Do financial hardships affect health? A study among older adults in Switzerland.

BACKGROUND: A growing number of studies have underlined the relationship between socioeconomic status and health. Following that literature, we explore the causal effect of financial hardships on changes in health at older ages. Rather than traditional measures of socioeconomic variables, we study the role of financial hardships. The declarative measurement of financial hardships is particularly relevant for assessing the impact of short-term financial difficulties on health among older adults. METHODS: In this study, we use data from the Lausanne cohort 65+. Participants are community-dwelling older adults representative of the population aged 65-70 years in 2004 and living in Lausanne (Switzerland) (n = 1352). We use longitudinal annual data with 11 years of follow-up (2006-16) to estimate dynamic panel models on several indicators measuring older adults' health (self-rated health, number of medical conditions, depressive symptoms, difficulties with daily living activities). RESULTS: We find evidence of causal effects of financial hardships on self-rated health (coef. = 0.059, P < 0.10) and on depressive symptoms (coef.=0.060, P < 0.05). On the other hand, we find no evidence of causality running from financial hardships to the number of medical conditions and the difficulties in daily living activities. CONCLUSION: These results make a contribution to the literature where nearly all previous research on associations between financial hardship and health does not establish causal relationships. Our results support the need to integrate health policies that mitigate the potential adverse health effects of financial hardship for older adults.

Instrumented 5-Time Sit-To-Stand Test: Parameters Predicting Serious Falls beyond the Duration of the Test.

BACKGROUND: Falls are a major cause of injuries in older adults. To evaluate the risk of falls in older adults, clinical assessments such as the 5-time sit-to-stand (5xSTS) test can be performed. The development of inertial measurement units (IMUs) has provided the possibility of a more in-depth analysis of the movements' biomechanical characteristics during this test. The goal of the present study was to investigate whether an instrumented 5xSTS test provides additional information to predict multiple or serious falls compared to the conventional stopwatch-based method. METHODS: Data from 458 community-dwelling older adults were analyzed. The participants were equipped with an IMU on the trunk to extract temporal, kinematic, kinetic, and smoothness movement parameters in addition to the total duration of the test by the stopwatch. RESULTS: The total duration of the test obtained by the IMU and the stopwatch was in excellent agreement (Pearson's correlation coefficient: 0.99), while the total duration obtained by the IMU was systematically 0.52 s longer than the stopwatch. In multivariable analyses that adjusted for potential confounders, fallers had slower vertical velocity, reduced vertical acceleration, lower vertical power, and lower vertical jerk than nonfallers. In contrast, the total duration of the test measured by either the IMU or the stopwatch did not differ between the 2 groups. CONCLUSIONS: An instrumented 5xSTS test provides additional information that better discriminates among older adults those at risk of multiple or serious falls than the conventional stopwatch-based assessment.

Identifying common patterns of health services use: a longitudinal study of older Swiss adults' care trajectories.

BACKGROUND: Population ageing puts pressure on health systems initially designed to handle acute and episodic illnesses. Segmenting an ageing population based on its healthcare utilization may enable policymakers to undertake evidence-based resource planning. We aimed to derive a typology of healthcare utilization trajectories in Swiss older adults. METHODS: Our work used data from the Lc65 + study, a population-based cohort of individuals aged 65 to 70 years at enrolment. The dimensions of healthcare utilization considered were ambulatory care, emergency care, hospitalizations, professional home care and nursing home stay. We applied the Sequence Analysis framework, within which we quantified the variation between each multidimensional pair of sequences, implemented a clustering procedure that grouped together older persons with similar profiles of health services use, and characterized clusters of individuals using selected baseline covariates. RESULTS: Healthcare utilization trajectories were analysed for 2271 community-dwelling older adults over a period of 11 years. Six homogeneous subgroups were identified: constant low utilization (83.3% of participants), increased utilization (4.9%), late health deterioration (4.4%), ambulatory care to nursing home (1.5%), early fatal event (3.8%) and high ambulatory care (2.1%). Associations were found between cluster membership and age, sex, household composition, self-perceived health, grip strength measurement, comorbidities, and functional dependency. CONCLUSIONS: The heterogeneous healthcare utilization profiles can be clustered into six common patterns. Different manifestations of functional decline were apparent in two distinct trajectory groups featuring regular home care use. Furthermore, a small proportion of individuals with a unique set of characteristics was related to the highest levels of ambulatory and emergency care use. New research avenues are outlined to investigate time-varying effects of health factors inside the clusters containing most unfavourable outcomes.

