Data-driven lifestyle patterns and risk of dementia in older Australian women.

INTRODUCTION: Many lifestyle factors have been associated with dementia, but there is limited evidence of how these group together. The aim of this study was to examine the clustering of lifestyle behaviors and associations with dementia. METHODS: This population-based study included 9947 older Australian women. Latent class analysis was employed to identify distinct lifestyle classes, and Cox proportional hazard regression compared these with incident dementia over 17 years. RESULTS: Three classes were identified: (1) "highly social and non-smokers" (54.9%), (2) "highly social, smokers, and drinkers" (25.1%), and (3) "inactive and low socializers" (20.0%). Women in Class 3 exhibited a higher risk of dementia compared to both Class 1 (hazard ratio [HR] = 1.19, 95% confidence interval [CI]: 1.08 to 1.30) and Class 2 (HR = 1.12, 95% CI: 1.00 to 1.25). DISCUSSION: A lifestyle pattern characterized by physical inactivity and low social engagement may be particularly detrimental for dementia risk in older women and should be prioritized in preventive strategies. HIGHLIGHTS: Latent class analysis was employed to identify distinct lifestyle clusters. Three lifestyle-related clusters were differentially associated with dementia risk. Inactive and low socializers exhibited the greatest risk of dementia. Targeting physical inactivity and low social engagement in prevention is vital.

Attitudes and Considerations for Multidomain Lifestyle Approaches to Dementia Prevention: A Qualitative Study.

BACKGROUND: Dementia, with the most common form being Alzheimer's disease, is a global health issue and lifestyle-based strategies may reduce risk. Individuals with a family history of dementia are an important target group, but little is known about their attitudes and perceptions of dementia risk reduction. OBJECTIVE: To elucidate the attitudes to and key considerations for multidomain lifestyle-based dementia prevention strategies in middle-aged Australians with a family history of dementia. METHODS: Twenty participants (80% female; age range 47-65 years), undertook semi-structured phone-based interviews. Inductive thematic analysis of interview transcripts was conducted. Hierarchical coding frames and illustrative quotes were compiled and critically challenged until a final set of themes was produced. RESULTS: Some participants expressed a positive attitude toward lifestyle-based dementia prevention. Reasons related to wanting to future proof, believing that risk reduction is relevant at all life stages and/or that there is always room for improvement. Other participants had a negative attitude, expressing that they were already following a healthy lifestyle, did not feel it was relevant to them yet, and/or held a deterministic view that dementia is random. Important considerations congregated on the themes of being tailored/personalized, taking a holistic approach, and involving small, achievable steps. CONCLUSIONS: In individuals with a family history of dementia, a positive attitude to dementia prevention holds promise for intervention efforts, but in individuals expressing negative attitudes, further education and individual-level counselling may be warranted. Multidomain lifestyle-based preventive strategies also need to be tailored to the needs of key target groups to optimize appeal and effectiveness.

Statistical Approaches for the Analysis of Combined Health-Related Factors in Association with Adult Cognitive Outcomes: A Scoping Review.

BACKGROUND: Dementia prevention is a global health priority, and there is emerging evidence to support associations between individual modifiable health behaviors and cognitive function and dementia risk. However, a key property of these behaviors is they often co-occur or cluster, highlighting the importance of examining them in combination. OBJECTIVE: To identify and characterize the statistical approaches used to aggregate multiple health-related behaviors/modifiable risk factors and assess associations with cognitive outcomes in adults. METHODS: Eight electronic databases were searched to identify observational studies exploring the association between two or more aggregated health-related behaviors and cognitive outcomes in adults. RESULTS: Sixty-two articles were included in this review. Fifty articles employed co-occurrence approaches alone to aggregate health behaviors/other modifiable risk factors, eight studies used solely clustering-based approaches, and four studies used a combination of both. Co-occurrence methods include additive index-based approaches and presenting specific health combinations, and whilst simple to construct and interpret, do not consider the underlying associations between co-occurring behaviors/risk factors. Clustering-based approaches do focus on underlying associations, and further work in this area may aid in identifying at-risk subgroups and understanding specific combinations of health-related behaviors/risk factors of particular importance in the scope of cognitive function and neurocognitive decline. CONCLUSION: A co-occurrence approach to aggregating health-related behaviors/risk factors and exploring associations with adult cognitive outcomes has been the predominant statistical approach used to date, with a lack of research employing more advanced statistical methods to explore clustering-based approaches.

