Effect Of Age Research Articles

EFFECT OF SEX AND AGE ON SURVIVAL OF ADULT CULEX TARSALIS FROM A SUSCEPTIBLE LABORATORY STRAIN EXPOSED TO PERMETHRIN IN THE CDC BOTTLE BIOASSAY

ABSTRACT This study investigates the effect of mosquito sex and age on the survival and resistance determination of adult Culex tarsalis exposed to permethrin, a pyrethroid commonly used for mosquito control, using the Centers for Disease Control and Prevention (CDC) bottle bioassay method. A permethrin-susceptible strain of Cx. tarsalis (Bakersfield strain) was used in this study. Survival was compared for young adult females (2–5 days old) relative to older adult females (7–10 days old) and separately for female and male mosquitoes of the same age (2–5 days old). Mortality was slightly higher for males than females during the first observation period (0–5 min) following permethrin exposure, and higher for older females relative to younger females from 5 to 10 min following permethrin exposure, with no differences in mortality by either sex or age for observation periods during the remainder of the diagnostic period. When evaluated over the full diagnostic period, survival varied with mosquito age but not sex. However, all mosquitoes, regardless of sex or age, died within the 30-min diagnostic period for this species, confirming their permethrin susceptibility per the CDC bottle bioassay. This research contributes valuable insight into the potential impact of sex and age on mosquito susceptibility to insecticides in the context of insecticide resistance determination.

Emerging socioeconomic correlates of loneliness. Evidence from the Barcelona Health Survey 2021

Abstract Purpose Recent evidence shows that loneliness is associated with socioeconomic factors. However, studies often focus on traditional socioeconomic indicators (income, occupation, educational level) only, disregarding other important socioeconomic determinants, such as job insecurity, housing conditions or material deprivation. Therefore, we analyse the association of a broad range of socioeconomic indicators with loneliness. Moreover, we investigate potential age and gender differences in this relationship. Methods We used cross-sectional data from the Barcelona Health Survey 2021, representative of the population of Barcelona (Spain). Individuals over the age of 14 were selected (n = 3,337). The outcome was a loneliness score based on 4 items of the UCLA scale. Loneliness was regressed on a series of sociodemographic and emerging socioeconomic correlates. Linear regression models were fitted, and potential age and gender moderation effects were tested by means of two-way interactions. Results Job insecurity and precarity-related factors, such as having a temporary job or working without a contract, material deprivation and financial difficulties, as well as poor housing conditions and facing housing insecurity were associated with increased loneliness levels. While the association between loneliness and precarity-related factors is stronger among younger individuals, material deprivation is associated with increased loneliness among older workers and women. Conclusion Beyond sociodemographic individual characteristics, socioeconomic factors are strongly associated with loneliness levels in the population. Findings support the relevance of broadening the scope of socioeconomic indicators, assessing both material conditions as well as perceived insecurity.

Abstract PR004: Age-induced chronic accumulation of glucocorticoids drives therapy resistance in lung cancer

Abstract Non-small cell lung cancer (NSCLC), a highly aggressive cancer, is the leading cause of cancer- related deaths in the U.S. While chemotherapy and targeted therapy are the main treatment modalities in the clinic, many patients do not respond to these treatments. Strikingly, the median age for lung cancer diagnosis is 71. Yet, preclinical and clinical research have largely been skewed towards young mice and patients. Here, we address this gap in knowledge and evaluate if old age affects the response to standard of care NSCLC therapies in KRAS-driven NSCLC. Using human sera from young and old healthy subjects to treat NSCLC cell lines, we show that age-driven circulatory changes are sufficient to drive a state of profound resistance to both chemotherapies as well as KRASG12C targeted therapies. We confirmed the relevance of our findings in vivo, by transplanting cancer cells derived from the K-rasLSL-G12D/+; p53fl/fl genetically engineered mouse model of lung cancer into young and old C57BL/6 mice. Using this model we showed that unlike young lung tumor-bearing mice on chemotherapy, old tumor-bearing mice do not respond to treatment and have a poor prognosis. Mechanistically, we found that old age drives a transcriptional reprogramming that favors drug resistance and identified the glucocorticoid receptor as a major driver of these transcriptional changes. We traced this to an age-induced chronic accumulation of glucocorticoids in circulation and within the tumor interstitial fluid. Chronic treatment with age-relevant concentrations of cortisol alone was sufficient to drive glucocorticoid receptor activation and induce resistance to therapies mirroring the effects of old age. Further supporting a driving role for glucocorticoids in driving age- induced drug resistance, blocking the glucocorticoid receptor genetically or pharmacologically rescues the drug resistance state imposed by old age in NSCLC cells. Lastly, using TCGA patient data we show an inverse correlation between glucocorticoid receptor activation (GR score) and progression-free survival of lung cancer patients. Together, our work demonstrates a role for age-induced glucocorticoids in circulation in promoting therapy-resistance in NSCLC patients and supports the use of therapeutic agents that block the glucocorticoid receptor as a strategy to increase therapy efficacy in NSCLC patients. Citation Format: Devesh Raizada, Felicia Lazure, Stanislav Drapela, Nadir Sarigul, Joanne Tejero, Didem Ilter, Ana Da Silva Gomes. Age-induced chronic accumulation of glucocorticoids drives therapy resistance in lung cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Tumor-body Interactions: The Roles of Micro- and Macroenvironment in Cancer; 2024 Nov 17-20; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(22_Suppl):Abstract nr PR004.