Older People's Health-Related Behaviors: Evidence from Three Cohorts of the Lc65+ Study.

Baby-boomers might be more health-conscious than earlier birth cohorts, but limited evidence has been produced so far. To investigate such changes, this study compared health-related behaviors at age 65 to 70 among three successive five-year birth cohorts (pre-war: born 1934-1938; war: born 1939-1943 and baby-boom: born 1944-1948) representative of the community-dwelling population. Information about alcohol use, smoking, physical activity, and nutrition was compared across the three cohorts (n = 4,270 participants) using Chi-squared test. Alcohol and the mean nutritional intake score did not vary across cohorts, whereas the consumption of nonalcoholic drinks increased significantly from pre-war to war and to baby-boom cohort (p<.001). Other differences across cohorts were observed only in women: the proportion of women who never or rarely engaged in sports decreased from 52.9% in the pre-war cohort to around 43% in subsequent cohorts (p<.001), while the proportion of women who had never smoked was higher in the pre-war cohort (56.1%) than in the war and the baby-boom cohorts (49.8% and 46.8%, respectively, p<.001). Overall, these results show some positive changes in older persons' health behaviors over time. Nevertheless, considerable room remains for improving lifestyles through public health interventions.

[Community-based medical practice. New academic teaching through a mass COVID-19 screening]. / Pratique médicale communautaire - Un nouvel enseignement universitaire à l'occasion d'un dépistage de masse de Covid-19.

Clusters of COVID-19 cases emerged during the months of December 2020 and January 2021 in the Vaud Alps. This epidemiological situation was worrying, as it appeared before a winter holiday period. In view of this epidemiological risk, the cantonal authorities decided to carry out mass screening in three communes from 5 to 13 February 2021 in addition to the standard measures in place. Seeing an opportunity to create innovative university teaching, Unisanté set up a new course for medical students of the University of Lausanne called Community Medical Practice. This immersion in the practice of public health enabled some thirty students to carry out several activities (clinical, research and epidemiological) in a unique pandemic context.

L'émergence de clusters de cas de Covid-19 a été constatée de décembre 2020 à janvier 2021 dans les Alpes vaudoises. Cette situation épidémiologique est devenue préoccupante, puisqu'elle est apparue avant une période de vacances hivernales. Face à ce risque épidémiologique, les autorités cantonales ont décidé d'effectuer un dépistage de masse, du 5 au 13 février 2021, dans trois communes en complément des mesures en vigueur. Voyant l'occasion de créer un exercice pédagogique novateur, Unisanté a mis en place un nouvel enseignement destiné aux étudiant·e·s de médecine de l'université de Lausanne, nommé Pratique médicale communautaire. Cette immersion dans la pratique de santé publique a permis à une trentaine d'étudiant·e·s d'exercer plusieurs activités (cliniques, de recherche et épidémiologiques) dans un contexte unique de pandémie.

Validity of the older people quality of life-7 domains (OQoL-7) scale.

