European Adults Research Articles

Accelerometer-Derived Sleep Metrics in Adolescents Reveal Shared Genetic Influences with Obesity and Stress in a Brazilian Birth Cohort Study

Abstract We aimed to test the association between sleep-related polygenic scores (PGSs) and accelerometer-based sleep metrics among Brazilian adolescents, and to evaluate potential mechanisms underlying the association through the enrichment of obesity, and cortisol pathway-specific polygenic scores (PRSet). Utilizing data from The 2004 Pelotas (Brazil) Birth Cohort, sleep time window and sleep efficiency were measured at the 11-year-old follow-up using ActiGraph accelerometers. Three sleep-PGSs were developed based on the most recent genome-wide association study (GWAS) of accelerometer-based sleep measures. PRSet, calculated using variants linked to body mass index (BMI) and plasmatic cortisol concentration, aimed to assess pleiotropic effects. Linear regression models, adjusted for sex and the first 10 principal components of ancestry, were employed to explore the impact of sleep-PGS and specific-PRSet on sleep phenotypes. The number of nocturnal sleep episodes-PGS was positively associated with sleep time window (β =2.306, SE: 0.92, p=0.011). Nocturnal sleep episodes were also associated with sleep time window when restricted to BMI-PRSet (β=2.682, SE: 0.912, competitive-p=0.003). Both number of sleep episodes and sleep time window cortisol-PRSets were associated (β=0.002, SE: 0.001, p=0.013; β=0.003, SE: 0.001, p=0.003, respectively) and exhibited enrichment in molecular pathways (competitive-p=0.011; competitive-p=0.003, respectively) with sleep efficiency. Sleep polygenetic components observed in European adults may partially explain accelerometer-based sleep time window in Brazilian adolescents. Specific BMI molecular pathway strengthened the association between sleep-PGS and sleep time window, while cortisol concentration pathway had a significant impact on the genetic liability for sleep efficiency. Our results suggest genetic overlap as a potential etiological pathway for sleep-related comorbidities, emphasizing common genetic mechanisms.

Adult Immunization Board: A platform to provide guidelines for implementation of adult immunization

Abstract Background Several organizations, including governments, (inter)national public health organizations and vaccine manufactures are currently considering how adult immunization can be further improved to increase health impact and promote a lifelong approach to vaccination. Despite many organizations thinking about ways to improve adult immunization, there is currently no multidisciplinary discussion platform focusing on this topic at the European level. Therefore, a group of experts in the field of adult immunization established the Adult Immunization Board (AIB). Methods AIB is established with the aim of contributing to the reduction of the impact of vaccine-preventable infections and diseases in European adults. AIB works by organizing 2 meetings per year: 1) a technical meeting to discuss specific technical aspects on adult immunization with subject-matter experts, and 2) a country meeting to discuss country specific aspects of adult immunization together with local experts. Results In April 2023 and 2024 the AIB organized its first technical meetings on “Assessing the health burden of vaccine-preventable infections in European Adults (2023)” and “Strategies for introducing and implementing vaccines for adults into National Immunization Programs in Europe (2024)”. In December 2023, the AIB organized its first country meeting in Italy with local experts to learn out best practices in adult immunization and address aspects to improve. Conclusions AIB is a platform that brings together the different key European stakeholders in adult immunization to effectively contribute towards the implementation and optimization of adult immunization programs in Europe. Key messages • Continued efforts to promote research, implementation, awareness, accessibility, and vaccine uptake are crucial to mitigate the burden of (future) infectious diseases in the adult population. • The AIB represents a significant step towards bolstering adult immunization efforts in the EU.

Factors that influence the need for mental health services for older adults in Europe

