Late (≥60 years old) and middle adulthood (40-59 years old) patients achieve similar improvement in patient-reported outcomes following ACL reconstruction.

PURPOSE: This study aimed to compare the range of motion (ROM), surgical outcomes, and patient-reported outcome measures (PROMs) following anterior cruciate ligament (ACL) reconstruction outcomes in patients 60 years or older at the time of surgery to 40- to 59-year-old patients. METHODS: In this retrospective cohort study from 2015 to 2022, a 3:1 propensity match was performed to match late adulthood patients (≥60 years old) undergoing ACL reconstruction with middle adulthood (40-59 years old) ACL reconstruction patients. Patients were matched based on sex, ACL graft utilized and concomitant procedures performed during ACL reconstruction. Statistical analysis compared demographics, preoperative injury management, surgical outcomes, PROMs, and minimal clinical important difference (MCID) and substantial clinical benefit (SCB) achievement rates for all ACL reconstruction patients included. RESULTS: Twenty late adulthood and 60 middle adulthood patients who underwent ACL reconstruction were included in the final cohort. Patients who were 60 years or older experienced no difference in reoperation rate (n.s.), incidence of retears (n.s.) or ROM (n.s.) at 1 year post-operatively. There were also no differences in International Knee Documentation Committee (ΔIKDC) (31.3 ± 19.1 vs. 34.2 ± 18.2, n.s.) or ΔPCS-12 (12.4 ± 9.8 vs. 12.9 ± 10.8, n.s.) scores at 1 year post-operatively. Furthermore, the younger and older patient cohorts demonstrated similar rates of achieving the MCID (80.0% vs. 83.3%, n.s.) and SCB (50.0% vs. 61.7%, n.s.) scores for IKDC. CONCLUSION: Patients 60 years or older and 40- to 59-year-old patients demonstrated similar outcomes after undergoing ACL reconstruction with allograft. This study concludes that ACL reconstruction in late adulthood can still be a successful treatment option and should allow surgeons to feel more comfortable when performing indicated surgical intervention for older patients who experience an ACL tear. LEVEL OF EVIDENCE: Level III, Therapeutic III, retrospective cohort study.

Relationship between Sociodemographic and Health-Related Factors and Sedentary Time in Middle-Aged and Older Adults in Taiwan.

Background and Objectives: This study aimed to investigate the associations between sociodemographic and health-related factors and sedentary time in middle-aged and older Taiwanese adults. Materials and Methods: A total of 1031 participants (460 men, 571 women; mean age 65.0 years ± 7.8 years; range 55 to 93 years) were randomly recruited from the National Computer Assessment Telephone Interview, Taiwan, in 2013. Sedentary time, TV viewing, physical activity, and sociodemographic factors were assessed through questionnaires. Body mass index was self-reported and calculated to evaluate obesity. In 2023, the associations between sedentary time and sociodemographic and health-related factors were analyzed using Pearson's correlation, cross tabulation, and logistic regression and were stratified by gender. Results: Over 47% of participants reported spending more than 2 h watching TV, and more than 33% reported engaging in over 6 h of total sedentary activities. Men and women with insufficient physical activity had a higher probability of prolonged sedentary time than their physically active counterparts (p = 0.032 for men, p = 0.024 for women). Both men and women who spent more than 2 h watching TV daily were more likely to have high sedentary time compared to those with shorter TV viewing durations (both p < 0.001). Highly educated and unmarried women exhibited a higher likelihood of prolonged sedentary time than their less educated and married counterparts (p = 0.021 and p = 0.01, respectively). Conclusions: Sedentary time showed significant and positive associations with both insufficient physical activity and prolonged TV viewing in both genders. Additionally, significant associations were observed between sedentary time and high education and unmarried status in women. These findings emphasize the importance of implementing gender-specific approaches in future interventions and policy initiatives aimed at reducing sedentary behavior among middle-aged and older adults.

Self-objectification: Implications for physical activity in middle-aged women and men.