BACKGROUND: The Older people Quality of Life-7 domains (OQoL-7) is a 28-item multidimensional questionnaire developed to measure community-dwelling older people's QoL. The OQoL-7 assesses both importance of and satisfaction in seven QoL domains (Material resources; Close entourage; Social and cultural life; Esteem and recognition; Health and mobility; Feeling of safety; and Autonomy). This study aimed to investigate concurrent and construct validity of the OQoL-7. A secondary aim was to compare different methods of weighting participants' ratings of satisfaction according to their individual ratings of importance, as compared to the OQoL-7 total score (unweighted). METHODS: Data came from the first and second samples of the Lausanne cohort 65+ study, assessed at the same age of 72-77 years in 2011 (N = 1117) and 2016 (N = 1091), respectively. To assess concurrent validity, the OQoL-7 was compared to other measures of the same concept (single QoL item) or related concepts (self-rated health, SF-12). Construct validity was tested by comparing subscores in the seven QoL domains in the presence and absence of two stressful events during the preceding year (financial difficulties and relationship difficulties). The effect of importance weighting was assessed using moderated regression analysis. RESULTS: The OQoL-7 total score was significantly associated with the single QoL item (Spearman's rho 0.46), self-rated health (Spearman's rho 0.34), SF-12 physical (Spearman's rho 0.22) and mental (Spearman's rho 0.28) component scores. Large differences (Cohen's d > 0.8) were observed in the presence or absence of stressful events in the expected QoL domains: "Material resources" in the presence or absence of "Financial difficulties" (Cohen's d 1.34), and "Close entourage" in the presence or absence of "Relationship difficulties" (Cohen's d 0.84). Importance weighting resulted in a very small improvement in the prediction of the single QoL item (ΔR2 0.018). All results were highly consistent across 2011 and 2016 samples. CONCLUSIONS: The OQoL-7 showed adequate concurrent and construct validity in two samples of older people. In future studies, the decision to use weighted or unweighted scores will depend on the priority given to either optimizing the prediction of QoL or limiting the burden on respondents and the amount of missing data.

Formal home care use by older adults: trajectories and determinants in the Lc65+ cohort.

BACKGROUND: Given the increasing importance of formal home care services in policies dedicated to elder care, there is major interest in studying individuals' characteristics determining their utilization. The main objective of this research was to quantify, during a 6-year timeframe, home care use trajectories followed by community-dwelling participants in a cohort study of older adults. The secondary objective was to identify factors associated with home care utilization using Andersen's Behavioural Model of Health Services Use. METHODS: We proceeded to an analysis of data prospectively collected in the setting of the Lc65+ population-based study conducted in Lausanne (Switzerland). Self-reported utilization of professional home care in 2012 and 2018 was used to define trajectories during this timeframe (i.e. non-users, new users, former users and continuing users). Bivariable analyses were performed to compare new users to non-users regarding the three dimensions of Andersen's model (predisposing, enabling and need factors) measured at baseline. Then, binomial logistic regression was used in a series of two hierarchical models to adjust for need factors first, before adding predisposing and enabling factors in a second model. RESULTS: Of 2155 participants aged between 69 and 78 in 2012, 82.8% remained non-users in 2018, whereas 11.2% started to use professional home care. There were 3.3% of continuing users and 2.7% of former users. New users exhibited a higher burden of physical and psychological complaints, chronic health conditions and functional limitations at baseline. After adjusting for these need factors, odds of home care utilization were higher only in participants reporting a difficult financial situation (OR 1.65, 95% CI 1.12-2.45). CONCLUSIONS: In the setting of a Swiss city, incident utilization of formal home care by older adults appeared to be largely determined by need factors. Modifiable factors like personal beliefs and knowledge about home care services did not play a role. After adjusting for need, odds of becoming home care user remained higher in participants reporting a difficult financial situation, suggesting such vulnerability does not hamper access to professional home care in this specific context.

Temporal changes in importance of quality of life domains: a longitudinal study in community-dwelling Swiss older people.