Abstract Background Mental health is an integral component of health, and affects close to a 100 million Europeans. Little is known about the predictors of older adult’s mental health demand among health systems in European countries. This study is based on the Andersen’s Behavior Model, that predicts that predisposing characteristics, enabling factors, and behavioral factors, influence need or demand factors of healthcare services. Aim This study has two overall objectives: (i) to investigate the determinants of older adults’ mental health services demand; and (ii) examine the relationship between predisposing characteristics, and enabling resources, with services demand. Methods Data from Wave 9, of the of the cross-national panel dataset of the Survey of Health, Ageing and Retirement in Europe (SHARE) were examined using a sample of 47, 345 older adults. Analysis: The Omnibus test was used to evaluate the fit model and Multinomial Logistics Regression were performed to test the null hypothesis that predisposing characteristics, enabling resources, and behavioral factors are not predictors of need or demand. Findings Predisposing characteristics such as gender (b=-.43, s.e.=.017, p<.001) and age (b=-1.96, s.e.=2.2, p<.001), and enabling factors such as homecare (b = 2.40, s.e.=0.1, p<.001), social support (b=-.26, s.e.=0.012, p<.001), financial support receiving (b=.51, s.e.=.086, p<.001), income (b=.09, s.e.=.009, p<.001), and behavioral factors such as use of technology are predictors of mental health services need or demand [Chi-Square= 3319.58, df = 15 and p <.001]. Implications for Policy and Practice Initiatives for the care of older adults should not only aim to increase access to care services for sub populations such as older adults with mental health but also consider enabling resources such as financial and social support and behavioral factors such as use of technology. Key messages • Demand for mental health services for older adults are influenced by predisposing, enabling and behavioral factors. • Investing in financial services, social support and technology may reduce the demand for mental health services among older adults.

The effects of hypothetical psychological interventions on alcohol use in European young adults

Abstract Background Low psychosocial well-being (PWB) and high emotion-driven impulsiveness (EDI) are associated with alcohol. Yet, it is unclear whether a hypothetical intervention targeting one or the other in adolescence might be more effective in reducing alcohol consumption (AC) in young adulthood. Therefore, we aimed to compare the separate causal effects of PWB and EDI in adolescence on AC in young adulthood. Methods We included 505 European young adults from the IDEFICS/I.Family cohort (mean age: 20.2 years; age range: 18.2-23.5 years) who did not drink alcohol at study entry. AC was operationalized as the amount of weekly consumed alcoholic beverages (mean: 4.2 drinks per week; range: 0.3-70 drinks per week). EDI was assessed using the negative urgency subscale from the UPPS-P Impulsive Behaviour Scale. PWB was assessed using the KINDLR Health-Related Quality of Life Questionnaire. Following the principles of target trial emulation, we estimated, separately, the average causal effects of PWB and EDI on AC accounting for relevant confounders and applying a semi-parametric doubly robust method (targeted maximum likelihood estimation). We stratified the results by sex and parental education. Results If all adolescents, hypothetically, had high levels of PWB, compared to low levels, we estimated a decrease in the average amount of alcoholic beverages in young adulthood by 0.1 drinks per week [95%-confidence interval: -2.3; 2.1]. Furthermore, if all adolescents had low levels of EDI, compared to high levels, we estimated an increase in alcoholic beverages in young adulthood by 1.5 drinks per week [0.1; 2.9]. Different effects for sex and parental education groups were found. Conclusions Hypothetical interventions targeting PWB in adolescents were not found to have effects on reducing AC in young adulthood. Interventions targeting EDI, however, would lead to an increase in AC. This may be due to unmeasured confounding and the missing distinction between drinking motives. Key messages • We demonstrate that causal inference methods, compared to traditional ones, improve the robustness of estimated effect measures and address important sources of bias in European cohort data. • To inform public health interventions on reducing alcohol consumption, future research should investigate different drinking motives, e.g. alleviating negative emotions or enhancing positive emotions.

Monitoring of the Analytical Performance of Four Different Blood Glucose Monitoring Systems: A Post-market Performance Follow-Up Study.

A sizeable minority of commercially available blood glucose monitoring (BGM) systems fail to satisfy regulatory accuracy requirements, such as ISO 15197:2013, after approval. This study assessed whether the BGMs tested could consistently meet these ISO requirements by investigating their accuracy in a non-standardized setting. In this 18-month post-market performance study, using the ISO criteria, healthcare professionals tested the accuracy of four CE-marked BGM systems (Roche Diabetes Care, Mannheim, Germany) on European adults with diabetes mellitus. ISOcriteria included 95% of blood glucose (BG) values being within ± 15mg/dl of a reference measurement for BG < 100mg/dl or ± 15% for BG ≥ 100mg/dl and, in the Parkes Consensus Error grid for type 1 diabetes comparing capillary BGM measurements versus reference method, 99% of BG values falling within zone A (no effect on clinical action or outcome) and zone B (altered clinical action with little or no effect on clinical outcome). BGM readings were obtained from 1650 participants, and the number of readings per BGM system was between 1712 and 2376. The percentage of BGM readings that fell within ISO 15197:2013 limits ranged from 99.4 to 99.9%. For all meter types, 100% of data points fell within zone A or zone B, and most data points for each meter (≥ 99.9%) were in zone A. All four CE-marked BGM models showed results within the accuracy limits defined by ISO 15197 in a non-standardized setting and thus consistently met regulatory accuracy requirements.