Prospective associations between diet quality and health-related quality of life in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study.

Changes between diet quality and health-related quality of life (HR-QoL) over 12 years were examined in men and women, in 2844 adults (46 % males; mean age 47·3 (sd 9·7) years) from the Australian Diabetes, Obesity and Lifestyle study with data at baseline, 5 and 12 years. Dietary intake was assessed with a seventy-four-item FFQ. Diet quality was estimated with the Dietary Guideline Index, Mediterranean-Dietary Approaches to Stop Hypertension Diet Intervention for Neurological Delay Index (MIND) and Dietary Inflammatory Index. HR-QoL in terms of global, physical component summary (PCS) and mental component summary (MCS) was assessed with the Short-Form Health Survey-36. Fixed effects regression models adjusted for confounders were performed. Mean MCS increased from baseline (49·0, sd 9·3) to year 12 (50·7, sd 9·1), whereas mean PCS decreased from baseline (51·7, sd 7·4) to year 12 (49·5, sd 8·6). For the total sample, an improvement in MIND was associated with an improvement in global QoL (ß = 0·28, 95 % CI (0·007, 0·55)). In men, an improvement in MIND was associated with an improvement in global QoL (ß = 0·28, 95 % CI (0·0004, 0·55)). In women, improvement in MIND was associated with improvements in global QoL (ß = 0·62 95 % CI (0·38, 0·85)), MCS (ß = 0·75, 95 % CI (0·29, 1·22)) and PCS (ß = 0·75, 95 % CI (0·29, 1·22)). Positive changes in diet quality were associated with broad improvements in HR-QoL, and most benefits were observed in women when compared to men. These findings support the need for strategies to assist the population in consuming healthy dietary patterns to lead to improvements in HR-QoL.

Associations between data-driven lifestyle profiles and cognitive function in the AusDiab study.

BACKGROUND: Mounting evidence highlights the importance of combined modifiable lifestyle factors in reducing risk of cognitive decline and dementia. Several a priori additive scoring approaches have been established; however, limited research has employed advanced data-driven approaches to explore this association. This study aimed to examine the association between data-driven lifestyle profiles and cognitive function in community-dwelling Australian adults. METHODS: A cross-sectional study of 4561 Australian adults (55.3% female, mean age 60.9 ± 11.3 years) was conducted. Questionnaires were used to collect self-reported data on diet, physical activity, sedentary time, smoking status, and alcohol consumption. Cognitive testing was undertaken to assess memory, processing speed, and vocabulary and verbal knowledge. Latent Profile Analysis (LPA) was conducted to identify subgroups characterised by similar patterns of lifestyle behaviours. The resultant subgroups, or profiles, were then used to further explore associations with cognitive function using linear regression models and an automatic Bolck, Croon & Hagenaars (BCH) approach. RESULTS: Three profiles were identified: (1) "Inactive, poor diet" (76.3%); (2) "Moderate activity, non-smokers" (18.7%); and (3) "Highly active, unhealthy drinkers" (5.0%). Profile 2 "Moderate activity, non-smokers" exhibited better processing speed than Profile 1 "Inactive, poor diet". There was also some evidence to suggest Profile 3 "Highly active, unhealthy drinkers" exhibited poorer vocabulary and verbal knowledge compared to Profile 1 and poorer processing speed and memory scores compared to Profile 2. CONCLUSION: In this population of community-dwelling Australian adults, a sub-group characterised by moderate activity levels and higher rates of non-smoking had better cognitive function compared to two other identified sub-groups. This study demonstrates how LPA can be used to highlight sub-groups of a population that may be at increased risk of dementia and benefit most from lifestyle-based multidomain intervention strategies.

The Design and Evaluation of Online Interactive Learning in an Undergraduate Nutrition Course.

