Adult Community Research Articles

Frailty and Medication Appropriateness in Rural Adults: Proposing Interventions through Pharmacist-Physician Collaborative Efforts.

Background: Frailty and polymedication are closely interrelated. Addressing these concurrent conditions in primary care settings relies on the utilization of potentially inappropriate medication (PIM) lists and medication reviews (MRs), particularly in rural areas, where healthcare professionals serve as the sole point of access to the medical system. The aim of this study was to examine the relationship between medication appropriateness and variables related to frailty in a rural municipality in order to propose potential strategies for therapy optimization. Methods: This cross-sectional study included all adult community dwellers aged 50 and above officially registered in the municipality of Tiriez (Albacete, Spain) in 2023 (n = 241). The primary outcome variable was frailty (assessed using the fatigue, resistance, ambulation, illness, and loss of weight (FRAIL) scale). The independent variables were age, gender, medication regimen, history of falls, comorbidities, PIMs (evaluated using the screening tool of older persons' prescriptions (STOPP) 2023 criteria), fall-risk-increasing drugs (FRID), and anticholinergic burden (ACB). Results: The prevalence of frailty was approximately 20%. FRID and ACB scores were statistically associated (p-value < 0.001) with frailty, 1.1 ± 1.3 vs. 2.5 ± 1.7, and 1.0 ± 1.3 vs. 2.8 ± 2.5, respectively. Regardless of age, frailty was observed to be more prevalent among females (odds ratio (OR) [95% confidence interval (CI)]: 3.5 [1.5, 9.0]). On average, 2.1 ± 1.6 STOPP criteria were fulfilled, with the prolonged use of anxiolytics and anti-peptic-ulcer agents being the most frequent. Priority interventions (PIs) included opioid dose reduction, benzodiazepine withdrawal, and the assessment of antidepressant and antiplatelet treatment plans. Conclusions: The optimization of medication in primary care is of paramount importance for frail patients. Interventional measures should focus on ensuring the correct dosage and combination of drugs for each therapeutic regimen.

The Cumulative Impact of Recurrent Experiences of Intimate Partner Violence on Emotion Dysregulation: A Longitudinal Investigation.

Intimate partner violence (IPV) disproportionately affects women and has been linked to a range of negative psychological outcomes, including emotion dysregulation. Although IPV is often recurrent and tends to escalate in severity over time, few studies have examined the potential effects of recurrent experiences of IPV on emotion dysregulation. The current study employed a longitudinal design to examine the cumulative impact of recurrent experiences of IPV on emotion dysregulation. Participants were 491 young adult community women (Mage = 21.74; 61.3% White, 35% African American/Black) who completed self-report measures of IPV and emotion dysregulation every 4 months for 28 months. Multilevel structural equation modeling techniques revealed that, at the within-person level, increases in cumulative IPV were associated with increases in global emotion dysregulation across the 28 months. In particular, the accumulation of IPV experiences over time was associated with increases in difficulties controlling impulsive behaviors when distressed and accessing effective emotion regulation strategies. At the between-person level, greater average cumulative IPV was associated with greater mean levels of global emotion dysregulation, as well as four specific dimensions of emotion dysregulation, including difficulties accepting emotional responses, accessing effective emotion regulation strategies, and both engaging in goal-directed behaviors and controlling impulsive behaviors when distressed. These findings suggest the potential cumulative impact of IPV on both global and more specific dimensions of emotion dysregulation. Results also highlight emotion dysregulation as a potentially important construct to assess and target in interventions for women experiencing recurrent IPV.

Intergenerationality in the Context of Age-Friendly Cities and Communities: Older people’s Experiences and Perspectives on Place and Community Living in the UK

ABSTRACT Intergenerational communities can be understood as communities where multiple age groups interact, feel valued, and contribute to community life in an inclusive way. However, older adults in many communities in the UK can be excluded from intergenerational mixing. The PlaceAge project undertook interviews, photo-diaries, community mapping workshops, and knowledge cafés to explore older adult experiences of and participation in their cities and communities. Three key themes were generated, showcasing intergenerationality: (1) Connectedness in place and space; (2) Feeling old in siloed communities; and (3) Play in everyday life. This research emphasizes the importance of inclusive and accessible intergenerational places and activities that foster sustainable social connections and combat ageism. It highlights the value of playfulness, skill-sharing and co-mentoring, and advocates for the importance of incorporating intergenerational opportunities into the planning and development of age-friendly cities and communities.