Increased feelings of nervousness among older Europeans post-pandemic

Abstract Background Feelings of nervousness are typically associated with situational factors and are temporary, less intense, and manageable with self-care. Study Aim This study examines which situational conditions are significant for feeling nervous among European older adults during the second wave of COVID-19. Methods Using data from Wave 9, COVID-19 Survey 2 (Summer, 2021) of the cross-national panel dataset the Survey of Health, Aging, and Retirement in Europe (SHARE), this study utilizes a sample of 49,253 adults over 50 years old from 27 countries in Europe. Analysis: Binary logistic regression indicates all variables are significant predictors of feeling nervous: Gender [Wald= 498.7, p = 0.001 (&amp;lt;0.05)]; chronic disease [Wald= 1635.002 p = 0.001 (&amp;lt;0.05)], employment [Wald= 164.544, p = 0.001 (&amp;lt;0.05)]; home care [Wald= 138.4, p = 0.001 (&amp;lt;0.05)], technology [Wald= 20.66, p = 0.001 (&amp;lt;0.05)]; social support [Wald= 106.66, p = 0.001 (&amp;lt;0.05)], and financial support [Wald=35.5, p = 0.001 (&amp;lt;0.05)] [Chi-Square=3216.401, df = 6 and p = 0.001 (p &amp;lt; 0.05)]. Findings The odds ratio (OR) for gender is .627 (95% CI .601- .653), for chronic disease, is 2.659 (95% CI: 1.716 - 4.119) and employment is .675 (95% CI: .635-.717) and homecare is (OR)3.47(95% CI: 2.83-4.28); OR for social support is 855(95% CI:.830-.881), financial support 1.779 (95% CI: 1.47-2.15), and technology (OR).956 (95% CI: 938-.975). The model correctly predicted 94% of cases without feeling nervous and 16% of cases where people did feel nervous, giving an overall percentage correct prediction rate of 68%. Implications for Policy and Practice: Knowledge from this study can inform the introduction of public health interventions for older adults targeted toward specific situational circumstances that reduce nervousness. Key messages • While feelings of nervousness can be situational, the impact on mental health can go beyond the contextual environment. • Public health policies can support targeted interventions aimed at developing the coping skills necessary to better respond in times of crisis.

Intergenerational cohabitation and welfare attitudes among European young adults

This article explores the relationship between intergenerational cohabitation and welfare attitudes focusing on the perspective of cohabiting adult children in Europe. Cohabitation constitutes a common support arrangement for young adults who face labour market risk, reducing their need for state-based welfare, but might also lead to feelings of frustration when the dependency clashes with social norms, increasing the incentives to demand policies that enable emancipation. Using data from the 8th wave of the European Social Survey, I fit ordered logistic models for a sample of 6895 young adults in 16 European countries, focusing on attitudes towards unemployment benefits and basic income. Results indicate that the link between labour market risk and attitudes is weaker when young adults live with their parents. Moreover, living with parents is associated with higher demand for basic income schemes, but this effect is weaker in countries where cohabitation constitutes a common support arrangement. These findings highlight the relevance of considering the household context when studying the link between labour market risk and welfare attitudes, and suggest that norms regarding the division of responsibilities between families and the state might hold back demand for state-based welfare in familialistic countries.

Serum and mucosal antibody-mediated protection and identification of asymptomatic respiratory syncytial virus infection in community-dwelling older adults in Europe

Serum and mucosal antibody-mediated protection and identification of asymptomatic respiratory syncytial virus infection in community-dwelling older adults in Europe

Experiencing Cerebrovascular Diseases like Stroke and Fear of Falling: Longitudinal Results from the Survey of Health, Ageing and Retirement in Europe.

