searches may increase loneliness among older adults with different physical capacities. Findings are contrary to prepandemic reports, underscoring the importance of broad-based contextual factors for understanding loneliness across adulthood and old age. [ABSTRACT FROM AUTHOR]

Background: This study investigated psychosocial factors related to preparedness for well‐dying among middle‐aged and older adults and verified a model that can predict it along with psychosocial factors and demographic profiles to provide useful information for intervention. Methods: The participants were 340 middle‐aged and older Korean adults aged 40–79 years. The predictive models were verified using stepwise regression and decision tree analyses. Results: The results revealed that personality, meaning of life, hardiness, intrinsic religiosity, death anxiety, family support, subjective well‐being, and expectations for future life were significantly correlated with preparedness for well‐dying among middle‐aged and older adults. A stepwise regression analysis revealed that meaning of life accounted for the greatest variance in preparedness for well‐dying. A decision tree model predicting preparedness for well‐dying included search for meaning, the presence of a spouse, family support, having a job, tenacity, conscientiousness, and positive emotions. Conclusion: These findings suggest that search for meaning and tenacity in middle‐aged and older adults as well as the presence of a spouse or occupation and family support may play important roles in preparing for well‐dying. [ABSTRACT FROM AUTHOR]

In this study, the researchers aimed to understand the life experience of older widowed women living alone. Employing a phenomenological approach, we interviewed 15 older women (age 62 to 95) living alone at homes in two villages in Central Java. Through systematic text condensation procedure, we identified five themes: (1) negative feelings at times, (2) getting used to living alone, (3) needing help to support independent living, (4) coping toward negative feelings, (5) attachment to the original house. We depicted the struggles of older women living alone in their homes. Despite the coping strategies they have developed over time, older women needed help during hard times, especially when getting sick. Families and neighbors were the main resources to maintain their independent living. Improving the home environment to increase suitability for aging residents and providing a support system are the options that best fit the needs and values the older women believed. [ABSTRACT FROM AUTHOR]

This study investigated the association between prior incarceration length and edentulism among US adults 55 years and older. Analyses explored indirect factors such as wealth, smoking status, mental health, and chronic health conditions that may explain this relationship. In addition, the study analyzed how associations between incarceration and edentulism vary by race and ethnicity. The authors used data from the 2012-2014 Health and Retirement Study (unweighted N = 11,630; weighted N = 72,872,877) to assess the relationship between incarceration duration and edentulism through multivariable logistic regression. The Karlson-Holm-Breen method evaluated indirect effects, and multiplicative interaction terms examined variations by race and ethnicity. Net of control variables analyses showed a positive association between having been incarcerated for more than 1 month and higher odds of edentulism. However, this association was rendered statistically nonsignificant after accounting for wealth, current smoking status, mental health, and chronic disease. Collectively, wealth and smoking explained approximately 60% of the association between prior incarceration length and edentulism. Racial moderation models indicated that longer incarceration times increased edentulism likelihood in non-Hispanic Whites specifically. To the authors' knowledge, this is the first study on the association between prior incarceration length and edentulism among older adults. Study findings indicated the relationship between incarceration and edentulism was explained by higher wealth and current smoking status. These findings highlight the need for adequate access to oral health care services for formerly incarcerated older adults to improve oral health and enhance their overall health and quality of life [ABSTRACT FROM AUTHOR]

