The Role of Urban Environments in Promoting Active and Healthy Aging: A Systematic Scoping Review of Citizen Science Approaches.

Promoting active and healthy aging in urban spaces requires environments with diverse, age-friendly characteristics. This scoping review investigated the associations between urban characteristics and active and healthy aging as identified by citizen science (CS) and other participatory approaches. Using a systematic scoping review procedure, 23 articles employing a CS or participatory approach (participant age range: 54-98 years) were reviewed. An inductive and deductive thematic analysis was completed to (a) identify local urban barriers and facilitators and (b) map them against the World Health Organization (WHO) Checklist of Essential Features of Age-Friendly Cities. A new Citizen Science Appraisal Tool (CSAT) was developed to evaluate the quality of CS and other participatory approaches included in the reviewed articles. A range of interconnected urban barriers and facilitators was generated by residents across the personal (e.g. perceived safety), environmental (e.g. unmaintained infrastructure), socio-cultural (e.g. cross-cultural activities), economic (e.g. affordable housing) and political (e.g. governmental support to migrant communities) domains. Mapping the barriers and facilitators to the WHO age-friendly checklist underscored the checklist's relevance and elucidated the need to explore barriers for migrant and cross-cultural communities and neighborhood development and alterations. The CSAT demonstrated strengths related to active engagement of residents and study outcomes leading to real-world implications. To advance the potential of CS to enrich our understanding of age-friendly environments, employing co-production to enhance relevance and sustainability of outcomes is an important strategy. Overall, employing CS highlighted the value of systematically capturing the experiences of older adults within studies aimed at promoting active and healthy aging.

Associations of social cohesion and quality of life with objective and perceived built environments: a latent profile analysis among seniors.

BACKGROUND: Healthy aging requires support from local built and social environments. Using latent profile analysis, this study captured the multidimensionality of the built environment and examined relations between objective and perceived built environment profiles, neighborhood social cohesion and quality of life among seniors. METHODS: In total, 693 participants aged 66-97 were sampled from two US locales in 2005-2008 as part of the Senior Neighborhood Quality of Life Study (SNQLS). Perceived social cohesion and quality of life were assessed using validated surveys. Six objective (geographic information system (GIS)-based) and seven perceived built environment latent profiles generated in previous SNQLS publications were used for analyses. Mixed-effects models estimated social cohesion and quality of life separately as a function of the built environment profiles. RESULTS: More walkable and destination-rich perceived built environment profiles were associated with higher social cohesion and quality of life. Objective built environment profiles were not associated with social cohesion and only positively associated with quality of life in only one locale (Baltimore/DC). CONCLUSIONS: Latent profile analysis offered a comprehensive approach to assessing the built environment. Seniors who perceived their neighborhoods to be highly walkable and recreationally dense experienced higher neighborhood social cohesion and quality of life, which may set the stage for healthier aging.

Organic Compounds in a Sub-Antarctic Ice Core: A Potential Suite of Sea Ice Markers.

Investigation of organic compounds in ice cores can potentially unlock a wealth of new information in these climate archives. We present results from the first ever ice core drilled on sub-Antarctic island Bouvet, representing a climatologically important but understudied region. We analyze a suite of novel and more familiar organic compounds in the ice core, alongside commonly measured ions. Methanesulfonic acid shows a significant, positive correlation to winter sea ice concentration, as does a fatty acid compound, oleic acid. Both may be sourced from spring phytoplankton blooms, which are larger following greater sea ice extent in the preceding winter. Oxalate, formate, and acetate are positively correlated to sea ice concentration in summer, but sources of these require further investigation. This study demonstrates the potential application of organic compounds from the marine biosphere in generating multiproxy sea ice records, which is critical in improving our understanding of past sea ice changes.

Employing citizen science to enhance active and healthy ageing in urban environments.

Engaging older residents in problem definition and solution-building is key to the success of place-based initiatives endeavouring to increase the age-friendliness of urban environments. This study employed the Our Voice framework, engaging older adult citizen scientists (n = 14) and community stakeholders (n = 15) across the city of Birmingham, UK. With the aim of identifying urban features impacting age friendliness and co-producing recommendations for improving local urban areas, citizen scientists participated in 12 technology-enabled walkability assessments, three in-person discussion groups, two one-to-one online discussions, and two workshops with community stakeholders. Together, citizen scientists co-produced 12 local and six city-wide recommendations. These recommendations were embedded into an implementation framework based on workshop discussions to identify age-friendly pathways in urban environments.

Creating active environments across the life course: "thinking outside the square".