Self-objectification (i.e., valuing the body primarily for its attractiveness to others) is negatively related to physical health, including physical activity (PA) attitudes and behaviors. Given the low levels of PA among middle-aged adults in the US, self-objectification may be a novel correlate of PA in this population. The present study examined self-objectification and PA variables in a cross-sectional Western U.S. community sample of women (n = 215) and men (n = 134), aged 45-64, including gender as a moderator of these relations. Data were collected via survey, including measures of self-objectification, PA enjoyment, PA perceived benefits and barriers, and self-reported levels of PA. Women and men in our sample did not differ in levels of self-objectification. Results of regression analyses indicated that self-objectification predicted less PA enjoyment. In addition, men higher in self-objectification reported higher levels of PA. The findings implicate self-objectification as a potentially novel determinant of PA attitudes and behaviors in middle-aged adults.

A developmental lens on food insecurity: the role of children in the household and age groups on food insecurity impacting mental health.

Objectives: The current study investigates the differential coping strategies and mental health consequences of food insecurity in relation to period of the lifespan (middle vs. late adulthood) and household composition (living with vs. without children).Method: Using a cross-sectional design, food-related coping strategies, anxiety (GAD-7), and depression (WHO-5) were compared among the following groups: middle adults with vs. without children, and middle adults without children vs. late adults without children. Predictive models using hierarchical linear regression examined the main effects of age and household composition with food insecurity predicting mental health; additionally, the interaction of food insecurity with age and household composition was tested in a separate model. Results: Middle-adults with and without children share similar frequencies in levels of food insecurity and coping strategies, which were significantly higher than late adults.Conclusion: The link between food insecurity and depression was stronger for middle-adults without children than late adults. Food insecurity was a stronger predictor of anxiety for middle-adults with children than those without.

Long-term outcomes of moyamoya disease following indirect revascularization in middle adulthood: A prospective, quantitative study.

BACKGROUND/PURPOSE: Our previous study demonstrated that indirect revascularization is effective in the treatment of adult moyamoya patients. This prospective study aims to evaluate the long-term effectiveness of indirect revascularization in moyamoya patients in middle adulthood. METHODS: From January 2013 to June 2019, moyamoya patients more than 40 years of age underwent indirect revascularizations were studied. The hypoperfusion area of brains was revascularized. The cerebral angiography and time-to-peak (TTP) scoring (ranged 0-14) of the magnetic resonance perfusion study were used to evaluate the revascularization effect. RESULTS: During the study period, 50 consecutive adult moyamoya patients underwent indirect revascularization. Seventeen patients (27 cerebral hemispheres) more than 40 years of age were included. The mean age was 47.9 ± 6.4 years, and 13 patients were female. The pre-operative Suzuki stages were I, II, III, IV, V, and VI in 1, 1, 9, 13, 0, and 3 hemispheres, respectively. After a mean follow-up period of 52.5 ± 20.6 months, all patients had improvement or stabilization of their clinical conditions. Available post-operative angiography demonstrated Matsushima grading A in 18 of 20 hemispheres. The mean TTP score of all 27 hemispheres improved from 5.0 ± 3.3 pre-operatively to 12.0 ± 2.1 after surgery (p < 0.001). The post-operative mean TTP score of the 7 hemispheres without angiographic follow-up was 10.4 ± 1.8. One patient had persistent mild motor weakness after 56-month follow-up. Transient complications with full recovery occurred in 3 patients. CONCLUSION: Indirect revascularization is a safe method with satisfactory long-term results in moyamoya patient in middle adulthood.

Is musculoskeletal pain related to locomotive syndrome even in young and middle-aged adults?