PURPOSE: Population aging is a global phenomenon requiring interventions to improve quality of life (QoL), a subjective and dynamic concept. Such interventions should be based on QoL domains considered as important from older people's viewpoint. It is unclear whether and how much these domains may vary over time as people age. This study aims to assess the importance of QoL domains, their pattern and determinants of change among the non-institutionalized older population over a 5-year period. METHODS: This longitudinal study included community-dwelling older adults (N = 1947, aged 68-77 years at baseline) from the Lausanne cohort 65+. In 2011 and 2016, participants rated the importance of 28 QoL items in seven domains. The difference between scores (0-100) of importance attributed to each QoL domain between two assessments was calculated and used as a dependent variable to assess the associations with covariates in multivariable analysis for each domain. RESULTS: Importance scores slightly but significantly decreased in five of the seven QoL domains. Despite the majority of participants did not modify their ranking of importance for each QoL domain between the two time points, the proportion of change was still substantial. Bivariate and multivariable analyses showed that education and to a lesser extent age, living arrangement and morbidity, were associated with decrease in the importance of specific QoL domains; characteristics indicating vulnerability (e.g., low education or morbidity) were associated with a decline in the importance. CONCLUSION: Although aging individuals modified the importance they give to the seven QoL domains, at population level, changes in opposite directions overall resulted in only small decline; importance seems less stable over time among individuals with vulnerable sociodemographic and health profiles.

Change in quality of life among community-dwelling older adults: population-based longitudinal study.

PURPOSE: This population-based study aimed to determine 5-year change in multidimensional QoL among community-dwelling older people, and to identify predictors of QoL change among demographic, socioeconomic, and health characteristics. METHODS: Data of the 2011 and 2016 annual assessments of 1845 older men and women (age range 68-77 years) from the Lc65 + cohort study were used. QoL was assessed using a 28-item instrument yielding a QoL overall score and seven domain-specific QoL subscores. Additional ratings of QoL included a single item (excellent; very good; good; fair; poor), expected QoL in 1 year (better; worse; same as today), and retrospective assessment of QoL 5-year change (better; worse; same as 5 years ago). The predictors of 5-year change in the QoL score were assessed using linear regression, controlling for baseline QoL score. RESULTS: All prospective and retrospective indicators of QoL converged towards a slight deterioration over 5 years. QoL subscores significantly decreased in domains "Close entourage" (P = 0.004), "Social and cultural life" (P < 0.001), "Esteem and recognition" (P = 0.001), "Health and mobility" (P < 0.001), and "Autonomy" (P < 0.001), whereas "Material resources" (P = 0.345) and "Feeling of safety" (P = 0.380) remained stable. A stronger decrease in QoL was observed in the most vulnerable profiles at baseline in terms of demographic, socioeconomic, and health characteristics. Changes in depressive symptoms and in disability-either worsening or improving-predicted QoL change in the expected direction. CONCLUSIONS: Age-related decline in QoL may be limited through the prevention of disability and depressive symptoms, and more generally by devoting special attention to vulnerable profiles.

Quality of life profile in three cohorts of community-dwelling Swiss older people.

BACKGROUND: Quality of life (QoL) is a subjective and dynamic concept resulting from an interplay between importance of and satisfaction with different aspects of life. However, it is unclear whether social contexts experienced by individuals born at specific times in history (cohort effects) may influence QoL in old age. This study aimed to compare among older persons born before, during, and at the end of World War II: a) satisfaction with QoL, overall and per domains; b) importance of QoL domains. METHODS: This repeated cross-sectional study included representative samples of community-dwelling adults born in 1934-1938 (pre-war), 1939-1943 (war), and 1944-1948 (baby-boom) from the Lausanne cohort 65+. QoL was assessed overall, and in seven domains in 2011 and 2016. Two-by-two cohort comparisons were performed at ages 68-72 (war versus baby-boom) and 73-77 years (pre-war versus war). RESULTS: Overall satisfaction with QoL did not differ between cohorts despite increased education level across cohorts and a shift between pre-war and war cohorts towards lower morbidity and higher proportion living alone. However, "Feeling of safety" consistently showed significant improvements from earlier to later-born cohorts. Furthermore, the war cohort reported higher satisfaction than pre-war cohort in "Autonomy". Conversely, no significant difference was observed between cohorts in importance of QoL domains, except increased importance given to "Health and mobility" in the war compared to pre-war cohort. CONCLUSIONS: Societal changes reflected in the profile of successive elders' cohorts did not appear to modify the overall satisfaction with QoL.