Objective: The aim of this study was to clarify the link between experiencing cerebrovascular diseases (strokes as an explicit example) and fear of falling (FOF) among middle-aged and older adults in Europe. Methods: Longitudinal data were used from wave 5 to wave 7 of the representative Survey of Health, Ageing and Retirement in Europe (SHARE). Self-reported tools were used to quantify the key variables. Fear of falling was similarly assessed using a dichotomous yes or no question, "For the past six months at least, have you been bothered by any of the health conditions on this card", with fear of falling being one of the options. It was adjusted for various sociodemographic and health-related factors. In particular, to account for unobserved heterogeneity, conditional fixed effect regressions (FE) were used. Accordingly, change in an individual's FOF status over the included waves was analysed and correlated with the reported change of all the included time-varying independent variables within the same individual, including experiencing stroke or other cerebrovascular diseases. The final analytical sample equalled n = 22.071 observations. Results: Conditional logistic FE regressions showed that the onset of a stroke or other forms of cerebrovascular disease was not associated with an increased likelihood of experiencing fear of falling (OR = 1.25, p = 0.095). However, stratified by sex, such an association was present in men (OR = 1.79, p = 0.006), though not in women (OR = 0.94, p = 0.732). Conclusions: The onset of a stroke or other cerebrovascular diseases was associated with an increased likelihood of experiencing FOF in men but not women. Efforts are required to assist older men in avoiding FOF after the onset of stroke or other cerebrovascular pathologies.

Physical Inactivity Levels Among European Adults Enrolled And Non-enrolled In Fitness And Sports Centers

Physical Inactivity Levels Among European Adults Enrolled And Non-enrolled In Fitness And Sports Centers

Frailty and Health-Related Quality of Life Among European Older Adults: The Moderating Effect of Human Development Index

ABSTRACT The Human Development Index (HDI) is a proxy for the social and economic level of countries, which is related to the health and well-being of older adults. This study aimed to examine the moderating effect of the HDI on the relationship between frailty and health-related quality of life among European older adults. Participants were 23,972 older adults (53.2% female, M = 74.2 years old, SD = 6.75 years old) from 24 European countries, joining wave 8 (2020) of the Survey of Health, Aging, and Retirement in Europe (SHARE). Multilevel modeling was used to analyze nested data. Significant differences in health-related quality of life among the several European Union countries were observed (intraclass correlation coefficient [ICC] = 0.18, LRT (1) = 5568.07, p < .001). The HDI has been shown to moderate the relationship between frailty and health-related quality of life among older adults, buffering the impact of frailty on the health-related quality of life. Since healthy aging is a priority for the European Union, policies mitigating the impact of HDI on the relationship between frailty and health-related quality of life should be implemented.

47 Physical activity, sedentary behavior, and sleep across lifespan in adults across European countries: Background and Design

Abstract Introduction Regular physical activity (PA) has benefits for health throughout the lifespan. In adults, PA benefits musculoskeletal, cardiometabolic health, and overall well-being (Dale et al., 2019). To promote health and well-being, the World Health Organization (WHO) recommends at least 150 minutes of moderate to vigorous (MV)PA or 75 min of vigorous-intensity PA (Bull et al., 2020). However, about 40 – 60% of the EU adults population is leading a predominantly sedentary lifestyle (Nikitara et al., 2021). Sedentary behavior (SB) includes activities such as watching television, playing computer games, and browsing the Internet (Wang et al., 2019). High levels of SB have been associated with decline of PA which, in turn, is associated with negative health outcomes, including obesity. Furthermore, there has been a growing focus on exploring the relationship between SB and sleep duration. This relation between SB and sleep duration is noteworthy, especially when considering that sleep duration guidelines recommend 7-9 hours of sleep for adults in the EU. In 2018, a systematic review synthesized findings from 56 studies that employed iso-temporal substitution models in PA, SB and sleep. Research has shown that changes in the time spent on these movement-related behaviors that make up a 24-h day can interact to influence health outcomes (Trembley et al., 2016). However, to -date, there are no specific recommendations on SB, and sleep is often not included. Therefore, this project will present the background, methods and design of a 24 hour movement summary of behaviors (PA, SB, sleep) for Europe. Methods Utilizing a cross-sectional design we will analyze existing data for PA, SB, and sleep from the Eurostat Organization on European adults 18 to 65+. Descriptive analysis using mean, median, and 95% Confidence Intervals, will be complemented by frequency distributions and histograms. Results The findings from this research have the potential to inform surveillance efforts, public health strategies, evidence-based guidelines, and possibly improve overall well-being. Conclusion Implications of this research may inform researchers on further questions to pursue, policy makers in resource allocation, and practitioners on where to focus intervention efforts.