Abstract B069: Designing a Hispanic/Latino community-driven HPV vaccine and HPV-related cancer awareness campaign for young adults and youth in Los Angeles County

Abstract Background: In Los Angeles, HPV vaccination is lowest among Hispanic/Latino (HL) youth, young adults, and HL adolescent girls of immigrant parents, despite HPV vaccination preventing more than 90% of cancers attributed to HPV infection. This study aims to address gaps in the HPV vaccine and HPV-related cancer awareness through community-driven exploration of multimedia sources and cultural tailoring of the Es Tiempo Campaign to HPV vaccine initiation materials. Methods: A mixed-methods design was used, combining quantitative surveys, qualitative listening sessions and focus groups. In May 2024, five youth between 14 and 17 years of age and seven young adults between 18 and 30 years of age who self-identified as HL were recruited through community outreach in Los Angeles. The twelve participants were surveyed and participated in two 90-minute Listening Sessions (grouped by age) to gather formative data. During the LS, participants reviewed culturally tailored designs of media materials (e.g., banners, posters) focused on HPV vaccination initiation. Focus groups with another twelve young adults gathered confirmative data. Descriptive statistics assessed demographics. Coding of transcripts identified themes. Results: Preliminary results from the Listening Sessions found that youth and young adults had similarities and differences in their preferences for receiving health information. Both age groups preferred health materials with visually appealing images and materials that could be easily found and distributed. All relied on health information provided by their providers including informational pamphlets, texts, and emails. Differences were found in whom they sought health advice from. Youths sought health advice from parents or family, while young adults did this too but only after reviewing health information first online. Both age groups identified social media, such as Instagram and TikTok as key sources for health information. However, neither group wanted to receive health information through Facebook or Twitter. Young adults wanted images showing HL patient-provider interactions, while youth preferred images of family or community. Youth liked cartoon-style images, but young adults wanted images of real HL people. For cultural tailoring, youth liked images that reflected a traditional colorful border. Young adults found this border was not representative of diverse HL communities. Conclusion: Community-driven research identified gaps in tailoring and guiding multimedia dissemination efforts for HPV vaccine initiation campaign materials among youth and young adults in the HL community. HL youth and young adults, as community informants, provided advice on multimedia platforms, design appropriateness, and comprehension. Community participation is essential to identify and create culturally competent designs at an appropriate literacy/language and age level and to produce materials for educational campaigns that are not only culturally specific but also visually appealing to the target population. Citation Format: Samantha Verganza, Patricia Escobedo, Rosa Barahona, Lourdes Baezconde-Garbanati. Designing a Hispanic/Latino community-driven HPV vaccine and HPV-related cancer awareness campaign for young adults and youth in Los Angeles County [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B069.

Insect seedling herbivory is influenced by multiple factors, but the plant apparency theory is more supported than other hypotheses – A case study in a subtropical forest

Insect herbivory is ubiquitous in various ecosystems, and directly influences the growth and survival of individual plants, especially during their vulnerable early life stages like the seedling phase. This, in turn, exerts a significant influence on forest community diversity and structure, as well as ecosystem function and stability. Notable variation in herbivory has been detected both among and within plant species. For decades, many hypotheses have been proposed to explain such variations, including both biotic and abiotic variables. However, most studies have considered only one or several of these hypotheses by focusing on a few potential variables, and their results were usually inconsistent; thus, the factors driving herbivory remain unclear. In this study, we examined leaf herbivory by insects of woody species seedlings in a subtropical forest in southwestern China over two seasons. In total, 24 potential variables that represented abiotic resource availability, characters of individual seedlings, conspecific and heterospecific species, and the whole seedling community were selected to test several commonly discussed alternative herbivory hypotheses. Overall, our findings showed that the plant apparency hypothesis was more supported than the other hypotheses in explaining insect seedling herbivory. Our results further indicated that the mechanisms and causes of insect herbivory are complex, multifactorial, species-specific and vary with seasons, indicating that there may be no uniform rules in explaining herbivory for all seedlings. Consequently, such complexity may play an important role in promoting species coexistence and biodiversity maintenance in seedling communities, which may further translate into the following generation of saplings or even adult communities. Changes in the community of insect herbivores and/or variables influencing insect herbivory, may disrupt stability of the original seedling community, thus affecting the regeneration and development of the entire forest community. Therefore, we suggest that issues related to insect herbivory should be considered when developing forest management and conservation.