A study in Simeh-Kuh, northern Iran, focuses on Ordovician strata, documenting acritarchs and chitinozoa, and has helped to understand ancient environments. The aim is chronostratigraphical calibration, using palaeontological data including brachiopods, trilobites, and graptolites. Ninety-three surface samples were collected and analysed, yielding a rich collection of 117 morphotypes, including 59 acritarch species and 58 chitinozoan species. Eight acritarch assemblage biozones (A–H) and 14 chitinozoan biozones (1–14) were established. Biozones A–F indicate Late Cambrian to Middle Ordovician ages in the Lashkarak Formation, while biozones G–H indicate the Late Ordovician in the Ghelli Formation. The Eremochitina brevis-Linochitina pissotensis biozones suggest late Floian to late Darriwilian ages, and the Belonechitina robusta-Armoricochitina nigerica biozones support a Late Ordovician age. These findings place the Alborz Mountains in the North Gondwana Domain during the Ordovician. Palynomorphs with a thermal alteration index of 4.0–4.5 indicate overmature organic matter in Lower Palaeozoic deposits, potentially linked to the Ordovician metamorphic event in the southern Caspian Sea. Additionally, four new species were identified: Cyathochitina sp. A, Tanuchitina hosseini-nezhadi sp. nov., Dactylofusa kazzazii sp. nov., and Inflatarium alborzensis sp. nov. Highlights: A palynological study at Simeh-Kuh in the Alborz Mountains, northern Iran has uncovered a richly preserved assortment of Cambrian–Ordovician acritarchs and chitinozoa. Fifty-eight chitinozoan species, spanning 22 genera, were identified from the Lashkarak and Ghelli formations at Simeh-Kuh. This facilitated the delineation of 14 distinct chitinozoan biozones. Fifty-nine acritarch species across 33 genera were identified from the Late Cambrian to Late Ordovician strata, contributing to recognising eight distinct assemblage biozones. The Lashkarak Formation has yielded four distinctive acritarch genera: Arbusculidium, Coryphidium, Striatotheca, and Arkonia. These genera hold notable significance as they are characteristic elements of the Peri-Gondwanan palaeoprovince. The identification of chitinozoans in the Lashkarak and Ghelli formations has facilitated the establishment of 14 chitinozoan biozones. Notably, these biozones are considered classical elements of the Northern Gondwana Domain/Peri-Gondwana palaeoprovince. The Belonechitina robusta, Tanuchitina fistulosa, Acanthochitina barbata, and Armoricochitina nigerica biozones were recognised in the Ordovician deposits at Simeh-Kuh. This discovery marks the region's first confirmation of Sandbian–Katian strata. A significant hiatus exists between the Ghelli and Geirud formations, spanning the Late Ordovician (latest Katian–Hirnantian), Silurian, and Early–Middle Devonian periods. Four new species have been established: Cyathochitina sp. A, Tanuchitina hosseini-nezhadi sp. nov., Dactylofusa kazzazii sp. nov., and Inflatarium alborzensis sp. nov. [ABSTRACT FROM AUTHOR]

Purpose: Breast cancer (BC) incidence is increasing globally. Age-specific BC incidence trend analyses are lacking for women under age 50 in Canada. In this study, we evaluate the incidence trends in breast cancer in women under age 50 in Canada and compare them with corresponding trends among women 50 to 54. Methods: BC case counts were obtained from the National Cancer Incidence Reporting System (1984-1991) and the Canadian Cancer Registry (1992-2019) both housed at Statistics Canada. Population data were also obtained from Statistics Canada. Annual female BC age-specific incidence rates from 1984 to 2019 were derived for the following age groups: 20 to 29, 30 to 39, 40 to 49, 40 to 44, 45 to 49, and 50 to 54. Changes in trends in age-specific BC incidence rates, if any, and annual percent changes (APCs) for each identified trend, were determined using JoinPoint. Results: Statistically significant increasing trends in BC incidence rates were noted for almost all age groups: since 2001 for 20 to 29 (APC = 3.06%, P <.001); since 2009 for 30 to 39 (APC = 1.25%, P =.007); since 1984 for both 40 to 49 (APC = 0.26%, P <.001) and 40 to 44 (APC = 0.19%, P =.011), increased since 2015 for 40 to 49 (APC = 0.77%, P =.047); and since 2005 for 50 to 54 (APC = 0.38%, P =.022). Among women 45 to 49 there was a non-significant increase since 2005 (APC = 0.24, P =.058). Statistically significant average annualized increases in BC incidence rates were observed for each age group studied. Conclusions: Examining age-specific incidence rates formed a more complete picture of BC time trends with significant increasing trends in the incidence of BC among women in their 20s, 30s, 40s, and early 50s. A greater awareness regarding the increasing number of cases of BC in women younger than 50 is critical to allow for earlier diagnosis with its resultant reduced mortality and morbidity. [ABSTRACT FROM AUTHOR]