OBJECTIVES: Locomotive syndrome (LS) is the leading cause of persons needing long-term care in old age and is characterized by locomotive organ impairment including musculoskeletal pain. The aim was to examine the association between musculoskeletal pain and LS in young and middle-aged persons. METHODS: A total of 836 participants (male 667, female 169; mean age 44.4 years) were examined in this cross-sectional study. The LS was evaluated by three screening tools: the two-step test, the stand-up test, and the 25-question Geriatric Locomotive Function Scale. Musculoskeletal pain, exercise habits, physical function (walkability and muscle strength), and physical activity were also assessed. RESULTS: The LS was found in 22.8% of participants. The number with musculoskeletal pain was significantly higher in those with the LS. A significant correlation was found between the degree of musculoskeletal pain and exercise habits. Less regular exercise was significantly associated with higher LS prevalence. Physical activity and function were greater in participants with more regular exercise. CONCLUSION: Musculoskeletal pain was significantly related to LS even in young and middle-aged persons. The present results suggest that control of musculoskeletal pain and improvement of exercise habits in young and middle-aged persons might help prevent the LS.

Weight change in middle adulthood and risk of cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

Obesity is a risk factor for several major cancers. Associations of weight change in middle adulthood with cancer risk, however, are less clear. We examined the association of change in weight and body mass index (BMI) category during middle adulthood with 42 cancers, using multivariable Cox proportional hazards models in the European Prospective Investigation into Cancer and Nutrition cohort. Of 241 323 participants (31% men), 20% lost and 32% gained weight (>0.4 to 5.0 kg/year) during 6.9 years (average). During 8.0 years of follow-up after the second weight assessment, 20 960 incident cancers were ascertained. Independent of baseline BMI, weight gain (per one kg/year increment) was positively associated with cancer of the corpus uteri (hazard ratio [HR] = 1.14; 95% confidence interval: 1.05-1.23). Compared to stable weight (±0.4 kg/year), weight gain (>0.4 to 5.0 kg/year) was positively associated with cancers of the gallbladder and bile ducts (HR = 1.41; 1.01-1.96), postmenopausal breast (HR = 1.08; 1.00-1.16) and thyroid (HR = 1.40; 1.04-1.90). Compared to maintaining normal weight, maintaining overweight or obese BMI (World Health Organisation categories) was positively associated with most obesity-related cancers. Compared to maintaining the baseline BMI category, weight gain to a higher BMI category was positively associated with cancers of the postmenopausal breast (HR = 1.19; 1.06-1.33), ovary (HR = 1.40; 1.04-1.91), corpus uteri (HR = 1.42; 1.06-1.91), kidney (HR = 1.80; 1.20-2.68) and pancreas in men (HR = 1.81; 1.11-2.95). Losing weight to a lower BMI category, however, was inversely associated with cancers of the corpus uteri (HR = 0.40; 0.23-0.69) and colon (HR = 0.69; 0.52-0.92). Our findings support avoiding weight gain and encouraging weight loss in middle adulthood.

Interpretation of familiar metaphors and proverbs by Polish people in middle and late adulthood.