Vaccination Across the Lifespan: A Public Health Imperative

Vaccination is an essential public health intervention, preventing infectious diseases, saving millions of lives globally, and reducing the burden on the healthcare system. Currently, vaccines prevent between 3.5 and 5 million deaths annually from diseases like diphtheria, tetanus, pertussis, influenza, and measles.1 It not only protects individuals but also contributes to herd immunity, safeguarding entire communities. Maintaining high vaccination coverage across all age groups reduces the burden of preventable illnesses and safeguards public health. Childhood immunization is a cornerstone of preventive healthcare, providing protection against various life-threatening diseases during the most vulnerable years of life. Key vaccines include the DTP, MMR, IPV, Hib, and pneumococcal. 2 Global immunization coverage has stagnated since 2022, with 14.5 million children missing all DTP doses and 6.5 million not completing follow-up doses. There is an urgent need for innovative solutions to meet the Immunization Agenda 2030 targets of 90% vaccination coverage. 3 Vaccination has a pivotal role in women's healthcare, especially during pregnancy. The CDC recommends the inactivated flu and Tdap vaccines for protection of both mother and baby, with the flu vaccine best administered by the end of October and Tdap between 27 and 36 weeks of gestation. The HPV vaccine is recommended for girls aged 9–14 (two doses) and women over 14 (three doses) to protect against cervical cancer and genital warts, but it should not be given during pregnancy due to insufficient safety data.4 Regular vaccinations are crucial for adults aged 50–64, including COVID-19, influenza, shingles, and Tdap/Td. Hepatitis B is recommended for those up to 59 years old, and MMR for those born in 1957 or later. For those 65 and older, COVID-19, influenza, pneumococcal, and shingles vaccines are essential, with an RSV recommended. Healthcare providers should be consulted to determine additional vaccines for older adults, as regular vaccinations are important to prevent serious health issues due to immune decline and chronic conditions. 5 A comprehensive vaccination strategy is important for community health, encompassing children, women, adults, and older adults. A strong public health infrastructure that guarantees vaccine access and affordability should serve as the foundation for this strategy. In order to improve vaccination coverage, public awareness campaigns must be customized to address the concerns of all age groups. Children's immunization programs must be implemented in schools and coincide with routine physical examinations while women, particularly those who are of reproductive age, require special attention. Adult immunization programs must to prioritize occupational health, and older people need to remain updated. Considering immunization as a top public health priority, policy makers and healthcare professionals must work together to ensure continuous monitoring and evaluation of vaccination campaign’s coverage and effectiveness in order to spot gaps and launch prompt interventions.

Negotiating autonomy, community, and divinity in urban Filipino young adults’ moral reasoning

Cultural approaches to examining the development of moral reasoning have been influential for decades. Still, gaps remain in understanding how individuals actively construct their moral reasoning within different sociocultural contexts and the period of young adulthood in the Filipino setting. Thus, this study examined the discourses used by urban Filipino young adults in reasoning about their moral conflicts and the ways they adopted and adapted these discourses in their reasoning. The study used a social constructionist perspective, informed by Shweder and colleagues’ ethics of Autonomy, Community, and Divinity and Jensen’s cultural-developmental approach. We conducted thematic analysis with attention to discourse on interviews with 12 urban young adults aged 21 to 29, producing three major discursive themes: harm and welfare, rules and roles, and liberal principles. The specific appropriation of these discourses suggests the dominance of the ethic of Autonomy. However, this often co-occurred with expressions of Community and Divinity, and the extent and manner of appropriation of these discourses varied according to individuals’ characteristics and experiences. By examining young adults’ negotiation of moral discourses in the Philippines, this research enriches understanding of moral reasoning in a sociohistorical context where young people increasingly contend with conflicts between traditional and global values.

Linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China: a cross-sectional study

BackgroundDepression affects the oral health of older adults; however, little is known about its impact on oral health among rural older adults in developing countries, which warrants further research. Taking China as an example, there is a large population base of rural older adults suffering from depression, and many rural older people also have long-term oral health problems, which have seriously affected their quality of life in later life. Therefore, this study aimed to explore linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China.MethodsFrom November 2020 to December 2020, 1,902 rural community-dwelling older people aged 60 years and older were investigated, via a cross-sectional survey. The general information, depressive status, oral health knowledge, attitudes, and practices of the participants were obtained through face-to-face structured questionnaires. Among them, the Zung Depression Self-Rating Scale was used to investigate the depressive symptoms of the participants in this survey. The generalized linear model and classification and regression tree model were used, separately.ResultsBased on linear analysis results, we found that minimal to mild depressive symptoms [regression coefficient (β) = -0.345; 95% confidence interval (CI): -0.582 to -0.109, P = 0.004] and depressive symptoms (β = -1.064; 95% CI: -1.982 to -0.146, P = 0.023) were significantly correlated with oral health knowledge. A negative correlation was observed between minimal to mild depressive symptoms (β = -0.385; 95% CI: -0.600 to -0.170, P < 0.001) and oral health attitudes. In addition, while both minimal to mild depressive symptoms (β = 0.018; 95% CI: -0.312 to 0.347, P = 0.916) and depressive symptoms (β = 0.604; 95% CI: -0.675 to 1.883, P = 0.355) were associated with oral health practices. Furthermore, the non-linear analysis showed a combined effect of depressive symptoms on oral health attitudes, indicating that older people of a younger age, not living alone, and not suffering from depressive symptoms are more likely to report better oral health attitudes.ConclusionBoth the linear and non-linear analyses in our study showed that depressive symptoms are significantly correlated with the poor oral health attitudes of older adults in rural communities. Furthermore, depressive symptoms were associated with oral health knowledge in the linear analysis. However, no statistically significant difference was found between depressive symptoms and oral health practices in either analysis. This research deepens our knowledge and understanding of relevant evidence in the mental and oral health of people in later life. In addition, analyzing the factors that affect the oral health of older people from the perspective of their depressive status provides new thinking directions and scientific references for improving the oral health of older adults in practical life.

Exploring the vitamin biosynthesis landscape of the human gut microbiota.

The human gut microbiota possesses the capacity to synthesize vitamins, especially B group vitamins, which are recognized as indispensable for various biological processes both among members of these bacterial communities and host cells. Accordingly, vitamin production by intestinal commensals has attracted significant interest. Nevertheless, our current understanding of bacterial vitamin synthesis is primarily based on individual genomic and monoculture investigations, therefore not providing an overall view of the biosynthetic potential of complex microbial communities. In the current study, we utilized over 100 bacterial genes known to be involved in the biosynthesis of B group and K vitamins to assess the corresponding vitamin biosynthetic potential of approximately 8,000 human gut microbiomes. Our analyses reveal that host-associated factors, such as age and geographical origin, appear to influence the diversity and abundance of vitamin biosynthetic pathways. Furthermore, we identify gut microbiota members that substantially contribute to these biosynthetic functions at each stage of human life. Interestingly, inference of microbial co-associations and network relationships uncovered the apparent key role played by folate and cobalamin in equilibrium establishment of the infant and adult gut microbial communities, respectively.IMPORTANCEOverall, this study expands our understanding of microbe-mediated vitamin biosynthesis in the human gut and may provide potential novel targets to improve availability of these essential micronutrients in the host.

Social Media Creations of Community and Gender Minority Stress in Transgender and Gender-Diverse Adults

Social Media Creations of Community and Gender Minority Stress in Transgender and Gender-Diverse Adults

Effects of Virtual Reality Motor-Cognitive Training for Older People With Cognitive Frailty: Multicentered Randomized Controlled Trial.