Determinants of quality of life in community-dwelling older adults: comparing three cut-offs on the excellent-to-poor spectrum.

PURPOSE: The aim of this study was to identify modifications in health, economic and social determinants of quality of life (QoL) in community-dwelling older adults when using different cut-offs to defining favorable QoL. METHODS: Data of year 2011 annual assessment in 1003 older men and women from the Lc65+ cohort study were used. Overall QoL was self-rated as 'excellent,' 'very good,' 'good,' 'fair,' or 'poor.' To identify significant health (self-rated health, SF-12v2 physical and mental health), economic (financial situation), and social (living with others, being socially supported, emotional support, group activities participation) determinants of QoL, a cut-off was set at three different positions to define favorable QoL on the 'excellent' to 'poor' spectrum: at least 'good' (model 1); at least 'very good' (model 2); and 'excellent' only (model 3). RESULTS: In all three models, bivariable analyses indicated significant associations between QoL and at least one variable from each health, economic, and social dimension. In multivariable analyses, only health-related variables remained significantly associated with QoL in model 1. Model 3 additionally retained financial situation. In model 2, QoL was positively associated with physical health [odds ratio (OR) 1.10, p < 0.001], mental health (OR 1.12, p < 0.001), self-rated health (OR 2.43, p < 0.001), group activities participation (OR 1.43, p = 0.037), being socially supported (OR 1.58, p = 0.024), and not reporting financial difficulties (OR 1.76; p = 0.036). CONCLUSIONS: Using different cut-offs to defining favorable QoL results in important changes in the number and type of significant health, economic and social determinants. A cut-off between 'good' and 'very good' appears to best reflect the multidimensional nature of QoL.

Intervals between response choices on a single-item measure of quality of life.

BACKGROUND: A single overall rating of quality of life (QoL) is a sensitive method that is often used in population surveys. However, the exact meaning of response choices is unclear. In particular, uneven spacing may affect the way QoL ratings should be analyzed and interpreted. This study aimed to determine the intervals between response choices to a single-item QoL assessment. METHODS: A secondary analysis was conducted on data from the Lc65+ cohort study and two additional, population-based, stratified random samples of older people (N = 5,300). Overall QoL was rated as excellent, very good, good, fair or poor. A QoL score (range 0-100) was derived from participants' answers to a 28-item QoL assessment tool. A transformed QoL score ranging from 1 (poor) to 5 (excellent) was calculated. The same procedure was repeated to compute seven domain-specific QoL subscores (Feeling of safety; Health and mobility; Autonomy; Close entourage; Material resources; Esteem and recognition; Social and cultural life). RESULTS: Mean (95 % confidence intervals) QoL scores were 96.23 (95.81-96.65) for excellent, 93.09 (92.74-93.45) for very good, 81.45 (80.63-82.27) for good, 65.44 (62.67-68.20) for fair and 54.52 (45.31-63.73) for poor overall QoL, corresponding to transformed QoL scores of respectively 5.00, 4.70, 3.58, 2.05, and 1.00. Ordinality of the categories excellent to poor was preserved in all seven QoL subscores. CONCLUSIONS: The excellent-to-poor rating scale provides an ordinal measure of overall QoL. The intervals between response choices are unequal, but an interval scale can be obtained after adequate recoding of excellent, very good, good, fair and poor.

Bidirectional relationship between the body mass index and substance use in young men.