BACKGROUND: The ability to understand figurative language, including metaphors and proverbs, decreases with age, although the phenomenon is not universal. Cognitive capacities and education play an important role in the competence connected with figurative language use and comprehension in people during the second half of life. AIMS: To identify possible similarities and differences in task performance by subjects representing middle adulthood (40-49 and 50-59 years old) and late adulthood (60-69 and 70-92 years old). Additionally, the analyses took into account factors significantly affecting the results, that is, tasks type (metaphors versus proverbs), the way the answer is given (open-ended versus multiple choice) and types of answers (abstract and concrete). This study also aimed to identify some cognitive correlates of task completion. METHODS & PROCEDURES: A total of 86 Caucasian subjects, aged 40-92 years, participated in this study (Mwhole group = 62.37, SD = 15.53); the group included 20 subjects aged 40-49 years (Mage = 45.4; SD = 3.05), 20 aged 50-59 years (Mage = 55.50; SD = 2.64), 20 aged 60-69 years (Mage = 64.40; SD = 2.78), and 26 aged 70-92 years (Mage = 79.15; SD = 6.27). A total of 20 well-known Polish metaphors and 20 popular Polish proverbs were used to assess the level of proverb and metaphor comprehension. The Montreal Cognitive Assessment Scale and Vocabulary subtest of the Polish version of WAIS-R were applied to assess the cognitive functions. OUTCOMES & RESULTS: The results of the analyses suggest that there are differences as well as certain similarities between the groups. At 70+ years of age, the ability to explain and comprehend metaphors and proverbs decreases when compared with younger adults. In the 70+ group, the ability to grasp the meaning of both metaphors and proverbs is similar, unlike in the younger groups which present a better ability to explain and comprehend metaphors than proverbs. The conditions related to the types of tasks, that is, spontaneous interpretation and choice of responses, do not affect scores of the oldest subjects. CONCLUSIONS: The analysis of response types, that is, abstract versus concrete, shows that, compared with younger groups, people aged 70+ years tend to less frequently provide abstract explanations and more often give concrete (but correct) responses, referring to situational data or examples from everyday life. Moreover, attention, short-term/delayed memory and lexical reserve influence the ability to use and comprehend figurative language to a varied degree. WHAT THIS PAPER ADDS: What is already known on the subject Studies focusing on metaphor and proverb interpretation by people in middle and late adulthood are rather scarce, and what is more, they provide inconclusive results. Research has shown that the capacities related to attention and memory, as well as language resources and executive functions, all deteriorate in older people, which negatively affects their ability to understand metaphors and proverbs. However, varied methods are applied to assess these skills, which may explain why the related findings are inconsistent. What this paper adds to existing knowledge The novelty of this study lies in the fact that the analyses took into account the type of task (metaphors versus proverbs), the method of responding (open-ended versus multiple-choice) and the nature of the answer (abstract versus concrete). This allowed us to highlight intergroup differences and to show specific characteristics of proverb and metaphor spontaneous interpretation and choice of correct answers. The results were compared among the participants representing relatively narrow age ranges classified as middle and late adulthood. What are the potential or actual clinical implications of this work? Analysis of how people in middle and late adulthood interpret metaphors and proverbs might constitute an element of preliminary screening assessment showing whether a decrease in this capacity is in the normal range or if it reflects a serious cognitive decline. It would be worthwhile if the diagnostic process included varied task designs, that is, both metaphors and proverbs, as well as spontaneous interpretation and multiple-choice, as well as varied types of responses.

Wisdom as the Mediator in the Relationships Between Meaning in Life and Attitude Toward Death.

The goal of the presented research was to investigate if wisdom plays a mediating role in the relationships between meaning in life and the attitude toward death in the period of middle and late adulthood. A study was carried out that included 567 persons aged 40 to 75 years. Three measures were used: Personal Meaning Profile, Three-Dimensional Wisdom Scale, and Death Attitude Profile-Revised. The conducted analyses allowed the authors to confirm the mediating role of wisdom in the relationships between meaning in life and fear of death as well as death avoidance in persons during the period of middle and late adulthood.

What are the Marital Problems of Happy Couples? A Multimethod, Two-Sample Investigation.

How couples handle marital conflict may depend on what issues they are facing, as some issues may be more difficult to resolve than others. What is unclear, however, is what issues happy couples face and how these issues may be different for couples depending on their developmental stage. To explore this possibility, the current study used both self-reports and observations drawn from two separate samples of happily married couples-one early in middle adulthood (N = 57 couples; average marital duration = 9 years) and one in older adulthood (N = 64 couples; average marital duration = 42 years). Results indicated that all issues were relatively minor, but early middle-aged couples reported more significant problems than did older couples. As to determining the most salient topic for happy couples, it depended on the spouses' gender, developmental stage, and how salience was assessed (i.e., highest rated issue vs. most discussed issue). Only moderate links were found between what happy couples said was their most serious concern and what they actually tried to resolve during observations of marital problem-solving, but there were differences in how spouses behaved based on the proportion of their time discussing certain topics. Findings suggest that more attention should be devoted to understanding what marital issues happy couples discuss and why, as doing so may reveal how couples maintain their marital happiness.