A Population Pharmacokinetic Study to Evaluate Doxorubicin Exposure Across All Age Groups.

The effect of age on doxorubicin pharmacokinetics remains inconclusive, especially in patients at the extremes of the age spectrum. We developed a population pharmacokinetic model to further investigate the impact of age on the pharmacokinetics of doxorubicin. A three-compartment model, incorporating allometric scaling was developed to describe doxorubicin pharmacokinetics across all ages. First, the effect of age in young patients was investigated, by adding a maturation function on clearance (CL), the central compartment (V1) and peripheral compartments (V2 and V3). Second, the impact of ageing was investigated by adding a maximal effect (Emax) function on CL, V1, V2, and V3. To investigate the overall impact of age on doxorubicin exposure, various simulations were conducted. A total of 168 patients (age: 0.11-90 years) with 555 doxorubicin samples were included. The maturation function was relevant for V1 and V2 (13.1 and 23.7L, respectively), leading to an increase in V1 and V2 with increasing age. In contrast, adding an Emax function only impacted V3 (1063L), resulting in a decrease of V3 with age. Simulations showed no clinically relevant difference in the exposure of doxorubicin between age groups. A population pharmacokinetic model with data across the age range showed that age predominantly affected volumes of distribution of the central and peripheral compartments. These effects were not considered to be clinically relevant based on performed simulations. This supports the use of currently used doxorubicin dosages of 1 mg/kg for infants and toddlers <10 kg and body surface area-based dosing for other patients.

The Multi-State Epigenetic Pacemaker enables the identification of combinations of factors that influence DNA methylation.

Epigenetic clocks, DNA methylation-based predictive models of chronological age, are often utilized to study aging associated biology. Despite their widespread use, these methods do not account for other factors that also contribute to the variability of DNA methylation data. For example, many CpG sites show strong sex-specific or cell-type-specific patterns that likely impact the predictions of epigenetic age. To overcome these limitations, we developed a multidimensional extension of the Epigenetic Pacemaker, the Multi-state Epigenetic Pacemaker (MSEPM). We show that the MSEPM is capable of accurately modeling multiple methylation-associated factors simultaneously, while also providing site-specific models that describe the per site relationship between methylation and these factors. We utilized the MSEPM with a large aggregate cohort of blood methylation data to construct models of the effects of age-, sex-, and cell-type heterogeneity on DNA methylation. We found that these models capture a large faction of the variability at thousands of DNA methylation sites. Moreover, this approach allows us to identify sites that are primarily affected by aging and no other factors. An analysis of these sites reveals that those that lose methylation over time are enriched for CTCF transcription factor chip peaks, while those that gain methylation over time are associated with bivalent promoters of genes that are not expressed in blood. These observations suggest mechanisms that underlie age-associated methylation changes and suggest that age-associated increases in methylation may not have strong functional consequences on cell states. In conclusion, the MSEPM is capable of accurately modeling multiple methylation-associated factors, and the models produced can illuminate site-specific combinations of factors that affect methylation dynamics.

Age of onset moderates the effects of Vascular Risk Factors on Neurodegeneration, Blood-Brain-Barrier permeability, and cognitive decline in Alzheimer's Disease.