Understanding factors that promote student engagement with online learning environments is important for benchmarking and improving the quality of teaching in a digital era. This study aimed to describe the online interactive content created for delivery of an undergraduate nutrition course and to evaluate student engagement with the online interactive content. We collected online questionnaire data in 2018 and 2019 from two cohorts of students enrolled in a Deakin University undergraduate nutrition unit. Two-sample unpaired t-tests were used to examine differences in participant engagement with online topic guides between static text-based and interactive content. A total of 89 participants (19-56 years) were included. Sixty four of students reported always/usually reading static text-based topic guides most weeks and 64% perceived them as moderately/highly effective. While 60% of participants reported reading the online interactive topic guides most weeks and 93% perceived them as moderate/highly effective. Most participants indicated the interactive topic guides were more effective than static text-based topic guides they experienced in other courses (76%). Hours dedicated to the online interactive topic guide were higher (6.4 SD 2.9 vs. 1.7 SD 1.7 h; P < 0.001) as was the rating of how engaging the topic guides were (7.2 SD 1.6 vs. 6.7 SD 2.5; P = 0.008). These findings suggest that interactive content is more engaging. However, this content may not be accessible to all students, and so familiarization and training prior to engaging in an interactive online unit may be needed.

Association between dietary protein intake and changes in health-related quality of life in older adults: findings from the AusDiab 12-year prospective study.

BACKGROUND: Adequate dietary protein intake is recommended for older adults to optimise muscle health and function, and support recovery from illness, however, its effect on health-related quality of life (HRQoL) is unclear. The aim of this study was to examine the association between total protein intake and different sources of dietary protein and HRQoL in Australians aged 60 years and older over a 12-year period. METHODS: This study used data from the Australian Diabetes, Obesity and Lifestyle study (AusDiab), a 12-year population-based prospective study. The sample included 752 (386 females) adults aged 60 years and older. Protein intake was estimated at baseline (1999/2000) from a 74-item Food Frequency Questionnaire, and HRQoL using the 36-item Short-form Health Survey assessed at baseline (1999/2000) and after 12 years (2011/12). The association between protein intake and change in HRQoL was evaluated using multivariate regression analysis adjusted for relevant confounders. The difference in change in HRQoL between participants with total protein intakes of < 1.0 g/kg/day, intakes of between 1.0-1.2 g/kg/day and intakes of > 1.2 g/kg/day were assessed using one-way ANCOVA. RESULTS: Total protein intake at baseline was not associated with 12-year changes in physical component summary (PCS) or mental component summary (MCS) scores of HRQoL. Higher animal, red meat and processed animal protein intakes were associated with deteriorations in PCS scores after adjusting for relevant confounders (ß = - 0.04; 95% CI: - 0.07, -0.01 ; p = 0.009; ß = - 0.05; 95% CI: - 0.08, - 0.01; p = 0.018; ß = - 0.17; 95% CI: - 0.31, - 0.02; p = 0.027 respectively). Higher red meat protein intake was associated with deteriorations in MCS scores after adjusting for relevant confounders (ß = - 0.04; 95% CI: - 0.08, - 0.01; p = 0.011). There was no difference in 12-year changes in PCS or MCS between participants consuming total protein of < 1.0 g/kg/day, 1.0-1.2 g/kg/day and intakes of > 1.2 g/kg/day. CONCLUSION: There was no relationship between total dietary protein intake and HRQoL, but higher protein intakes from animal, red meat and processed animal sources were associated with a deterioration in HRQoL scores over 12 years. Due to the number of associations examined and high drop out of older less healthy participants, further research is required to confirm the associations detected in healthy and less healthy participants, with a view to making protein intake recommendations for older adults.

Nineteen-Year Associations between Three Diet Quality Indices and All-Cause and Cardiovascular Disease Mortality: The Australian Diabetes, Obesity, and Lifestyle Study.