Longitudinal Associations Between Cognition and Grip Strength, Differentiated by Sex and Physical Activity: A Population-Based Study in Older Adults From 17 European Countries.

Objectives (1) To investigate longitudinal associations between grip strength (GS) and cognition over 4 years in European older adults, (2) to examine differences in temporal associations between men and women and between levels of physical activity, (3) to explore in each year 2015 and 2019 associations between GS quartiles and cognitive performance, and (4) to explore longitudinal associations between GS quartiles (year 2015) and cognitive performance (year 2019). Methods: 25,281 individuals (14,200 women) from 17 European countries aged ≥50 years responded to waves 6th and 8th of the SHARE project. We analyzed GS, a general cognition index, and physical activity level. Results: Panel analyses revealed a bidirectional relationship over 4 years between GS and cognition, with differences between sex, as well as between participants with moderate-to-vigorous and low physical activity levels. Conclusion: Women and participants with low physical activity were more likely to experience cognitive performance deficits 4 years later.

Predictors of the onset of low handgrip strength in Europe: a longitudinal study of 42,183 older adults from 15 countries

ObjectivesA low handgrip strength (HGS) is a significant risk factor for multiple diseases. However, most relevant studies investigate the complications of a low HGS, while the risk potential of causative factors of low HGS remain poorly characterized.MethodsWe investigated the potentials of quality of life, depression, dyslipidaemia, diabetes mellitus, cancer, Alzheimer’s disease, stroke, frailty, and difficulties performing daily activities in predicting low HGS (≤ 27 kg for men, ≤ 16 kg for women) in European older adults aged 50 or above from 15 countries (n = 42,183). All data was collected from four successive waves of survey of health, ageing, and retirement in Europe (SHARE) conducted between 2013 and 2020. Logistic models are applied, and estimated effects are presented as odds ratios and probabilities.ResultsCollectively, 3016 participants (men; n = 1395; 7.38%, women; n = 1621, 6.97%) developed low HGS during the 6.5 years study period. After adjusting for covariables, we identified an advancing age (1.6–48.1% points higher risk of low HGS), male gender (1.0%-point higher risk of low HGS), lower quality of life (1.6%-point higher), and stroke (1.5%-points) as significant risk factors for low HGS. We also found a dose-dependent association of Euro-D depression scores with the risk of low HGS, as the higher scores were associated with between 0.6- and 2.3%-points higher risk of developing low HGS than participants without depression. Among physical performance indicators, difficulty climbing stairs (2.0%-points higher low HGS risk) or rising from a chair (0.7%-points) were significantly associated with developing low HGS. Lastly, frailty (0.9%-points higher risk of low HGS) and the fear of falling down (1.6%-points higher risk) also increased the risk of developing low HGS.ConclusionAltogether, we report several risk factors for developing low HGS. Our observations may help evaluating and monitoring high-risk population for developing low HGS in pre-clinical settings.

A Comparison of Oral Function in Older In- and Outpatients: An Observational Study.

(1) Background: Insufficient data exist regarding oral function among older adults in Europe. Therefore, we aimed to assess and compare oral function between older in- and outpatients and identify predictors of low masticatory performance. (2) Methods: Patients were consecutively recruited from the outpatient center (n = 31) and the inpatient geriatric department (n = 31) at a tertiary University Hospital in Switzerland in 2023. Assessments on oral function included the total number of intraoral eruptive teeth, number of supporting zones with dentures, maximal bite force (Dental Prescale II, Fuji Film Corp., Tokyo, Japan), and masticatory performance (Hue-Check Gum©, University of Bern, Bern, Switzerland) using a visual (SA1-SA5) and a digital (SD_Hue) scale. The visual and digital assessment of masticatory performance showed a strong correlation (Kendall tau = 0.83). Low masticatory performance was defined as SA-Grade 1-2 (vs. SA3-SA5 as reference). In a multivariate model adjusting for age, sex, and clinical setting, we investigated associations of maximal bite force, few eruptive teeth, and few supporting zones with low masticatory performance. (3) Results: Mean age was 81.9 (standard deviation (sd) 5.2) years, and 62.9% were female. Overall, maximal bite force was 247 N (sd 261). A total of 39 patients (63.9%) had a low masticatory performance, 62.9% a low maximal bite force, and 50% a low number of eruptive teeth (<10). Masticatory performance, number of eruptive teeth, and maximal bite force did not significantly differ between in- and outpatients. The number of supporting zones was significantly higher in outpatients compared to inpatients (median 4, interquartile range (IQR) 4-4; vs. 4, IQR 2-4; p = 0.03). In the multivariate model, maximal bite force and a low number of eruptive teeth were independently associated with low masticatory performance (adjusted odds ratio 7.4 (95% CI, 1.8-30.4; p < 0.01), and OR 7.8 (95% CI, 1.7-36.4; p < 0.01), respectively). (4) Conclusions: Impaired oral function is highly prevalent in both European older in- and outpatients to a similar degree. The association of low masticatory performance with maximal bite force and with a low number of eruptive teeth may indicate that a basic screening should include either of these parameters to identify impaired oral function.