Cognitive frailty refers to a clinical syndrome in which physical frailty and mild cognitive impairment coexist. Motor-cognitive training and virtual reality (VR) have been used to launch various therapeutic modalities to promote health in older people. The literature advocates that motor-cognitive training and VR are effective in promoting the cognitive and physical function of older people. However, the effects on older people with cognitive frailty are unclear. This study examined the effects of VR motor-cognitive training (VRMCT) on global cognitive function, physical frailty, walking speed, visual short-term memory, inhibition of cognitive interference, and executive function in older people with cognitive frailty. This study used a multicentered, assessor-blinded, 2-parallel-group randomized controlled trial design. Participants were recruited face-to-face in 8 older adult community centers. Eligible participants were aged ≥60 years, were community dwelling, lived with cognitive frailty, had no dementia, and were not mobility restricted. In the intervention group, participants received VRMCT led by interventionists with 16 one-hour training sessions delivered twice per week for 8 weeks. In the control group, participants received the usual care provided by the older adult community centers that the investigators did not interfere with. The primary outcome was global cognitive function. The secondary outcomes included physical frailty, walking speed, verbal short-term memory, inhibition of cognitive interference, and executive function. Data were collected at baseline (T0) and the week after the intervention (T1). Generalized estimating equations were used to examine the group, time, and interaction (time × group) effects on the outcomes. In total, 293 eligible participants enrolled in the study. The mean age of the participants was 74.5 (SD 6.8) years. Most participants were female (229/293, 78.2%), had completed primary education (152/293, 52.1%), were married (167/293, 57.2%), lived with friends (127/293, 43.3%), and had no VR experience (232/293, 79.5%). In the intervention group, 81.6% (119/146) of participants attended >80% (13/16, 81%) of the total number of sessions. A negligible number of participants experienced VR sickness symptoms (1/146, 0.7% to 5/146, 3%). VRMCT was effective in promoting global cognitive function (interaction effect: P=.03), marginally promoting executive function (interaction effect: P=.07), and reducing frailty (interaction effect: P=.03). The effects were not statistically significant on other outcomes. VRMCT is effective in promoting cognitive functions and reducing physical frailty and is well tolerated and accepted by older people with cognitive frailty, as evidenced by its high attendance rate and negligible VR sickness symptoms. Further studies should examine the efficacy of the intervention components (eg, VR vs non-VR or dual task vs single task) on health outcomes, the effect of using technology on intervention adherence, and the long-term effects of the intervention on older people with cognitive frailty at the level of daily living. ClinicalTrials.gov NCT04730817; https://clinicaltrials.gov/study/NCT04730817.

Tracking anthropometric dimensions and grip strength among children, adolescents and adults in an indigenous community of southern Mexico: 1968-1978-2000.

To track body size and proportions, arm dimensions and grip strength in children, adolescents, and adults resident in an indigenous community in Oaxaca who were measured on two or three occasions across surveys in 1968, 1978, and 2000. The three cross-sectional surveys included measures of height, weight, sitting height, arm circumference, triceps skinfold, and grip strength in surveys of schoolchildren in 1968 and of schoolchildren, adolescents and adults in 1978 and 2000. Cross-checks of surnames, forenames and ages/dates of birth of participants in the three surveys identified three samples of individuals measured on two occasions (1968-1978, two age groups in 1978-2000) and a subsample of individuals measured in the three surveys. Partial correlations controlling for age at each observation were calculated for each variable in the three sex-specific samples measured on two occasions, and for the subsamples of males and females measured on three occasions. Allowing for variation in age among subsamples, inter-age correlations were moderate to high for stature, moderate for sitting height and estimated leg length, and low to moderate for weight, BMI, arm and estimated arm muscle circumference, triceps skinfold, and grip strength. Allowing for the relatively broad chronological age intervals, the inter-age correlations for height, weight and BMI were at the low end, while those for grip strength and for strength per unit body weight for males (though not females) were generally in the range of correlations noted in studies of European samples. Likely associated with improved health, nutritional, and sanitation conditions, obesity and overweight were emerging among adults by 2000. Obesity and overweight in adults paralleled the introduction of mechanized agriculture that reduced routine physical work. Among children, the association of obesity and overweight is likely with increased nutritional availability, but poor choices in diet.

