Meeting 24-h movement behavior guidelines is linked to academic engagement, psychological functioning, and cognitive difficulties in youth with internalizing problems.

BACKGROUND: This study aimed to investigate associations of meeting 24-h movement behavior (24-HMB: physical activity [PA], screen time [ST] in the school-aged youth, and sleep) guidelines with indicators of academic engagement, psychological functioning, and cognitive function in a national representative sample of U.S. youth. METHODS: In this cross-sectional study, 1794 participants aged 6 to 17 years old were included for multivariable logistic regression to determine the above-mentioned associations, while adjusting for sociodemographic and health covariates. RESULTS: The proportion of participants who met 24-HMB guideline(s) varied greatly (PA+ ST+ sleep = 34 [weighted 1.17 %], PA + ST = 23 [weighted 1.72 %], PA + sleep = 52 [weighted 2.15 %], PA = 34 [weighted 2.88 %], ST = 142 [weighted 7.5 %], ST+ sleep = 209 [weighted 11.86 %], sleep = 725 [weighted 35.5 %], none = 575 [weighted 37.22 %]). Participants who met ST guideline alone and integrated (ST + Sleep and ST + sleep + PA) guidelines demonstrated the consistently beneficial associations with learning interest/curiosity, caring for school performance, completing required homework, resilience, cognitive difficulties, self-regulation (ps < 0.05). CONCLUSION: Meeting 24-HMB guidelines in an isolated or integrative manner was associated with improved academic engagement, psychological functioning, and reduced cognitive difficulties. These findings highlight the importance of the promotion of 24-HMB guidelines in youth with internalizing problems. Future longitudinal studies are needed to investigate whether changes or modifications of meeting specific 24-HMB guidelines (especially ST) is beneficial for youth with internalizing problems.

Life-course socioeconomic conditions, multimorbidity and polypharmacy in older adults: A retrospective cohort study.

Socioeconomic conditions across the life course may contribute to differences in multimorbidity and polypharmacy in old age. However, whether the risk of multimorbidity changes during ageing and whether life-course socioeconomic conditions are associated with polypharmacy remain unclear. We investigated whether disadvantaged childhood socioeconomic conditions (CSCs) predict increased odds of multimorbidity and polypharmacy in older adults, whether CSCs remain associated when adjusting for adulthood socioeconomic conditions (ACSs), and whether CSCs and ACSs are associated cumulatively over the life course. We used data for 31,432 participants (multimorbidity cohort, mean [SD] age 66·2[9] years), and 21,794 participants (polypharmacy cohort, mean age 69·0[8.9] years) from the Survey of Health, Ageing, and Retirement in Europe (age range 50-96 years). We used mixed-effects logistic regression to assess the associations of CSCs, ASCs, and a life-course socioeconomic conditions score (0-8; 8, most advantaged) with multimorbidity (≥2 chronic conditions) and polypharmacy (≥5 drugs taken daily). We found an association between CSCs and multimorbidity (reference: most disadvantaged; disadvantaged: odds ratio (OR) = 0·79, 95% confidence interval (CI) 0·70-0·90; middle: OR = 0·60; 95%CI 0·53-0·68; advantaged: OR = 0·52, 95%CI 0·45-0·60, most advantaged: OR = 0·40, 95%CI 0·34-0·48) but not polypharmacy. This multimorbidity association was attenuated but remained significant after adjusting for ASCs. The life-course socioeconomic conditions score was associated with multimorbidity and polypharmacy. We did not find an association between CSCs, life-course socioeconomic conditions, and change in odds of multimorbidity and polypharmacy with ageing. Exposure to disadvantaged socioeconomic conditions in childhood or over the entire life-course could predict multimorbidity in older age.

Lower social participation partly explains the association between perceived neighbourhood crime and depressive symptoms in European adults aged 50 years or older: A longitudinal mediation analysis.