Las maneras en las que las parejas manejan el conflicto conyugal puede depender de qué problemas enfrentan, ya que algunos problemas pueden ser más difíciles de resolver que otros. Sin embargo, lo que no está claro es qué problemas enfrentan las parejas felices y cómo estos pueden ser diferentes para las parejas según su etapa de desarrollo. Para analizar esta posibilidad, el presente estudio utilizó autoinformes y observaciones tomados de dos muestras distintas de parejas felizmente casadas: una a principios de la mediana edad (N = 57 parejas; duración conyugal promedio = 9 años) y una en la tercera edad (N = 64 parejas; duración conyugal promedio = 42 años). Los resultados indicaron que todos los problemas fueron relativamente menores, pero las parejas de principios de la mediana edad informaron problemas más importantes que las parejas mayores. En cuanto a la determinación del problema más prominente para las parejas felices, dependió del género de los cónyuges, la etapa de desarrollo y cómo se evaluó la prominencia (p. ej.: el problema más puntuado frente al problema más debatido). Solo se hallaron vínculos moderados entre lo que las parejas felices declararon como su mayor preocupación y lo que en realidad intentaron resolver durante las observaciones de la resolución de problemas conyugales, pero hubo diferencias en las maneras en las que los cónyuges se comportaron según la proporción de su tiempo debatiendo ciertos temas. Los resultados sugieren que debería dedicarse más atención a comprender qué problemas conyugales debaten las parejas felices y por qué, ya que hacerlo puede revelar cómo las parejas mantienen su felicidad conyugal.

Locomotive syndrome testing in young and middle adulthood.

Background: Previous epidemiological studies on locomotive syndrome (LS) have been mainly conducted in retired elderly people. However, from the view point of its prevention, it is important to assess currently working younger people. The purpose of this study was to examine the status of the level of LS in young and middle-aged adult workers.Methods: This cross-sectional study was performed at four companies. We used the two-step test, stand-up test, and 25-question Geriatric Locomotive Function Scale (GLFS-25) as screening tools of LS. We also questioned the subjects for knee pain and low back pain.Results: A total of 715 workers participated in this study. The percentage of females with LS increased with age. However, the percentage of males with LS was approximately 20% in each age category. Two-step and stand-up test scores worsened in an age-dependent manner, although GLFS-25 scores varied independently of age. Knee pain, low back pain and physical activity were significantly related to LS-level.Conclusion: Our results suggest that there is some degree of LS even in young and middle-aged adults. Knee pain, low back pain and physical activity levels are key factors related to LS even in young and middle-aged adults.

CATSLife: A Study of Lifespan Behavioral Development and Cognitive Functioning.

The purpose of this update is to provide the most current information about both the Colorado Adoption Project (CAP) and the Longitudinal Twin Study (LTS) and to introduce the Colorado Adoption/Twin Study of Lifespan behavioral development and cognitive aging (CATSLife), a product of their merger and a unique study of lifespan behavioral development and cognitive aging. The primary objective of CATSLife is to assess the unique saliency of early childhood genetic and environmental factors to adult cognitive maintenance and change, as well as proximal influences and innovations that emerge across development. CATSLife is currently assessing up to 1600 individuals on the cusp of middle age, targeting those between 30 and 40 years of age. The ongoing CATSLife data collection is described as well as the longitudinal data available from the earlier CAP and LTS assessments. We illustrate CATSLife via current projects and publications, highlighting the measurement of genetic, biochemical, social, sociodemographic and environmental indices, including geospatial features, and their impact on cognitive maintenance in middle adulthood. CATSLife provides an unparalleled opportunity to assess prospectively the etiologies of cognitive change and test the saliency of early childhood versus proximal influences on the genesis of cognitive decline.

Enhancing GABA Signaling during Middle Adulthood Prevents Age-Dependent GABAergic Interneuron Decline and Learning and Memory Deficits in ApoE4 Mice.

