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Background The role of diet quality in the accumulation of multiple chronic conditions is mostly unknown. This study examined diet quality in association with the number of chronic conditions and the rate of multimorbidity development among community-dwelling older adults. Methods We used data from 2 784 adults aged ≥65 years from the Seniors-ENRICA 2 cohort. Diet quality was assessed at baseline (2015–17) with the Alternate Healthy Eating Index-2010 (AHEI-2010) and the Mediterranean Diet Adherence Screener (MEDAS). Information on medical diagnoses was obtained from electronic clinical records up to 2021. Results Higher adherence to the AHEI-2010 was associated with a lower number of total chronic conditions (β [95% CI] quartile 4 vs 1: −0.57 [−0.86 to 0.27], p trend < .001] and cardiometabolic conditions (−0.30 [−0.44 to −0.17], p trend < .001) at baseline, while higher adherence to the MEDAS was associated with a lower number of total chronic conditions (−0.30 [−0.58 to −0.02], p trend = .01) and neuropsychiatric and neurodegenerative conditions (−0.09 [−0.17 to −0.01], p trend = .01). After a median follow-up of 5.2 years (range: 0.1–6.1 years) higher adherence to the AHEI-2010 was associated with a lower increase in chronic conditions (β [95% confidence interval] quartile 4 vs 1: −0.16 [−0.30 to −0.01], p trend = .04) and with lower rate of chronic disease accumulation. Conclusions Higher diet quality, as measured by the AHEI-2010, was associated with a lower number of chronic health conditions and a lower rate of multimorbidity development over time. [ABSTRACT FROM AUTHOR]

Hypoglycemia is the most common adverse event associated with insulin treatment in diabetes. The consequences of hypoglycemia can be quite aversive and potentially life threatening. The physical sequelae provide ample reason for patients to fear hypoglycemia and avoid episodes. For these reasons, our purpose in this study was to develop a new measure that explores specific fear of hypoglycemia (FH) in adult patients with type 1 diabetes and to examine its psychometric properties. The instrument developed to assess FH was initially made up of 20 items, of which 18 were negative and 2 were positive, assessed on a 5-point Likert scale (1-5). This scale was completed by 229 patients with type 1 diabetes. Additionally, a structured interview and a closed question called subjective fear of hypoglycemia were included as diagnostic criteria. A factor analysis employing the principal-components method and promax rotation was carried out, resulting in a new scale composed of 15 items. Three factors (fear, avoidance, and interference) were obtained and explained 58.27% of the variance. The scale showed good internal consistency (Cronbach's [alpha] = 0.891) and test-retest reliability (r = 0.908, p less than 0.001), as well as adequate concurrent and predictive validity. The cutoff score that provided the highest overall sensitivity and specificity was set at 28 points. The Fear of Hypoglycemia 15-item scale (FH-15) demonstrated good reliability and validity. This study suggests that the new instrument may serve as a valuable measure of specific FH for use in research and clinical practice. (Contains 6 tables and 1 footnote.)

Background Leucine is suggested to play a central role in age-related physical decline, but the effect of dietary leucine intake on physical functioning is uncertain. We examined the prospective association between dietary leucine intake and impaired lower-extremity function (ILEF) and frailty in older adults. Methods We used data from 2 956 adults aged ≥60 and older from the Seniors-ENRICA cohort. At baseline (2008–2010) and in 2012, dietary information was obtained with a validated computerized face-to-face diet history, from which energy-adjusted cumulative leucine intake per body weight was calculated. Participants were followed up through 2017 to assess incident ILEF, ascertained with the Short Physical Performance Battery, and incident frailty, according to the Fried phenotype criteria. Statistical analysis was performed with Cox models adjusted for the main potential confounders. Results During follow-up, we identified 515 incident cases of ILEF and 241 of frailty. Compared with participants in the lowest tertile of leucine intake (35.5–89.0 mg/kg/d), those in the highest tertile (107.4–372.5 mg/kg/d) had a lower risk of ILEF (fully adjusted hazard ratio [95% confidence interval]: 0.70 [0.53–0.93], p trend:.01) and of frailty (0.63 [0.41–0.96], p trend:.03]. A higher consumption of important sources of leucine in this population, including unprocessed beef, oily and white fish, and bread, were also associated with a lower risk of incident ILEF and frailty. Conclusions Higher leucine intake was associated with reduced risk of ILEF and frailty. Dietary leucine, obtained from foods rich in high-quality protein, could be a key nutrient to prevent age-related physical function decline in older adults. [ABSTRACT FROM AUTHOR]

