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Public health measures in response to the COVID-19 pandemic forced individuals to spend more time at home. We sought to investigate the relationship between housing characteristics and sleep duration in the context of COVID-19.

The objectives of this study were to explore the perspectives of older adults about the most important domains of aging well and to identify the social determinants of a person-centered index capturing these domains. We conducted a mixed-methods study of 40 semi-structured interviews and epidemiological data from 670 older adults participating in the International Mobility in Aging Study (IMIAS) in Saint-Hyacinthe and Kingston. A composite index capturing the domains of aging well was constructed on the basis of findings from qualitative content analysis. Bivariate and multivariate regressions were carried out to examine the determinants of aging well, including economic determinants, health behaviours, health services, and the social environment. The qualitative results confirm the importance of symptomatic health conditions and psychosocial components. The index was computed as a continuous score (0 to 100) containing health components (ADL disability, mobility disability, pain, self-rated health, and cognitive function), and psychosocial components (mood, productive activities, social relations, life satisfaction, and self-mastery). Mean scores were 81 among Canadian older adults, and 83 and 79 for men and women respectively. Being male, having sufficient income, doing leisure physical activity, and feeling safe in one’s neighbourhood were all significantly associated with a higher score on the aging well index. The composite index highlights important aspects of health and psychosocial well-being that could be augmented according to older adults themselves. Modifiable social determinants of aging well could guide social and health policies to maximize well-being in this population. Les objectifs de cette étude étaient d’explorer la perspective de personnes âgées à propos des plus importants domaines de ce que signifie bien vieillir, ainsi que d’identifier les déterminants sociaux d’un index de bien vieillir centré sur la personne incluant ces domaines. Nous avons effectué une étude à méthodes mixtes utilisant 40 entretiens semi-dirigés et des données épidémiologiques provenant de 670 personnes âgées ayant participé à l’étude internationale sur la mobilité au cours du vieillissement (IMIAS) au Canada, à Saint-Hyacinthe et à Kingston. Un index comprenant les domaines mentionnés par les participants au devis qualitatif a été construit à partir de mesures existantes. Des régressions bivariée et multivariée ont ensuite été estimées afin d’examiner les déterminants sociaux de l’index de bien vieillir, notamment les déterminants économiques, les comportements de santé, l’accès aux services de santé, et l’environnement social. Les résultats du devis qualitatif confirment l’importance de conditions de santé symptomatiques et de composantes psychosociales. Un index continu (0 à 100) a été développé, comprenant des domaines de la santé (incapacité dans les activités de la vie quotidienne, incapacité de mobilité, douleur, santé perçue et fonction cognitive) et psychosociaux (humeur, activités productives, relations sociales, satisfaction dans la vie et maitrise de soi). Les scores moyens étaient de 81 pour l’ensemble des répondants canadiens, ainsi que de 83 et 79 pour les hommes et les femmes, respectivement. Être un homme, avoir un revenu suffisant, faire des activités physiques comme loisir et se sentir en sécurité dans son quartier étaient des déterminants associés de manière statistiquement significative à un score plus élevé sur l’index de bien vieillir. L’index proposé dans cette étude met en lumière des aspects importants de la santé et des domaines psychosociaux qui pourraient être améliorés selon la perspective de personnes âgées canadiennes. Les déterminants sociaux modifiables qui ont été identifiés pourraient guider des politiques sociales et de santé afin de maximiser le bien-être de cette population.

To examine the evolution of physical activity (PA) level within a day in patients with COPD, PA was assessed using accelerometry for 7 d, 24 hr/d. PA level consistently decreased in the evening in these patients, especially when periods of the day were split on the basis of mealtimes or equal tertiles.

ObjectivesTo evaluate the impact of covariates on performance accuracy of the Beck Depression Inventory II (BDI-II) and to determine the optimal cut-off score for the BDI-II in cardiac outpatients. Differences of optimal cut-off scores were also verified across covariate subgroups.Design and settingProspective cross-sectional study at the Department of Nuclear Medicine of the Montreal Heart Institute (Quebec, Canada).MethodsA total of 750 adult cardiac outpatients (mean ± SD age 58 ± 10 years, 31% women) completed the BDI-II and the Primary Care Evaluation of Mental Disorders (PRIME-MD; a psychiatric interview used as the reference standard for determining diagnosis of major depressive disorder). The receiver operating characteristics (ROC) curve of the BDI-II was adjusted for age, sex, level of education, smoking status, obesity, anxiety disorder, psychotropic medication, and history of coronary artery disease. The ROC analyses were conducted to determine optimal cut-off scores.ResultsForty-two (6%) patients met criteria for current major depressive disorder according to the PRIME-MD. After adjusted for covariates, the area under the ROC curve was significantly smaller than the unadjusted curve (0.76, 95% CI 0.66 to 0.85 vs. 0.84, 95% CI 0.77 to 0.89; ΔAUC = −0.07, 95% CI −0.13 to −0.02). While the optimal cut-off score was 10 for the total sample (sensitivity 83%, specificity 73%), the analyses indicated different cut-off scores across covariate subgroups: e.g. sex (women 13; men 10), and anxiety disorders (yes 15; no 10).ConclusionsBDI-II is a good screening instrument for depression in cardiac outpatients. However, the present results suggest that covariates can affect the classification accuracy of the BDI-II’s original recommended cut-off score. Scholars and clinicians should be aware of the principle that a screening score established in one population may not be relevant to another.

Pulmonary rehabilitation plays a key role in the management of chronic obstructive pulmonary disease (COPD). Although the American Thoracic Society recently provided a grade of 1A for evidence of health-related quality of life (HRQoL) benefits related to pulmonary rehabilitation, knowledge about the psychological and behavioral processes explaining the impact of pulmonary rehabilitation on HRQoL in COPD patients remains limited. This review describes the state of knowledge over the past year concerning HRQoL benefits after pulmonary rehabilitation and suggests avenues for future research.

Achieving optimal asthma control and minimizing the risk of exacerbation are the main goals of asthma treatment.