BACKGROUND: Examining a variety of diet quality methodologies will inform best practice use of diet quality indices for assessing all-cause and cardiovascular disease (CVD) mortality. OBJECTIVES: To examine the association between 3 diet quality indices (Australian Dietary Guideline Index, DGI; Dietary Inflammatory Index, DII; Mediterranean-DASH (Dietary Approaches to Stop Hypertension) Intervention for Neurodegenerative Delay, MIND) and risk of all-cause mortality, CVD mortality, and nonfatal CVD events ≤19 y later. METHODS: Data on 10,009 adults (mean age 51.8 y; 52% female) from the Australian Diabetes, Obesity, and Lifestyle study were used. An FFQ was used to calculate DGI, DII, and MIND at baseline. Cox proportional hazard models were used to estimate HRs and 95% CI of all-cause mortality, CVD mortality, and nonfatal CVD events (stroke; myocardial infarction) according to 1 SD increase in diet quality, adjusted for age, sex, education, smoking, physical activity, energy intake, history of stroke or heart attack, and diabetes and hypertension status. RESULTS: Deaths due to all-cause (n = 1955) and CVD (n = 520), and nonfatal CVD events (n = 264) were identified during mean follow-ups of 17.7, 17.4, and 9.6 y, respectively. For all-cause mortality, HRs associated with higher DGI, DII, and MIND were 0.94 (95% CI: 0.89, 0.99), 1.08 (95% CI: 1.02, 1.15), and 0.93 (95% CI: 0.89, 0.98), respectively. For CVD mortality, HRs associated with higher DGI, DII, and MIND were 0.93 (95% CI: 0.85, 0.99), 1.10 (95% CI: 1.00, 1.24), and 0.90 (95% CI: 0.82, 0.98), respectively. There was limited evidence of associations between diet quality and nonfatal CVD events. CONCLUSIONS: A better quality diet predicted lower risk of all-cause and CVD mortality in Australian adults, whereas a more inflammatory diet predicted higher mortality risk. These findings highlight the applicability of following Australian dietary guidelines, a Mediterranean-style diet, and a low-inflammatory diet for the reduction of all-cause and CVD mortality risk.

Associations of Diet Quality with Midlife Brain Volume: Findings from the UK Biobank Cohort Study.

BACKGROUND: Higher quality diets may be related to lower dementia rates. Midlife is emerging as a critical life stage for a number of dementia risk factors. OBJECTIVE: This study examines whether diet quality is related to brain structure during midlife, and if this differs by sex. METHODS: This study used data from 19184 UK Biobank participants aged 40-65 years. Diet quality was assessed using three dietary indices including the Mediterranean Diet Score (MDS), Healthy Diet Score (HDS), and Recommended Food Score (RFS). MRI brain measures included total, grey, white and hippocampal volume. Linear regression examined associations between diet quality and brain volume, controlling for potential confounders. RESULTS: Better quality diet across all indices was significantly related to larger grey matter volume: MDS ß= 429.7 (95%CI: 65.2, 794.2); HDS ß= 700.1 (348.0, 1052.1); and RFS ß= 317.1 (106.8, 527.3). Higher diet scores were associated with greater total volume: HDS ß= 879.32 (286.13, 1472.50); RFS ß= 563.37 (209.10, 917.65); and white matter volume: RFS ß= 246.31 (20.56, 472.05), with the exception of Mediterranean diet adherence. Healthy eating guidelines and dietary variety associations with total and grey matter volume were more prominent in men. CONCLUSION: Findings suggest that diet quality is associated with brain structure during midlife, potentially decades prior to the onset of dementia.

A Dietary Inflammatory Index and associations with C-reactive protein in a general adult population.

PURPOSE: Chronic low-grade inflammation is implicated in many of the diseases of ageing. Lifestyle factors, including diet may alter low-grade inflammation. This study aimed to assess cross-sectional associations between the Dietary Inflammatory Index (DII) score and the inflammatory marker C-reactive protein (CRP); and determine if any association differs according to age (< 50 vs ≥ 50 years). METHODS: DII scores were calculated for respondents of the Australian Health Survey 2011-2012 using data from two 24-h recalls. Serum CRP was measured using ultrasensitive immunoturbidimetric assay. Associations between DII and CRP were assessed using multivariate linear regression adjusting for confounders (age education, physical activity, sex and smoking). Associations were assessed for the whole cohort and stratified at age 50 years. RESULTS: The analysis included 2558 respondents with a mean BMI of 26.8 kg/m2 (< 50 years n = 1099; ≥ 50 years n = 1459). Respondents in the lowest DII quartile (anti-inflammatory diet) reportedly consumed more grains, vegetables and legumes, fruit, milk products, meat, poultry, fish and eggs, unsaturated oils and alcohol compared to respondents in DII quartile 4. No associations were seen between DII and CRP after adjustment for confounders in the whole cohort or when stratified < 50 or ≥ 50 years. CONCLUSIONS: The DII was not associated with CRP in this cross-sectional study. Inflammation is complex characterised by a cascade of the multiple inflammatory markers and understanding the temporal relationship between diet and the inflammatory process is an important area for future research.