Objective To explore the associations between health and how people evaluate and experience their lives. Methods We analysed data from nationally-representative household surveys originally conducted in 2011-2012 in Finland, Poland and Spain. These surveys provided information on 10 800 adults, for whom experienced well-being was measured using the Day Reconstruction Method and evaluative well-being was measured with the Cantril Self-Anchoring Striving Scale. Health status was assessed by questions in eight domains including mobility and self-care. We used multiple linear regression, structural equation models and multiple indicators/ multiple causes models to explore factors associated with experienced and evaluative well-being. Findings The multiple indicator/multiple causes model conducted over the pooled sample showed that respondents with younger age (effect size, (β = 0.19), with higher levels of education (β = -0.12), a history of depression (β = - 0.17), poor health status (β = 0.29) or poor cognitive functioning (β = 0.09) reported worse experienced well-being. Additional factors associated with worse evaluative well-being were male sex (β = -0.03), not living with a partner (β = 0.07), and lower occupational (β = -0.07) or income levels (β = 0.08). Health status was the factor most strongly correlated with both experienced and evaluative well-being, even after controlling for a history of depression, age, income and other sociodemographic variables. Conclusion Health status is an important correlate of well-being. Therefore, strategies to improve population health would also improve people's well-being. [TEXT NOT REPRODUCIBLE IN ASCII] Objectif Etudier les associations entre la sante et la maniere dont les personnes evaluent et ressentent leur vie. Methodes Nous avons analyse les donnees tirees des enquetes sur les menages representatifs a l'echelle nationale qui ont ete menees en 2011-2012 en Finlande, Pologne et Espagne. Ces enquetes ont fourni des informations sur 10 800 adultes, dont le bien-etre a ete mesure en utilisant la methode de reconstruction de la journee et le bien-etre evaluatif a ete quantise avec l'echelle de Cantril (Cantril Self-Anchoring Striving Scale). L'etat de sante a ete evalue par des questions dans huit domaines, y compris la mobilite et le fait de prendre soin de soi-meme. Nous avons utilise des modeles d'equation structured a regression lineaire multiple et des modeles a indicateurs eta causes multiples pour etudier les facteurs associes au bien-etre ressenti et evaluatif. Resultats Le modele a indicateurs et a causes multiples applique sur l'echantillon groupe a montre que les repondants jeunes (ampleur de l'effet [β] = 0,19), avec un niveau d'education plus eleve (β = -0,12), des antecedents de depression (β = -0,17), un mauvais etat de sante (β = 0,29) ou de faibles facultes cognitives (β = 0,09) avaient signale le plus faible bien-etre ressenti. Des facteurs supplementaires associes avec la plus mauvaise evaluation de bien-etre etaient: etre de sexe male (β = -0,03), ne pas vivre avec un partenaire (β = 0,07), un statut professionnel inferieur (β = -0,07) ou des niveaux de revenus plus faibles (β = 0,08). L'etat de sante etait le facteur le plus correle a la fois avec le bien-etre ressenti et evaluatif, meme apres controle des antecedents de depression, de l'age, des revenus et des autres variables sociodemographiques. Conclusion L'etat de sante est un facteur de correlation important du bien-etre. Par consequent, les strategies d'amelioration de la sante de la population devraient egalement ameliorer le bien-etre des personnes. [TEXT NOT REPRODUCIBLE IN ASCII] Objetivo Examinar la relation entre la salud y como las personas evaluan y experimentan sus vidas. Metodos Se analizaron datos de encuestas a hogares representatives a nivel national realizadas inicialmente entre 2011 y 2012 en Finlandia, Polonia y Espana. Estas encuestas proporcionaron information sobre 10 800 adultos, para quienes el bienestar experiential se midio con el metodo de reconstruction de dfa y el bienestar evaluativo se midio con la escala Cantril. Se evaluo el estado de salud mediante preguntas de ocho ambitos, que incluian la movilidad y el cuidado personal. Se emplearon modelos de regresion lineal multiple y ecuaciones estructurales, asi como modelos de causas multiples/indicadores multiples a fin de examinar los factores asociados con el bienestar experiential y evaluativo. Resultados El modelo de causas multiples/indicadores multiples realizado en la muestra combinada mostro que los encuestados de menor edad (tarnaho del efecto [β] = 0,19), con niveles superiores de education (β = -0,12), antecedentes de depresion (β = -0,17), mal estado de salud (β = 0,29) o mal funcionamiento cognitivo (β = 0,09) presentaron menor bienestar experiencial. Otros factores asociados con menor bienestar evaluativofueron el sexo masculino (β = -0,03), no vivir en pareja (β = 0,07) y un nivel ocupacional β = -0,07) o de ingresos inferior (β = 0,08). El estado de salud fueel factor que mas se correlaciono tanto con el bienestar experiencial como evaluativo, incluso despues de examinar los antecedentes de depresion, la edad, los ingresos y otras variables sociodemograficas. Conclusion El estado de salud guarda una correlation importante con el bienestar. Por lo tanto, las estrategias para mejorar la salud de la poblacion podrian asimismo mejorar el bienestar de las personas., Introduction Many national surveys are in progress to evaluate well-being as an indicator of societal progress that goes beyond traditional indices, such as gross domestic product (GDP). These surveys inform [...]

We compared the trajectory of activities of daily living (ADL) in a nationally representative sample of older Nigerians with their Spanish peers and identified factors to explain country-specific growth models. Data from two household multistage probability samples were used, comprising older adults from Spain (n = 2,011) and Nigeria (n = 1,704). All participants underwent assessment for ADL. Risk factors including sex, household income, urbanicity, years of education, depression, alcohol consumption and smoking were assessed using validated methods. State-space model in continuous time (SSM-CT) methods were used for trajectory comparison. Compared with Nigerians (µADL80=0.44, SE = 0.015, p < 0.001), Spanish older adults had higher disability scores (µADL80=1.23, SE = 0.021, p < 0.001). In SSM-CT models, the rate of increase in disability was faster in Nigerians (Nigeria: β = 0.061, p<.01; Spain: β = 0.028, p < 0.010). An increasing course of disability in the Spanish sample was predicted by female sex, lower education and depression diagnosis. The rate of increase in disability was faster in older Nigerians living in an economically disadvantaged context. [ABSTRACT FROM AUTHOR]