Apolipoprotein E4 (apoE4) is the major genetic risk factor for Alzheimer's disease (AD). However, the underlying mechanisms are still poorly understood. We previously reported that female apoE4 knock-in (KI) mice had an age-dependent decline in hilar GABAergic interneurons that correlated with the extent of learning and memory deficits, as determined by Morris water maze (MWM), in aged mice. Enhancing GABA signaling by treating aged apoE4-KI mice with the GABAA receptor potentiator pentobarbital (PB) for 4 weeks before and during MWM rescued the learning and memory deficits. Here, we report that withdrawal of PB treatment for 2 weeks before MWM abolished the rescue in aged apoE4-KI mice, suggesting the importance of continuously enhancing GABA signaling in the rescue. However, treating apoE4-KI mice during middle adulthood (9-11 months of age) with PB for 6 weeks prevented age-dependent hilar GABAergic interneuron decline and learning and memory deficits, when examined at 16 month of age. These data imply that increasing inhibitory tone after substantial GABAergic interneuron loss may be an effective symptomatic, but not a disease-modifying, treatment for AD related to apoE4, whereas a similar intervention before substantial interneuron loss could be a disease-modifying therapeutic. SIGNIFICANCE STATEMENT: We previously reported that female apoE4-KI mice had an age-dependent decline in hilar GABAergic interneurons that correlated with the extent of cognitive deficits in aged mice. The current study demonstrates that enhancing GABA signaling by treating aged apoE4-KI mice with a GABAA receptor potentiator pentobarbital (PB) before and during behavioral tests rescued the cognitive deficits; but withdrawal of PB treatment for 2 weeks before the tests abolished the rescue, suggesting the importance of continuously enhancing GABA signaling. However, treating apoE4-KI mice during middle adulthood with PB for a short period of time prevented age-dependent hilar GABAergic interneuron decline and cognitive deficits late in life, suggesting early intervention by enhancing GABA signaling as a potential strategy to prevent AD related to apoE4.

Alterations of functional connectivities from early to middle adulthood: Clues from multivariate pattern analysis of resting-state fMRI data.

In contrast to extended research interests in the maturation and aging of human brain, alterations of brain structure and function from early to middle adulthood have been much less studied. The aim of the present study was to investigate the extent and pattern of the alterations of functional interactions between brain regions from early to middle adulthood. We carried out the study by multivariate pattern analysis of resting-state fMRI (RS-fMRI) data of 63 adults aged 18 to 45 years. Specifically, using elastic net, we performed brain age estimation and age-group classification (young adults aged 18-28 years vs. middle-aged adults aged 35-45 years) based on the resting-state functional connectivities (RSFCs) between 160 regions of interest (ROIs) evaluated on the RS-fMRI data of each subject. The results indicate that the estimated brain ages were significantly correlated with the chronological age (R=0.78, MAE=4.81), and a classification rate of 94.44% and area under the receiver operating characteristic curve (AUC) of 0.99 were obtained when classifying the young and middle-aged adults. These results provide strong evidence that functional interactions between brain regions undergo notable alterations from early to middle adulthood. By analyzing the RSFCs that contribute to brain age estimation/age-group classification, we found that a majority of the RSFCs were inter-network, and we speculate that inter-network RSFCs might mature late but age early as compared to intra-network ones. In addition, the strengthening/weakening of the RSFCs associated with the left/right hemispheric ROIs, the weakening of cortico-cerebellar RSFCs and the strengthening of the RSFCs between the default mode network and other networks contributed much to both brain age estimation and age-group classification. All these alterations might reflect that aging of brain function is already in progress in middle adulthood. Overall, the present study indicated that the RSFCs undergo notable alterations from early to middle adulthood and highlighted the necessity of careful considerations of possible influences of these alterations in related studies.

The longitudinal association of adipose-to-lean ratio with incident cardiometabolic morbidity: The CARDIA study.