The role of Vascular risk factors (VRFs) in the progression of Alzheimer's Disease (AD) and cognitive decline remains to be elucidated, with previous studies resulting in conflicting findings. The possible impact of age-specific mechanisms of resilience/vulnerability is an under addressed issue. We evaluated the association of VRFs with markers of amyloid deposition, neurodegeneration, and blood-brain-barrier (BBB) permeability (Albumin quotient, Qalb), stratifying patients into early-onset (< 65, EOAD), classic late-onset (65-75, cLOAD) and very late-onset (> 75, vLOAD), to evaluate the moderating effect of age of onset. Moreover, we explored the effects of VRFs on cognitive decline at one year follow-up (ΔMMSE). For 368 patients with biologically confirmed AD, we computed eight risk factors in a composite measure of cumulative vascular risk (vascular score, VS). Stratifying patients according to age of onset, we regressed VS and main individual VRFs on p-tau/Aβ42, t-tau and Qalb, and used bootstrapped mediation analysis to test direct and indirect associations of VS with t-tau, using Qalb as mediator. In a subset of 105 patients, we performed multivariate backward regressions to assess the effects of sex, APOE, Qalb, VS, p-tau/Aβ42 and t-tau on ΔMMSE. VS was positively associated with CSF t-tau in more vulnerable groups burdened by more aggressive disease progression (EOAD: β = 0.256, p = 0.019) or aging (vLOAD: β = 0.007, p < 0.001). Conversely, in patients with classic age of onset VS was associated with higher BBB permeability (cLOAD: β = 0.173, p = 0.015), which simultaneously causes the decrease of CSF t-tau, as a possible resilience response. Cognitive decline was not associated with VS in any of the subgroups. Instead, it was affected by both higher CSF t-tau and increased Qalb values in those with very early or very late onset (EOAD and vLOAD), but by Qalb alone in patients with classic age of onset, where CSF t-tau levels might be buffered by BBB permeability. Our results show that age of onset weighs on the heterogeneous effects played by VRFs in AD, which do not seem to have direct impact on cognitive decline. These findings stress the importance of a tailored patient-centered approach to the application of vascular prevention strategies in AD.

Tissue-Specific Effects of Aging on Repeat-Mediated Mutation Hotspots In Vivo

Aging constitutes complex and dynamic alterations in molecular and physiological processes and is associated with numerous disorders, in part due to increased genetic instability. The aging population is projected to double by 2050, underscoring the urgent need to better understand the relationships between aging and age-related disorders. Repetitive DNA elements are intrinsic sources of genetic instability and have been found to co-localize with mutation hotspots in human cancer genomes. In this study, we explored the relationship between aging and DNA repeat-mediated genetic instability in vivo using an H-DNA-forming mirror-repeat sequence from the cancer-associated human c-MYC gene. Utilizing a unique mutation-reporter mouse model, we observed tissue-specific effects of aging on H-DNA-induced genetic instability, with mutation frequencies increasing in spleen tissues and remaining unchanged in testis tissues. Analysis of the mutation spectra revealed large deletion mutations as the primary contributor to increasing H-DNA-induced mutations, supported by increased cleavage activity of H-DNA structures in aged spleen tissues. Our findings demonstrate that aging has distinct tissue-specific effects on repeat-mediated, cancer-associated mutations, providing insights into the complex relationship between aging and cancer.

Modeling Acoustic Attenuation, Sound Velocity and Wave Propagation in Lithium‐Ion Batteries via a Transfer Matrix

AbstractA simple 1D transfer matrix model of a battery is introduced and parametrized using harvested individual cell components at 0 % and 100 % SoC. This model allows for the calculation of group velocity and attenuation. The results of the model show good agreement with measured values, highlighting increased attenuation and group velocity at the resonances. This emphasizes the importance of selecting a suitable interrogation frequency for ultrasound investigations in lithium‐ion batteries. The model accurately replicates the observed weakening of resonances with increasing SoC. Additionally, it provides the basis to fit US spectroscopy data in the future, enabling immediate determination of component thickness and the Young's modulus of individual components, along with aiding in the identification aging effects of the anode and cathode materials. The model can visualize wave propagation within the battery. At certain frequencies, standing waves form which could be used in high‐intensity ultrasound applications targeted at individual cell components.

