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Background: The relationship between serum vitamin D levels and metabolic syndrome (MetS) has been controversial. This study focused on the relationship between the prevalence of MetS and serum vitamin D levels in middle-aged and elderly people. Methods: This study included middle-aged and older adults who participated in the 2023 Zhejiang Provincial Nutrition and Health Survey, which was conducted in 90 districts and counties in Zhejiang Province, China. Results: A total of 11,305 participants were included in this study. MetS was prevalent in 31.7% of participants. Vitamin D and vitamin D3 concentrations were inversely associated with MetS prevalence (Ptrend<0.05), but not with vitamin D2, regardless of whether logistic regression models were adjusted for confounding factors. After adjusting for age, sex, physical activity level, smoking status, education level, annual per capita household income, and body mass index residuals, the highest tertile (Q3) of vitamin D (odds ratio [OR], 0.779; 95% confidence interval [CI], 0.702–0.865) and vitamin D3 (OR, 0.787; 95% CI, 0.709–0.875) concentrations had a lower risk of MetS than the lowest tertile (Q1). We found that vitamin D and D3 levels were correlated with age (Pinteraction<0.05). When age-stratified analyses were performed, vitamin D and vitamin D3 levels were significantly negatively associated with MetS in older adults but not in middle-aged adults. Conclusions: Low total serum vitamin D and vitamin D3 levels were associated with a higher risk of MetS in adults aged 60 years and older. [ABSTRACT FROM AUTHOR]

Background/Objectives: Low or moderate alcohol drinking may reduce the risk of depression, but depression may induce alcohol drinking. However, the bidirectional associations between alcohol drinking and depression were inconsistent, and many prior analyses were not properly conducted. This study explored the within-individual bidirectional associations between alcohol drinking and depressive symptoms under a causal analytic framework. Methods: Using data for the baby boomer cohorts (born between 1948 and 1965) from the Health and Retirement Study (HRS), we employed the unit fixed-effect models with lagged measures to examine the within-individual bidirectional associations between the number of alcohol drinks per week and the changes in the eight-item Center for Epidemiological Studies-Depression (CES-D) scores. Results: Among 11,057 participants at baseline, about 48% were drinkers and 19% had a CES-D ≥4, i.e., at a high risk of depression. Among male low/moderate drinkers, increasing alcohol drinking between consecutive visits was significantly associated with a decrease in depression scores after adjusting for prior alcohol drinking (−0.15 points per 7 drinks/week increase, p = 0.009). Conversely, among male drinkers and female heavy drinkers, increasing depression scores between visits increased alcohol drinking after adjusting for prior depression scores (ranging from 0.22 to 0.79 drinks/week per 1 point increase of depression score, all p values < 0.01). Conclusions: The bidirectional associations between alcohol drinking and depressive symptoms were evident only among male drinkers, and alcohol drinking should not be recommended as a solution for preventing or relieving depressive symptoms. Limitations: Measures of alcohol drinking and depression were coarse, and the study cohorts were limited to the US baby boomer generation. Generalizing findings to other populations should be cautious. [ABSTRACT FROM AUTHOR]

Objectives: The Asia Working Group of Sarcopenia (AWGS) 2019 consensus proposed a new concept named "possible sarcopenia". The present study was to estimate the association between indoor air pollution by solid fuel usages for cooking and possible sarcopenia among middle-aged and older Chinese population. Methods: A longitudinal cohort analysis was carried out using nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 17,708 participants were recruited and followed up in the CHARLS. Cox proportional hazards models were used to estimate the effects of cooking fuel usages on the new onset of possible sarcopenia. Stratified analyses were performed according to gender and age, and sensitivity analyses were performed using the complete dataset. Results: A total of 4,653 participants were included in the final cohort analysis. During the follow-up of 4 years (2011–2015), a total of 1,532 (32.92%) participants developed new-onset possible sarcopenia. Compared with clean fuel usages for cooking, solid fuel usages were associated with a higher risk of possible sarcopenia (HR = 1.37, 95% CI = 1.23—1.52, p-value < 0.001). After adjusting for potential confounders, there was a trend for association between solid fuel usages and an increased risk of possible sarcopenia. Stratified analyses by gender and age demonstrated a stronger association of the solid fuel usages with possible sarcopenia in the middle-aged female participants (Model 1: HR = 1.83, 95% CI = 1.24—2.69, p-value = 0.002; Model 2: HR = 1.65, 95% CI = 1.10—2.47, p-value = 0.016). Sensitivity analyses indicated that the results were robust. Conclusion: Indoor air pollution from solid fuel usages for cooking was a modifiable risk factor for sarcopenia, especially in middle-aged female population. These findings provide a new prevention strategy to reduce the growing burden of sarcopenia, especially for middle-aged female individuals using solid fuels for cooking. [ABSTRACT FROM AUTHOR]

This study investigates verbal fluency as an indicator of executive function in middle-aged adults with mild sensorineural hearing loss, comparing them to age-matched controls with normal hearing. In this study, 50 middle-aged participants were recruited, comprising 25 with bilateral unaided mild hearing loss and 25 age-matched controls with normal hearing. Demographic information, including age, gender, and health-related factors, was collected. Audiological evaluations confirmed the participants' hearing status, and verbal fluency tests were conducted, encompassing semantic, phonemic, and alternate fluency tasks. Significant differences in audiological measures were observed between both groups. Verbal fluency tests revealed lower mean ranks between the groups on almost all tasks suggesting distinct accuracy and error patterns. This study establishes a link between mild sensorineural hearing loss and executive function in middle-aged adults, evidenced by deficits in verbal fluency tasks. The findings underscore the need for targeted interventions to address cognitive impairments, emphasizing the importance of comprehensive care strategies for individuals in this population. [ABSTRACT FROM AUTHOR]

Background: Episodic memory naturally deteriorates with age, and its deficits are widely recognized as the most significant feature and the most sensitive indicator of cognitive decline. It has been suggested that adopting a healthy lifestyle can play a protective role in preserving episodic memory. This study aimed to systematically examine the relationship between lifestyle factors (social activities, leisure activities, physical activities, internet use, smoking, alcohol drinking, and sleep quality) and episodic memory in middle-aged and older adults. Methods: The current study included 10,392 participants from the Chinese Health and Retirement Longitudinal Survey. A linear mixed model was used to explore the associations between lifestyle factors and episodic memory performance and the age- and sex-specific effects of the association. Results: Low-frequency alcohol drinking, higher engagement in social, leisure, and physical activities, increased internet use, and improved sleep quality were associated with better episodic memory performance in middle-aged and older adults. Stratified analyses demonstrated that internet use significantly correlated with episodic memory performance in middle-aged adults but not in older adults. On the other hand, sleep quality showed a significant association with episodic memory performance in women but not in men. Conclusions: This study highlights the association between various lifestyle factors and episodic memory performance, with variations observed based on age and sex. Adopting healthy lifestyle factors can have positive effects on episodic memory in middle-aged adults, emphasizing the importance of adhering to healthy lifestyles from middle age onwards to counteract episodic memory decline. [ABSTRACT FROM AUTHOR]