The built environment and physical activity agenda provides a unique opportunity for public health, physical activity and planning researchers to be front and centre of a movement aimed at creating healthier and more sustainable environments. However, in order to optimise environments that encourage physical activity across the life course, researchers in this field need to think beyond their "square" -that is, the target group, setting and physical activity behaviour with which they work. We suggest that researchers working in this field need a better understanding of systems theory to appreciate that a change to one part of a complex system can positively and negatively influence other parts of the system. An understanding of systems theory would help minimise unintended negative consequences to other population subgroups or to other types of physical activity from the implementation of our research findings. In this way, a more comprehensive set of research, practice and programme-related activities may emerge, which will advance physical activity research and practice, and improve population health across the life course.

Dietary adherence and weight loss success among overweight women: results from the A TO Z weight loss study.

BACKGROUND: Dietary adherence has been implicated as an important factor in the success of dieting strategies; however, studies assessing and investigating its association with weight loss success are scarce. OBJECTIVE: We aimed to document the level of dietary adherence using measured diet data and to examine its association with weight loss success. DESIGN: Secondary analysis was performed using data from 181 free-living overweight/obese women (mean+/-s.d. age=43+/-5 years, body mass index=31+/-4 kg m(-2)) participating in a 1-year randomized clinical trial (the A TO Z study) comparing popular weight loss diets (Atkins, Zone and Ornish). Participants' dietary adherence was assessed as the difference between their respective assigned diet's recommended macronutrient goals and their self-reported intake. Association between dietary adherence and 12-month weight change was computed using Spearman's correlations. Differences in baseline characteristics and macronutrient intake between the most and least adherent tertiles for diet groups were compared using t-tests. RESULTS: Within each diet group, adherence score was significantly correlated with 12-month weight change (Atkins, r(s)=0.42, P=0.0003; Zone, r(s)=0.34, P=0.009 and Ornish, r(s)=0.38, P=0.004). Twelve-month weight change in the most vs least adherent tertiles, respectively, was -8.3+/-5.6 vs -1.9+/-5.8 kg, P=0.0006 (Atkins); -3.7+/-6.3 vs -0.4+/-6.8 kg, P=0.12 (Zone) and -6.5+/-6.8 vs -1.7+/-7.9 kg, P=0.06 (Ornish). CONCLUSIONS: Regardless of assigned diet groups, 12-month weight change was greater in the most adherent compared to the least adherent tertiles. These results suggest that strategies to increase adherence may deserve more emphasis than the specific macronutrient composition of the weight loss diet itself in supporting successful weight loss.

Cognitive Performance Does not Limit Physical Activity Participation in the Lifestyle Interventions and Independence for Elders Pilot Study (LIFE-P).

OBJECTIVES: We examined whether multiple domains of baseline cognitive performance were associated with prospective physical activity (PA) adherence in the Lifestyle Interventions and Independence for Elders Pilot study (LIFE-P). DESIGN, SETTING, PARTICIPANTS: The LIFE-P study was a single-blind, multicenter, randomized controlled trial of a PA intervention compared to a successful aging educational intervention in sedentary, mobility-limited older adults. INTERVENTION: A 12-month structured, moderate-intensity, multi-modal PA program that included walking, resistance training, and flexibility exercises. For the first 2 months (adoption), 3 center-based exercise sessions (40-60 min) / week were conducted. During the next 4 months (transition), center-based sessions were conducted 2 times / week. The subsequent maintenance phase consisted of optional once-to-twice-per-week center-based sessions and home-based PA. MEASUREMENTS: Tests of executive and global cognitive functioning, working memory and psychomotor speed were administered at baseline. Median test scores were used to dichotomize participants into low or high cognitive performance groups. RESULTS: 52 mobility-limited older adults (age: 76.9 ±5 yrs) were randomized to the PA arm of LIFE-P. Compared to participants with high cognitive performance, participants with low performance had similar PA adherence rates (all P ≥ 0.34). Furthermore, weak and non-significant univariate relationships were elicited between all measures of cognition and overall PA adherence levels (r values ranged: -0.20 to 0.12, P ≥ 0.12). CONCLUSION: These data suggest that cognitive performance does not limit long-term PA adherence in mobility-limited older adults. Additional studies in larger cohorts are warranted to verify these findings.

Genetic Moderators of the Impact of Physical Activity on Depressive Symptoms.

