Late Middle-aged Adults Research Articles

Resistance training enhances delayed memory in healthy middle-aged and older adults: A randomised controlled trial

ObjectivesHigh-intensity exercise is a potential therapeutic tool to postpone or prevent the onset of cognitive decline. However, there is a lack of sufficient evidence regarding the longitudinal effects of structured resistance training on cognitive function in healthy adults. The purpose of this study was to investigate the effect of two ecologically valid, intense 12-week resistance training programs on cognitive function in late middle-aged adults. DesignSingle-site parallel randomised controlled trial at the Department of Exercise Science strength and conditioning laboratory. Groups allocated by minimisation randomisation. MethodsForty-five healthy adults (age range=41–69 years) were enrolled and randomised into (A) high-load, long rest resistance training (n=14), or (B) moderate-load, short rest resistance training (n=15) twice per week for 12 weeks, or a non-exercising control (n=16). Follow-up within seven days. Data were collected September 2016–December 2017. Cognitive function assessed using the CogState computerised battery. Assessors were blinded to participant group allocation. Secondary outcomes were maximal muscle strength and body composition. ResultsForty-four participants were analysed in 2018. Delayed verbal memory performance was improved (p=0.02) in resistance training groups (g=0.67–0.79) when compared to the control group, with no differences between training groups. Likewise, increases in maximal muscle strength were observed (p<0.01) in resistance training groups when compared to the control group, with no differences between training groups. No differences in body composition were observed. There were no adverse events or side-effects of the intervention. Conclusions12 weeks of intense resistance training improves delayed verbal memory irrespective of training design (i.e., high-load vs. moderate-load). Trial registrationThis study is registered at www.anzctr.org.au ACTRN12616000690459.

Information and communication technology among early and late middle-aged adults in urban China: Daily use and anticipated support in old age.

Guided by the unified theory of acceptance and use of technology (UTAUT), the study explored information and communications technology (ICT) use and anticipation among middle-aged adults in urban China. Path analysis was performed on data from 401 participants aged 45-65 to examine the associations between anticipated ICT support and the acceptance and adoption process of ICT. For the late middle-aged adults, those who had greater belief in ICT usefulness and received more social support for ICT use were more likely to anticipate greater ICT support in old age. These associations were not found in the early middle-aged group. The frequency of ICT use may be the key explanation for different ICT predictors and patterns. The constructs of UTAUT are sequential steps. Middle-aged adults may believe in ICT usefulness even though they have not witnessed it in person.

Disconnection Between Self-Reported and Objective Cognitive Impairment in Obstructive Sleep Apnea.

Recent studies show that obstructive sleep apnea (OSA) is a possible contributor to abnormal cognitive decline in older adults. These new observations create the need to identify older adults with OSA who are at risk of the developing dementia if not treated. This study's goal was to verify whether self-reported cognitive complaints could become a useful tool to screen for objective cognitive deficits in late middle-aged and older adults with OSA. Fifty-seven participants with OSA with an apnea-hypopnea index (AHI) ≥ 15 events/h (3% or arousal) and aged between 55 and 85 years were compared to 54 participants in a mild/non-OSA group on their ability to evaluate their objective cognitive functioning. They underwent overnight polysomnography followed by a comprehensive neuropsychological assessment. We recruited a similar proportion of participants with mild cognitive impairment (MCI) in both groups (OSA: 36.8%; mild/non-OSA: 35.2%). They filled out questionnaires assessing mood, sleep, and cognition. Group (OSA versus mild/non-OSA) × cognitive status (MCI versus non-MCI) analyses of variance were performed on cognitive complaint questionnaires. We found that among participants without objective cognitive deficits, participants in the OSA group reported more cognitive complaints compared to those in the mild/non-OSA group. Among participants with objective cognitive deficits, those in the OSA group reported less cognitive complaints compared to those in the mild/non-OSA group. Participants with OSA and MCI were less aware of their deficits compared to those in the mild/non-OSA group, possibly reflecting a distinctive OSA-associated cognitive impairment. Our results underscore the importance of referring patients with OSA for a comprehensive neuropsychological assessment when an abnormal cognitive decline is suspected.