Audio-based exergames are beneficial in that they allow users to exercise in an eyes-free and hands-free environment. In this study, we explored two audio-based exergame elements, narrative features and thematic music, that can impact exercise amount (step count and duration) and exercise enjoyment. We conducted a two-week long between-subjects study with 43 young adults and 43 middle-aged adults using SPORTIFY, an audio-based exergame. Our experimental results showed that (1) Using narrative features had a significant main effect on exercise amount and exercise enjoyment both for young adults and middle-aged adults. (2) Using thematic music had no significant main impact on exercise amount and exercise enjoyment both for young adults and middle-aged adults. (3) A significant interaction effect for exercise amount was observed in middle-aged adults, whereas a significant interaction effect for exercise enjoyment was observed in young adults. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a serious health concern requiring effective diagnostic strategies, particularly since its symptoms overlap with those of other conditions. Despite extensive research on early diabetes detection across various age groups, middle-aged adults have been relatively underexplored. This study focuses on this demographic to examine symptom-diabetes associations, examine the influence of symptoms in diabetes prediction, and determine an optimal machine learning (ML) model for diabetes prediction. Materials and Methods: This study utilized data from a previous cohort study conducted in Bangladesh. The original dataset included demographic and symptom-related information from 520 patients visiting the ABC Hospital in Bangladesh, India. The participants comprised both diabetic and non-diabetic individuals showing diabetes-like symptoms. For our study, data from 296 middle-aged adults (aged 40–60 years) were extracted. Chi-square tests assessed diabetes-symptom associations, and the Boruta algorithm examined feature influence. Seven ML classification models were evaluated for predictive accuracy. Results: Results showed that 60% of the 296 participants were diabetic. Symptoms like polyuria, polydipsia, weakness, sudden weight loss, partial paresis, polyphagia, and visual blurring were significantly associated with diabetes. All demographic and symptom-related features were influential in diabetes prediction, with polyuria, polydipsia, gender, alopecia, and irritability emerging as the most influential. Among the ML models tested, the random forest model exhibited the highest sensitivity (98.59%) and outperformed others in accuracy (96.58%) and area under the curve score (96.00%), making it the most efficient model for predicting diabetes in middle-aged adults. Conclusion: Diabetes associated symptoms provide valuable diagnostic opportunities for early diabetes detection in middle-aged adults. Future research should explore genetic, lifestyle, and environmental factors to improve diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Background: The rapid increase in the aging population and the critical role of cognitive functioning in successful aging have shifted scholarly focus toward identifying its risk and protective factors. This study aimed to examine the protective correlates of cognitive functioning among middle-aged adults in Pakistan. Methodology: A correlational research design was employed, and purposive sampling was used to recruit participants. The sample size of 140 middle-aged adults (males = 43, females = 97), aged 35-55 years (M = 44.23, SD = 7.1), was calculated using G-power analysis. Data collection tools included the Montreal Cognitive Assessment (MoCA), the Islamic Practices subscale, and a demographic questionnaire. Statistical analyses were conducted using SPSS version 23. Results: Cognitive functioning was positively associated with education, number of friends, and participation in religious activities. In contrast, negative relationships were observed with age, number of children, obesity, hypertension, and comorbidities. Regression analysis indicated that education, social connections, and religious participation were significant positive predictors of cognitive functioning, while age and obesity emerged as significant negative predictors. Conclusion: The findings suggest that various modifiable protective factors can enhance cognitive functioning. These insights emphasize the importance of addressing modifiable factors to mitigate the effects of normal and pathological aging, offering valuable guidance for middle-aged adults and healthcare professionals. [ABSTRACT FROM AUTHOR]

Background: Sedentary behavior is linked to excess fat mass; however, this association may be inconclusive due to potential measurement errors in self-reported sedentary behavior. Objective: To assess the association between changes in sedentary behavior and fat mass in a Cohort of Health Workers (HWCS) from 2004 to 2010. Methods: A total of 1,285 adults participating in the Cohort of Health Workers were evaluated in 2004 and 2010. Fat mass (kg) was measured by dual X-ray absorptiometry. A self-administered questionnaire was used to estimate the sedentary behavior. Sedentary behavior was also estimated using accelerometry in a sample of 142 health workers. Accelerometry data were used to correct self-reported sedentary behavior using a generalized linear model, which included values for sleeping time, age, sex, sedentary behavior, glucose, and triglycerides. Concordance between both methods was assessed using a kappa and Bland–Altman analysis. Once sedentary behavior was corrected, the values were used to evaluate the association between changes in sedentary behavior and body fat mass using a fixed effect model in the cohort, adjusting for confounders. Results: Self-reported sedentary behavior was 2.8 ± 1.8 and 2.3 ± 1.6 h/day, and body fat mass was 24.9 ± 8.1 and 26.8 ± 8.5 kg in 2004 and 2010, respectively. After applying the correction model, the self-reported sedentary behavior was 7.6 ± 1.2 and 7.5 ± 1.2 h/day in 2004 and 2010, respectively. For every hour increase in corrected sedentary behavior, there was an observed increase of 0.847 (p > 0.001) kg in body fat mass during the 6.8 years in the Cohort of Health Workers from 2004 to 2010. Conversely, non-corrected self-reported sedentary behavior was associated with a non-significant reduction of 0.097 kg (p = 0.228) for every hour of sedentary behavior. Conclusions: Increased sedentary behavior was associated with increased body fat mass when corrected self-reported sedentary behavior was used. Implementing public health strategies to reduce sedentary behavior is imperative. [ABSTRACT FROM AUTHOR]

Background/Objectives: Depression and anxiety are prevalent disorders, particularly during emerging adulthood. Uncertainty about the future, exacerbated by unstable times, can lead to heightened future anxiety in this group. This study aimed to examine the complex associations of depression symptoms, future anxiety, and self-efficacy in adults from Poland. Additionally, we investigated age and gender differences in depression symptoms, future anxiety, and self-efficacy. Methods: A cross-sectional online survey study was performed in 2023 in Poland using snowball sampling. A convenience sample of 284 adults participated in this study, ranging in age between 18 and 65 years old (M = 32.18, SD = 11.87), including 95 men (33.45%) and 189 (66.55%) women, and also 157 (55.63%) emerging adults (18–28 years old) and 126 (44.37%) middle-aged adults (29–65 years old). The Patient Health Questionnaire (PHQ-9), Dark Future Scale (DFS-5), and Generalized Self-Efficacy Scale (GSES) were used to measure depression, future anxiety, and self-efficacy, respectively. Results: A 2-way ANOVA showed that both emerging adults and women scored significantly higher in depression symptoms and future anxiety than middle-aged adults and men, respectively. Furthermore, women scored lower in self-efficacy than men. Analyses revealed that there was a positive correlation between depression and future anxiety. Self-efficacy was negatively correlated with depression and future anxiety. Self-efficacy and future anxiety accounted for 48% of depression variance, controlling for age and gender. Future anxiety was found to be a partial mediator of the relationship between self-efficacy and depression. Conclusions: This study significantly advances the understanding of mental health in adults, grounded in social cognitive theories, revealing that low self-efficacy heightens future anxiety, thereby exacerbating depression symptoms in the Polish adult population, independent of age and gender. Emerging adults and women need psychological support to reduce depression and future anxiety. Women, in particular, should be the main focus of interventions to boost self-efficacy. Implementing targeted preventive measures and support systems can mitigate the challenges faced by emerging adults and women. [ABSTRACT FROM AUTHOR]

Love is a complex construct of undeniable importance for human beings and an area of research that has progressed over the past decades. The capacity to love, specifically, refers to the capacity for involvement, investment, and maintenance of a committed romantic relationship, resulting from complex developmental processes that begin in childhood and continue to be shaped throughout development. Despite its relevance, there is still little evidence of its relationships with indicators of positive human functioning. This study examines the link between the capacity to love and emotional, psychological, and social well-being. Furthermore, it delves into potential differences in the capacity to love based on life cycle stages (emerging adulthood and midlife) and gender. The research involved 535 participants, with 282 (52.7%) falling under the emerging adulthood category (18–25 years) and 253 (47.3%) classified as middle-aged adults (45–65 years). Multivariate variance analyses indicate emerging adults demonstrate a greater capacity to love in all dimensions except acceptance of loss, grief, and jealousy. Concerning gender, there were no significant differences. Prediction models indicate that age and acceptance of loss and grief are significant and positive predictors of all types of well-being, and basic trust is a significant and positive predictor of emotional well-being. Overall, this research sheds light on the vital role the capacity to love plays in human well-being and emphasizes the need for interventions that focus on nurturing and developing this aspect of human relationships. [ABSTRACT FROM AUTHOR]