AIM: To assess the association of adipose-to-lean ratio (ALR) with incident type 2 diabetes mellitus (T2DM), hypertension, and dyslipidemia in middle adulthood. METHOD: Black and White Coronary Artery Risk Development in Young Adults participants without T2DM, hypertension, or dyslipidemia in 2005-06 (baseline) were included. Baseline adipose and lean mass were assessed via dual-energy X-ray absorptiometry. ALR was calculated as adipose divided by lean mass and then standardized within sex strata. Single time-point incident morbidity was assessed every five years from baseline through 2016. Cox proportional hazards regression was used to estimate hazard ratios (HR) for morbidity over 10 years per 1-SD increment in ALR adjusted for cardiovascular risk factors. RESULT: The cumulative incidence of T2DM was 7.9 % (129 events/N = 1643; 16,301 person-years), 26.7 % (485 events/N = 1819; 17,895 person-years) for hypertension, and 49.1 % (435 events/N = 855, 8089 person-years) for dyslipidemia. In the adjusted models, ALR was positively associated with a risk of T2DM (HR [95 % CI]; 1.69 [1.31, 2.19]) and hypertension (1.23 [1.08, 1.40]). There was no significant interaction between ALR and sex for any morbidity. CONCLUSION: ALR in middle adulthood is associated with incident T2DM and hypertension. The extent to which localized body composition measures might inform morbidity risk merits further investigation.

An Emerging 21st-Century Midlife Sleep Crisis? Cohort Differences in Sleeping Patterns Among Americans in Midlife and Older Adulthood.

OBJECTIVES: To descriptively document birth cohort differences in sleeping patterns, self-reported age-specific sleep duration, and insomnia symptoms among adults aged 50+ from the National Health Interview Survey (NHIS) and the Health and Retirement Study (HRS). METHODS: We analyzed respondents aged 50+ (born 1920-1969) from the 2006-2018 NHIS (n = 162,400) and HRS (n = 28,918). We fit multinomial models among the NHIS sample predicting age-specific optimal sleep duration (optimal for age vs short for age, and optimal for age vs long for age). For the HRS sample, we fit growth curve models predicting age-based insomnia symptom trajectories. The models for both samples adjusted for age, gender, race/ethnicity, and educational attainment. RESULTS: Results regarding sleep duration in the NHIS, suggested that cohorts born in the 1950s and 1960s had significantly higher odds of reporting short sleep duration than cohorts before them. Results from the HRS similarly illustrated that cohorts born in the 1950s and 1960s had significantly higher levels of insomnia symptoms than those born before them. The worsening sleep among cohorts entering midlife was consistent regardless of alternative cohort specification, when age groups or periods were analyzed, and when more extensive covariates were modeled. DISCUSSION: We observe a pronounced decline in healthy sleeping patterns among American cohorts in midlife, with consistent and striking results across data sets, methods, and measures. These findings have important implications for the well-being and longevity of Americans who have entered midlife in the 21st century.

Navigating Adult Life from Emerging to Middle Adulthood: Patterns of Systemic Influences and Time Perspective in Migrants.

This study emerges at the intersection of adult development and systems theory frameworks and their contributions to understanding migration experiences and associated cultural transitions. The adult development approach enables a deep understanding of the complexities that adults experience when they move from exploring themselves and their environment in emerging adulthood to establishing their identities and roles during middle adulthood. The systems theory framework, on the other hand, provides insights into the role of social and cultural dimensions in the lives of emerging and middle-adult immigrants who have navigated diverse cultures, roles, and identities. The study highlights the patterns and dynamic interactions of diverse systems of influences and their roles in shaping the self and relational identities of thirty emerging and middle-aged adults who have experienced migration.

Dyadic associations and prediction of maternal and paternal sexual satisfaction in couples-Findings from an 18-year longitudinal study.