Dietary patterns and associations with biomarkers of inflammation in adults: a systematic review of observational studies.

BACKGROUND: Evidence indicates that low-grade inflammation is involved in manychronic diseases of ageing. Modifiable lifestyle factors including dietcan affect low-grade inflammation. Dietary patterns allow assessment of the complex interactions of food nutrients and health and may be associated with inflammatory status. This systematic review aimed to summarises current evidence from observational studies for associations between dietary patterns and inflammatory biomarkers in the general adult population. This review followed the PRISMA guidelines. METHODS: We conducted a systematic search in Embase, CINAHL Complete, Global Health and MEDLINE complete databases. Search terms included terms for diet ("dietary patterns", "diet scores") and inflammation ("inflammation", "c-reactive protein", "interleukin"). RESULTS: The search produced 7161 records. Duplicates were removed leaving 3164 for screening. There were 69 studies included (60 cross-sectional, 9 longitudinal). Papers included studies that were: 1) observational studies; 2) conducted in community-dwelling adults over 18 years of age; 3) assessed dietary patterns; 4) measured specified biomarkers of inflammation and 5) published in English. Dietary patterns were assessed using diet scores (n = 45), data-driven approaches (n = 22), both a data-driven approach and diet score (n = 2). The most frequently assessed biomarkers were CRP (n = 64) and/or IL-6 (n = 22). Cross-sectionally the majority of analyses reported an association between higher diet scores (mostly Mediterranean and anti-inflammatory diet scores) and lower inflammatory markers with 82 significant associations from 133 analyses. Only 22 of 145 cross-sectional analyses using data-driven approaches reported an association between a dietary patterns and lower inflammatory markers; the majority reported no association. Evidence of an association between dietary patterns and inflammatory markers longitudinally is limited, with the majority reporting no association. CONCLUSIONS: Adherence to healthy, Mediterranean and anti-inflammatory dietary scores, appear to be associated with lower inflammatory status cross-sectionally. Future research could focus on longitudinal studies using a potential outcomes approach in the data analysis. TRIAL REGISTRATION: PROSPERO Registration Number CRD42019114501 .

Fruit and vegetable consumption and psychological distress in Australian pregnant and breastfeeding women.

BACKGROUND AND OBJECTIVES: Mental health disorders amongst pregnant and postpartum women are an increasing public health concern. Our aim was to determine the association between fruit and vegetable intake and psychological distress in a nationally representative sample of Australian pregnant and breastfeeding women. METHODS AND STUDY DESIGN: This study used cross-sectional data collected by the Australian Bureau of Statistics in the 2014 to 2015 Australian National Health Survey. Participants included 166 pregnant and 207 breastfeeding women >18 years old. Number of serves of fruit and vegetables usually consumed each day was reported. The Kessler Psychological Distress Scale (K10) measured levels of global non-specific psychological distress. The association between fruit and vegetable intake and psychological distress was investigated using linear regression adjusted for available known covariates (age, education, physical activity). RESULTS: Mean±SD fruit intake was greater in pregnant compared to breastfeeding women (2.0±1.0 versus 1.7±1.0, p<0.05). The mean K10 score for both the pregnant and breastfeeding women was in the 10-15 'little or no psychological distress" range. In pregnant women, combined fruit and vegetable intake was inversely associated with psychological distress in the fully adjusted model (ß=-0.37, 95% CI -0.72, -0.02). There was no association between fruit and vegetable intake and psychological distress in breastfeeding women. CONCLUSIONS: A higher intake of combined fruit and vegetables was found to be associated with less psychological distress in pregnant women. Further research, including longitudinal and intervention studies, are required to determine causality between fruit and vegetable intake and psychological distress in this population group.

Effects of a multicomponent exercise program combined with calcium-vitamin D3-enriched milk on health-related quality of life and depressive symptoms in older men: secondary analysis of a randomized controlled trial.