Objective To establish a simple model for arteriosclerosis (AS) screening to provide a viable tool for the timely identification of AS risk among residents aged 40-65 years. Methods Data were obtained from the Sleep and Chronic Diseases Program in Fuquan City. The original dataset was divided into a training subset and a validation subset (80%: 20%). LASSO and logistic regression models were used to screen variables, perform multivariate regression analyses. Internal validation was performed using the Bootstrap method. Nomogram Plot was constructed, and risk score thresholds were determined based on ROC curves to classify high-risk populations. Results RS Model was established to include age, gender, napping, sleep efficiency, sleep disorders, hypertension and diabetes, with AUC = 74.80% and a model risk score threshold = 84.20. PHC Model was established to include age, gender, napping, sleep efficiency, systolic blood pressure, fasting blood glucose, and pulse variables, with AUC = 82.80% and a risk score threshold of 78.00. Decision curves showed that both models performed well in terms of calibration and actual benefits for health management. Conclusion The two AS screening models exhibit acceptable accuracy and differentiation. Therefore, it can be applied in residents' self-health management and in primary care organizations' screening work in a large scale. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate quality of life (QoL) in middle-aged adults living alone and identify comprehensive biological, psychological, interpersonal, and contextual factors related to QoL using the dynamic biopsychosocial model. As a secondary analysis, this study used data from the 2017 Korea Community Health Survey conducted by the Korea Disease Control and Prevention Agency. Methods: Among the total 228,381 respondents, 10,639 middle-aged individuals aged 40–64 years from single-person households (5,036 men and 5,603 women) were included in the analysis. QoL was measured using the EuroQoL-5 Dimension (EQ-5D). The EQ-5D descriptive statistics were provided according to biological, psychological, interpersonal, and contextual factors. Considering the data structure of the multistage stratified cluster sampling method, a complex samples general linear model statistic was used to identify the predictors of QoL. Results: QoL was lower in those who had undesirable psychological status (e.g., more depressive symptoms, poor subjective health, and higher perceived stress), less engagement in social networking (less frequent contact with friends and less frequent participation in social activities such as religious activities, friendship gathering, and leisure), and lower physical, behavioral, and socioeconomic factors. Conclusions: This study's findings indicate that psychological and interpersonal factors should be addressed and prioritized to improve the QoL of middle-aged adults living alone. By providing many opportunities for easily accessible social activities that meet the needs and interests of this demographic, their QoL can be improved through strengthening social support. [ABSTRACT FROM AUTHOR]

Despite theoretical accounts asserting the importance of children for the wellbeing of individuals as they age, research evidence suggests that children may be inconsequential when it comes to loneliness. Yet, there is reason to expect some subgroups may be more vulnerable to the impact of childlessness than others and this may also differ depending on the type of loneliness being assessed. This paper addresses the relationship between childlessness and social and emotional loneliness in middle and later life, including differential vulnerability associated with age, gender and marital/partner status. The study drew on data from three waves (2007, 2012 and 2018) of the Canadian General Social Survey for a nationally representative sample of adults aged 45 and older (N = 49,892). In general, childlessness assumed greater importance with regard to social than emotional loneliness. Women reported lower levels of social loneliness in conjunction with childlessness than men. Further, childlessness was associated with higher levels of overall and social loneliness among older than middle-aged adults. Fewer interactions were evident between marital/partner status and childlessness. Among women specifically, those who were co-habiting, separated/divorced or never married reported lower levels of social loneliness than their married counterparts. In contrast, childlessness was linked to greater emotional loneliness only among separated/divorced men and widowed women. Overall, our results suggest that having children available does matter for feelings of loneliness in middle and later life but that the relationship varies and is contingent on the social contexts (age, gender, marital/partner status) and the type of loneliness (social, emotional) involved. [ABSTRACT FROM AUTHOR]

Epidural Hematoma (EDH) is a common condition of traumatic brain injury. It has a good prognosis if prompt surgical intervention is conducted. There is a dearth of studies on neuropsychological assessment of executive functioning exclusively in post-operative EDH patients. Moreover, age as a variable in determining executive functions in patients post-head injury, has been studied mostly in the older adults. This cross-sectional case-control study assessed Executive Functions (EF) in 62 post-surgery patients with EDH and compared 57 healthy controls (HC) using standardized assessment tools of sustained attention, speed, working memory, fluency, set-shifting, perseveration, planning, and response inhibition. Further, executive functions in two phases of adulthood, viz. Early Adulthood (20–39 years) and Middle Adulthood (40–60 years) were compared in the EDH group (E-EDH and M-EDH) and HC (E-HC and M-HC). A two-way Analysis of Variance (ANOVA) and correlational analysis was conducted. Results showed a trend where the M-EDH group performed significantly poorer on executive function tests (viz a viz., time taken, errors, and correct responses), followed by E-EDH, M-HC, and E-HC. The main effect of age was found significant on Digit Symbol, Color Trail 1, N-Back 2, Animal Naming, and Stroop Effect (p < 0.01 level) while N-Back 1, WCST-PE, and Tower of London (p < 0.05 level). The findings have significant clinical and therapeutic implications. In addition, it gives guidance regarding planning specific neuropsychological tests and rehabilitation targeting specific areas of executive functions decline due to age in EDH post-surgery patients. [ABSTRACT FROM AUTHOR]

Physical inactivity and loneliness are both associated with health risks and can affect each other through various social and behavioral mechanisms. However, current evidence on this relationship is equivocal and mostly based on cross-sectional data. This longitudinal study aimed to determine whether current levels of physical activity (moderate and vigorous intensity) and loneliness are associated with future respective states of themselves and each other. We used data from waves 6-14 (2002-2018) of the Health and Retirement Study (n  = 20 134) in a mixed-effects and random-intercept cross-lagged panel model. Analysis showed that current loneliness and physical activity were associated with each future respective state. Additionally, weekly participation in moderate-intensity, but not vigorous-intensity, physical activity was associated with a lower likelihood of becoming lonely in the future (relative risk [RR] = 0.94; 95% CI, 0.90-0.99). However, changes in physical activity were not associated with deviation from a person's typical level of loneliness (for vigorous intensity, mean deviation [MD] = 0.00; 95% CI: −0.04 to 0.03; for moderate-intensity, MD = 0.01; 95% CI: −0.03 to 0.04). Loneliness was not associated with moderate- or vigorous-intensity physical activity in subsequent waves. This suggests that while lower physical activity levels can be associated with future loneliness, changing levels of physical activity has little impact on loneliness at the individual level. [ABSTRACT FROM AUTHOR]

Aim: To understand the experiences of individuals who undergo LEA due to DFU after disability. Design: A descriptive research design in qualitative research. Methods: Semi‐structured interviews were used in this qualitative descriptive study. Eleven middle‐aged patients (45–59 years) who underwent LEA due to DFU were purposively selected and interviewed. Qualitative data were thematically analysed. Results: Three themes and 10 subthemes were identified. The themes were (1) role function confusion, (2) self‐concept stress and (3) unreasonable objective support. Subthemes included (1) weakened career role, (2) family role reversal, (3) social role restriction, (4) over‐focusing on appearance, (5) immersion in patient experience, (6) living with faith, (7) polarization of independent consciousness, (8) low perceived benefits of peer support, (9) existence of treatment disruption and (10) poor participation in medical decision‐making. [ABSTRACT FROM AUTHOR]