Neighbourhood crime likely increases the risk of developing depression among older adults. However, little is known about the underlying behavioural and social pathways. We examined the association between perceived neighbourhood crime and depressive symptoms and whether this relationship was mediated by health behaviours (physical activity, smoking, and alcohol consumption) and social participation. Furthermore, we explored differential vulnerability across age, gender, education and household wealth. Data were drawn from six waves of longitudinal data (from 2004/2005 to 2017) of approximately 15,000 adults aged 50 years and older, derived from the multi-national Survey of Health, Ageing and Retirement in Europe. Perceived neighbourhood crime and covariates were measured at baseline, time-variant mediators and depressive symptoms across all waves. Confounder-adjusted mediator and outcome models were fitted with mixed-effects models. Total association was decomposed into direct and indirect pathways applying causal mediation analyses with Monte-Carlo simulations. Perceived crime was associated with higher risk of depressive symptoms; 4.6% of the effect was mediated via lower engagement in social activities (b = 0.005; 95% CI: 0.001-0.009). No mediation was detected through physical activity, smoking or alcohol consumption. Exploratory analyses revealed that the mediating role of social participation was more pronounced among participants with low household wealth (b = 0.012; 95% CI: 0.004-0.023; 7.3% mediated). Lower engagement in social activities partly explained the association between perceived neighbourhood crime and depressive symptoms in adults aged 50 years or older. Policies targeting disadvantaged communities to prevent crime and support social participation might be beneficial for population mental health, especially among financially vulnerable older residents.

Muscle strength is associated with COVID-19 hospitalization in adults 50 years of age or older.

BACKGROUND: Weak muscle strength has been associated with a wide range of adverse health outcomes. Yet, whether individuals with weaker muscle strength are more at risk for hospitalization due to severe COVID-19 is still unclear. The objective of this study was to investigate the independent association between muscle strength and COVID-19 hospitalization. METHODS: Data from adults 50 years of age or older were analysed using logistic models adjusted for several chronic conditions, body-mass index, age, and sex. Hand-grip strength was repeatedly measured between 2004 and 2017 using a handheld dynamometer. COVID-19 hospitalization during the lockdown was self-reported in summer 2020 and was used as an indicator of COVID-19 severity. RESULTS: The study was based on the Survey of Health, Ageing and Retirement in Europe (SHARE) and included 3600 older adults (68.8 ± 8.8 years, 2044 female), among whom 316 were tested positive for the severe acute respiratory syndrome coronavirus 2 (8.8%), and 83 (2.3%) were hospitalized due to COVID-19. Results showed that higher grip strength was associated with a lower risk of COVID-19 hospitalization [adjusted odds ratio (OR) per increase of 1 standard deviation in grip strength = 0.64, 95% confidence interval (95% CI) = 0.45-0.87, P = 0.015]. Results also showed that age (OR for a 10 -year period = 1.70, 95% CI = 1.32-2.20, P < 0.001) and obesity (OR = 2.01, 95% CI = 1.00-3.69, P = 0.025) were associated with higher risk of COVID-19 hospitalization. Sensitivity analyses using different measurements of grip strength as well as robustness analyses based on rare-events logistic regression and a different sample of participants (i.e. COVID-19 patients) were consistent with the main results. CONCLUSIONS: Muscle strength is an independent risk factor for COVID-19 severity in adults 50 years of age or older.

Evolution of physical activity habits after a context change: The case of COVID-19 lockdown.

