The silent epidemic of loneliness: identifying the antecedents of loneliness using a lagged exposure-wide approach.

BACKGROUND: A large and accumulating body of evidence shows that loneliness is detrimental for various health and well-being outcomes. However, less is known about potentially modifiable factors that lead to decreased loneliness. METHODS: We used data from the Health and Retirement Study to prospectively evaluate a wide array of candidate predictors of subsequent loneliness. Importantly, we examined if changes in 69 physical-, behavioral-, and psychosocial-health factors (from t0;2006/2008 to t1;2010/2012) were associated with subsequent loneliness 4 years later (t2;2014/2016). RESULTS: Adjusting for a large range of covariates, changes in certain health behaviors (e.g. increased physical activity), physical health factors (e.g. fewer functioning limitations), psychological factors (e.g. increased purpose in life, decreased depression), and social factors (e.g. greater number of close friends) were associated with less subsequent loneliness. CONCLUSIONS: Our findings suggest that subjective ratings of physical and psychological health and perceived social environment (e.g. chronic pain, self-rated health, purpose in life, anxiety, neighborhood cohesion) are more strongly associated with subsequent loneliness. Yet, objective ratings (e.g. specific chronic health conditions, living status) show less evidence of associations with subsequent loneliness. The current study identified potentially modifiable predictors of subsequent loneliness that may be important targets for interventions aimed at reducing loneliness.

Sense of control and likelihood of prescription drug misuse 10-years later among middle-aged and older adults.

Objectives: Sense of control (i.e. one's beliefs about their ability to influence life circumstances) has been linked to various psychological outcomes. However, it is unknown if sense of control is protective against prescription drug misuse (PDM). The present study sought to evaluate if sense of control is associated with reduced odds of PDM 9 to 10 years later among a sample of middle-aged and older adults.Methods: Data were evaluated from participants (M = 54 years, SD = 10.86; N = 2,108) of the second and third waves of the Midlife in the United States study. Logistic regression models were used to assess whether baseline sense of control (Wave 2) predicted odds of PDM 9 to 10 years later (Wave 3).Results: Findings revealed that greater sense of control at baseline was related to reduced odds of subsequent PDM (OR = 0.78; 95% CI: 0.64, 0.95), adjusting for baseline PDM, sociodemographic characteristics, health behaviors, psychological factors, number of prescription medications, and health. When assessing the subscales of sense of control separately, constraints (OR = 1.19; 95% CI: 1.00, 1.42), but not mastery (OR = 0.96; 95% CI: 0.80, 1.12), was predictive of odds of subsequent PDM. Further, being female was associated with greater odds of PDM (OR = 1.46; 95% CI: 1.02, 2.09), but did not moderate the association between sense of control and PDM.Conclusions: Sense of control may be a novel and viable target for interventions (e.g. using mobile phone apps) aimed at mitigating prescription drug misuse.

The positive influence of sense of control on physical, behavioral, and psychosocial health in older adults: An outcome-wide approach.

Accumulating research indicates robust associations between sense of control and salutary health and well-being outcomes. However, whether change in sense of control is associated with subsequent outcomes has been under-evaluated. Participants (N = 12,998) were from the Health and Retirement Study-a diverse, nationally representative, and longitudinal sample of U.S. adults aged >50 years. We examined how increase in sense of control (from t0:2006/2008 to t1: 2010/2012) was associated with better outcomes on 35 indicators of: physical-, behavioral-, and psychosocial-health (t2:2014/2016). We used multiple logistic-, linear-, and generalized-linear regression models and controlled for sociodemographic characteristics, personality traits, sense of control, and all outcomes in the pre-baseline wave (t0:2006/2008). During the 4-year follow-up, people in the highest (vs. lowest) quartile of sense of control, conditional on prior sense of control, had reduced risk of mortality and improved physical-health outcomes (lower risk of: stroke, lung disease, physical limitations, cognitive impairment, chronic pain and higher self-rated health). Sense of control was related to better health-behaviors (increased physical activity, reduced sleep problems), higher psychological well-being (positive affect, life satisfaction, optimism, purpose, personal-, health-, financial-mastery), lower psychological distress (depression, hopelessness, negative affect, perceived constraints), decreased loneliness, and increased contact with friends. Sense of control was unrelated to other physical health indicators (diabetes, hypertension, heart disease, cancer, arthritis, overweight/obesity), health behaviors (binge drinking, smoking), and social factors (living with spouse/partner, frequency of contact with children and other family). These findings underscore the importance of sense of control as a potential intervention target for fostering physical-, behavioral-, and psychosocial-health.