Distinct trajectories of physical activity and related factors during the life course in the general population: a systematic review

BackgroundIn recent years, researchers have begun applying a trajectory approach to identify homogeneous subgroups of physical activity (PA) in heterogeneous populations. This study systematically reviewed the articles identifying longitudinal PA trajectory classes and the related factors (e.g., determinants, predictors, and outcomes) in the general population during different life phases.MethodsThe included studies used finite mixture models for identifying trajectories of PA, exercise, or sport participation. Three electronic databases, PubMed (Medline), Web of Science, and CINAHL, were searched from the year 2000 to 13 February 2018. The study was conducted according to the PRISMA recommendations.ResultsTwenty-seven articles were included and organized into three age group: youngest (eleven articles), middle (eight articles), and oldest (eight articles). The youngest group consisted mainly of youth, the middle group of adults and the oldest group of late middle-aged and older adults. Most commonly, three or four trajectory classes were reported. Several trajectories describing a decline in PA were reported, especially in the youngest group, whereas trajectories of consistently increasing PA were observed in the middle and oldest group. While the proportion of persistently physically inactive individuals increased with age, the proportion was relatively high at all ages. Generally, male gender, being Caucasian, non-smoking, having low television viewing time, higher socioeconomic status, no chronic illnesses, and family support for PA were associated either with persistent or increasing PA.ConclusionsThe reviewed articles identified various PA subgroups, indicating that finite mixture modeling can yield new information on the complexity of PA behavior compared to studying population mean PA level only. The studies also provided novel information how different factors relate to changes in PA during life course. The recognition of the PA subgroups and their determinants is important for the more precise targeting of PA promotion and PA interventions.Trial registrationPROSPERO registration number: CRD42018088120.

Religious Affiliation, Informal Participation, and Network Support Associated With Substance Use: Differences Across Age Groups.

Background. Associations between religious involvement and substance use are well established. However, limited research examines the effects of religious affiliation, informal participation, and network support on substance use among two distinct age cohorts. Objectives. This study aims to examine whether religious affiliation, informal participation, and network support are associated with alcohol, tobacco, and marijuana use among young and late middle-age adults. Method. The UC Berkeley Social Networks Study (Wave 1, 2015) offers novel cohort data on young (21-30 years old, n = 483) and late middle-age (50-70 years old, n = 673) adults. Poisson regression models were used to predict alcohol use, while logistic regression models were used to predict odds of smoking and marijuana use. Results. Among young adults, membership in a religious organization was associated with less alcohol, tobacco, and marijuana use. Conversely, participating in informal organizations was associated with more alcohol and marijuana use. Desiring more people to talk to and get together with were associated with more smoking and drinking, respectively. However, wishing more people to ask for help was associated with less substance use altogether. In a similar pattern, among older adults, religious involvement was associated with less alcohol and marijuana use. Desiring more people to ask for help was also related to less marijuana use. Conclusion. Younger adult participation in informal groups serves to encourage social substance use. In contrast, older people are more involved in religious groups, which support social behaviors that do not include substance use.

Correction: Childhood socioeconomic position and physical capability in late-middle age in two birth cohorts from the Copenhagen aging and midlife biobank.

[This corrects the article DOI: 10.1371/journal.pone.0205019.].

Characterizing the Effects of Sex, APOE ɛ4, and Literacy on Mid-life Cognitive Trajectories: Application of Information-Theoretic Model Averaging and Multi-model Inference Techniques to the Wisconsin Registry for Alzheimer's Prevention Study.

Prior research has identified numerous genetic (including sex), education, health, and lifestyle factors that predict cognitive decline. Traditional model selection approaches (e.g., backward or stepwise selection) attempt to find one model that best fits the observed data, risking interpretations that only the selected predictors are important. In reality, several predictor combinations may fit similarly well but result in different conclusions (e.g., about size and significance of parameter estimates). In this study, we describe an alternative method, Information-Theoretic (IT) model averaging, and apply it to characterize a set of complex interactions in a longitudinal study on cognitive decline. Here, we used longitudinal cognitive data from 1256 late-middle aged adults from the Wisconsin Registry for Alzheimer's Prevention study to examine the effects of sex, apolipoprotein E (APOE) ɛ4 allele (non-modifiable factors), and literacy achievement (modifiable) on cognitive decline. For each outcome, we applied IT model averaging to a set of models with different combinations of interactions among sex, APOE, literacy, and age. For a list-learning test, model-averaged results showed better performance for women versus men, with faster decline among men; increased literacy was associated with better performance, particularly among men. APOE had less of an association with cognitive performance in this age range (∼40-70 years). These results illustrate the utility of the IT approach and point to literacy as a potential modifier of cognitive decline. Whether the protective effect of literacy is due to educational attainment or intrinsic verbal intellectual ability is the topic of ongoing work. (JINS, 2019, 25, 119-133).