Background: : Sexual satisfaction is one of many crucial factors for the long-term success of romantic relationships. Longitudinal studies examining the dyadic associations between maternal and paternal factors in middle adulthood for predicting sexual satisfaction in later adulthood are scarce. Method: The German longitudinal intervention study "Future Family" followed families with at least one child over 18-years (Pre: N = 477, mothers: M = 35.2 years, fathers: M = 38.8 years, children: M = 4.1 years). At the time of the 18-year follow-up, N = 150 mothers (M = 54.1 years) were still living together with the biological fathers (M = 56.1 years; mean relationship duration: 32 years). Dyadic associations between individual and dyadic factors at Pre were analyzed with Actor-Partner Interdependence models to predict sexual satisfaction 18 years later. Results: Higher relationship quality was significantly associated with higher levels of one's own sexual satisfaction 18 years later. Higher levels of maternal and paternal mental health problems were linked to lower levels of sexual satisfaction in both the individual themselves and their partner. General life satisfaction of mothers and fathers only predicted their own sexual satisfaction. The model for dysfunctional parenting yielded no significant effects. Conclusions: The results indicate that relationship quality, mental health problems, and general life satisfaction of both parents could be starting points for preventive and therapeutic interventions to achieve long-term effects in sexual satisfaction in married couples.

Type 2 diabetes and cognitive performance in middle age: a cross-sectional study.

INTRODUCTION: Type 2 diabetes has been associated with cognitive decrements already in middle-age. However, the sample sizes of the studies have been small and the neuropsychological tests used have been heterogeneous. In addition, only a few studies have matched the groups in terms of age, education and gender. In this cross-sectional matched pairs study, we investigated the cognitive performance of Finnish middle-aged type 2 diabetes patients compared to healthy individuals. METHOD: A neuropsychological test battery consisting of 16 tests and 21 outcome measures was applied to 28 patients and 28 age-, education- and gender-matched healthy individuals. Various exclusion criteria were applied to minimize the risk of cognitive dysfunction due to factors other than diabetes. RESULTS: We did not find between-group differences in any of the neuropsychological tests measuring attention, concept formation and reasoning, construction and motor performance, executive functions, memory, processing speed or working memory. In addition, there were no group differences in the frequency or severity of subjective cognitive symptoms, or in anxiety, depression, burnout, fatigue or alcohol use disorder symptoms. The effect sizes in this study were mostly negligible or small, with the mean effect size being -0.12. CONCLUSIONS: In a carefully matched sample of middle-aged type 2 diabetes patients and healthy individuals, we found no significant effects and no meaningful evidence of cognitive differences between the groups.

Chronic Comorbidities in Middle Aged Patients Contribute to Ineffective Emergency Hematopoiesis in Covid-19 Fatal Outcomes.

BACKGROUND AND AIMS: Mexico is among the countries with the highest estimated excess mortality rates due to the COVID-19 pandemic, with more than half of reported deaths occurring in adults younger than 65 years old. Although this behavior is presumably influenced by the young demographics and the high prevalence of metabolic diseases, the underlying mechanisms have not been determined. METHODS: The age-stratified case fatality rate (CFR) was estimated in a prospective cohort with 245 hospitalized COVID-19 cases, followed through time, for the period October 2020-September 2021. Cellular and inflammatory parameters were exhaustively investigated in blood samples by laboratory test, multiparametric flow cytometry and multiplex immunoassays. RESULTS: The CFR was 35.51%, with 55.2% of deaths recorded in middle-aged adults. On admission, hematological cell differentiation, physiological stress and inflammation parameters, showed distinctive profiles of potential prognostic value in patients under 65 at 7 days follow-up. Pre-existing metabolic conditions were identified as risk factors of poor outcomes. Chronic kidney disease (CKD), as single comorbidity or in combination with diabetes, had the highest risk for COVID-19 fatality. Of note, fatal outcomes in middle-aged patients were marked from admission by an inflammatory landscape and emergency myeloid hematopoiesis at the expense of functional lymphoid innate cells for antiviral immunosurveillance, including NK and dendritic cell subsets. CONCLUSIONS: Comorbidities increased the development of imbalanced myeloid phenotype, rendering middle-aged individuals unable to effectively control SARS-CoV-2. A predictive signature of high-risk outcomes at day 7 of disease evolution as a tool for their early stratification in vulnerable populations is proposed.