Predicting THE Determinants of Mobile TV Adoption in an Emerging Market: Moderating Effect of Gender and Age

This article focuses on the impact of consumer-centric factors on the adoption of mobile TV in an emerging market, considering the widespread use of mobile technologies worldwide. It aims to explore the motivations behind users’ utilization of mobile TV and over-the-top platforms in the era of digitalization. The study identifies eight independent factors affecting mobile TV adoption intention, grouped using a three-dimensional THE (technology, human, and environment) framework. Data was collected from 324 smartphone users to test the hypothesized relationships using covariance based structural equation modeling (CB-SEM) analysis. Further, moderating effect of gender and age was studied on the proposed relationships. The findings revealed that factors such as cost, content, perceived enjoyment, individual viewing experience, social influence, and convenience play a significant role in the successful adoption of mobile TV. On the other hand, app switching and technology readiness were found to be statistically insignificant. The results offer valuable insights to industry players regarding consumers’ adoption behaviour of mobile TV, helping them minimize business risks and focus their efforts, resources, and investments on profitable innovations. The study is first of its kind in India and adds two relatively new factors, that is individual viewing experience and app-switching, to the existing literature on technology adoption theories.

Predictive factors of extremity graft occlusion after endovascular repair of abdominal aortic aneurysm: A 13-year single center experience

Aim: Graft leg thrombosis (GLT) after Endovascular Aortic Repair (EVAR) is an important problem affecting morbidity/mortality. In addition to anatomical factors such as aortic neck angle and diameter in graft leg thrombosis; we aimed to convey the roles of graft extension to the external iliac artery and the effect of graft type selection on the results. Material and Methods: Analysis of 512 patients who underwent EVAR between 2010 and 2023 was performed. The effects of anatomical factors, graft material, underlying diseases, age and gender on the development of graft leg thrombosis were evaluated. Anatomical measurements were evaluated in terms of their predictive power for graft leg thrombosis by Receiver Operating Characteristic (ROC) analysis. Results: The prevalence of graft leg occlusion was significantly associated with some anatomical factors, especially increased aortic neck angle (OR=1.07, p&lt;0.001) and descent to the external iliac artery (OR=13.43, p&lt;0.001). Poliytetrafluoroethylene (PTFE) grafts were associated with a reduced risk of graft leg occlusion (OR=0.26, p=0.002). ROC analysis showed that aortic neck angle had the highest predictive accuracy for GLT (AUC=0.817, p&lt;0.001). There were no significant differences in age, gender, smoking status, diabetes, and hypertension as comorbidities. Peripheral artery disease was shown to increase the risk. Conclusion: Our findings highlight the role of aortic anatomy and graft material selection in the risk of graft leg thrombosis. The use of PTFE grafts appears to be protective against graft leg thrombosis. This information highlights the importance of personalized surgical planning and postoperative management to optimize patient outcomes. Future research should focus on developing models that include these factors.

The influence of relative pubertal maturity on executive function development in adolescent girls.

A positive association between pubertal maturity as assessed by skeletal development, and specific cognitive abilities has recently been demonstrated in a cohort of adolescent girls. The current study explores the impact of chronological age and relative pubertal maturity on executive function within the same cohort. Relative maturity, determined by the difference between chronological age and skeletal age, establishes the criteria for enrolling participants into average, advanced, or delayed relative maturity subgroups. Performance is assessed using the Numerical Stroop test and analyzed across four conditions, each with varying task requirements related to inhibition and task switching. The effects of chronological age and relative maturity on executive functions are tested by a linear mixed model. Within the examined age-range (12-15 y), a more protracted development was found for inhibition as compared to switching. In line with the previous findings, the results reveal significant development in executive performance as a function of chronological age, and relative maturity also demonstrated significant effect on the development of executing functioning. The significant interaction effect between Chronological Age and Relative Maturity suggests that the degree of interplay between these factors varies across the examined age range. Specifically, relative maturity may have a more noticeable impact on EF functioning in middle adolescence compared to early adolescence.

The advantage of matcha green tea over other drinks: A comprehensive review

Matcha green tea is a finely ground powder made from specially cultivated and processed leaves of Camellia sinensis. Key components of matcha include catechins, caffeine, theanine, fat-soluble vitamins, insoluble dietary fibers, chlorophylls, and proteins. Studies indicate that matcha green tea may offer various health benefits, such as reducing the effects of aging, alleviating stress, and mitigating cognitive impairment. Furthermore, regular consumption of matcha tea supports gut microbiome health, enhances immune function, and reduces the risk of inflammation as well as certain types of cancer. This review strengthens the connection between regular intake of matcha green tea and overall well-being.