OBJECTIVE: Habits, defined as well-learned associations between cues and behaviours, are essential for health-related behaviours, including physical activity (PA). Despite the sensitivity of habits to context changes, little remains known about the influence of a context change on the interplay between PA habits and behaviours. We investigated the evolution of PA habits amidst the spring COVID-19 lockdown, a major context change. Moreover, we examined the association of PA behaviours and autonomous motivation with this evolution. DESIGN: Three-wave observational longitudinal design. METHODS: PA habits, behaviours, and autonomous motivation were collected through online surveys in 283 French and Swiss participants. Variables were self-reported with reference to three time-points: before-, mid-, and end-lockdown. RESULTS: Mixed effect modelling revealed a decrease in PA habits from before- to mid-lockdown, especially among individuals with strong before-lockdown habits. Path analysis showed that before-lockdown PA habits were not associated with mid-lockdown PA behaviours (ß = -.02, p = .837), while mid-lockdown PA habits were positively related to end-lockdown PA behaviours (ß = .23, p = .021). Autonomous motivation was directly associated with PA habits (ps < .001) and withto before- and mid-lockdown PA behaviours (ps < .001) (but not with end-lockdown PA behaviours) and did not moderate the relations between PA behaviours and habits (ps > .072). CONCLUSION: PA habits were altered, and their influence on PA behaviours was impeded during the COVID-19 lockdown. Engagement in PA behaviours and autonomous motivation helped in counteracting PA habits disruption.

Disadvantaged Early-Life Socioeconomic Circumstances Are Associated With Low Respiratory Function in Older Age.

BACKGROUND: Poor lung function in late life may stem from early-life risk factors, but the epidemiological evidence is inconsistent. We investigated whether individuals who experienced disadvantageous socioeconomic circumstances (SEC) in early life showed lower levels of respiratory function in older age, a steeper decline over time, and whether these relationships were explained by adult-life SEC, body mass index, and physical inactivity in older age. METHODS: We used data from the Survey of Health Ageing and Retirement in Europe (2004-2015). Participants' peak expiratory flow (PEF) was assessed with a mini-Wright peak flow meter at second, fourth, and sixth waves. Confounder-adjusted linear mixed-effect models were used to examine the associations between early-life SEC and PEF in older age. A total of 21,734 adults aged 50-96 years (46,264 observations) were included in the analyses. RESULTS: Older adults with disadvantaged early-life SEC showed lower levels of PEF compared with those with advantaged early-life SEC. The association between early-life SEC and late-life PEF persisted after adjusting for adult-life SEC, smoking, physical inactivity, and body mass index. PEF declined with age, but the effect of early-life SEC on this decline was not consistent across robustness and sensitivity analyses. CONCLUSIONS: Early life is a sensitive period for respiratory health. Further considering the effect of SEC arising during this period may improve the prevention of chronic respiratory diseases.

Association between Adverse Childhood Experiences and Muscle Strength in Older Age.

BACKGROUND: Muscle weakness - a biomarker of health - may have its origins in early life and be related to factors such as adverse childhood experiences (ACE), which refer to a set of early-life traumatic and stressful psychosocial events out of the child's control. To date, evidence of an association between ACE and muscle strength in older age is lacking. -Objective: Here, we assessed the associations between ACE during the first 15 years of life and the risk of low muscle strength (LMS) later in life. We also examined whether adult-life socioeconomic circumstances (i.e., educational attainment, main occupational position, and satisfaction with household financial situation) and unhealthy behaviors (i.e., physical inactivity, unhealthy eating, smoking, and high level of alcohol consumption) explained this association. METHODS: We used data from the Survey of Health, Ageing, and Retirement in Europe, a 12-year cohort study with 6 -repeated measurements between 2004 and 2015. Muscle strength was measured using a handheld dynamometer. Confounder-adjusted logistic mixed-effect models were used to examine the associations between ACE (child in care, parental death, parental mental illness, parental drinking, period of hunger, or property taken away) and the risk of LMS in older age. -Results: 24,179 participants (96,372 observations; 13,477 women; aged 50-96 years) living in 14 countries were included. LMS increased with age for both genders. For women, there was a gradual increase in the risk of LMS with the number of experienced ACE (ORs = 1.22 for 1 ACE, 1.74 for ≥2 ACE compared to no ACE). However, there was no significant association among men. This association was only slightly attenuated when adjusting for socioeconomic circumstances and unhealthy behaviors in adulthood. CONCLUSIONS: ACE are associated with later-life muscle weakness among women. These associations were not compensated by the adoption of healthy behaviors or an improvement in socioeconomic circumstances in adulthood. These results suggest that tackling these early-life risk factors in women could promote long-term grip strength, a biomarker of aging.