Background: Unhealthy alcohol use has been considered a coping strategy related to stressful and traumatic life events such as relationship loss. Yet, the effects of marital status on health behaviors are generally studied cross-sectionally or over one transition. We explored associations between the frequency and quantity of alcohol use with the number of episodes and duration of separation/divorce events across adulthood among English adults in mid to later life. Methods: This study used life history data from wave 3 (2006/07) of the English Longitudinal Study of Aging to compute marital sequences based on marital status at each year of age from 18 years of 6,355 adults aged 50–80 years. These sequences were used to compute the portion of adulthood spent separated/divorced and the number of episodes of divorce. These variables were used as predictors in logistic regressions predicting unhealthy alcohol use, while also controlling for current marital status. Results: We found that the number of episodes of separation/divorce increased the odds of drinking ≥5 days/week and binge drinking (≥6 drinks/occasion for women; ≥8 drinks/occasion for men), whereas the portion of adulthood spent divorced was not associated with drinking frequency or binge drinking. Some nuances by gender were also noted. Conclusions: Recurrent transitions into separation/divorce over adulthood appears to increase risk of unhealthy alcohol use in mid to later life beyond the risks associated with current marital status. [ABSTRACT FROM AUTHOR]

This article discusses aspects of the ways Jews belonged and were seen as belonging in the Middle Ages, alongside the ways they were set aside and portrayed as outsiders in medieval Europe. It details different social, cultural and religious means through which the affinity of Jews to their medieval homes were expressed together with expressions of difference and alienation. The introduction sets the stage for the articles in this volume that explore different facets of this topic. [ABSTRACT FROM AUTHOR]

This article examines the complexity of Jewish life in rural regions in Germany during the late Middle Ages and underscores the importance of investigating micro-histories for a more comprehensive understanding of Jewish identity and experiences in these settings. Introducing the common practice of territorial lords to limit the number of Jewish households residing in the small towns of their domain, this article argues against the portrayal of Jews as passive recipients of such settlement policies. It highlights their active participation in selecting incoming community members, especially in cases in which Jews aimed to prevent the immigration of co-religionists. Focusing on the case study of Münzenberg, where the Jew Anschel solicited the expulsion of most of the local community, three main incentives of Jewish political and legal interventions come to light: tax distribution, economic competition and personal relationships and conflicts. The article explores these incentives through various examples of Jewish townspeople who skilfully navigated negotiations, leveraging the interests and concerns of territorial lords and various courts. [ABSTRACT FROM AUTHOR]

Objectives: To investigate associations between sociodemographic factors, pre‐existing chronic comorbidities, and general practitioner‐led diagnosis of long COVID. Design, setting, patients: We conducted a retrospective observational case–control study using de‐identified electronic general practice data, recorded between January 2020 and March 2023, from 869 general practice clinics across four primary health networks in Victoria and New South Wales. Main outcome measures: Sociodemographic factors and pre‐existing chronic comorbidities associated with general practitioner‐led diagnosis of long COVID. Results: A total of 1588 patients had a recorded general practitioner‐led long COVID diagnosis. Females exhibited a higher likelihood of general practitioner‐led long COVID diagnosis (adjusted odds ratio [aOR], 1.58; adjusted confidence interval [aCI], 1.35–1.85) compared with males. Patients aged 40–59 years had a higher likelihood of general practitioner‐led long COVID diagnosis (aOR, 1.68; aCI, 1.40–2.03) compared with patients aged 20–39 years. The diagnosis was more likely in patients of high socio‐economic status (aOR, 1.37; aCI, 1.05–1.79) compared with those of mid socio‐economic status. Mental health conditions (aOR, 2.69; aCI, 2.25–3.21), respiratory conditions (aOR, 2.25; aCI, 1.85–2.75), cancer (aOR, 1.64; aCI, 1.15–2.33) and musculoskeletal conditions (aOR, 1.50; aCI, 1.20–1.88) were all significantly associated with general practitioner‐led long COVID diagnosis. Conclusions: Female sex, middle age, high socio‐economic status and pre‐existing comorbidities, including mental health conditions, respiratory conditions, cancer and musculoskeletal conditions, were associated with general practitioner‐led long COVID diagnosis among general practice patients. These factors largely parallel the emerging international evidence on long COVID and highlight the patient characteristics that practitioners should be cognisant of when patients present with symptoms of long COVID. [ABSTRACT FROM AUTHOR]