In the Realm of Uncertainty: Quantum Thinking Promotes Tolerance for Ambiguity.

According to the principles of quantum mechanics, individuals are unable to accurately predict the precise outcome of a measurement or observation. Despite the significant impact of quantum thinking on science, there is a lack of understanding regarding the psychological consequences associated with adopting such a mindset. This research investigates how engaging in quantum thinking, which accepts the universe's inherent complexities and uncertainties, influences one's tolerance for ambiguity. To test our hypothesis, we conducted three complementary studies involving diverse populations (students and community adults), multiple measures of tolerance of ambiguity (self-report data and behavioral indicators), and different priming procedures (text reading and sentence scrambling tasks). Study 1 demonstrated that university students exposed to quantum thinking principles exhibited greater tolerance for ambiguity within an English as a Foreign Language (EFL) setting. Moving beyond the educational setting, Study 2 corroborated these observations by evaluating an individual's ease with uncertainty and unpredictability across different everyday scenarios. Addressing potential self-report biases, Study 3 incorporated a behavioral measure to objectively validate the observed effect. Together, these findings suggest that the thinking mindset prevalent in physics significantly impacts individuals' cognitive flexibility and behavior, highlighting the broad relevance of quantum thinking beyond its scientific origins.

Effect of Risk Factors on Blood Pressure Using Multivariate Model amongst Adult Tribal Population in a District of India

Abstract Background: This research study uses multivariate model to analyse the effect of various risk factors on blood pressure (BP) levels amongst adults in the tribal communities. Materials and Methods: A community-based cross-sectional observational study with adult tribal population residing in Lohandiguda, Bastar district, Chhattisgarh, India. A multistage sampling was followed and the modified World Health Organization questionnaire for hypertensive patients was used. Results: Three hundred and thirty adults were included. Positive moderate-weak correlation in all three groups shown by body mass index (BMI) (0.208, 0.214 and 0.287) and waist–hip ratio (WHR) (0.223, 0.240 and 0.359) with systolic BP and (BMI = 0.223, 0.240 and 0.240; WHR = 0.166, 0.198 and 0.288) diastolic BP, respectively, was found. The Pearson correlation coefficient shows that the highest predictor of high BP was BMI (0.226) followed by WHR (0.198), age (0.182), number of bidi/cigarette use per day (0.131) and smokeless tobacco frequency per day (0.114). The multivariate general linear model is moderately distinguishable (0.529) amongst all study subjects and (0.543) amongst addicted study subjects with BP having strong significance (0.000) each for addicted and overall study subjects. Conclusion: These findings call for careful consideration in the development of dietary recommendations, quitting addictions, increased attention on physical activities and public health policies tailored to tribal communities.

Association of foods consumption and physical activity with prefrailty and frailty among Chinese older adults in urban communities: A cross-sectional study.

Frailty has become a public health challenge in China. To investigate the association of foods consumption and physical activity with prefrailty and frailty among older Chinese adults in urban communities. In a cross-sectional study from February to July 2023, 1183 older adults aged between 65y-88y were enrolled from urban communities in Chongqing and Shandong province, China. Frailty Index (FI) was applied to measure prefrailty and frailty. Partial proportional odds model was used to assess the association between foods consumption, physical activity and prefrailty/frailty. Higher Dietary Diversity Score (DDS), (OR=0.61, 95% CI=0.46-0.80; OR=0.47, 95% CI=0.28-0.79), Consuming animal-based foods ≥2 times/day (OR=0.62, 95% CI=0.47-0.82; OR=0.54, 95% CI=0.33-0.88), soy products ≥2 times/week (OR=0.69, 95% CI=0.53-0.89; OR=0.51, 95% CI=0.31-0.84), fresh vegetables ≥2 times/day (OR=0.42, 95% CI=0.31-0.57; OR=0.41, 95% CI=0.23-0.72), and nuts ≥2 times/week (OR=0.71, 95% CI=0.55-0.91; OR=0.52, 95% CI=0.32-0.85) was associated with a lower risk of prefrailty and frailty. In addition, higher frequency and longer duration of walking (OR=0.61, 95% CI=0.42-0.88; OR=0.63, 95% CI=0.48-0.81), exercise (OR=0.48, 95% CI=0.35-0.64; OR=0.44, 95% CI=0.32-0.61) per week were significantly associated with lower risk of prefrailty. Furthermore, higher frequency and longer duration of walking (OR=0.42, 95% CI=0.25-0.72; OR=0.46, 95% CI=0.29-0.74), and housework (OR=0.39, 95% CI=0.24-0.65; OR=0.57, 95% CI=0.34-0.96) per week, were significantly associated with lower frailty. Higher DDS and higher frequency of animal-based foods, soy products, fresh vegetables, and nuts consumption is significantly associated with lower risk of prefrailty and frailty. Additionally, walking and exercising are significantly associated with lower risk of prefrailty, while walking and doing housework is significantly associated with lower frailty.