Are loneliness and social isolation equal threats to health and well-being? An outcome-wide longitudinal approach.

The detrimental effects of loneliness and social isolation on health and well-being outcomes are well documented. In response, governments, corporations, and community-based organizations have begun leveraging tools to create interventions and policies aimed at reducing loneliness and social isolation at scale. However, these efforts are frequently hampered by a key knowledge gap: when attempting to improve specific health and well-being outcomes, decision-makers are often unsure whether to target loneliness, social isolation, or both. Filling this knowledge gap will inform the development and refinement of effective interventions. Using data from the Health and Retirement Study (13,752 participants (59% women and 41% men, mean [SD] age = 67 [10] years)), we examined how changes in loneliness and social isolation over a 4-year follow-up period (from t0:2008/2010 to t1:2012/2014) were associated with 32 indicators of physical-, behavioral-, and psychosocial-health outcomes 4-years later (t2:2016/2018). We used multiple logistic-, linear-, and generalized-linear regression models, and adjusted for sociodemographic, personality traits, pre-baseline levels of both exposures (loneliness and social isolation), and all outcomes (t0:2008/2010). We incorporated data from all participants into the overall estimate, regardless of whether their levels of loneliness and social isolation changed from the pre-baseline to baseline waves. After adjusting for a wide range of covariates, we observed that both loneliness and social isolation were associated with several physical health outcomes and health behaviors. However, social isolation was more predictive of mortality risk and loneliness was a stronger predictor of psychological outcomes. Loneliness and social isolation have independent effects on various health and well-being outcomes and thus constitute distinct targets for interventions aimed at improving population health and well-being.

Associations Between Satisfaction With Aging and Health and Well-being Outcomes Among Older US Adults.

Importance: Researchers and policy makers are expanding the focus from risk factors of disease to seek potentially modifiable health factors that enhance people's health and well-being. Understanding if and to what degree aging satisfaction (one's beliefs about their own aging) is associated with a range of health and well-being outcomes aligns with the interests of older adults, researchers, health systems, and politicians. Objectives: To evaluate associations between changes in aging satisfaction and 35 subsequent health and well-being outcomes. Design, Setting, and Participants: This cohort study used data from the Health and Retirement Study, a national, diverse, and longitudinal sample of 13 752 US adults older than 50 years, to evaluate if changes in aging satisfaction (between combined cohorts from 2008 and 2010 and 4 years later, in 2012 and 2014) were subsequently associated with 35 indicators of physical, behavioral, and psychosocial health and well-being in 2016 and 2018. Statistical analysis was conducted from July 24, 2020, to November 6, 2021. Exposure: Aging satisfaction. Main Outcomes and Measures: A total of 35 physical (eg, stroke), behavioral (eg, sleep problems), and psychosocial (eg, depression) outcomes were evaluated using multiple linear and generalized linear regression models. Data from all participants, irrespective of how their levels of aging satisfaction changed from the prebaseline to baseline waves, were incorporated into the overall estimate, which was conditional on prior satisfaction. Results: During the 4-year follow-up period, participants (N = 13 752; 8120 women [59%]; mean [SD] age, 65 [10] years; median age, 64 years [IQR, 56-72 years]; 7507 of 11 824 married [64%]) in the highest (vs lowest) quartile of aging satisfaction had improved physical health (eg, 43% reduced risk of mortality [risk ratio, 0.57; 95% CI, 0.46-0.71]), better health behaviors (eg, 23% increased likelihood of frequent physical activity [risk ratio, 1.23; 95% CI, 1.12-1.34]), and improved psychosocial well-being (eg, higher positive affect [ß = 0.51; 95% CI, 0.44-0.58] and lower loneliness [ß = -0.41; 95% CI, -0.48 to -0.33]), conditional on prebaseline aging satisfaction. Conclusions and Relevance: This study suggests that higher aging satisfaction is associated with improved subsequent health and well-being. These findings highlight potential outcomes if scalable aging satisfaction interventions were developed and deployed at scale; they also inform the efforts of policy makers and interventionists who aim to enhance specific health and well-being outcomes. Aging satisfaction may be an important target for future interventions aiming to improve later-life health and well-being.