Executive functioning is associated to everyday interference of pain in patients with chronic pain.

Dysfunction in executive functions is common among patients with chronic pain. However, the relationships between executive functioning and pain management have not been extensively studied. In this study, 189 outpatients (160 women, 29 men; mean age 33.15) with chronic pain underwent an extensive neuropsychological assessment, including several tests of executive functions. In addition, all participants completed self-assessment questionnaires regarding pain and interference of pain in everyday life. After adjusting for effects of age, education, and depression, several aspects of executive functioning were significantly associated with self-assessed everyday interference of pain (rs = 0.13-0.22, all ps < 0.05). This indicates that lower performance on tests of executive functioning was significantly associated with a higher degree of pain interference and a lower degree of life control. Pain characteristics such as pain intensity, pain duration, and pain spreading were not associated with executive functioning. These results suggest that preserved executive functions are related to better coping with pain, but not directly to the pain itself, in patients with chronic pain. Depression was also associated with self-management of pain, indicating that patients with lower executive functioning in combination with depression may need special attention during rehabilitation.

Effects of age on accuracy of advanced imaging modalities in identifying intervertebral disc extrusions in Dachshunds.

The aim of this study was to ascertain whether patient age was a significant factor for the accurate identification of compressive intervertebral disc extrusions (IVDE) in Dachshunds using non-contrast computed tomography (CT). This retrospective analysis encompassed 150 Dachshunds evaluated for suspected IVDE at a referral hospital in south-eastern Queensland, Australia. Each case underwent diagnostic evaluation by CT, either with or without myelography, or magnetic resonance imaging (MRI), followed by surgical intervention for an intervertebral disc extrusion. In the <9-year dog cohort, 94.7% (71/75) were diagnosed with IVDE via non-contrast CT and proceeded to surgery. In contrast, the ≥9-year dog cohort, only 56% (42/75) were diagnosed via non-contrast CT, with the remaining 44% (33/75) necessitating CT myelography or MRI for diagnosis. The odds of requiring CT myelography or MRI increased 13.95-fold (95% CI, 4.62-42.13) in Dachshunds aged 9 years or older. Furthermore, each additional year of age was associated with a 0.60 increase in the odds of undergoing these advanced imaging modalities (CT myelography or MRI) (95% CI, 0.49-0.74). Age significantly affected the efficacy of non-contrast CT in diagnosing IVDE in Dachshunds. Dogs aged 9 years and above were substantially more likely to require CT myelography or MRI due to the reduced visibility of disc extrusions on non-contrast CT. Veterinarians performing advanced imaging on older Dachshunds for suspected IVDE should be aware of the limitations of non-contrast CT in obtaining an accurate diagnosis and localisation of IVDE, and be prepared to perform either CT myelography or MRI if required.

Pharmacokinetics of Antiretroviral Drugs in Older People Living with HIV, Part II: Drugs Licensed Before 2005.

Advances in antiretroviral therapy led to an increase in life expectancy among people living with human immunodeficiency virus (HIV). As aging is characterized by several physiological changes that can influence pharmacokinetics (PK), this systematic review aims to describe the impact of aging on the PK of antiretrovirals (ARV) approved by the Food and Drug Administration (FDA) before 2005. Searches were performed in BVS, EMBASE, and PubMed databases for publications until June 2024. Peer-reviewed published studies were included if they met the following criteria: adults (≥ 18 years) living with HIV; reporting at least one PK parameter or plasma concentration of any ARV approved by the US FDA before 2005 and still used in the clinic: lamivudine (3TC), emtricitabine (FTC), tenofovir disoproxil fumarate (TDF), abacavir (ABC), zidovudine (ZDV), efavirenz (EFV), nevirapine (NVP), atazanavir (ATV), lopinavir (LPV), ritonavir (RTV), tipranavir (TPV), and fosamprenavir (FPV); PK parameters stratified per age group as young (aged 18-49 years) or older (age ≥ 50 years) adults; and manuscripts published in English, Portuguese, or Spanish. All studies were evaluated for risk of bias. The review protocol was registered in the PROSPERO database (registration no. CRD42023463092). Among 106 studies included, only 22 evaluated the PK of participants aged 50 years or older and only 5 studies compared the PK between young and older adults for ATV, RTV, EFV, and 3TC. Our analysis revealed an increase in minimal concentration (Cmin) values for LPV, RTV, and ATV in older adults. While increased values of the area under the curve (AUC) and maximum concentration (Cmax) were observed in older adults using ATV, 3TC, and FTC, no differences in PK were apparent between young and older adults for ABC and EFV, with no estimation possible for ZDV. Exposure to 3TC, TDF, FTC, ATV, LPV, and RTV increases with age, while exposure to ABC and EFV appears to be unaffected. Despite the large quantity of data on PK in young adults, there is still a gap in knowledge about the effects of aging on the PK of these ARVs.