BACKGROUND: Obesity and substance use are major concern in young people. This study explored the bidirectional longitudinal relationships between the body mass index (BMI) of young men and their use of (1) 4 classes of nonmedical prescription drugs; (2) alcohol; (3) tobacco; and (4) cannabis. METHODS: Baseline and follow-up data from the Cohort Study on Substance Use Risk Factors were used (N = 5007). A cross-lagged panel model, complemented by probit models as sensitivity analysis, was run to determine the bidirectional relationships between BMI and substance use. Alcohol was assessed using risky single-occasion drinking (RSOD); tobacco, using daily smoking; and cannabis, using hazardous cannabis use (defined as twice-weekly or more cannabis use). Nonmedical prescription drugs use (NMPDU) included opioid analgesics, sedatives/sleeping pills, anxiolytics, and stimulants. RESULTS: Different associations were found between BMI and substance use. Only RSOD (ß = -.053, P = .005) and NMPDU of anxiolytics (ß = .040, P = .020) at baseline significantly predicted BMI at follow-up. Baseline RSOD predicted a lower BMI at follow-up, whereas baseline NMPDU of anxiolytics predicted higher BMI at follow-up. Furthermore, BMI at baseline significantly predicted daily smoking (ß = .050, P = .007) and hazardous cannabis use (ß = .058, P = .030). CONCLUSIONS: These results suggest different associations between BMI and the use of various substances by young men. However, only RSOD and NMPDU of anxiolytics predicted BMI, whereas BMI predicted daily smoking and hazardous cannabis use.

Video Gaming Disorder and Sport and Exercise in Emerging Adulthood: A Longitudinal Study.

Among the negative consequences of video gaming disorder, decreased participation in sport and exercise has received little attention. This study aimed to assess the longitudinal association between video gaming disorder and the level of sport and exercise in emerging adult men. A questionnaire was completed at baseline and 15-month follow-up by a representative national sample of 4,933 respondents. The seven items of the Game Addiction Scale were used to construct a latent variable representing video gaming disorder. Level of sport and exercise was also self-reported. Cross-lagged path modeling indicated a reciprocal causality between video gaming disorder and the level of sport and exercise, even after adjusting for a large set of confounders. These findings support the need for better promotion of sport and exercise among emerging adults in order to contribute to the prevention of video gaming disorder, and to raise the level of sport and exercise activity in addicted gamers.

Domains of importance to the quality of life of older people from two Swiss regions.

BACKGROUND: Quality of life (QoL) is a subjective perception whose components may vary in importance between individuals. Little is known about which domains of QoL older people deem most important. OBJECTIVE: This study investigated in community-dwelling older people the relationships between the importance given to domains defining their QoL and socioeconomic, demographic and health status. METHODS: Data were compiled from older people enrolled in the Lc65+ cohort study and two additional, population-based, stratified random samples (n = 5,300). Principal components analysis (PCA) was used to determine the underlying domains among 28 items that participants defined as important to their QoL. The components extracted were used as dependent variables in multiple linear regression models to explore their associations with socioeconomic, demographic and health status. RESULTS: PCA identified seven domains that older persons considered important to their QoL. In order of importance (highest to lowest): feeling of safety, health and mobility, autonomy, close entourage, material resources, esteem and recognition, and social and cultural life. A total of six and five domains of importance were significantly associated with education and depressive symptoms, respectively. The importance of material resources was significantly associated with a good financial situation (ß = 0.16, P = 0.011), as was close entourage with living with others (ß = 0.20, P = 0.007) and as was health and mobility with age (ß = -0.16, P = 0.014). CONCLUSION: The importance older people give to domains of their QoL appears strongly related to their actual resources and experienced losses. These findings may help clinicians, researchers and policy makers better adapt strategies to individuals' needs.

Energetics and mechanics of walking in patients with chronic low back pain and healthy matched controls.