Diabetes, glycemic profile and risk of vitiligo: A Mendelian randomization study.

Previous observational studies have shown that vitiligo usually co-manifests with a variety of dysglycemic diseases, such as Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM). Mendelian randomization (MR) analysis was performed to further evaluate the causal association between fasting plasma glucose, glycosylated hemoglobin (HbA1c), T1DM, T2DM and vitiligo. We used aggregated genome-wide association data from the Integrative Epidemiology Unit (IEU) online database of European adults vitiligo; HbA1c data were from IEU. Fasting blood glucose data were obtained from the European Bioinformatics Institute (EBI). T1DM and T2DM data were from FinnGen. We used bidirectional two-sample and multivariate MR analyses to test whether dysglycemic measures (fasting blood glucose, HbA1c), diabetes-related measures (T1DM, T2DM) are causatively associated with vitiligo. Inverse variance weighting (IVW) method was used as the main test method, MR-Egger, Weighted mode and Weighted median were used as supplementary methods. We found no statistically significant evidence to support a causal association between dysglycemic traits and vitiligo, but in the correlation analysis of diabetic traits, our data supported a positive causal association between T1DM and vitiligo (p=0.018). In the follow-up multivariate MR analysis, our results still supported this conclusion (p=0.016), and suggested that HbA1c was not a mediator of T1DM affecting the pathogenesis of vitiligo. No reverse causality was found in any of the reverse MR Analyses of dysglycemic traits and diabetic traits. Our findings support that T1DM is a risk factor for the development of vitiligo, and this conclusion may explain why the co-presentation of T1DM and vitiligo is often seen in observational studies. Clinical use of measures related to T1DM may be a new idea for the prevention or treatment of vitiligo.

The role of accelerometer-derived sleep traits on glycated haemoglobin and glucose levels: a Mendelian randomization study

Self-reported shorter/longer sleep duration, insomnia, and evening preference are associated with hyperglycaemia in observational analyses, with similar observations in small studies using accelerometer-derived sleep traits. Mendelian randomization (MR) studies support an effect of self-reported insomnia, but not others, on glycated haemoglobin (HbA1c). To explore potential effects, we used MR methods to assess effects of accelerometer-derived sleep traits (duration, mid-point least active 5-h, mid-point most active 10-h, sleep fragmentation, and efficiency) on HbA1c/glucose in European adults from the UK Biobank (UKB) (n = 73,797) and the MAGIC consortium (n = 146,806). Cross-trait linkage disequilibrium score regression was applied to determine genetic correlations across accelerometer-derived, self-reported sleep traits, and HbA1c/glucose. We found no causal effect of any accelerometer-derived sleep trait on HbA1c or glucose. Similar MR results for self-reported sleep traits in the UKB sub-sample with accelerometer-derived measures suggested our results were not explained by selection bias. Phenotypic and genetic correlation analyses suggested complex relationships between self-reported and accelerometer-derived traits indicating that they may reflect different types of exposure. These findings suggested accelerometer-derived sleep traits do not affect HbA1c. Accelerometer-derived measures of sleep duration and quality might not simply be ‘objective’ measures of self-reported sleep duration and insomnia, but rather captured different sleep characteristics.