Synthesis of biocompatible PEG-Based star polymers with cationic and degradable core for siRNA delivery.

Star polymers with poly(ethylene glycol) (PEG) arms and a degradable cationic core were synthesized by the atom transfer radical copolymerization (ATRP) of poly(ethylene glycol) methyl ether methacrylate macromonomer (PEGMA), 2-(dimethylamino)ethyl methacrylate (DMAEMA), and a disulfide dimethacrylate (cross-linker, SS) via an "arm-first" approach. The star polymers had a diameter ~15 nm and were degraded under redox conditions by glutathione treatment into individual polymeric chains due to cleavage of the disulfide cross-linker, as confirmed by dynamic light scattering. The star polymers were cultured with mouse calvarial preosteoblast-like cells, embryonic day 1, subclone 4 (MC3T3-E1.4) to determine biocompatibility. Data suggest star polymers were biocompatible, with ≥ 80% cell viability after 48 h of incubation even at high concentration (800 µg/mL). Zeta potential values varied with N/P ratio confirming complexation with siRNA. Successful cellular uptake of the star polymers in MC3T3-E1.4 cells was observed by confocal microscopy and flow cytometry after 24 h of incubation.

Rapid cellular internalization of multifunctional star polymers prepared by atom transfer radical polymerization.

Poly(ethylene glycol) (PEG) star polymers containing GRGDS (Gly-Arg-Gly-Asp-Ser) peptide sequences on the star periphery were synthesized by atom transfer radical polymerization (ATRP) of poly(ethylene glycol) methyl ether methacrylate (PEGMA), GRGDS modified poly(ethylene glycol) acrylate (GRGDS-PEG-Acryl), fluorescein o-methacrylate (FMA), and ethylene glycol dimethacrylate (EGDMA) via an "arm-first" method. Star polymers were approximately 20 nm in diameter, as measured by dynamic light scattering and atomic force microscopy. Conjugation of FMA to the stars was confirmed by fluorescence microscopy, and successful attachment of GRGDS segments to the star periphery was confirmed by (1)H NMR spectroscopy. Both fluorescent PEG star polymers with and without peripheral GRGDS peptide segments were cultured with MC3T3-E1.4 cells. These star polymers were biocompatible with ≥ 90% cell viability after 24 h of incubation. Cellular uptake of PEG star polymers in MC3T3-E1.4 cells was observed by confocal microscopy. Rapid uptake of PEG star polymers with GRGDS peptides (∼ 100% of FITC-positive cells in 15 min measured by flow cytometry) was observed, suggesting enhanced delivery potential of these functional star polymers.

Perceived changes in life satisfaction from the past, present and to the future: A comparison of U.S. and Japan.

The current study examined how perceptions of change in life satisfaction vary by age and culture. Perceptions of past, present, and future life satisfaction were examined in adults aged 33-79 from the Midlife in the United States Study (N = 4,803) and from the Survey of Midlife in Japan (N = 974). Both cultures exhibited the same age-related pattern of change in perceptions of life satisfaction. Younger adults perceived improvement in life satisfaction from the past to present and from present to the future. The perceived improvement was more modest among middle-aged adults and then shifted to a decline among older adults. Despite the same curvilinear pattern in both cultures, the perceived improvement was not as positive, and the shift toward expecting declines occurred at an earlier age among Japanese adults compared to U.S. adults. Findings support existing theories of life span development but suggest that cultural context may influence both the positive outlook and the timing of these processes across adulthood. (PsycINFO Database Record (c) 2019 APA, all rights reserved).