Combined Effect of Ambient Temperature and Relative Humidity on Skin Aging Phenotypes in the Era of Climate Change: Results From an Indian Cohort Study.

Background: There is no doubt that global warming, with its extreme heat events, is having an increasing impact on human health. Heat is not independent of ambient temperature but acts synergistically with relative humidity (RH) to increase the risk of several diseases, such as cardiovascular and pulmonary diseases. Although the skin is the organ in direct contact with the environment, it is currently unknown whether skin health is similarly affected. Objective: While mechanistic studies have demonstrated the mechanism of thermal aging, this is the first epidemiological study to investigate the effect of long-term exposure to heat index (HI) as a combined function of elevated ambient temperature and RH on skin aging phenotypes in Indian women. Methods: The skin aging phenotypes of 1510 Indian women were assessed using the Score of Intrinsic and Extrinsic Skin Aging (SCINEXA™) scoring tool. We used data on ambient temperature and RH, combined into an HI with solar ultraviolet radiation (UVR), and air pollution (particulate matter <2.5 µm [PM2.5]; nitrogen dioxide [NO2]) from secondary data sources with a 5-year mean residential exposure window. An adjusted ordinal multivariate logistic regression model was used to assess the effects of HI on skin aging phenotypes. Results: HI increased pigmentation such as hyperpigmented macula on the forehead (odds ratios [OR]: 1.31, 95% confidence interval [CI]: 1.12, 1.54) and coarse wrinkles such as crow's feet (OR: 1.17, 95% CI: 1.05, 1.30) and under-eye wrinkles (OR: 1.3, 95% CI: 1.15, 1.47). These associations were robust to the confounding effects of solar UVR and age. Prolonged exposure to extreme heat, as indicated by high HI, contributes to skin aging phenotypes. Conclusion: Thus, ambient temperature and RH are important factors in assessing the skin aging exposome.

Understanding Parenting Stress in Adoptive Parents: A Longitudinal Multilevel Study of Parents' Self-Criticism, Child Negative Emotionality, and Child Age at Placement.

Research on parenting stress in adoptive parents during the early years post-placement reveals significant variability, yet few studies examine both parent- and child-related factors. This study investigates the role of the personality dimension of self-criticism and perceived negative child emotionality in relation to parenting stress during the first four years after transnational adoption. Additionally, it explores the moderating effect of child age at placement, a key factor associated with early adversity. Drawing upon a longitudinal five-wave dataset in the first 4 years after the child arrived in the adoptive family, this study used multi-informant data of 96 adoptive mothers and fathers of transnationally adopted children (mean child age at placement = 13.48 months). Data were analyzed using a multilevel structural equation modeling approach. Parents' self-criticism was positively associated with parenting stress at the between-parent level. At the within-parent level, year-to-year fluctuations in both parents' self-criticism and perceived child's negative emotionality were positively associated with corresponding fluctuations in parenting stress. Child age at placement did not moderate any of these associations. Overall, this study yielded convincing evidence for the dynamic nature of parenting stress in the first years after child placement, the role of parental self-criticism, and the child's perceived negative emotionality herein.

Racial and Ethnic Disparities in Perceived Health Status Among Patients With Cardiovascular Disease.

Understanding health outcomes among people with cardiovascular disease (CVD) is crucial for improving treatment strategies and patient quality of life. This study investigated racial and ethnic disparities in perceived health status among non-Hispanic Black, Hispanic, and non-Hispanic White adults with CVD. The study had a retrospective cross-sectional design and used data from the Medical Expenditure Panel Survey spanning 8 calendar years (2014-2021). The study population consisted of adults diagnosed with various CVDs. We used ordinal logistic regression models adjusted for demographic and socioeconomic characteristics, CVD severity, comorbidities, and health care expenditures to assess racial and ethnic differences in perceived health status. Among the 11,715 (weighted frequency, 15,431,283) adults with CVD, we observed significant differences in perceived health status across racial and ethnic cohorts. The unadjusted analysis showed that non-Hispanic Black adults had significantly higher odds than non-Hispanic White adults of perceiving their health as poorer (odds ratio [OR]= 1.89; 95% CI, 1.74-2.07; P < .001), with a similar observation among Hispanic adults (OR = 2.05; 95% CI, 1.85-2.26; P < .001). Although female sex, higher education, and better income had protective effects on perceived health status independent of race, we found significant racial and ethnic differences in the effect of older age, physical and cognitive limitations, and health insurance status on perceived health status. This study revealed substantial racial disparities in perceived health status among adults with CVD, with notable differences in the effects of predictive factors. Addressing these disparities requires targeted interventions to improve health care access and enhance socioeconomic conditions tailored to the needs and experiences of racial and ethnic populations.