Background: Prosody voice measures, especially jitter and shimmer, have been associated with cognitive impairment and hold potential as early indicators of risk for cognitive decline. Prior research suggests that voice measures assessed concurrently with longitudinal cognitive outcomes are associated with 10-year cognitive declines in middle-age and older adults from Midlife in the U.S. (MIDUS) study. Results: Using a subsample from the same study, we expanded previous research to examine voice measures that were (1) collected 8 years before cognitive outcomes, (2) derived from narrative speech in logical memory tests instead of word list recall tests, and (3) independent of the cognitive outcomes. Multilevel analyses controlled for covariates of age, sex, education, neurological conditions, depressive symptoms, and chronic conditions. The results indicated that higher jitter and lower shimmer predicted greater 10-year declines in episodic memory and working memory. Conclusion: These findings extend previous research by highlighting prosody voice measures assessed 8 years earlier as predictors of subsequent cognitive declines over a decade. [ABSTRACT FROM AUTHOR]

For families with an early history of parental abuse and neglect (EHPAN), personal and situational stressors can increase relational vulnerabilities. We examined relationship dynamics between midlife adults with EHPAN and their parents during the first year of the COVID-19 pandemic. Analysis of semi-structured qualitative interviews with 31 participants (aged 44–50), examined patterns of contact and support to provide insights into relationship dynamics and relational changes experienced during the pandemic. Three relational themes characterized midlife adult child-parent relationships during COVID-19: tightening ties with parents while taking few COVID-19 precautions; keeping customary ties to maintain the status quo centered around instrumental support; loosening ties in which the relationship drifted. We found areas of resilience and vulnerabilities within each type of relationship. Recognizing that past adversity continues to shape relationship dynamics throughout the life course underscores the need for further research to identify factors that contribute to long-term family resilience and challenges. [ABSTRACT FROM AUTHOR]

Childhood unexpected trauma casts a lifelong shadow on subsequent financial behaviours. The existing literature has mainly investigated stock or bond market participation, and few scholars focus on insurance decisions. Our paper enriches previous studies by testing the impact of childhood famine exposure on household life insurance demand in middle and older age groups. Using CHARLS, we discover that householders exposed to the 1959–1961 Great Chinese Famine as children were more inclined to own life insurance policies and pay higher premiums. Specifically, respondents who experienced the famine between 0–2 or 7–17 years old highly promoted their life insurance demand, whereas no statistically significant effects were observed for preschool famine experience. Additionally, women and people with three or more children were more likely to be influenced by the famine. Finally, risk and time preference were effective mediation factors, both channelling around 5% of the relationship. [ABSTRACT FROM AUTHOR]

Objectives: Playfulness describes individual differences in (re)framing situations in a way that they are experienced as interesting, intellectually stimulating, or entertaining. We extended the study of playfulness to groups of middle- and higher age and examined the relations of four facets of playfulness (Other-directed, Lighthearted, Intellectual, and Whimsical) to indicators of positive psychological functioning. Method: We collected self-report data from 210 participants aged between 50 and 98 years. Results: The playfulness expressions in this age group were comparable to younger adults. We found that playfulness relates to life satisfaction, the PERMA domains of well-being, and character strengths with small-to-medium correlation effect sizes. The OLIW facets showed differential associations, with regression analyses revealing that particularly Other-directed is positively associated with positive psychological functioning. Conclusion: Our findings highlight the importance of playful relationships across the lifespan. We discuss the findings regarding the role of playfulness for healthy aging. [ABSTRACT FROM AUTHOR]