Simple Summary: A significant portion of adults with clinically normal hearing sensitivity have difficulty understanding speech in background noise. Current clinical assessments fail to explain this phenomenon, prompting the exploration of auditory mechanisms beyond those covered by routine clinical testing. One mechanism important for separating sound sources—a key task for understanding speech-in-noise—is temporal processing, or the extraction and organization of acoustic timing characteristics. Here, we investigate the hypothesis that deficits in temporal processing contribute to difficulties in understanding speech-in-noise. We explore this in middle-aged adults—an under-investigated group, despite their high prevalence of speech-in-noise difficulties. In this study, we found that differences in speech-in-noise abilities were associated with deficits in two aspects of temporal processing: the neural encoding of periodic speech features, such as pitch, and perceptual sensitivity to rapid acoustic timing differences between ears. Interestingly, the use of these mechanisms was task-dependent, suggesting various aspects of temporal processing differentially contribute to speech-in-noise perception based on the characteristics of the listening environment. These findings contribute to our overall understanding of which auditory mechanisms play a role in speech-in-noise difficulties in normal hearing listeners, and can inform future clinical practice to serve this population. Auditory temporal processing is a vital component of auditory stream segregation, or the process in which complex sounds are separated and organized into perceptually meaningful objects. Temporal processing can degrade prior to hearing loss, and is suggested to be a contributing factor to difficulties with speech-in-noise perception in normal-hearing listeners. The current study tested this hypothesis in middle-aged adults—an under-investigated cohort, despite being the age group where speech-in-noise difficulties are first reported. In 76 participants, three mechanisms of temporal processing were measured: peripheral auditory nerve function using electrocochleography, subcortical encoding of periodic speech cues (i.e., fundamental frequency; F0) using the frequency following response, and binaural sensitivity to temporal fine structure (TFS) using a dichotic frequency modulation detection task. Two measures of speech-in-noise perception were administered to explore how contributions of temporal processing may be mediated by different sensory demands present in the speech perception task. This study supported the hypothesis that temporal coding deficits contribute to speech-in-noise difficulties in middle-aged listeners. Poorer speech-in-noise perception was associated with weaker subcortical F0 encoding and binaural TFS sensitivity, but in different contexts, highlighting that diverse aspects of temporal processing are differentially utilized based on speech-in-noise task characteristics. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the association between handgrip strength and suicidal ideation in representative samples of adults aged ≥50 years from six LMICs (China, Ghana, India, Mexico, Russia, and South Africa). Methods: Cross‐sectional, community‐based data from the World Health Organization's Study on Global Aging and Adult Health were analyzed. Handgrip strength quintiles by sex were created based on the average value of two handgrip measurements of the dominant hand. Self‐reported information on past 12‐month suicidal ideation was collected. Multivariable logistic regression analysis was conducted to assess associations. Results: Data on 34,129 individuals were analyzed [mean (SD) age 62.4 (16.0) years; age range 50–114 years; 52.1% females]. After adjustment for potential confounders, in the overall sample, compared to the handgrip strength quintile with the highest values [Quintile 1 (Q1)], Q2, Q3, Q4, and Q5 were associated with significant 2.15 (95% CI = 1.05–4.39), 2.78 (95% CI = 1.06–7.32), 3.53 (95% CI = 1.68–7.42), and 6.79 (95% CI = 2.80–16.48) times higher odds for suicidal ideation. Conclusions: Lower handgrip strength was significantly and dose‐dependently associated with higher odds for suicidal ideation in adults aged ≥50 years from LMICs. Future longitudinal studies are needed to understand the underlying mechanisms, and whether increasing general muscular strength and physical function may lead to reduction in suicidal ideation. [ABSTRACT FROM AUTHOR]

This study explored how personality and serious leisure activities, such as playing pickleball, contribute to eudaimonic well-being in middle-aged and older adults. Data were collected at pickleball events at the 2017 Huntsman World Senior Games from a convenience sample of 250 players aged between 50 and 91 years (M = 65.11, SD = 7.49). Of the five personality dispositions examined, conscientiousness (β = 0.32, p <.001), neuroticism (β = −0.22, p <.01), and openness to experience (β = 0.18, p <.01) were discovered to be significant predictors of eudaimonic well-being. Serious leisure also contributed to eudaimonic well-being (β = 0.28, p <.01). The findings of this study enhance the understanding of the behaviors exhibited by older adults and elucidate the positive impact exerted on eudaimonic well-being by personality and serious leisure. [ABSTRACT FROM AUTHOR]

Background: Many recent studies suggest the existence of a relationship between oral health and the occurrence of depressive symptoms. The aim of this study was to assess the relationship between the number of lost teeth and the occurrence of depressive symptoms in middle-aged adults. Methods: An analysis was performed on the data obtained from the PONS project (POlish-Norwegian Study), conducted in the Świętokrzyskie Province in Poland in 2010–2011. The research material included the cross-sectional data of 11,901 individuals aged 40–64 years (7967 women). Depressive symptoms, used as outcome variables, were assessed with a questionnaire. The participants provided the responses to questions concerning the occurrence of eight symptoms over the last 12 months. The answers were scored as 1 point or 0 points. The participants were divided into three tercile groups based on their total scores: no or mild (0–2 points), moderate (3–5 points), and severe depressive symptoms (6–8 points). The self-reported number of lost teeth was analysed according to the following categories: 0–4, 5–8, 9–27, and a complete lack of natural teeth. Multivariable logistic regression analysis for depressive symptoms was used in relation to the number of lost teeth. The following covariates were included in the adjusted model: age, sex, place of residence, education, marital status, BMI, diabetes status, stressful life events in the last year, use of antidepressants, smoking, and sugar and sweet consumption. Results: The likelihood of both moderate (OR = 1.189; 95%CI: 1.028–1.376; p <.020) and severe (OR = 1.846; 95%CI: 1.488–2.290; p <.001) depressive symptoms showed the strongest relationship with a total lack of natural teeth. A loss of more than 8 natural teeth was also significantly associated (OR = 1.315; 95%CI: 1.075–1.609; p <.008) with the occurrence of severe depressive symptoms. Conclusions: The loss of natural teeth was positively related to the occurrence of depressive symptoms in middle-aged adults. Thus, there is an urgent need to intensify stomatological prophylaxis, education and treatment for middle-aged individuals. [ABSTRACT FROM AUTHOR]

Introduction: A lower ability to buffer pulse pressure (PP) in the face of increasing mean arterial pressure (MAP) may underlie the disproportionate increase in systolic blood pressure (SBP) in women from young adulthood through middle-aged relative to men. Aim: To evaluate the contribution of MAP to the change in PP and pressure wave contour in men and women from young adulthood to middle age. Methods: Central pressure waveform was obtained from radial artery applanation tonometry in 312 hypertensive patients between 16 to 49 years (134 women, mean age 35 ± 9 years), 185 of whom were on antihypertensive treatment. Results: Higher MAP levels (≥ 100 mmHg) were significantly associated with higher brachial and central SBP (P < 0.001), PP (P < 0.001), incident wave (P = 0.005), AP (P < 0.001), and PWV (P < 0.001) compared to lower MAP levels. The relationship between MAP and brachial PP (P < 0.001), central PP (P < 0.001), incident wave (P < 0.001), and AP (P < 0.01), but not PWV, strengthens with age. The age-related increase in the contribution of MAP to brachial PP (P < 0.001), central PP (P < 0.001), and incident wave (P < 0.001) was more prominent in women than in men beginning in the fourth decade. In multiple regression analyses, MAP remained a significantly stronger predictor of central PP and incident wave in women than in men, independent of age, heart rate, and antihypertensive treatment. In turn, age remained a significantly stronger predictor of central PP and incident wave in women than in men, independent of MAP, heart rate, and antihypertensive treatment. Conclusions: Women of reproductive age showed a steeper increase in PP with increasing MAP, despite comparable increases in arterial stiffness in both sexes. The difference was driven by a greater contribution of MAP to the forward component of the pressure wave in women. [ABSTRACT FROM AUTHOR]

Recent World Health Organization records show that hypertension is more common in Africa than in other parts of the world, and remains a major common risk factor for cardiovascular diseases, stroke, renal diseases, and death. However, little is known about hypertension management strategies among people in rural areas. Therefore, this phenomenological study aimed to investigate knowledge of hypertension management strategies among middle-aged adults in rural areas of Anambra state. Focus group discussions were used to collect data from 40 middle-aged adults (20 males and 20 females). The data were analysed thematically. Results showed that the participants were all aware of hypertension but lacked in-depth knowledge of disease management strategies. Most of the participants did not believe that engaging in regular physical exercise/activity, and other factors like reduction in salt and alcohol intake could help in controlling high blood pressure. Social workers who are also social service providers are needed to raise awareness among middle-aged people in rural areas about hypertension management strategies. This can be done through the provision of social services like education, health services, and transport services, as this will go a long way in helping rural dwellers gain more knowledge of hypertension management strategies. With the provision of health services, the rural population will not only know management strategies for hypertension but will also be able to check their blood pressure regularly, while transport services will make it possible for the rural population who do not have health centres in their community and means of transporting themselves to the neighbouring community for treatment to do so. Future research should focus on the importance of welfare/home visits as an avenue for awareness creation on hypertension management strategies, as this will be an avenue for the provision of better social services for people in rural areas and an improvement in social service research. [ABSTRACT FROM AUTHOR]