PURPOSE: Osteoporosis is associated with both lower health-related quality of life and depression in older people. We examined the independent and combined effects of a multi-component exercise program and calcium-vitamin D3 fortified milk on health-related quality of life (HR-QoL) and depression in older men. METHODS: In this 12-month, factorial design randomized controlled trial, 180 healthy community-dwelling men aged 50-79 years with normal to below average bone mineral density were allocated into one of four groups: exercise + fortified milk; exercise; fortified milk; or controls. Exercise consisted of high-intensity resistance training with weight-bearing exercise (3 days per week; 60-75 min per session). Men assigned to fortified milk consumed 400 ml/day of low-fat milk containing 1000 mg/day calcium and 800IU/day vitamin D3. Questionnaires were used to assess HR-QoL (SF-36) and depressive symptoms (Center for Epidemiologic Studies Depression Scale) at baseline, and 6 and 12 months. A linear mixed model analysis was used to test whether there was a synergistic interaction between exercise and calcium-vitamin D3. If no significant interactions were detected, the main effects of exercise and fortified milk were examined. RESULTS: Mean adherence to the exercise program and fortified milk was 67% (95% CI 61, 73%) and 90% (95% CI 86, 93%), respectively. There were no exercise-by-fortified milk interactions nor main effects of exercise or calcium-vitamin D for any of the HR-QoL measures or depressive symptoms. CONCLUSION: In healthy community-dwelling older men, exercise training and/or calcium-vitamin D fortified milk did not improve HR-QoL or depressive symptoms.

Diet quality and cognitive function in mid-aged and older men and women.

BACKGROUND: To date much research into nutrition and cognitive function has been at the nutrient or food level, with inconsistent results. There is increasing interest in the dietary pattern approach to assess whole diet quality and its association with cognitive function. This study investigated if diet quality is associated with cognitive function in men and women aged 55 years and over. METHODS: Adults aged 55-65 years in the Wellbeing, Eating and Exercise for a Long Life (WELL) study in Victoria, Australia (n = 617) completed a postal survey including a 111-item food frequency questionnaire in 2010 and 2014. Diet quality was assessed via the revised dietary guideline index (DGI-2013) and also by its individual components which assessed key food groups and dietary behaviours from the Australian Dietary Guidelines. The Telephone Interview of Cognitive Status (TICS-m) measured cognitive function in 2014. Associations between past (2010) and recent (2014) diet quality and its components, and cognitive function were assessed by linear regression adjusted for covariates. RESULTS: After adjustment for age, sex, education, urban/rural status and physical activity there were no associations between diet quality in 2010 and cognitive function in 2014. However participants who reported higher dietary variety (B = 0.28, 95% CI 0.03, 0.52) and women who reported "sometimes" adding salt to food after cooking (B = 0.98, 95% CI 0.25, 1.71) in 2010 displayed better cognitive function in 2014. In 2014, usual consumption of higher fibre bread choices in the total sample (B = 1.32, 95% CI 0.42, 2.23), and higher diet quality (B = 0.03, 95% CI 0.00, 0.07) and greater fluid consumption (B = 0.14, 95% CI 0.01, 0.27) in men were all associated with better cognitive function. In addition, men who reported "usually" adding salt to their food during cooking displayed poorer cognitive function (B = -1.37, 95% CI -2.39, - 0.35). There were no other associations between dietary intake and cognitive function observed in the adjusted models. CONCLUSION: An association between dietary variety and some limited dietary behaviours and cognitive function was observed, with variation by gender. Future research should consider trajectories of dietary change over longer time periods as determinants of health and function in older age.

Education and lifestyle predict change in dietary patterns and diet quality of adults 55 years and over.