Normal aging, though lacking widespread neurodegeneration, is nevertheless characterized by cognitive impairment in learning, memory, and executive function. The aged brain is spared from neuron loss, but white matter is lost and damage to myelin sheaths accumulates. This myelin damage is strongly associated with cognitive impairment. Although the cause of the myelin damage is not known, microglia dysregulation is a likely contributor. Immunologic proteins interact with microglial receptors to modulate microglia-mediated phagocytosis, which mediates myelin damage clearance and turn-over. Two such proteins, "eat me" signal C1q and "don't eat me" signal CD47, act in opposition with microglia. Both C1q and CD47 have been implicated in Multiple Sclerosis, a demyelinating disease, but whether they play a role in age-related myelin pathology is currently unknown. The present study investigates C1q and CD47 in relation to age-related myelin degeneration using multilabel immunofluorescence, RNAscope, and confocal microscopy in the cingulum bundle of male and female rhesus monkeys across the lifespan. Our findings showed significant age-related elevation in C1q localized to myelin basic protein, and this increase is associated with more severe cognitive impairment. In contrast, CD47 localization to myelin decreased in middle age and oligodendrocyte expression of CD47 RNA decreased with age. Lastly, microglia reactivity increased with age in association with the changes in C1q and CD47. Together, these results suggest disruption in the balance of "eat me" and "don't eat me" signals during normal aging, biasing microglia toward increased reactivity and phagocytosis of myelin, resulting in cognitive deficits. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the impact of an educational intervention on middle-aged women's knowledge and behaviour regarding various aspects of a healthy lifestyle. Design: Quasi-experimental study involving 150 middle-aged women (divided into experimental and control groups). Setting: Participants were selected from health centres of Tehran, Iran. Method: Data collection included demographic information, knowledge of a healthy lifestyle and healthy lifestyle behaviour. Participants in both the intervention and control groups completed the questionnaires before and 2 months after the educational intervention. The intervention involved 10 minutes of face-to-face training followed by distribution of training booklets provided by the Ministry of Health in Iran. Statistical analyses were conducted using SPSS. Results: Within the intervention group, significant differences were observed in total healthy lifestyle knowledge and subscales for physical activity knowledge, anthropometry knowledge, healthy diet knowledge, and smoking knowledge, between the pre- and post-intervention periods. Other than for smoking behaviour, there was no significant difference in healthy behaviours pre- and post-intervention for the experimental and also the control group. Conclusion: While there was an increase in knowledge about healthy lifestyles following the intervention, this knowledge increase was not associated with a change in healthy lifestyle behaviours. Attention should therefore be given to other influences including socio-economic factors, mental health status, environmental factors, cultural influences, duration of the intervention and psychological factors if changes in healthy behaviour are to be achieved. [ABSTRACT FROM AUTHOR]

BACKGROUND: Vision loss increases with age and is thus more likely to happen later in one's career. With more individuals working beyond typical retirement age, the possibility of experiencing vision loss while working has increased. OBJECTIVE: The purpose of this study was to investigate how developing vision loss during midlife affects employment and retirement. METHOD: Using longitudinal Health and Retirement Study data, we identified a sample of 167 workers, 44 to 64 years old, who developed vision loss and a matched comparison sample of 800 workers who did not. We explored job retention and retirement differences between the groups and differences between people with vision loss who retained jobs versus those who did not. RESULTS: Vision loss was associated with leaving the labor force, although there was a clear trend over time of increasing likelihood of job retention. Occupational category was associated with job retention and people who continued working had more favorable financial situations. Retirees with vision loss were more likely to report involuntary retirement and dissatisfaction with retirement. CONCLUSIONS: The decreasing likelihood of leaving the labor market after vision loss is an encouraging finding of this study. Workers who left the labor force after vision loss were more likely to be in precarious financial positions, and retirees did not have positive experiences with retirement. Assisting workers with vision loss to remain in the labor force is of vital importance, and increasing awareness and usage of free services for this population may reduce involuntary retirement and its negative consequences. [ABSTRACT FROM AUTHOR]

Social participation is an effective way to reduce loneliness among older adults. However, little is known about Black older adults' (BOAs') poor participation in social programs. This study thus explores the varied factors that shape BOAs' participation in social programs and services and how lack of social participation contributes to loneliness. 13 BOAs with mean age of 63.8 participated in this narrative study. Misrepresentation of BOAs in social programs and services, lack of opportunity for employment engagement, affordability and accessibility were key themes. These findings highlight the need for integration of strategies to increase cultural diversity in programs in Ontario. [ABSTRACT FROM AUTHOR]