Abstract P113: Hypertension Prevalence, Awareness, Treatment, and Control in Community-Dwelling Adults in Low-Resource Areas of Chicago, Illinois

Background: Hypertension (HTN) is an established risk factor for cardiovascular disease that disproportionately affects adults in low-resource communities. We examined hypertension prevalence, awareness, treatment, and control—the HTN control cascade—in low-resource neighborhoods in Chicago, Illinois. Methods: Using data from Keep Your Heart Healthy, a Northwestern Feinberg School of Medicine student-led community health program, we evaluated a convenience sample of adults who completed three blood pressure (BP) measurements at a community screening event between 2013 and 2019. Among adults with HTN (average systolic BP ≥140 mmHg, average diastolic BP ≥90 mmHg, or self-reported BP medication use), HTN awareness (self-reported history of HTN), HTN treatment (self-reported treatment among those who were aware), and HTN control (systolic BP &lt;140 mmHg and diastolic BP &lt;90 mmHg, among those who were aware and treated) rates were calculated. Results: Among 11,167 adults (mean age 50.9±14.8 years; 58.6% female; 63.9% Hispanic/Latino, 28.0% Black), HTN was prevalent in 45.3%. Of participants with HTN, 66.7% were aware of the diagnosis. Of those who were aware, 65.3% reported taking BP medication, of whom 48.3% achieved BP control. Overall, 21.0% of participants with HTN were aware, treated, and controlled (Figure). Additionally, 37.6% of all participants met criteria for pre-HTN (120-139 or 80-89 mmHg). Conclusions: In low-resource communities of Chicago, only 21.0% of participants with HTN were aware, treated, and controlled. Less than half of patients on treatment for HTN were controlled, revealing significant opportunity to improve HTN control in low-resource communities.

Clinical correlates of irritability, anger, hostility, and aggression in posttraumatic stress disorder.

Although irritability, anger, and aggression are diagnostic symptoms of posttraumatic stress disorder (PTSD), their clinical significance and associations with psychopathology remain unclear. In a sample of community adults with probable PTSD (n = 151), we measured irritability, physical aggression, verbal aggression, anger, and hostility with the Brief Irritability Test and the Brief Aggression Questionnaire. Participants' psychopathology, including depression, attention deficit and hyperactivity disorder (ADHD), psychotic-like experiences, insomnia, as well as suicidal behaviors were also assessed. Correlation analysis showed that irritability and anger were modestly related to all PTSD dimensions; physical aggression was related to avoidance, negative alterations in cognitions and mood (NACM), and hyperarousal; hostility was related to reexperiencing, NACM, and hyperarousal; while verbal aggression was not significantly related to any PTSD dimensions. After adjustment for trauma exposure and PTSD symptoms, irritability was associated with almost all psychopathology and suicidal behaviors, however, anger, hostility, and aggression were sparsely related to some psychopathology or suicidal behaviors. Particularly, anger was only related to ADHD and insomnia. Latent profile analysis based on PTSD, irritability, anger, hostility, and aggression indicated two discrete subgroups: the high severity group (33.8%) and the low severity group (66.2%), with high severity group reporting higher rates of comorbidity and suicidal behaviors. The findings support irritability, aggression, anger, and hostility as separate constructs; moreover, irritability, anger, and aggression should be independently measured in PTSD. Our findings also suggest the significance of irritability as a separate hallmark of PTSD and the need to incorporate PTSD dimensions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