BACKGROUND: Converging evidence suggests that physical activity is an effective intervention for both clinical depression and sub-threshold depressive symptoms; however, findings are not always consistent. These mixed results might reflect heterogeneity in response to physical activity, with some subgroups of individuals responding positively, but not others. OBJECTIVES: 1) To examine the impact of genetic variation and sex on changes in depressive symptoms in older adults after a physical activity (PA) intervention, and 2) to determine if PA differentially improves particular symptom dimensions of depression. DESIGN: Randomized controlled trial. SETTING: Four field centers (Cooper Institute, Stanford University, University of Pittsburgh, and Wake Forest University). PARTICIPANTS: 396 community-dwelling adults aged 70-89 years who participated in the Lifestyle Interventions and Independence for Elders Pilot Study (LIFE-P). INTERVENTION: 12-month PA intervention compared to an education control. MEASUREMENTS: Polymorphisms in the serotonin transporter (5-HTT), brain-derived neurotrophic factor (BDNF), and apolipoprotein E (APOE) genes; 12-month change in the Center for Epidemiologic Studies Depression Scale total score, as well as scores on the depressed affect, somatic symptoms, and lack of positive affect subscales. RESULTS: Men randomized to the PA arm showed the greatest decreases in somatic symptoms, with a preferential benefit in male carriers of the BDNF Met allele. Symptoms of lack of positive affect decreased more in men compared to women, particularly in those possessing the 5-HTT L allele, but the effect did not differ by intervention arm. APOE status did not affect change in depressive symptoms. CONCLUSIONS: Results of this study suggest that the impact of PA on depressive symptoms varies by genotype and sex, and that PA may mitigate somatic symptoms of depression more than other symptoms. The results suggest that a targeted approach to recommending PA therapy for treatment of depression is viable.

Local cerebral glucose metabolic rates in obsessive-compulsive disorder. Patients treated with clomipramine.

In a recent study, we reported abnormal local cerebral glucose metabolic rates in the orbital frontal cortex of patients with obsessive-compulsive disorder. Eight patients with obsessive-compulsive disorder scanned previously were scanned again during treatment with the tricyclic antidepressant clomipramine hydrochloride. Comparisons of local cerebral glucose metabolic rates for both groups showed a relative decrease in regions of the orbital frontal cortex and the left caudate, and an increase in other areas of the basal ganglia, including the right anterior putamen. When comparing patients who responded well to clomipramine with those who were either poor or partial responders, we found significant decreases only in the left caudate of patients who responded well to the drug. The present study suggests that clomipramine-induced improvement in obsessive-compulsive symptoms is associated with a return of regional brain metabolism to a more normal level in regions of the orbital frontal cortex and the caudate nucleus.

Anteroposterior gradients in cerebral glucose use in schizophrenia and affective disorders.

Local cerebral uptake of deoxyglucose labeled with fluorine 18 was measured by positron emission tomography in 16 patients with schizophrenia and 11 patients with affective disorder. Patients received no medication a minimum of 14 days and an average of 39.8 days. The subjects were administered the deoxyglucose 18F just before receiving a 34-minute 1/s series of unpleasant electrical stimuli to the right forearm while resting with eyes closed in a darkened, acoustically attenuated psychophysiologic testing chamber. Following monitored stimulation in the controlled environment, subjects were scanned and images converted to values of glucose use in micromoles per 100 g per minute according to Sokoloff's model. Data were analyzed with a four-way analysis of variance (ANOVA) with independent groups (normals, schizophrenics, and affectives) and repeated measures for slice level (supraventricular, midventricular, and infraventricular), hemisphere (right, left), and anteroposterior position (four sectors). Both normal subjects and patients showed a significant anteroposterior gradient in glucose use with highest values in the frontmost sector. Patients both with schizophrenia and with affective illness showed less of an anteroposterior gradient especially at superior levels, which was statistically confirmed by ANOVA. Absolute glucose levels in patients, which were actually higher in posterior regions rather than lower in frontal regions, were the largest contributors to the effect. Neither group differences in whole brain glucose use nor left-right asymmetries reached statistical significance. These results are consistent with our earlier reports of a relative hypofrontal function in schizophrenia compared with controls. This report extends this finding to affective illness, sharing a lack of diagnostic specificity with many biologic measures.

Brain metabolism in teenagers with attention-deficit hyperactivity disorder.

