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The age-performance relationship describes changes in the organism’s structural and functional capabilities over the course of the lifespan. The typical, empirical pattern is an asymmetrical inverted-U shape association with peak capacity occurring early in life. This process is well described in the literature, with an increasing interest in features that characterize this pattern, such as the rate of growth, age of peak performance, and rate of decline with aging. This is usually examined in cohorts of individuals followed over time with repeat assessments of physical or cognitive abilities. This framework ought to be integrated into public health programs, embedding the beneficial (such as physical or cognitive training) or adverse effects (such as chronic diseases or injuries) that respectively sustain or limit capabilities. The maintenance of physical or cognitive performances at older ages would result in both optimal health and promote resistance to disabling conditions and chronic diseases, such as obesity and type 2 diabetes. The causes of accelerated degeneration of health optima are mainly: sedentary and unhealthy lifestyles -including poor nutrition-, exposure to environmental pollutants, and heterogeneity in aging. Better knowledge of optima, compatible with or required for good health, should also allow for establishing ideal conditions for longevity.

International audience; To determine if self-rated health (SRH), a single-item measure of health status where individuals are asked to rate their own health, predicts mortality in a middle-aged sample and if the predictive ability of SRH diminishes with time. Data (6316 men and 3035 women) are drawn from the Whitehall II study. SRH and covariates were measured at baseline (1985-1988) when the average age of individuals was 44.5 years (SD = 6.1). The mortality follow-up was available for a mean of 17.5 years and was classified as having occurred in the first 10 years or the subsequent follow-up period (range 6 to 9 years). The association between SRH and mortality was assessed using a Cox regression model with relative index of inequality (RII) to summarize associations. There were no sex differences in the association between SRH and mortality in either the short (p = .39) or the long term (p = .16). Sex-adjusted short-term association (RII = 3.80; 95% confidence interval (CI) 2.28, 6.35) was significantly (p = .004) stronger than the long-term association (RII = 1.56; 95% CI 1.04, 2.34). Explanatory variables accounted for 80% of the SRH-mortality association in men and 29% in women. SRH predicts mortality equally well in men and women. However, the covariates explained a much larger proportion of the SRH-mortality relationship in men compared with women. In this middle-aged cohort, SRH predicts mortality strongly in the short term but only weakly in the long term.

International audience; Little is known about the role that work-related factors play in the decline of cognitive function. This study examined the association between perceived organisational justice and cognitive function among middle-aged men and women. Perceived organisational justice was measured at phases 1 (1985-8) and 2 (1989-90) of the Whitehall II study when the participants were 35-55 years old. Assessment of cognitive function at the screening clinic at phases 5 (1997-9) and 7 (2003-4) included the following tests in the screening clinic: memory, inductive reasoning (Alice Heim 4), vocabulary (Mill Hill), and verbal fluency (phonemic and semantic). Mean exposure to lower organisational justice at phases 1 and 2 in relation to cognitive function at phases 5 and 7 were analysed using linear regression analyses. The final sample included 4531 men and women. Lower mean levels of justice at phases 1 and 2 were associated with worse cognitive function in terms of memory, inductive reasoning, vocabulary and verbal fluency at both phases 5 and 7. These associations were independent of covariates, such as age, occupational grade, behavioural risks, depression, hypertension and job strain. This study suggests an association between perceived organisational justice and cognitive function. Further studies are needed to examine whether interventions designed to improve organisational justice would affect employees' cognition function favourably.

International audience; The course of major depressive disorder is often characterized by progressing chronicity, but whether this applies to the course of self-reported psychological distress remains unclear. We examined whether the risk of self-reported psychological distress becomes progressively higher the longer the history of distress and whether prolonged history of distress modifies associations between risk markers and future distress. Participants were British civil servants from the prospective Whitehall II cohort study (n=7934; 31.5% women, mean age 44.5 years at baseline) followed from 1985 to 2006 with repeat data collected in 7 study phases. Psychological distress was assessed with the 30-item General Health Questionnaire (GHQ). Sex, socioeconomic status, marital status, ethnicity, physical activity, alcohol consumption, smoking, and obesity were assessed as risk markers. Recurrent history of psychological distress was associated with a progressively increasing risk of future distress in a dose-response manner. Common risk markers, such as low socioeconomic status, non-White ethnicity, being single, and alcohol abstinence, were stronger predictors of subsequent distress in participants with a longer history of psychological distress. Sex differences in psychological distress attenuated with prolonged distress history. The participants were already adults in the beginning of the study, so we could not assess the progressive chronicity of psychological distress from adolescence onwards. These data suggest that self-reported psychological distress becomes more persistent over time and that a longer prior exposure to psychological distress increases sensitivity to the stressful effects of certain risk markers.