A mixed-effects location scale model for time-to-event data: A smoking behavior application.

In general, mixed-effects location scale models (MELS) allow assessment of within-person and between-person variability with time-to-event data for outcomes that follow a normal or ordinal distribution. In this article, we extend the mixed-effects location scale model to time-to-event data in relation to smoking data. Better understanding of the time-graded within-person variability of factors involved in nicotine dependence can be helpful to researchers in their efforts to fine-tune smoking cessation programs. We illustrate the MELS model with data on time to first cigarette measured every day for 7 days in smokers randomized to two groups: a) those asked to keep smoking, or b) those asked to stop. Our results show that some individuals remain very stable in their time to first cigarette over the week, while others show variable patterns. The stable individuals smoked every day, did not smoke immediately upon waking, and were all in the group asked to keep smoking. Conversely, the variable individuals had at least one day during which they did not smoke, other days during which they smoked within the first 5 min of waking, and they were almost all in the group asked to quit smoking. These findings suggested that MELS have the potential to provide insights on how people try to stop smoking. More importantly, this model can be applied to other clinically important outcomes such as time to relapse in a range of cessation programs.

Effect of childhood socioeconomic conditions on cancer onset in later life: an ambidirectional cohort study.

OBJECTIVES: Living in low socioeconomic conditions during childhood is associated with poor health outcomes in later life. Whether this link also applies to cancer is unclear. We examined whether childhood socioeconomic conditions (CSCs) are associated with cancer risk in later life and whether this effect remained after adjusting for adulthood socioeconomic conditions (ASCs). METHODS: Data for 26,431 individuals ≥ 50 years old included in SHARE were analysed. CSCs were constructed by using indicators of living conditions at age 10. ASC indicators were education, main occupation, and household income. Gender-stratified associations of CSCs with cancer onset (overall and by site) were assessed by Cox regression. RESULTS: In total, 2852 individuals were diagnosed with cancer. For both men and women, risk of overall cancer was increased for advantaged CSCs and remained so after adjusting for ASCs (hazard ratio = 1.36, 95% CI 1.10, 1.63, and 1.70, 95% CI 1.41, 2.07). CONCLUSIONS: Advantaged CSCs are associated with an increased risk of overall cancer at older age, but results vary by cancer sites and sex. Participation in cancer screening or exposure to risk factors may differ by social conditions.

Reflective and impulsive processes explain (in)effectiveness of messages promoting physical activity: a randomized controlled trial.

OBJECTIVE: The present study tested whether taking into account both the reflective and the impulsive processes of physical activity (PA) is helpful in understanding how, and for whom, PA-promoting messages will be (in)effective in changing behavior. METHOD: Participants (N = 101) were presented with a persuasive message promoting either PA (experimental condition) or healthy eating (control condition). Reflective intentions to be physically active were assessed both at baseline and after exposure to the message. Impulsive approach tendencies toward PA (IAPA) and sedentary behaviors (IASB) were assessed using a manikin task. The main outcome variable was accelerometer-assessed free time spent in moderate to vigorous physical activity (MVPA) over 1 week after exposure to the message. RESULTS: Although the PA-promoting message had no direct effect on MVPA, the results showed that (a) this message increased intentions to practice PA, notably among participants with low or moderate (but not high) baseline intentions; (b) objective MVPA was positively predicted by postmessage PA intentions and IAPA, and negatively predicted by IASB; and (c) postmessage PA intentions predicted MVPA for individuals with low or moderate (but not high) IASB. A follow-up moderated mediation analysis corroborated these earlier results, showing that PA-promoting messages positively predicted MVPA through postmessage intentions only among individuals with low or moderate baseline intentions and low or moderate IASB. CONCLUSIONS: By identifying 2 boundary conditions, this study revealed important insights in explaining when PA-promoting messages will be effective to predict objective MVPA and when they will not.