BACKGROUND: Diet is a key risk factor for chronic disease, and an increasing concern among older adults. We aim to examine the changes in dietary patterns using principal component analysis and a diet quality index among older adults and examine the predictors of dietary change over a 4 year period. METHODS: Data was obtained via a postal survey in a prospective cohort, the Wellbeing Eating and Exercise for a Long Life (WELL) study. Australian adults aged 55 years and over (n = 1005 men and n = 1106 women) completed a food frequency at three time points and provided self-reported personal characteristics. Principal component analysis was used to assess dietary patterns and diet quality was assessed using the 2013 Revised Dietary Guideline Index. The relationships between predictors and change in dietary patterns were assessed by multiple linear regression. RESULTS: Two dietary patterns were consistently identified in men and women at three time points over 4 years. One was characterised by vegetables, fruit and white meat, and the other was characterised by red and processed meat and processed foods. Reduced consumption of key food groups within the principal component analysis-determined dietary patterns was observed. An increase in diet quality over 4 years was observed in men only. Reported higher education levels and favourable lifestyle characteristics, including not smoking and physical activity, at baseline predicted an increase in healthier dietary patterns over 4 years. CONCLUSIONS: There was stability in the main dietary patterns identified over time, however participants reported an overall decrease in the frequency of consumption of key food groups. Compliance with the Australian Dietary Guidelines remained poor and therefore targeting this population in nutritional initiatives is important. Design of nutrition promotion for older adults need to consider those with lower socioeconomic status, as having a lower level of education was a predictor of poorer dietary patterns. It is important to consider how nutrition behaviours can be targeted alongside other lifestyle behaviours, such as smoking and inadequate physical activity to improve health.

Dietary patterns are associated with depressive symptoms in older Australian women but not men.

Studies have examined the association between depressive symptoms and dietary patterns; however, only few studies focused on older adults. The present study examines the association between current and past dietary patterns and depression in a community-dwelling adult population aged 55 years and over. Adults (n 4082) were recruited into the Wellbeing, Eating and Exercise for a Long Life study in Victoria, Australia. In 2010 and 2014, data were collected using self-administered questionnaires including a 111-item FFQ, the RAND thirty-six-item Short Form Health Survey of health-related quality of life and the International Physical Activity Questionnaire. Depressive symptoms were assessed using the Geriatric Depression Scale in 2014. Current (2014) and past (2010) dietary patterns were determined using principal component analysis. Association between dietary patterns and depressive symptoms was assessed using a mixed model analysis with adjustment for covariates. Two similar dietary patterns were identified in men and women (n 2142). In women, a healthy dietary pattern (characterised by frequent intake of vegetables, fruits and fish) was associated with lower levels of depressive symptoms (current diet: ß = -0·260, 95 % CI -0·451, -0·070; past diet: ß = -0·201, 95 % CI -0·390, -0·013). A current unhealthy dietary pattern in women (characterised by frequent intake of red and processed meat, potatoes, hot chips, cakes, deserts and ice cream) was associated with higher levels of depressive symptoms (ß = 1·367, 95 % CI 0·679, 2·056). No associations were identified in men. Further research is needed to confirm these findings and to understand the differences that may occur by sex.

Total physical activity but not diet quality associated with postnatal depressive symptoms amongst women living in socioeconomically disadvantaged neighborhoods.

Lifestyle behaviors such as healthy diet and some forms of physical activity have been linked to lower risk of depressive symptoms in the general population. However, little is known regarding their associations with postnatal depressive symptoms. Given that postnatal women (particularly those living in socioeconomically disadvantaged neighborhoods) are more likely to have poorer diet quality, lower physical activity levels and greater risk of depressive symptoms, this study sought to determine the associations between diet quality, total and domain specific physical activity and depressive symptoms amongst postnatal women from socioeconomically disadvantaged neighborhoods. It was hypothesized that higher diet quality and levels of leisure-time physical activity would be associated with lower depressive symptoms. In 2007-2008, cross-sectional data were collected from 246 women living in socioeconomically disadvantaged neighborhoods in Victoria, Australia. Participants completed self-report measures of diet (using a 17 item dietary questionnaire), domain specific physical activity (International Physical Activity Questionnaire), and depressive symptoms (Centre for Epidemiologic Studies Depression Scale). Linear regression analyses were used to determine the associations between diet quality, physical activity and postnatal depressive symptoms. There was a significant inverse association between total physical activity (B, -0.009; 95% CI, -0.016 to -0.001; P = .023) and postnatal depressive symptoms. No association was found between other domain-specific physical activity (i.e. leisure-time, domestic or transport-related physical activity), or diet quality and postnatal depressive symptoms. Acknowledging the cross-sectional nature of this study, these findings suggest that total physical activity may play a more important role than diet quality in the relationship with postnatal depressive symptoms.

Associations between inflammatory and neurological markers with quality of life and well-being in older adults.