Changes in memory performance are one of the main symptoms of normal aging. The storage of similar experiences as different memories (ie. behavioral pattern separation), becomes less efficient as aging progresses. Studies have focused on hippocampus dependent spatial memories and their role in the aging related deficits in behavioral pattern separation (BPS) by targeting high similarity interference conditions. However, parahippocampal cortices such as the perirhinal cortex are also particularly vulnerable to aging. Middle age is thought to be the stage where mild mnemonic deficits begin to emerge. Therefore, a better understanding of the timing of the spatial and object domain memory impairment could shed light over how plasticity changes in the parahipocampal-hippocampal system affects mnemonic function in early aging. In the present work, we compared the performance of young and middle-aged rats in both spatial (spontaneous location recognition) and non-spatial (spontaneous object recognition) behavioral pattern separation tasks to understand the comparative progression of these deficits from early stages of aging. Moreover, we explored the impact of environmental enrichment (EE) as an intervention with important translational value. Although a bulk of studies have examined the contribution of EE for preventing age related memory decline in diverse cognitive domains, there is limited knowledge of how this intervention could specifically impact on BPS function in middle-aged animals. Here we evaluate the effects of EE as modulator of BPS, and its ability to revert the deficits caused by normal aging at early stages. We reveal a domain-dependent impairment in behavioral pattern separation in middle-aged rats, with spatial memories affected independently of the similarity of the experiences and object memories only affected when the stimuli are similar, an effect that could be linked to the higher interference seen in this group. Moreover, we found that EE significantly enhanced behavioral performance in middle-aged rats in the spatial and object domain, and this improvement is specific of the high similarity load condition. In conclusion, these results suggest that memory is differentially affected by aging in the object and spatial domains, but that BPS function is responsive to an EE intervention in a multidomain manner. [ABSTRACT FROM AUTHOR]

Aims: Night blindness (NB), an important manifestation of VA deficiency, may be associated with the odds of diabetes. The aim of this study was to explore the probable association between NB history and diabetes in Chinese community-dwelling adults. Methods: This multi-center, cross-sectional study enrolled a total of 5664 participants aged 18–82 years from eight sites in China. Information on demographics and medical history was collected using a standardized questionnaire. Diabetes was diagnosed based on the oral glucose tolerance test or a self-reported history. NB history was ascertained by a face-to-face interview with reference to the recommendation by the World Health Organization. Logistic regression analysis was used to evaluate the association between NB history and the odds of diabetes. Results: A total of 5049 participants were finally included, with 252 ascertained with NB history and 1076 with diabetes. The mean age of included participants was 52.9 years, and the percentage of participants with NB history was significantly higher in participants with diabetes than those without (7.0% vs. 4.5%). The multivariable adjusted odds ratio for diabetes was 1.41 (95% confidence interval 1.06, 1.89) in participants with NB history compared with those without. Furthermore, mediation analysis showed that obesity, as assessed by waist-height ratio, partially mediated the relationship between NB history and increased odds of diabetes. Conclusions: The results suggest that NB history might be associated with increased odds of diabetes in Chinese community-dwelling adults. [ABSTRACT FROM AUTHOR]