Introduction: Strong evidence suggests that olfactory dysfunction (OD) can predict additional neurocognitive decline in neurodegenerative conditions such as Alzheimer's and Parkinson's diseases. However, research exploring olfaction and cognition in younger populations is limited. The aim of this review is to evaluate cognitive changes among non-elderly adults with non-COVID-19-related OD. Methods: We performed a structured comprehensive literature search of PubMed, Ovid Embase, Web of Science, and Cochrane Library in developing this scoping review. The primary outcome of interest was the association between OD and cognitive functioning in adults less than 60 years of age. Results: We identified 2878 studies for title and abstract review, with 167 undergoing full text review, and 54 selected for data extraction. Of these, 34 studies reported on populations of individuals restricted to the ages of 18–60, whereas the remaining 20 studies included a more heterogeneous population with the majority of individuals in this target age range in addition to some above the age of 60. The etiologies for smell loss among the included studies were neuropsychiatric disorders (37%), idiopathic cause (25%), type 2 diabetes (7%), trauma (5%), infection (4%), intellectual disability (4%), and other (18%). Some studies reported numerous associations and at times mixed, resulting in a total number of associations greater than the included number of 54 studies. Overall, 21/54 studies demonstrated a positive association between olfaction and cognition, 7/54 demonstrated no association, 25/54 reported mixed results, and only 1/54 demonstrated a negative association. Conclusion: Most studies demonstrate a positive correlation between OD and cognition, but the data are mixed with associations less robust in this young adult population compared to elderly adults. Despite the heterogeneity in study populations and outcomes, this scoping review serves as a starting point for further investigation on this topic. Notably, as many studies in this review involved disorders that may have confounding effects on both olfaction and cognition, future research should control for these confounders and incorporate non-elderly individuals with non-psychiatric causes of smell loss. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular problems are the leading cause of death among adults in our country. These illnesses primarily affect metropolitan populations, particularly in major cities. To prevent these diseases, efforts have focused on identifying and controlling cardiovascular risk factors such sedentary lifestyle. Aim: The study aimed to assess the exercise habits of cardiovascular risks middle‑aged adults. Materials and Methods: The research approach used in this study was quantitative approach with descriptive design. Purposive sampling technique was used to select the samples. Totally 60 cardiovascular patients were recruited from Saveetha Medical College and Hospital Thandalam, Chennai. Data were gathered by using structured questionnaires and risk score calculator. Collected data were analyzed by using descriptive and inferential statistics. Results: The above Table 1 shows that 59 (98.33%) had moderate level of physical activity and 1 (1.67%) had high level of physical activity among middle‑aged adults. The mean and standard deviation of physical activity among middle‑aged adults was 62.26 ± 5.92. The median was 62.0 with minimum score of 38.0 and maximum score of 73.0. The demographic variable age (χ2 = 6.610, P = 0.037) had statistically significant association with level of physical activity among middle‑aged adults at P < 0.05 level and the other demographic variables had not shown statistically significant association with level of physical activity among middle‑aged adults. Conclusion: Physical activity promotion and support should be a global priority because of the health benefits it provides for adults. [ABSTRACT FROM AUTHOR]

The main objectives of this systematic review and meta-analysis study include evaluating the methodological quality of existing randomized controlled trials (RCTs) for weight loss and features of online intervention [OI]s in each trial, examining the associations between the methodological quality, intervention features and the effectiveness of OIs, and comparing the effectiveness of OIs and other intervention modalities through systematic review and meta-analysis. Systematic searches were conducted using PubMed, Cochrane Library, CINAHL, and PsycINFO in the past two decades (2000 through 2019). Inclusion criteria includes Online intervention (intervention modality), middle-aged adults with overweight or obesity, at least six months or longer study period, an RCT, and 70% plus retention rate. Risk of Bias was assessed using Miller et al. in (Hester, Miller (eds) Handbook of alcoholism treatment approaches: Effective alternatives (3rd ed.). Allyn & Bacon, Boston, 2003)'s Methodological Quality Rating Scale (MQRS) and GRADE. MOOSE guidelines was referred for data synthesis. In total, 29 OIs were evaluated using 10 criteria for methodological quality and eight criteria for intervention features. Results revealed that the mean methodological quality score of the RCTs was 12.1 (out of 16), and the mean intervention features score was 6.6 (out of 8). RCTs with higher scores were more effective in weight loss than those with lower scores. Results of meta-regression showed that methodological quality was more important than intervention features to increase the effectiveness. Results of meta-analysis showed that OIs were significantly more effective than controls. Compared to OIs only, OIs with interactions with others and professionals were more effective. The study limitation includes assessing 'effectiveness' based on weight only due to lack of other indicators to compare between studies; some results are self-reported; and feedback from intervention participants were hard to review. Nevertheless, this study may contribute to improving the effectiveness of existing OIs for weight loss considering methodological quality and better intervention features. [ABSTRACT FROM AUTHOR]

This study explores how urban middle-aged education program participants can increase their agricultural entrepreneurship volition (AEV) during the COVID-19 pandemic in South Korea. We examined the direct and indirect effects of formal learning experiences (FLE) and informal learning experiences (ILE) on AEV. Multiple regression, mediation, moderation, and moderated mediation methods using Process Macro were conducted with 411 samples. ILE and outcome expectancy had direct positive effects on volition, while FLE and social networking did not. Both learning experiences had indirect effects on AEV through social networking and outcome expectancy. The group who spent above 100 hours in formal learning had a moderating effect on the relationship between FLE and outcome variables compared to those who spent less than 50 hours. Considering the limited middle-aged adults' digital accessibility, developing user-friendly distance education guidelines, supporting social networking and ILE, and tailoring programs to individual expectations are required to encourage agricultural entrepreneurship. Combining career transition perspective and migration perspective, this article contributes to a theoretical framework explaining urban middle-aged adults' agricultural entrepreneurship. This paper approaches middle-aged adults' agricultural entrepreneurship as a career transition event for their old stage of life and quantifies determinants of AEV during COVID-19. [ABSTRACT FROM AUTHOR]

This study examines the impact of leisure activities on leisure domain and life domain satisfactions and subjective well‐being (SWB) and explores the differences between genders in these associations, using data from 316 middle‐aged adults. The results suggest that sports and travel & outdoor activities have the greatest impact on physiological, psychological, and relaxing satisfactions. Social activities are key ingredients in social, psychological, and physiological satisfactions as seen by men, whereas cultural activities and hobbies are important in women's psychological satisfaction. While relaxing and social satisfactions are important in men's SWB, psychological satisfaction is the most important factor in women's SWB. [ABSTRACT FROM AUTHOR]

Recent records by the World Health Organization show that hypertension is more prevalent in Africa than in other parts of the world, and remains the foremost common risk factor for cardiovascular-related diseases, stroke, renal diseases, and death. However, little is known about the risk factors for hypertension by people from rural areas, especially among middle-aged adults. Therefore, the study examined the knowledge of the risk factors for hypertension among middle-aged adults in rural areas of Anambra state, Nigeria. Focus group discussions were used to collect data from 40 middle-aged adults (20 males and 20 females). Two key themes stood out from the data collection guides. These are "awareness of hypertension and its' symptoms" and "knowledge of risk factors of hypertension". The findings showed that the participants were aware of hypertension but lacked in-depth knowledge of the risk factors for the disease. Most participants did not believe that intake of certain foods like starchy foods and excess alcohol consumption could lead to one being hypertensive. There is a need for social workers to sensitize and enlighten the middle-aged adults in the study area on the risk factors for the disease. [ABSTRACT FROM AUTHOR]