OBJECTIVES: Stressful experiences, poor self-rated health, and negative emotional states have been implicated with higher levels of inflammatory markers and lower levels of neurotrophic factors in some healthy adults and clinical populations, but these relationships are unclear in the elderly. This study aimed to identify the associations between systemic inflammatory and neurological markers with well-being and health-related quality of life (HR-QoL) in independently living elderly people. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: A total of 268 men and women aged ≥65 years living independently in retirement communities in Melbourne, Australia. MEASURES: Questionnaires were used to assess HR-QoL [Short Form (SF)-36 version 2] and well-being (Personal Wellbeing Index). Serum inflammatory cytokines [interleukin (IL)-4, IL-6, IL-1ß, IL-8, IL-10, tumor necrosis factor (TNF)-α, and high sensitive C-reactive protein (hs-CRP)] were standardised to Z-scores and used to calculate pro- and anti-inflammatory composite score and an overall composite inflammatory index. Plasma levels of the neurological markers amyloid ß (1-40) and amyloid ß (1-42), brain derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1) and vascular endothelial growth factor (VEGF), were also assessed. RESULTS: No significant associations were found between any inflammatory or neurological marker with HR-OoL or well-being, with the exception that lower perceptions of the HR-QoL vitality subscale were associated with higher levels of hs-CRP [unstandardized beta-coefficient (ß): -1.50; 95% CI: -2.53, -0.46; P = 0.004] and Z-scores in the pro-inflammatory composite score (ß = -2.06; 95% CI: -3.49, -0.62; P = 0.005). CONCLUSIONS/IMPLICATIONS: In elderly people residing in independent living retirement communities, there was no consistent evidence indicating that circulating inflammatory or neurological markers were associated with the key physical or mental HR-QoL domains or overall well-being. This suggests that these biomarkers may not be effective predictors in relatively healthy communities, and may be more beneficial in frail or clinical populations. Clinical Trials registry: Australian New Zealand Clinical Trials Registry (ACTRN12613001161718). http://www.anzctr.org.au/.

Diet quality and telomere length in older Australian men and women.

PURPOSE: Telomere length is a biomarker of cellular ageing, with longer telomeres associated with longevity and reduced risk of chronic disease in older age. Consumption of a healthy diet may contribute to longevity via its impact on cellular ageing, but studies on diet and telomere length to date have been limited and their findings equivocal. The aim of this study was to examine associations between three indices of diet quality and telomere length in older men and women. METHODS: Adults aged 57-68 years participating in the Wellbeing, Eating and Exercise for a Long Life (WELL) study in Victoria, Australia (n = 679), completed a postal survey including an 111-item food frequency questionnaire in 2012. Diet quality was assessed via three indices: the Dietary Guideline Index, the Recommended Food Score, and the Mediterranean Diet Score. Relative telomere length was measured by quantitative polymerase chain reaction. Associations between diet quality and telomere length were assessed using linear regression adjusted for covariates. RESULTS: After adjustment for age, sex, education, smoking, physical activity, and body mass index (BMI), there were no significant associations between diet quality and relative telomere length. CONCLUSIONS: In a sample of older adults residing in Victoria, Australia, men and women aged 57-68 years with better-quality diets did not have longer telomeres. Further investigation in longitudinal studies will determine whether diet can influence telomere length over time in an ageing population.

Influence of Sequential vs. Simultaneous Dual-Task Exercise Training on Cognitive Function in Older Adults.

Emerging research indicates that exercise combined with cognitive training may improve cognitive function in older adults. Typically these programs have incorporated sequential training, where exercise and cognitive training are undertaken separately. However, simultaneous or dual-task training, where cognitive and/or motor training are performed simultaneously with exercise, may offer greater benefits. This review summary provides an overview of the effects of combined simultaneous vs. sequential training on cognitive function in older adults. Based on the available evidence, there are inconsistent findings with regard to the cognitive benefits of sequential training in comparison to cognitive or exercise training alone. In contrast, simultaneous training interventions, particularly multimodal exercise programs in combination with secondary tasks regulated by sensory cues, have significantly improved cognition in both healthy older and clinical populations. However, further research is needed to determine the optimal characteristics of a successful simultaneous training program for optimizing cognitive function in older people.