Carpal tunnel syndrome: estimations of incidence and prevalence rates and population attributable fraction of risk from the French Pays de la Loire region, 2002-2004 Carpal tunnel syndrome (CTS) represents one of the most frequent problems occurring in the working population. In France, CTS is the leading cause of worker’s compensation claims for occupational diseases. CTS has been chosen as the sentinel health event for upper limb musculoskeletal disorders within the work-related musculoskeletal disorders epidemiologic surveillance program, implemented in 2002 in the French Pays de la Loire region. This program combines several complementary components to describe the epidemiologic state of CTS: incidence rates and the proportion of cases that might be attributable to work in the general population, prevalence rates among the workers. The average 12-month incidence of surgical CTS was 2.7 in 1,000 women and 1.2 in 1,000 men in the Maine-et-Loire area. Prevalence rates of CTS estimated in a sample of workers from the whole region were 4.0% in women and 2.4% in men, after shoulder cuff rotator syndrome. The proportion of cases attributable to work was particularly high among blue collar workers of both genders and among female employees. According to the occupational categories and economic sector of activity, these estimations have allowed the identification of the ones for which intervention programs should be implemented as a priority, Le syndrome du canal carpien (SCC) représente l'un des problèmes de santé liés au travail les plus fréquents. Il occupe le premier rang des maladies professionnelles indemnisées du régime général de la Sécurité sociale. Dans le cadre du programme de surveillance épidémiologique des troubles musculo-squelettiques (TMS) mis en oeuvre en 2002 à titre pilote dans la région des Pays de la Loire, le SCC a été retenucomme traceur des TMS du membre supérieur. Ce programme associe plusieurs approches complémentaires pour décrire la situation épidémiologique du SCC : estimation de l'incidence et de la part des cas attribuables à l'activité professionnelle en population générale, estimation de la prévalence en population salariée. L'incidence annuelle du SCC opéré estimée dans le Maine-et-Loire s'élevait à 2,7 pour 1000 femmes et 1,2 pour 1000 hommes. La prévalence du SCC estimée sur un échantillon de salariés de la région s'élevait à 4,0% chez les femmes et 2,4% chez les hommes, se situant au 2ème rang après le syndrome de la coiffe des rotateurs à l'épaule. La part des cas attribuables au travail est particulièrement élevée parmi les ouvriers et ouvrières et parmi les employées. Ces indicateurs ont été estimés selon la profession et le secteur d'activité, permettant d'identifier ceux sur lesquels les actions préventives devront être mises en oeuvre de façon prioritaire.

Objectives. We examined the association between physical activity and cognitive functioning in middle age. Methods. Data were derived from a prospective occupational cohort study of 10308 civil servants aged 35–55 years at baseline (phase 1; 1985–1988). Physical activity level, categorized as low, medium, or high, was assessed at phases 1, 3 (1991–1994), and 5 (1997–1999). Cognitive functioning was tested at phase 5, when respondents were 46–68 years old. Results. In both prospective (odds ratio [OR] = 1.65; 95% confidence interval [CI]=1.30, 2.10) and cross-sectional (OR=1.79; 95% CI=1.38, 2.32) analyses, low levels of physical activity were a risk factor for poor performance on a measure of fluid intelligence. Analyses aimed at assessing cumulative effects (summary of physical activity levels at the 3 time points) showed a graded linear relationship with fluid intelligence, with persistently low levels of physical activity being particularly harmful (OR=2.21; 95% CI=1.37, 3.57). Conclusions. Low levels of physical activity are a risk factor for cognitive functioning in middle age, fluid intelligence in particular.

International audience; Measures of quality of life (QoL) have been found to be predictors of mortality and morbidity; however, there is still limited understanding of the multifaceted nature of these measures and of potential correlates. Using two large populations from the UK and US, we aimed to evaluate and compare measured levels of QoL and the key factors correlated with these levels. Participants were 6,472 white subjects (1,829 women) from the Whitehall II Study (mean age 55.8 years) and 3,684 white subjects (1,903 women) from the Western New York Health Study (mean age 58.7 years). QoL was assessed in both using the physical and mental health component summaries of the short form-36 questionnaire (SF-36). Analysis of covariance was used to compare gender-specific mean scores for the two populations across several potential correlates (including socio-demographic, lifestyle and co-morbidity factors). Levels of reported physical QoL tended to be higher in the UK population (51.2 vs. 48.6) while mental QoL was higher in the US group (53.1 vs. 51.1). Age, sleep duration and depressive symptoms were the main factors correlated with both physical and mental QoL in both samples. Increasing age was associated with poorer physical health but higher mental health scores in both populations (P