The relationship between sex‐specific blood biomarkers and memory changes in middle‐aged adults remains unclear. We aimed to investigate this relationship using the data from the Framingham Heart Study (FHS). We conducted association analysis, partial correlation analysis, and causal dose–response curves using blood biomarkers and other data from 793 middle‐aged participants (≤ 60 years) from the FHS Offspring Cohort. The results revealed associations of adiponectin and fasting blood glucose with midlife memory change, along with a U‐shaped relationship of high‐density lipoprotein cholesterol with memory change. No significant associations were found for the other blood biomarkers (e.g., amyloid beta protein 42) with memory change. To our knowledge, this is the first sex‐specific network analysis of blood biomarkers related to midlife memory change in a prospective cohort study. Our findings highlight the importance of targeting cardiometabolic risks and the need to validate midlife‐specific biomarkers that can accelerate the development of primary preventive strategies. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a critical public health challenge globally, especially in urban settings where lifestyle factors contribute significantly to its prevalence. Understanding its prevalence among middle-aged adults is vital for early intervention and management. Objectives: This study aims to determine the prevalence of hypertension and identify its associated demographic and lifestyle factors among 300 middle-aged adults in urban areas. Methods: A cross-sectional study was conducted among 300 randomly selected middle-aged adults from urban localities. Blood pressure measurements were taken, and a structured questionnaire was used to gather data on demographics, dietary habits, physical activity, and health history. Descriptive and inferential statistics were employed to analyze the data. Results: The study found a high prevalence of hypertension among the participants. Key factors associated with higher rates of hypertension included age, obesity, sedentary lifestyle, and high salt intake. The data indicated a significant need for targeted public health strategies to address these risk factors. Conclusion: Hypertension is prevalent among middle-aged adults in urban areas, with several modifiable lifestyle factors contributing to its high rate. The study emphasizes the need for urban health initiatives focusing on awareness, lifestyle modification, and regular screening to mitigate the risk of hypertension and related complications. [ABSTRACT FROM AUTHOR]

Reductions in the ability to encode and retrieve past experiences in rich spatial contextual detail (episodic memory) are apparent by midlife--a time when most females experience spontaneous menopause. Yet, little is known about how menopause status affects episodic memory-related brain activity at encoding and retrieval in middle-aged premenopausal and postmenopausal females, and whether any observed group differences in brain activity and memory performance correlate with chronological age within group. We conducted an event-related task fMRI study of episodic memory for spatial context to address this knowledge gap. Multivariate behavioral partial least squares was used to investigate how chronological age and retrieval accuracy correlated with brain activity in 31 premenopausal females (age range, 39.55-53.30 years; mean age, 44.28 years; SD age, 3.12 years) and 41 postmenopausal females (age range, 46.70-65.14 years; mean age, 57.56 years; SD age, 3.93 years). We found that postmenopausal status, and advanced age within postmenopause, was associated with lower spatial context memory. The fMRI analysis showed that only in postmenopausal females, advanced age was correlated with decreased activity in occipitotemporal, parahippocampal, and inferior parietal cortices during encoding and retrieval, and poorer spatial context memory performance. In contrast, only premenopausal females exhibited an overlap in encoding and retrieval activity in angular gyrus, midline cortical regions, and prefrontal cortex, which correlated with better spatial context retrieval accuracy. These results highlight how menopause status and chronological age, nested within menopause group, affect episodic memory and its neural correlates at midlife. [ABSTRACT FROM AUTHOR]

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Purpose: There is increasing interest in the health benefits of plant-based diets (PBDs). Evidence reports favourable associations with inflammatory profiles and reduced cardiovascular disease risk. However, limited studies have examined relationships between PBD indices (PDIs) and inflammatory biomarkers. We explored overall PDI, healthful PDI (hPDI) and unhealthful PDI (uPDI) associations with inflammatory biomarker profiles. Methods: This cross-sectional analysis included 1986 middle- to older-aged adults from the Mitchelstown Cohort. PDI scores were calculated using validated food frequency questionnaires. PDI score associations with inflammatory biomarkers were assessed via linear regression analysis, with adjustment for potential confounders. Results: Comparison of quintiles (Q5 vs Q1) revealed lower concentrations of C-reactive protein (CRP), interleukin 6 (IL-6), white blood cells (WBCs), neutrophils and monocytes, and the leptin-to-adiponectin ratio (PDI and hPDI P < 0.05); lower leptin (PDI, P < 0.05), and complement component 3 (C3), tumour necrosis factor alpha (TNF-α), plasminogen activator inhibitor 1, lymphocytes and eosinophils (hPDI, P < 0.05); and higher concentrations of adiponectin (PDI and hPDI, P < 0.05). Conversely, higher concentrations of C3, CRP, IL-6, TNF-α, resistin, WBCs, neutrophils, lymphocytes, monocytes and eosinophils, and the neutrophil-to-lymphocyte ratio, and lower adiponectin concentrations were observed comparing uPDI quintiles (P < 0.05). In fully adjusted regression models, higher hPDI scores were associated with lower concentrations of C3, TNF-α, WBCs, neutrophils and monocytes (all P < 0.01). Higher uPDI scores were associated with higher C3 and TNF-α concentrations (all P < 0.01). Conclusion: This study provides evidence that a more healthful PBD is associated with a more favourable inflammatory profile and that a more unhealthful PBD is associated with the reverse. [ABSTRACT FROM AUTHOR]

Adults aged 50–64 years have a high incidence of symptomatic influenza associated with substantial disease and economic burden each year. We conducted a randomized, controlled trial to compare the immunogenicity and safety of an adjuvanted quadrivalent inactivated influenza vaccine (aIIV4; n = 1027) with a nonadjuvanted standard dose IIV4 (n = 1017) in this population. Immunogenicity was evaluated on Days 22, 181, and 271. On Day 22, upper limits (UL) of 95% confidence intervals (CI) for geometric mean titer (GMT) ratios (IIV4/aIIV4) were <1.5 and 95% CI ULs for the difference in seroconversion rate (SCR IIV4 − aIIV4) were <10% for all four vaccine strains, meeting primary endpoint noninferiority criteria. Protocol-defined superiority criteria (95% CI ULs < 1.0) were also met for A(H1N1) and A(H3N2). Immune responses following aIIV4 vaccination were more pronounced in persons with medical comorbidities and those not recently vaccinated against influenza. Safety data were consistent with previous studies of MF59 adjuvanted seasonal and pandemic influenza vaccines. These findings support the immunological benefit of aIIV4 for persons aged 50–64 years, especially those with comorbidities. [ABSTRACT FROM AUTHOR]

This study explored how middle-aged workers' career trajectory patterns were associated with their financial security later in life. Grounded by a life course perspective, we approached their career trajectories by considering a 'human agency within structure' framework. We explored sequences of employment status, starting with their lifetime main job to subsequent jobs after contractual retirement, using data from 1,010 middle-aged adults in Seoul, South Korea. The sequence analysis identified six career trajectory patterns. Stable career patterns included the Permanent to permanent trajectory as well as the Permanent to self-employment trajectory and these were most common among males with higher education degrees, higher earnings and better career alignment. Unstable career patterns such as the Temporary to temporary trajectory, the Permanent to temporary trajectory or the Churning trajectory were most common among those who were female, had lower levels of education lower earnings or had retired involuntarily. Further results showed that unstable career patterns were associated with lower levels of monthly earnings and total assets post-contractual retirement. Individuals with unstable career patterns were also less likely to be financially prepared for retirement. We suggest individualising education programmes for retirement preparation based on various career trajectories and demographic attributes to aid middle-aged adults in preparing for financial security later in life. [ABSTRACT FROM AUTHOR]

Health effects of weekend catch-up sleep (CUS) could differ depending on both the ability to obtain sufficient sleep during weekdays and amount of weekend CUS required to compensate for sleep lost during the week. Using data from 3128 middle-aged (40–64 years) participants of the Sleep Heart Health Study, we examined the longitudinal association of these two aspects of sleep with all-cause mortality. CUS was calculated as the difference in self-reported habitual sleep duration between weekends and weekdays, and classified into no, short (1 h), and long (2 h or more) CUS. Polysomnography-measured total sleep time, representing the ability to obtain sufficient sleep, was classified into short (< 360 min) or normal (≥ 360 min) sleep durations. We estimated multivariable-adjusted mortality hazard ratios (HRs) and 95% confidence intervals (CIs) for six groups divided by the extent of CUS and sleep duration. Participants were followed up for a median (interquartile range) of 12.3 (11.3–13.5) years. Short weekend CUS with normal sleep duration was associated with lower mortality compared to no CUS with normal sleep duration (HR, 0.48; 95% CI 0.27–0.83). When stricter cutoffs were applied for sleep durations, while the protective effect of short CUS with normal sleep duration (≥ 390 min) was strengthened (HR, 0.36; 95% CI 0.17–0.78), the harmful effect of short CUS with short sleep duration (< 330 min) emerged (HR, 1.84; 95% CI 1.08–3.14). Results highlight the importance of balancing sleep ability and CUS. Sufficient sleep may reduce weekday sleep debt and only a short CUS would be required on weekends, improving mortality in middle-aged adults. [ABSTRACT FROM AUTHOR]