OBJECTIVES: We sought to obtain and compare values of cerebral glucose metabolism in normal minors and minors with Attention Deficit Hyperactivity Disorder (ADHD). We also sought to confirm our earlier findings of reduced brain metabolism in adults with ADHD, and to examine whether these results might be diagnostically useful. DESIGN: Case-control study. SETTING: Adolescents were recruited to National Institutes of Health Clinical Center/Research Facility through advertisement at local high schools and ADHD organizations. PATIENTS: Subjects were 10 normal adolescents and 10 adolescents with ADHD diagnosed with structured interviews using DSM-III-R criteria. MAIN OUTCOME MEASURES: Positron emission tomography and fludeoxyglucose F18 were used to study cerebral glucose metabolism in minors while they performed an auditory-attention task. RESULTS: Global or absolute measures of metabolism did not statistically differ between groups, although hyperactive girls had a 17.6% lower absolute brain metabolism than normal girls. As compared with the values for the controls, normalized glucose metabolism was significantly reduced in six of 60 specific regions of the brain, including an area of the left anterior frontal lobe (P < .05). Lower metabolism in that specific region of the left anterior frontal lobe was significantly inversely correlated with measures of symptom severity (P < .001-.009, r = -.56 to -.67). CONCLUSIONS: Global or absolute measures of metabolism using positron emission tomography and fludeoxyglucose F18 did not statistically differentiate between normal adolescents with ADHD. Positron emission tomography scans can be performed and are well tolerated by normal teenagers and teenagers with ADHD. The feasibility of normal minors participating in research involving radiation was established.

Cerebral glucography with positron tomography. Use in normal subjects and in patients with schizophrenia.

Local cerebral uptake of deoxyglucose labeled with fluorine 18 was measured by positron-emission tomography in eight patients with schizophrenia who were not receiving medication and in six age-matched normal volunteers. Subjects sat in an acoustically treated, darkened room with eyes closed after injection of 3 to 5 mCi of deoxyglucose 18F. After uptake, seven to eight horizontal brain scans parallel to the canthomeatal line were done. Scans were treated digitally, with a 2.3-cm strip peeled off each slice and ratios to whole-slice activity computed. Patients with schizophrenia showed lower ratios in the frontal cortex, indicating relatively lower glucose use than normal control subjects; this was consistent with previously reported studies of regional cerebral blood flow. Patients also showed diminished ratios for a 2.3-cm square that was positioned over central gray-matter areas on the left but not on the right side. These findings are preliminary; issues of control of mental activity, brain structure identification, and biologic and anatomic heterogeneity of schizophrenia remain to be explored.

Smoking in older women. Is being female a 'risk factor' for continued cigarette use?

Current national data indicate that a greater percentage of women entering their fifth and sixth decades of life are current, as opposed to former, smokers, while for men the opposite pattern is present. A representative sample of 1876 men and women aged 50 to 65 years living in a northern California community were interviewed to examine factors related to gender differences in quit rates in this age group. In this well-educated community, a significantly greater percentage of women (25.6%) continued to smoke relative to men (18.6%), with a greater percentage of men reporting being former smokers. Multivariate analysis revealed educational level and marital status, rather than gender, to be significant, Independent factors associated both with current cigarette use and with successful quitting. Our data indicate that it is not being female per se, but rather the disparities in educational level and marital status that are linked with being an older woman, that are associated with continued smoking in this age group. In light of this, delivery of relevant information and support on the part of physicians and other health professionals may be of particular use to this population segment.

Diet vs exercise in weight maintenance. The effects of minimal intervention strategies on long-term outcomes in men.

The effect of a minimal intervention strategy on maintenance of weight lost through either energy restriction alone or exercise alone during the previous year was studied in a sample of middle-aged men. At the end of the initial year of weight loss, dieters (n = 44) and exercisers (n = 46) were randomly assigned to either an intervention condition, comprising monthly mailed informational packets and monthly to quarterly telephone contacts, or an assessment-only condition. The intervention had a significantly greater impact on weight maintenance in exercisers than it did in dieters. In addition, dieters showed a more variable pattern of weight gain and weight loss during the maintenance year than did exercisers. Based on 7-day food records and a 7-day physical activity recall questionnaire, exercisers reported a greater energy intake and a greater amount of time spent in vigorous activity relative to dieters at both the beginning and the end of the maintenance year. We conclude that exercise is easier to maintain in men using minimal contact strategies than dietary approaches to weight control focusing on modification of energy intake, with subsequent benefits in terms of both overall maintenance and stability of weight.

Piloting the feasibility and effectiveness of print- and telephone-mediated interventions for promoting the adoption of physical activity in Australian adults.