Interplay of Physical, Psychological, and Social Frailty among Community-Dwelling Older Adults in Five European Countries: A Longitudinal Study

Frailty is a dynamic condition encompassing physical, psychological, and social domains. While certain factors are associated with overall or specific frailty domains, research on the correlations between physical, psychological, and social frailty is lacking. This study aims to investigate the associations between physical, psychological, and social frailty in European older adults. The study involved 1781 older adults from the Urban Health Centres Europe project. Baseline and 1-year follow-up data were collected on physical, psychological, and social frailty, along with covariates. Linear regression analyzed unidirectional associations, while cross-lagged panel modeling assessed bi-directional associations. Participants’ mean age was 79.57 years (SD = 5.54) and over half were female (61.0%). Physical and psychological frailty showed bi-directional association (effect of physical frailty at baseline on psychological frailty at follow-up: β = 0.14, 95%CI 0.09, 0.19; reversed direction: β = 0.05, 95%CI 0.01, 0.09). Higher physical frailty correlated with increased social frailty (β = 0.05, 95%CI 0.01, 0.68), but no association was found between social and psychological frailty. This longitudinal study found a reciprocal relationship between physical and psychological frailty in older adults. A relatively higher level of physical frailty was associated with a higher level of social frailty. There was no association between social and psychological frailty. These findings underscore the multifaceted interplay between various domains of frailty. Public health professionals should recognize the implications of these interconnections while crafting personalized prevention and care strategies. Further research is needed to confirm these findings and investigate underlying mechanisms.

Cognitive performance trends among European older adults: exploring variations across cohorts, gender, and educational levels (2007–2017)

BackgroundThis study explores recent cohort trends in cognitive performance among older Europeans from 2007 to 2017, addressing three key questions: (1) Did cognitive performance improve universally and across the performance distribution during this period? (2) Did these improvements occur across educational levels and for both men and women? (3) Can established risk factors explain these performance gains?MethodsUsing data from the Survey of Health, Ageing and Retirement in Europe (SHARE) across 12 European countries, we assessed immediate recall, delayed recall, and verbal fluency in individuals aged 60 to 94 in both 2007 and 2017 (n = 32 773). Differences between the two time points were estimated with linear mixed effects regression models and quantile regression.ResultsCognitive performance improved in all age groups, across educational levels, and for both men and women between 2007 and 2017. Notably, improvements were more pronounced at the upper end of the performance distribution for delayed recall and verbal fluency. Education explained approximately 20% of the observed improvements. Risk factors did not explain the observed improvements.ConclusionsEuropean cohorts of both younger-old and older adults continue to exhibit improvements in cognitive performance. Variation in the size of the cohort improvements across the performance distributions in delayed recall and in verbal fluency may contribute to growing inequalities in cognitive outcomes. Future research should further investigate the potential heterogeneity in cognitive performance gains.Trial registrationNot applicable.

Safety and Immunogenicity of a 4-Component Generalized Modules for Membrane Antigens Shigella Vaccine in Healthy European Adults: Randomized, Phase 1/2 Study.

We report data from stage 1 of an ongoing 2-staged, phase 1/2 randomized clinical trial with a 4-component generalized modules for membrane antigens-based vaccine against Shigella sonnei and Shigella flexneri 1b, 2a, and 3a (altSonflex1-2-3; GSK). Europeans aged 18-50 years (N = 102) were randomized (2:1) to receive 2 injections of altSonflex1-2-3 or placebo at 3- or 6-month interval. Safety and immunogenicity were assessed at prespecified time points. The most common solicited administration-site event (until 7 days after each injection) and unsolicited adverse event (until 28 days after each injection) were pain (altSonflex1-2-3, 97.1%; placebo, 58.8%) and headache (32.4%; 23.5%), respectively. All serotype-specific functional IgG antibodies peaked 14-28 days after injection 1 and remained substantially higher than prevaccination at 3 or 6 months postvaccination; the second injection did not boost but restored the initial immune response. The highest seroresponse rates (≥4-fold increase in titers over baseline) were obtained against S. flexneri 2a (enzyme-linked immunosorbent assay [ELISA] after injection 1, 91.0%; after injection 2 [day 113; day 197], 100%; 97.0% and serum bactericidal activity [SBA] after injection 1, 94.4%; after injection 2, 85.7%; 88.9%) followed by S. sonnei (ELISA after injection 1, 77.6%; after injection 2, 84.6%; 78.8% and SBA after injection 1, 83.3%; after injection 2, 71.4%; 88.9%). Immune responses against S. flexneri 1b and S. flexneri 3a, as measured by both ELISA and SBA, were numerically lower compared to those against S. sonnei and S. flexneri 2a. No safety signals or concerns were identified. altSonflex1-2-3 induced functional serotype-specific immune responses, allowing further clinical development in the target population. Clinical Trials Registration . NCT05073003.