Background: This study tested a hypothesised model of the effects of adverse life events on the mental health of middle‐aged and older adults living alone, as mediated by thought suppression and help‐seeking behaviours, considering gender differences. Methods: A questionnaire survey was conducted on a sample of 1202 (622 men; 580 women) individuals from 247445 residents aged 50–79 in District A of Tokyo. The questionnaire items covered parameters on adverse life events, help‐seeking behaviour, thought suppression, and mental health status. Results: Multiple group structural equation‐modelling analysis revealed that the seriousness of adverse life events, help‐seeking behaviours, and mental health scores were higher in women than in men. No significant gender differences were observed in thought suppression. The findings support all three proposed hypotheses: severe adverse life events will: (a) give rise to help‐seeking behaviours, which will have a positive effect on mental health; (b) intensify thought suppression, which will harm mental health; and (c) inhibit help‐seeking behaviour, especially in single middle‐aged and older adult men. Conclusion: There is a need to develop interventional programs based on the theory of replacement thinking to encourage help‐seeking behaviours in middle‐aged and older adults. [ABSTRACT FROM AUTHOR]

Objectives: (1) To delineate whether cognitive flexibility and inhibitory ability are neurocognitive markers of passive suicidal ideation (PSI), an early stage of suicide risk in depression and (2) to determine whether PSI is associated with volumetric differences in regions of the prefrontal cortex (PFC) in middle-aged and older adults with depression. Design: Cross-sectional study. Setting: University medical school. Participants: Forty community-dwelling middle-aged and older adults with depression from a larger study of depression and anxiety (NIMH R01 MH091342-05 PI: O'Hara). Measurements: Psychiatric measures were assessed for the presence of a DSM-5 depressive disorder and PSI. A neurocognitive battery assessed cognitive flexibility, inhibitory ability, as well as other neurocognitive domains. Results: The PSI group (n = 18) performed significantly worse on cognitive flexibility and inhibitory ability, but not on other neurocognitive tasks, compared to the group without PSI (n = 22). The group with PSI had larger left mid-frontal gyri (MFG) than the no-PSI group. There was no association between cognitive flexibility/inhibitory ability and left MFG volume. Conclusions: Findings implicate a neurocognitive signature of PSI: poorer cognitive flexibility and poor inhibitory ability not better accounted for by other domains of cognitive dysfunction and not associated with volumetric differences in the left MFG. This suggests that there are two specific but independent risk factors of PSI in middle- and older-aged adults. [ABSTRACT FROM AUTHOR]

Information on the Internet is easily accessible and it is common source to look up health related information. The purpose of this study was to explore the relationship between cyberchondria, intolerance of uncertainty, external health locus of control and defensive pessimism along with exploring the predictors cyberchondria among middle-aged adults. The sample consisted of 120 individuals, 64 females and 56 males, between the age group 40 to 59 years from Mumbai Metropolitan City. Demographic details, Cyberchondria Severity Scale Short Form, Intolerance of Uncertainty Scale, Health Locus of Control scale and Defensive Pessimism Questionnaire were filled by the participants using Google Forms. All variables had a significant positive relationship with each other except for external health locus of control and defensive pessimism. As expected, intolerance of uncertainty, external health locus of control and defensive pessimism independently significantly predicted cyberchondria. Cyberchondria is becoming an important concern. Appropriate intervention strategies can be developed based on these findings. [ABSTRACT FROM AUTHOR]

Background: Insomnia is known to be a major risk factor for incident hypertension. Nonrestorative sleep (NRS), which refers to insufficiently rested sleep, has reported to associate with various diseases. This study aimed to investigate the longitudinal association between insomnia-related symptoms including NRS and incident hypertension 1–2 years later by age group (young, 18–39 years and middle-age, 40–64 years) using existing cohort data involving Hispanics/Latinos. Methods: This study included 1100 subjects who had participated in both the Hispanic Community Health Study/Study of Latinos and its follow-up study, the Sueño Ancillary Study, and met additional eligibility criteria. Incident hypertension was assessed by self-reported history and/or the use of antihypertensives. The Women's Health Initiative Insomnia Rating Scale (WHIIRS) was used to evaluate insomnia-related symptoms (difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, difficulty returning to sleep, and NRS). Logistic regression analyses were conducted to assess the degree to which insomnia-related symptoms at baseline predicted incident hypertension. Results: Among the participants (64% middle-aged, 36% young adults), 140 (12.7%) developed hypertension during the follow-up period. Among the sleep-related symptoms, only NRS predicted incident hypertension after adjusting for sociodemographic factors and physical condition (odds ratio: 1.88, 95% confidence interval: 1.10–3.21, p = 0.022) in middle-aged adults. None of the insomnia-related symptoms were associated with incident hypertension in the young adults. No association was found between WHIIRS-defined insomnia (total score ≥ 9) and incident hypertension in middle-aged adults or young adults. Conclusion: The present findings suggest the importance of focusing on NRS to help prevent the development of hypertension in middle-aged adults. [ABSTRACT FROM AUTHOR]

Aging is a physical procedure for people and nature. Our aging world is expanding because of the life span extension. Aging has a crucial relationship with our body composition (muscles, bones, and adipose tissue), which is characterized by an increase in fat mass and a gradual decrease in muscle mass and strength and bone density. These alterations affect physical performance and impact quality of life enhancing the risk for non-communicable diseases, immobilization, and disability. As far we know, osteoarthritis of lower limbs, sarcopenic obesity, and muscle mass and/or strength loss are treated separately. However, bones, muscles, adipose tissue, and aging appear to have an interconnection through a dialogue as they talk to each other. Health disorders are coming into the surface when this relationship is disrupted. The aim of our study is to search deeper into this interconnection, so that when adipose tissue increases, we have to take a look into the condition of muscle mass, bone, and connective tissue and vice versa, through the assessment of physical performance. Consequently, the triad muscle-bone-adipose tissue disorders by aging should be treated as a single entity. [ABSTRACT FROM AUTHOR]

Aging populations experience disproportionate risk for cognitive decline, which may be exacerbated by coronavirus (COVID-19) illness, particularly among women. This study tested sex as a moderator of associations between COVID-19 state anxiety and cognition in middle-aged/older adults. Adults aged 50+ (N = 275; 151 men/124 women) completed the Coronavirus Anxiety Scale and Cognitive Failures Questionnaire online from remote locations in July/August 2020. A subset of participants (n = 62) completed an objective cognitive task (Stroop). Multiple regressions determined whether sex moderated associations between COVID-19 anxiety and cognitive outcomes. Sex was a significant moderator, such that for women (not men), greater COVID-19 anxiety was associated with more memory failures and blunders (subjective measures) and worse processing speed (objective measure). COVID-19 state anxiety is linked to everyday cognition and processing speed in women, but not men. Consistency across subjective and objective measures promotes the need for sex-specific understanding of the pandemic's behavioral and cognitive effects in mid-to-late life. [ABSTRACT FROM AUTHOR]

Racial disparities in later-life depression among Americans are well-documented. Perceived discrimination has been linked to depressive symptoms among aging Black adults, but little research has considered how vicarious exposure to discrimination shapes the mental health of middle-aged and older Black adults. A subsample of Black adults aged 50–69 years (N = 273) were drawn from the Nashville Stress and Health Study. Lifetime vicarious exposures to major discrimination were assessed. Additionally, multivariate linear regression was employed to examine the association between vicarious experiences of major discrimination and depressive symptoms. Once the Black adults in the sample had reached ages 50 and older, the most common discriminatory events that they had vicariously experienced in their lifetime occurred as a result of their loved ones' unfair interactions with law enforcement and the job market, respectively. Furthermore, our findings revealed that vicarious experiences of major discrimination were associated with higher levels of depressive symptoms among middle-aged and older Black adults. Vicarious, as well as personal, exposures to discrimination shape the mental health of Black Americans over the lifespan. The secondhand effects of discrimination must be considered for interventions aimed at reducing the mental health consequences of racism-related adversity as Black adults age. [ABSTRACT FROM AUTHOR]