How I think about how I feel: Personal beliefs about emotion prospectively predict suicide-related outcomes and depression symptoms

One transdiagnostic process that may be critical to depression and suicidal ideation is beliefs about the nature of one's own emotions, both concurrently and longitudinally. In a sample of community adults (n = 143), we assessed personal emotion beliefs about the degree to which one's own emotions are malleable, unique, and last a long time. There were significant associations between stronger views that one's own emotions were fixed, unique to you, and had a longer duration and higher clinical symptom severity, including higher levels of current suicidal ideation, and less adaptive emotion regulation. Mediation analyses using longitudinal data clarified that the differential engagement in emotion regulation, specifically rumination, represented the link tying specific personal emotion beliefs to clinical symptoms and that, in certain cases, the opposite pathway is also significant – differences in clinical symptoms mediated the relationship between specific personal emotion beliefs and emotion regulation (rumination) longitudinally. Additionally, personal emotion beliefs varied based on depression status, as determined using a semi-structured clinical interview. For example, individuals meeting current criteria for Major Depressive Disorder (MDD) held stronger views that their emotions were unique to them compared to individuals with remitted MDD or no history of MDD. The current study's findings highlight the important role of specific personal emotion beliefs in clinical symptoms concurrently and longitudinally and mechanisms in these relationships. These results could guide future research on interventions to promote more adaptive beliefs about emotion to improve clinical outcomes.

Applying a Bayesian Spatiotemporal Model to Examine Excess County-Level Cardiovascular Disease Death Rates During the COVID-19 Pandemic.

Amid the COVID-19 pandemic, national cardiovascular disease (CVD) death rates increased, especially among younger adults. County-level variation has not been documented. Using county-level CVD deaths (ICD-10 codes: I00-I99) from the US National Vital Statistics System, we developed a Bayesian multivariate spatiotemporal model to estimate excess CVD death rates in 2020 based on trends from 2010-2019 for adults aged 35-64 and ≥65 years. Among adults aged 35-64 years, 64.7% of counties experienced significant excess CVD death rates. The median county-level CVD death rate in 2020 was 150 per 100,000 persons, which exceeded the predicted rate for 2020 (median excess death rate: 11 per 100,000; median excess rate ratio: 1.08). Among adults aged ≥65 years, 15.2% of counties experienced significant excess CVD death rates. The median county-level CVD death rate was 1,546 per 100,000 in 2020, which exceeded the predicted rate in 2020 (median excess death rate: 48 per 100,000, median excess rate ratio: 1.03). Counties with significant excess death rates in 2020 were geographically dispersed. In 2020, disruptions of county-level CVD death rates were widespread, especially among younger adults, suggesting the continued importance of CVD prevention and treatment in younger adults in communities across the country.

The relationship between morningness-eveningness and naturalness bias

ABSTRACT The naturalness bias in which people perceive natural items to be safer, healthier, and better than synthetic alternatives has been found to be associated with numerous individual difference variables (e.g. connectedness to nature and religiosity). However, no research has examined the role of morningness-eveningness in influencing preferences for naturalness. Here, we propose that evening individuals may exhibit a weaker preference for naturalness compared to morning individuals due to their greater exposure to artificial lighting, technology, and stimuli. To systematically test our theoretical perspective, we conducted three complementary and high-powered studies. In an online survey (Study 1), student participants with a stronger evening orientation displayed a diminished preference for natural drugs compared to those with a morning orientation. Using a sample of community adults, Study 2 replicated the findings of Study 1 in a real-world, behavioral context. Study 3 examined the relationship between morningness-eveningness and preference for naturalness within the domain of beverages. The results revealed that individuals with an evening-orientation had decreased odds of selecting natural water without minerals. Taken together, the findings suggest that an individual’s diurnal preference toward eveningness may have implications for their bias toward and perception of naturalness across various domains.