Exploring the attitudes and experiences of Hungarian primary care physicians on the utilisation of digital health solutions.

During the COVID-19 pandemic, digital health solutions ensured the continuity of care especially in primary healthcare practices. COVID-19 accelerated the adoption of digital health solutions. The aim of this study is to describe the digital health-related attitudes and experiences of Hungarian Primary Care Physicians (PCPs) and also analyse the socio-demographic effects on digital health attitudes among PCPs. This study used a quantitative and qualitative mixed methodological approach to examine the digital health-related attitudes and experience of Hungarian PCPs. As part of the "E-physicians and E-patients in Hungary" survey, we conducted an online survey among medical doctors working in Hungary between July 2021 to May 2022. A total of 1,774 questionnaires were received, consisting of 1,576 medical doctors and 198 dentists. Among the medical doctors there were 415 primary care physicians (PCPs). In addition to the online questionnaire survey, qualitative research in the form of semi-structured interviews with doctors was also conducted. These interviews took place between October 2021 and June 2022. A total of 62 interviews were conducted,19 with PCPs. Primary care physicians are more open to technologies that facilitate communication and collaboration with patients, while showing less interest in technologies that support clinical work. Of the demographic variables (age, gender, type of settlement), age was found to have the most significant effect on digital health knowledge, use and intended use. Both the interviews and the multivariate analysis indicate that individuals with greater knowledge, expertise, and experience are more likely to perceive the advantages of digital solutions. This highlights the importance of training, especially given the significant aging population among Hungarian primary care physicians, who may not be accustomed to using these tools naturally. The way PCPs perceive patient expectations regarding the use of digital health tools has a significant impact on the PCPs' use and intended use of digital tools. When looking at perceived patient needs among PCPs the effect of age and municipality type of PCPs is significant. As age increases, the perception of patient needs decreases (from 5.02 to 4.47), and by municipality type, the average number of perceived needs decreases as one moves from larger cities to smaller municipalities (from 4.85 to 4.14). Digital health solutions have the potential to enhance the work of PCPs, but successful implementation requires addressing specific needs, demographic differences, and challenges faced by PCPs. Development of infrastructure, education, and institutional support is necessary to ensure more efficient and higher-quality healthcare delivery through the use of digital technologies.

Temporal dynamics of unmet long-term care needs in China: an age period cohort analysis

Abstract Rapid demographic changes and heavy reliance on informal care pose significant challenges to meeting long-term care (LTC) needs in China. Understanding changes in unmet LTC needs across different times and places can inform future LTC system planning and care resource allocation, identifying emerging care needs and services gaps in different regions. Drawing on data from 6,030 urban and 5,070 rural residents in the Chinese Longitudinal Health Longevity Survey 2005–2017/18, this study investigates variations in unmet LTC needs across different age groups, periods and birth cohorts among Chinese older adults and their place-based rural–urban differences. We applied the age-period-cohort interaction model to disentangle the three temporal processes, and found that, overall, rural older adults experienced higher risk of unmet LTC needs and had larger variation in age effects, yet the age, period and cohort effects on unmet needs among rural older people differed from their urban counterparts. Although ‘younger’ older adults (aged below 85) had fewer care needs than older adults, they had a higher risk of experiencing unmet needs. The risk of having unmet needs did not change significantly over the 12 years, though unmet LTC needs were more pronounced among more-recent cohorts than previous generations, especially in urban areas. The findings contribute to the social gerontology debate regarding changing patterns in unmet LTC needs, and provide crucial policy insights, underscoring the necessity of targeted interventions to address ‘younger’ older adults’ care needs and increased investmed in the formal LTC system to tackle the escalating care gap.