Background: Utilization of oral health services is a global public health challenge. Low- and middle-income countries are disproportionately affected. Uganda is one of the low- and middle-income countries where only 4% of the population has access to oral health services. Northern Uganda is one of the regions in the country with limited information about oral health utilization. Objective: To assess factors associated with utilization of oral health services among adults aged 18–70 years in Lira district, Northern Uganda. Methods: This was a quantitative cross-sectional study conducted in Lira District. Multistage sampling was used to select 576 respondents. Data was collected using a researcher-administered structured questionnaire that was adopted, modified, and pretested. Data was analyzed at three levels, including univariate, bivariate, and multivariate at 0.05 significance level. Results: Of the 634 respondents, 576 responded, giving a 90.9% response rate. Results show that utilization of oral health services was 20.5% (118) among adults aged 18–70 years in 6 months. Predictors of utilization of oral services among this age group are: having not attended any formal education (AOR = 0.2, 95%CI 0.06–0.62), having poor attitudes towards oral health services (AOR = 0.55, 95%CI 0.34–0.89), having cultural influence on the utilization of the oral health services (AOR = 4.84, 95% CI 2.77–8.43), accessing the services from private not-for-profit facilities (AOR = 4.67, 95% CI 1.79–12.16), being un sure of the availability of the equipment used (AOR = 0.42, 95% CI 0.18–0.9), and availability of friendly services (AOR = 2.53, 95% CI 1.12–5.50). Conclusions and recommendations: Utilization of oral health services is low in Lira district, with only 2 in 10 of the adults aged 18-70years of age utilizing oral health services in 6 months. To improve utilization, targeted health education campaigns should address cultural barriers and attitudes, while ensuring that public health facilities are better equipped and provide more user-friendly services. [ABSTRACT FROM AUTHOR]

Introduction: The general population experiences mortality rates that are related to high levels of high-sensitivity C-reactive protein (hs-CRP). We aim to assess the linkage of longitudinal trajectories in hs-CRP levels with all-cause mortality in Chinese participants. Methods: We utilized data from the China Health and Retirement Longitudinal Study (CHARLS). The exposures were dynamic changes in the hs-CRP and cumulative hs-CRP from 2012 to 2015, and the outcome was all-cause mortality. All participants were categorized into four trajectories according to hs-CRP levels. Multivariable logistic regression analysis, adjusted for potential confounders, was employed to evaluate the relationship of different trajectories of hs-CRP with mortality risk. A two-sample Mendelian randomization (TSMR) method and SHapley Additive exPlanations (SHAP) for identifying determinants of mortality risk were also employed. Results: The study included 5,445 participants with 233 deaths observed, yielding a mortality proportion of 4.28%. Compared to individuals maintaining low, stable levels of hs-CRP (Class 1), individuals with sustained elevated levels of hs-CRP (Class 4), those experiencing a progressive rise in hs-CRP levels (Class 2), or those transitioning from elevated to reduced hs-CRP levels (Class 3) all faced a significantly heighted death risk, with adjusted Odds Ratios (ORs) ranging from 2.34 to 2.47 across models. Moreover, a non-linear relationship was found between them. Further TSMR analysis also supported these findings. SHAP showed that hs-CRP was the fifth most important determinant of mortality risk. Conclusions: Our study shows all-cause mortality increases with dynamic changes in hs-CRP levels among middle-aged and elderly adults in China, and cumulative hs-CRP shows an L-shaped relationship with all-cause mortality. [ABSTRACT FROM AUTHOR]

Aging is often associated with changes in social, sexual, emotional and pain functioning, as well as with the increased prevalence of certain psychopathologies. However, the neurodevelopmental basis underpinning these age‐related changes remains to be determined. Considering the key roles of oxytocin (OTR) and μ‐opioid (MOPr) receptor systems in regulating social, sexual, pain, reward and emotional processing, it seems plausible that they are also implicated in age‐related behavioural alterations. Although the ontogeny of both receptors has been well characterized in rodent brains from early development till adulthood, little is known concerning the neuroadaptations occurring from middle age to old age. Therefore, we mapped the neuroadaptations in OTR and MOPr in the brains of mice at those developmental endpoints. Quantitative OTR and MOPr autoradiographic binding was carried out in the brains of male mice at 2, 6, 9, 12 and 18 months of age. A significant whole brain decline in OTR density was detected between 2 and 6 months of age, with no additional decline thereafter. Interestingly, for MOPrs, the decline in density was not detected until 9 months of age. Region‐specific age‐related decline in OTR density was concentrated in the lateral anterior olfactory nuclei (AOL) and, for MOPr, in the AOL and the nucleus accumbens for MOPr. Identifying the tipping point of these age‐related variations in both receptors may assist with our understanding of the neurobiology underlining age‐related changes in social, pain and emotional functioning/processing. It may also help us target interventions to specific developmental windows to abrogate certain age‐related psychopathologies. [ABSTRACT FROM AUTHOR]