PURPOSE: Walking in patients with chronic low back pain (cLBP) is characterized by motor control adaptations as a protective strategy against further injury or pain. The purpose of this study was to compare the preferred walking speed, the biomechanical and the energetic parameters of walking at different speeds between patients with cLBP and healthy men individually matched for age, body mass and height. METHODS: Energy cost of walking was assessed with a breath-by-breath gas analyser; mechanical and spatiotemporal parameters of walking were computed using two inertial sensors equipped with a triaxial accelerometer and gyroscope and compared in 13 men with cLBP and 13 control men (CTR) during treadmill walking at standard (0.83, 1.11, 1.38, 1.67 m s(-1)) and preferred (PWS) speeds. Low back pain intensity (visual analogue scale, cLBP only) and perceived exertion (Borg scale) were assessed at each walking speed. RESULTS: PWS was slower in cLBP [1.17 (SD = 0.13) m s(-1)] than in CTR group [1.33 (SD = 0.11) m s(-1); P = 0.002]. No significant difference was observed between groups in mechanical work (P ≥ 0.44), spatiotemporal parameters (P ≥ 0.16) and energy cost of walking (P ≥ 0.36). At the end of the treadmill protocol, perceived exertion was significantly higher in cLBP [11.7 (SD = 2.4)] than in CTR group [9.9 (SD = 1.1); P = 0.01]. Pain intensity did not significantly increase over time (P = 0.21). CONCLUSIONS: These results do not support the hypothesis of a less efficient walking pattern in patients with cLBP and imply that high walking speeds are well tolerated by patients with moderately disabling cLBP.

Associations of physical activity and sport and exercise with at-risk substance use in young men: a longitudinal study.

OBJECTIVE: This study aims to measure the associations of physical activity and one of its components, sport and exercise, with at-risk substance use in a population of young men. METHOD: Baseline (2010-2012) and follow-up (2012-2013) data of 4748 young Swiss men from the Cohort Study on Substance Use Risk Factors (C-SURF) were used. Cross-sectional and prospective associations between at-risk substance use and both sport and exercise and physical activities were measured using Chi-squared tests and logistic regression models adjusting for covariates. RESULTS: At baseline, logistic regression indicated that sport and exercise is negatively associated with at-risk use of cigarettes and cannabis. A positive association was obtained between physical activity and at-risk alcohol use. At baseline, sport and exercise was negatively associated with at-risk use of cigarettes and cannabis at follow-up. Adjusted for sport and exercise, physical activity was positively associated with at-risk use of cigarettes and cannabis. CONCLUSION: Sport and exercise is cross-sectionally and longitudinally associated with a low prevalence of at-risk use of cigarettes and cannabis. This protective effect was not observed for physical activity broadly defined. Taking a substance use prevention perspective, the promotion of sport and exercise among young adults should be encouraged.

Health impact of sport and exercise in emerging adult men: a prospective study.

PURPOSE: Health benefits of sport and exercise are well documented in children, adolescents and adults, but little is known about emerging adulthood-a period of life characterized by significant demographic and developmental changes. The present study aimed to assess the health impact of changes in sport and exercise levels during that specific period of life. METHODS: The analysis used baseline and 15-month follow-up data (N = 4,846) from the cohort study on substance use risk factors. Associations between baseline exercise levels or changes in exercise levels and health indicators (i.e., health-related quality of life, depression, body mass index, alcohol dependence, nicotine dependence and cannabis use disorder) were measured using chi-squared tests and ANOVA. Direction of effects was tested using cross-lagged analysis. RESULTS: At baseline, all health indicator scores were observed to be better for regular exercisers than for other exercise levels. At follow-up, participants who had maintained regular exercise over time had better scores than those who had remained irregular exercisers or had discontinued, but their scores for health-related quality of life and depression were close to those of participants who had adopted regular exercise after the baseline questionnaire. Cross-lagged analysis indicated that regular exercise at baseline was a significant predictor of health-related quality of life and substance use dependence at follow-up, but was itself predicted only by health-related quality of life. CONCLUSIONS: From a health promotion perspective, this study emphasizes how important it is for emerging adult men to maintain, or adopt, regular sport and exercise.