This study examined the feasibility and effectiveness for increasing physical activity of a print-based intervention, and a print- plus telephone-mediated intervention among mid-life and older Australian adults. A randomised controlled trial study design was used. In mid-2002, 66 adults (18 men, 48 women) aged 45-78 years, who identified themselves as underactive, were recruited through advertisements and word-of-mouth at two sites (Melbourne and Brisbane), and randomised to either the print or print-plus-telephone mediated intervention group. Participants in both groups attended an initial briefing session, and over the 12-week intervention period received an instructional newsletter and use of a pedometer (both groups), and individualised telephone calls (print-plus-telephone group only). Self-reported physical activity data were collected at baseline, 12 and 16 weeks. Measures of self-reported global physical activity, moderate-vigorous intensity activity and walking all showed increases between baseline and 12 weeks for both intervention groups. These increases were generally maintained by 16 weeks, although participants in the print-plus-telephone group maintained slightly higher levels of global reported activity and walking (by approximately 30 mins/wk) than those in the print group. These interventions show potential for promoting initial increases in physical activity among mid-life and older Australian adults, and should be evaluated across more extended time periods.

Right frontotemporal activation by tonal memory in dyslexia, an O15 PET Study.

A prior study documented the failure of dyslexic men to activate left temporoparietal cortex during phonologic processing. Because of reports of an anomalous right planum temporale in developmental dyslexia, the functional implications of which are unknown, this study examined the ability of dyslexics to activate right temporal cortex. Regional cerebral blood flow was measured in 15 right-handed dyslexic men during rest and during a tonal memory task expected to activate right-sided cortex in controls. A matched control sample (n = 18) showed significant activation of several right frontotemporal regions as well as of left temporal cortex. In contrast, severely dyslexic men activated fewer right frontotemporal regions, while making many more errors than controls, but showed normal activation of left mid to anterior temporal cortex. These results support hypothesized underlying deficits in rapid temporal processing and possible involvement of right (in addition to left) temporal cortex in severe dyslexia.

Increased temporal lobe glucose use in chronic schizophrenic patients.

Temporal lobe glucose metabolic rate was assessed in 21 off-medication patients with schizophrenia and 19 normal controls by positron emission tomography with 18F-deoxyglucose. Patients with schizophrenia had significantly greater metabolic activity in the left than the right anterior temporal lobe, and the extent of this lateralization was in proportion to the severity of psychopathology.

Positron emission tomography in schizophrenic patients with and without neuroleptic medication.

Positron emission tomography using [18F]2-fluoro-2-deoxy-D-glucose was performed in nine chronic schizophrenic patients both when medication-free and when medicated with neuroleptics. Total brain cortex, temporal cortex, and basal ganglia glucose use was significantly increased with medication; however, there was no change in anterior/posterior metabolic gradients.

Regional cerebral glucose metabolism in bulimia nervosa.

OBJECTIVE: The authors' purpose in this study was to further delineate the character of cerebral metabolism in bulimia nervosa and to determine if functional links could be made between regional cerebral metabolism and the symptoms of depression, obsessive-compulsive disorder, and bulimia nervosa. METHOD: Regional cerebral glucose metabolism was measured by using positron emission tomography in 11 inpatients with bulimia nervosa and 18 normal comparison subjects matched in sex (all were women), age, and educational level. The bulimic patients were also tested for symptoms of major depression and obsessive-compulsive disorder. RESULTS: The patients with bulimia showed a correlation between lower left anterolateral prefrontal regional cerebral glucose metabolism and greater depressive symptoms. However, the orbitofrontal regional cerebral glucose metabolism of patients with bulimia was not greater than that of comparison subjects, nor was higher orbitofrontal metabolism correlated with greater obsessive-compulsive disorder symptoms. CONCLUSIONS: These findings lead to the conclusion that left anterior lateral prefrontal cortex hypometabolism varies with the depressive symptoms observed in bulimia but that temporal lobe hypermetabolism and asymmetries appear to be independent of the mood state.

Effect of naltrexone on alcohol "high" in alcoholics.

OBJECTIVE: Subjective effects of alcohol in alcoholics treated with naltrexone or placebo were compared. METHOD: In a previously reported double-blind clinical trial of 50 mg/day of naltrexone or placebo for treatment of alcoholism, 36 of 70 detoxified male veterans deviated from abstinence. Of these 36, 29 subsequently reported on the subjective effects of drinking during the trial. RESULTS: A larger proportion of naltrexone-treated subjects (seven of 12) than placebo-treated subjects (two of 17) reported that the "high" produced by alcohol during the study was significantly less than usual. The naltrexone-treated subjects also drank less alcohol than the placebo-treated subjects during the first drinking episode. There was no difference between groups in reported intoxication, craving, memory, or loss of temper. CONCLUSIONS: The lower alcohol consumption by the naltrexone-treated subjects may have resulted from naltrexone's blockage of the pleasure produced by alcohol.