Objectives: Even low to moderate levels of alcohol consumption can have detrimental health consequences, especially in older adults (OA). Although many studies report an increase in the proportion of drinkers among OA, there are regional variations. Therefore, we examined alcohol consumption and the prevalence of hazardous alcohol use (HAU) among men and women aged 50+ years in four European regions and investigated predictors of HAU. Methods: We analyzed data of N = 35,042 participants of the European SHARE study. We investigated differences in alcohol consumption (units last week) according to gender, age and EU-region using ANOVAs. Furthermore, logistic regression models were used to examine the effect of income, education, marital status, history of a low-quality parent–child relationship and smoking on HAU, also stratified for gender and EU-region. HAU was operationalized as binge drinking or risky drinking (<12.5 units of 10 ml alcohol/week). Results: Overall, past week alcohol consumption was 5.0 units (±7.8), prevalence of HAU was 25.4% within our sample of European adults aged 50+ years. Male gender, younger age and living in Western Europe were linked to both higher alcohol consumption and higher risks of HAU. Income, education, smoking, a low-quality parent–child relationship, living in Northern and especially Eastern Europe were positively associated with HAU. Stratified analyses revealed differences by region and gender. Conclusions: HAU was highly prevalent within this European sample of OA. Alcohol consumption and determinants of HAU differed between EU-regions, hinting to a necessity of risk-stratified population-level strategies to prevent HAU and subsequent alcohol use disorders. [ABSTRACT FROM AUTHOR]

Background: Stress is a motivator to consume alcohol, a well-documented relapse risk, and is known to differentially affect biological and psychological processes as people age. Objectives: Because alcohol consumption is known to acutely decrease stress and increase affect, this study examined differences in ratings of stress and affect in middle-aged versus younger adults who regularly consume alcohol. Methods: A sample of younger (n = 17) and middle-aged (n = 18) drinkers was studied during a 3-day period of typical alcohol consumption. Resting levels of respiratory sinus arrhythmia (RSA) were measured during a baseline study visit since RSA is a well-documented biomarker of stress and is known to decrease with age. Ecological momentary assessment (EMA) survey ratings (n = 1,598) were modeled using hierarchical regression to assess differences in stress and affect throughout the day between the two age groups. Results: As anticipated, middle-aged participants had lower RSA than those who were younger. Although the middle-aged adults showed overall lower stress, generally they also experienced higher affect than the younger adults. Middle-aged adults experienced a significant reduction in stress following drinking while no such effect was observed in the younger adults. Conclusions: To our knowledge, this is the first investigation using EMA methodology to examine stress and affect between younger and middle-aged adults who habitually consume alcohol. These cross-sectional data suggest potential momentary stress relief to engaging with moderate alcohol consumption in a middle-aged population. Future work must address this important motivational process in curtailing maintenance of alcohol consumption and preventing escalation of consumption. [ABSTRACT FROM AUTHOR]

This cross-sectional study assessed the nutrition and physical activity (PA) needs, practices, and programming preferences of adults ages 40+ years from seven states (n = 1,250). Respondents were mostly educated, White, food-secure, adults ages 60+ years. Many were married, suburban-residing, and interested in health programming. By self-report most respondents were "at nutritional risk" (59.3%), in "somewhat good health" (32.3%), and sedentary (49.2%). One-third reported PA intention in the next two months. Desired programs were less than four weeks and under 4 h weekly. Respondents preferred to attend self-directed online lessons (41.2%). Program format preference varied by age (P < 0.05). More respondents aged 40–49 years and 70+ years reported a preference for online group sessions compared to those aged 50 to 69 years. Respondents ages 60 to 69 years reported the highest preference for interactive apps. More older respondents (60 years and older) preferred asynchronous online lessons compared to the younger respondents (age 59 years and younger). There were significant program participation interest differences by age, race, and location (P< 0.05). These results revealed a need and preference for self-directed, online health programming for middle-aged and older adults. [ABSTRACT FROM AUTHOR]

Over the past several years, mobile learning concepts have changed the way people perceived on mobile devices and technology in the learning environment. In earlier days, mobile devices were used mainly for communication purposes. Later, with many new advanced features of mobile devices, they have opened the opportunity for individuals to use them as mediated technology in learning. The traditional way of teaching and learning has shifted into a new learning dimension, where an individual can execute learning and teaching everywhere and anytime. Mobile learning has encouraged lifelong learning, in which everyone can have the opportunity to use mobile learning applications to gain knowledge. However, many of the previous studies on mobile learning have focused on the young and older adults, and less intention on middle-aged adults. In this research, it is targeted for the middle-aged adults which are described as those who are between the ages of 40 to 60. Middle-aged adults typically lead very active lives while at the same time are also very engaged in self-development programs aimed at enhancing their spiritual, emotional, and physical well-being. In this paper, we investigate the methodology used by researchers based on the research context namely, acceptance, adoption, effectiveness, impact, intention of use, readiness, and usability of mobile learning. The research context was coded to the identified methodologies found in the literature. This will help one to understand how mobile learning can be effectively implemented for middle-aged adults in future work. A systematic review was performed using EBSCO Discovery Service, Science Direct, Google Scholar, Scopus, IEEE and ACM databases to identify articles related to mobile learning adoption. A total of 65 journal articles were selected from the years 2016 to 2021 based on Kitchenham systematic review methodology. The result shows there is a need to strengthen research in the field of mobile learning with middle-aged adults. [ABSTRACT FROM AUTHOR]

Context The prevalence of age-related cognitive decline has been on the rise as the global population age, putting the independence and quality of life of elderly at risk. Anthocyanin, as a subclass of dietary flavonoids, may have a beneficial impact on cognitive outcomes. Objectives To examine the effects of dietary anthocyanin supplementation on cognition of the cognitively healthy middle-aged and older adults. Data Sources PubMed, ScienceDirect, CINAHL, EMBASE, ProQuest and Cochrane databases were searched. Data Extraction and Analysis Thirteen studies were included in this meta-analysis. Anthocyanin-rich supplementation was found to significantly improve the processing speed of the older adults (95%CI 0.08, 0.44; P = 0.004). No significant differences were observed between intervention and control groups on memory, attention, executive function and psychomotor performance. Current neuroimaging studies have found promising effects of anthocyanin supplementation on brain activation and cerebral perfusion. Conclusion Anthocyanin-rich supplementation may preserve cognitive processing speed and neuro-activities in older adults, which improves their daily functioning and quality of life. This review provides useful insights to guide direction and methodological designs for future studies to explore the underlying mechanisms of anthocyanins. Systematic Review and Meta-analysis Registration PROSPERO registration No. CRD42021228007. [ABSTRACT FROM AUTHOR]

Context The skeletal effects of vitamin D remain controversial and it is uncertain whether variation in serum 25-hydroxyvitamin D (25OHD) levels over time influences bone mineral density (BMD). Objective We evaluated longitudinal stability of serum 25OHD and associations with changes in BMD in participants aged 46-70 years at baseline. Methods We studied 3698 Busselton Healthy Ageing Study participants (2040 female) with serum 25OHD and dual-energy x-ray absorptiometry (DXA) BMD assessments at baseline and at ∼6 years follow-up. Restricted cubic splines were used to evaluate associations between changes in 25OHD and BMD. Results Mean season-corrected serum 25OHD was 81.3 ± 22.7 and 78.8 ± 23.1 nmol/L at baseline and 6 years, respectively, and showed moderate correlation (intraclass correlation coefficient: 0.724). Significant predictors of change in 25OHD concentration (Δ25OHD) included baseline 25OHD, change in body mass index and vitamin D supplementation at follow-up. Greater decline in serum 25OHD over time was associated with significantly greater reduction in BMD at total hip and femoral neck, but the magnitude of the differences was small (estimated differences 0.004 g/cm2 and 0.005-0.007 g/cm2, respectively, for lowest quartile of Δ25OHD compared with higher quartiles, adjusted for sex, baseline BMD, 25OHD, and demographics). No significant associations between Δ25OHD and lumbar spine BMD were observed. Increase in 25OHD levels was not associated with change in BMD. Conclusions In this predominantly vitamin D–replete middle-aged cohort, serum 25OHD showed moderate longitudinal stability. Declining serum 25OHD over time was associated with greater reduction in BMD at the total hip and femoral neck. [ABSTRACT FROM AUTHOR]