Trunk neuromuscular responses to a single whole-body vibration session in patients with chronic low back pain: a cross-sectional study.

OBJECTIVE: Whole-body vibration (WBV) exercise is progressively adopted as an alternative therapeutic modality for enhancing muscle force and muscle activity via neurogenic potentiation. So far, possible changes in the recruitment patterns of the trunk musculature after WBV remain undetermined. The main objective of this study was to evaluate the short-term effects of a single WBV session on trunk neuromuscular responses in patients with chronic low back pain (cLBP) and healthy participants. METHODS: Twenty patients with cLBP and 21 healthy participants performed 10 trunk flexion-extensions before and after a single WBV session consisting of five 1-minute vibration sets. Surface electromyography (EMG) of erector spinae at L2-L3 and L4-L5 and lumbopelvic kinematic variables were collected during the trials. Data were analyzed using 2-way mixed analysis of variance models. RESULTS: The WBV session led to increased lumbar EMG activity during the flexion and extension phases but yielded no change in the quiet standing and fully flexed phases. Kinematic data showed a decreased contribution to the movement of the lumbar region in the second extension quartile. These effects were not different between patients with cLBP and healthy participants. CONCLUSIONS: Increased lumbar EMG activity after a single WBV session most probably results from potentiation effects of WBV on lumbar muscles reflex responses. Decreased EMG activity in full trunk flexion, usually observed in healthy individuals, was still present after WBV, suggesting that the ability of the spine stabilizing mechanisms to transfer the extension torque from muscles to passive structures was not affected.

Older people's experience of the partial lockdown during the COVID-19 pandemic in Switzerland: a cross-sectional study.

OBJECTIVES: This study aimed to evaluate older people's experience of a COVID-19 partial lockdown (16 March-11 May 2020) in Lausanne, Switzerland. SETTING AND PARTICIPANTS: Community-dwelling participants of the Lausanne cohort (Lc65+) in 2020, aged 71-86 years (n=2642). DESIGN AND OUTCOME: This cross-sectional study was nested within the Lc65+ longitudinal study. A specific COVID-19 questionnaire was sent on 17 April 2020 to evaluate participants' experience of the lockdown (outcome). Multinomial logistic regression models were used to determine the sociodemographic, living environment, health and social factors associated. RESULTS: Out of 2642 participants, 67.8% described the lockdown as 'somewhat' difficult (reference group), 21.5% as 'not at all' difficult (positive) and 10.7% as 'very or extremely' difficult (negative). The relative risk of a positive experience was higher in participants living alone (relative risk ratio, RRR=1.93, 95% CI 1.52 to 2.46) or in a house (RRR=1.49, 1.03 to 2.16); lower in those who reported fear of falling (RRR=0.68, 0.54 to 0.86), functional difficulties (RRR=0.78, 0.61 to 0.99), feeling of loneliness (RRR=0.67, 0.49 to 0.91), unfamiliarity with communication technologies (RRR=0.69, 0.52 to 0.91), usual social support (RRR=0.71, 0.50 to 0.93), previous participation in group activities (RRR=0.74, 0.59 to 0.92) and among women (RRR=0.75, 0.59 to 0.95). The relative risk of a negative experience was higher in participants with fear of falling (RRR=1.52, 1.07 to 2.15), and lower in those who had a terrace/garden (RRR=0.66, 0.44 to 0.99) and owned a dog (RRR=0.32, 0.11 to 0.90). CONCLUSIONS: Only one in 10 participants experienced the lockdown as very or extremely difficult. Specific interventions targeting vulnerability factors, such as fear of falling, could lessen the impact of any future similar situation.