Objective: This study investigates the associations and mediating pathways between grip strength, cognitive function, and depression in middle-aged and elderly individuals in China. Methods: Utilizing data from the 2011 China Health and Retirement Longitudinal Study (CHARLS), we employed logistic regression and mediation analysis to examine the relationships and mediating factors between grip strength, cognitive function, and depression, while adjusting for potential confounders. Results: The study included 6,841 participants, of whom 1,734 (25.35%) exhibited symptoms of depression. Our findings indicate that weak grip strength is significantly associated with an increased risk of depression (OR: 1.57, 95% CI: 1.32-1.87) among the middle-aged and elderly population. Conversely, good cognitive function was found to be protective against depression (OR: 0.94, 95% CI: 0.93-0.95). Grip strength indirectly affected depression through cognitive function, accounting for 9.4% of the total effect (β = -0.008, 95% CI [-0.013, -0.004]). This mediating effect was 23.8% in men (β = -0.013, 95% CI [-0.020, -0.007]); and 23.2% in those aged 60 years and over (β = -0.015, 95% CI [-0.022, -0.009]). Conclusion: This study highlights that weak grip strength increases risk of depressive symptoms, and adequate cognitive function can mitigate the association between weak grip strength and an increased risk of depression among middle-aged and elderly individuals in China. Psychological care for elder adults with weak grip strength and poor cognitive function should be strengthened. [ABSTRACT FROM AUTHOR]

Introduction: Personal views of aging (VoA) reflect individuals' perceptions, attitudes, and expectations regarding their aging selves. The present crosssectional study was aimed at examining whether personality traits, as defined by the Big Five model, are associated with different VoA concepts related to both subjective age and awareness of age-related gains and losses in midlife and older age. Materials and methods: A sample of 224 participants aged 46-85 years reported their felt age and completed the Awareness of Age-Related Change (AARC) questionnaire, assessing perceptions of age-related gains (AARC-Gains) and losses (AARC-Losses) in various functioning domains, as well as the short version of the Big Five Inventory. Results: Linear regression models showed that Openness contributed to explain youthful subjective age. Extraversion explained higher AARC-Gains scores, whereas Emotional Stability, along with younger chronological age and perceiving better self-rated health, contributed to explaining lower AARCLosses scores. Discussion: These findings confirm the relationship between personality traits and personal VoA. They further suggest that such an association varies depending on the VoA measure considered. They underscore the importance of considering personality among those individual characteristics capable of shaping personal VoA, with implications for the development of tailored interventions and the understanding of the underlying mechanisms linking personal VoA to health and longevity outcomes in midlife and older age. [ABSTRACT FROM AUTHOR]

Evidence regarding the relationship between remnant cholesterol (RC) and hyperuricemia is limited. The purpose of this study is to investigate the association between RC and hyperuricemia in the middle aged and elderly Chinese. Information was extracted from the China Health and Retirement Longitudinal Study (CHARLS) survey 2011 and survey 2015. Four logistic regression models were established. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were applied to balance the baseline. Next, sensitivity analyses and restricted cubic spline (RCS) analysis were conducted to further explore the association. Cross-lagged panel model (CLPM) and mediation analysis were used to deduce the causal relationship between RC and hyperuricemia. This study contained 6,447 participants. A positive association between high RC and hyperuricemia was found in the full adjusted model (OR:1.80, P < 0.001). Similar results were also seen after PSM (OR:1.86, P < 0.001), IPTW (OR:1.80, P < 0.001) and sensitive analysis in non-overweight subgroups (OR:1.77, P < 0.001). Though non-linear relationship was not observed, CLPM exhibited that high level of RC can directly cause increase of blood uric acid (standardized β = 0.005, P < 0.001). Moreover, mediation analysis suggested that the positive association can be mediated by hypertension (β = 0.024; p = 0.004), CRP (β = 0.050; p < 0.001) and WBC (β = 0.024; p = 0.010). High level of RC is an independent risk factor for hyperuricemia, which can be mediated by inflammation and hypertension. [ABSTRACT FROM AUTHOR]