Hypertension and obesity moderate the relationship between β-amyloid and cognitive decline in midlife

BackgroundThis study tested if central obesity, hypertension, or depressive symptoms moderated the relationship between β-amyloid (Aβ) and longitudinal cognitive performance in late middle-aged adults enriched for Alzheimer's disease (AD) risk. MethodsParticipants (n = 207; ages = 40–70 years; 73% parental AD) in the Wisconsin Registry for Alzheimer's Prevention study completed 3+ neuropsychological evaluations and a [11C]PiB positron emission tomography scan or lumbar puncture. Linear mixed-effects regression models tested interactions of risk factor × Aβ × visit age on longitudinal Verbal Learning & Memory and Speed & Flexibility factor scores. ResultsThe relationship between Aβ and Verbal Learning & Memory decline was moderated by hypertension (χ2(1) = 3.85, P = .04) and obesity (χ2(1) = 6.12, P = .01); those with both elevated Aβ and the risk factor declined at faster rates than those with only elevated Aβ or elevated risk factors. ConclusionIn this cohort, hypertension and obesity moderated the relationship between Aβ and cognitive decline.

Childhood socioeconomic position and physical capability in late-middle age in two birth cohorts from the Copenhagen aging and midlife biobank.

This study examines the association between childhood socioeconomic position and objective physical capability including new functional measures of potential relevance to a population in late-middle age. The study population covers two Danish birth cohorts followed-up in the Copenhagen Aging and Midlife Biobank (age 48–58 years, 2009–2011, N = 4,204). Results from linear regression models revealed that being born in higher socioeconomic position was associated with higher jump height: Paternal occupational class four = 0.19 cm (95% confidence interval (CI): -0.44, 0.82), three = 0.59 cm (95% CI: -0.02, 1.19), two = 1.29 cm (95% CI: 0.64, 1.94), and one = 1.29 cm (95% CI: 0.45, 2.13) (reference = five); medium parental social class = 0.88 cm (95% CI: 0.03, 1.72) and high = 1.79 cm (95% CI: 0.94, 2.63) (reference = low). Higher childhood socioeconomic position was also associated with better chair rise performance and hand grip strength, while among women it was related to reduced flexibility: Medium parental social class = -1.31 cm (95% CI: -3.05, 0.42) and high = -2.20 cm (95% CI: -3.94, -0.47) (reference = low); unwed mother = 1.75 cm (95% CI: 0.36, 3.14) (reference = married). Overall, the findings suggest that higher childhood socioeconomic position is primarily related to moderately better scores in the most strenuous physical capability measures and hand grip strength among healthy adults in late-middle age.

Investigating the Domains of Life Satisfaction in Middle-Aged, Late Middle-Aged, and Older Adults with a Physical Disability

Little research exists that explores which domains of life satisfaction contributed to life satisfaction among Korean older adults with a physical disability. The purpose of this study was to investigate which domains of life satisfaction predicted life satisfaction by the identified different age groups among Korean older adults with a physical disability. This study analyzed the Panel Survey of Employment for the Disabled (PSED) collected in 2015 in Korea. A total of 2331 participants were used and examined their socio-demographic status, the satisfaction of life domains (social, health, finance, leisure, work and marital), and the overall life satisfaction. The results show that marital and employment statuses play an important role in promoting the overall life satisfaction for adults and older adults with a physical disability. In addition, this study suggests that the social and leisure satisfaction of an individual are the major contribution to life satisfaction among older adults (aged 55 and over) who have a physical disability.

Affective instability predicts the course of depression in late middle-age and older adulthood

BackgroundAffective instability is a facet of emotion dysregulation that characterizes various mental disorders, including Major Depressive Disorder (MDD). However, it is unclear as to how affective instability predicts the course of MDD. It is also unknown whether affective instability is a relevant predictor of MDD in later adulthood, a period when there is a decrease in both affective instability and MDD prevalence. Thus, we investigated the role of affective instability in the course of MDD in a sample of late middle-age and older adults. MethodsUsing a longitudinal design over five years, 1,630 adults aged 55–64 years (M = 59.60, SD = 2.70) completed a baseline assessment of affective instability (self-report, informant-report, interviewer-report), three assessments of MDD (computerized interview), and eight assessments of depressive symptoms (self-report). ResultsBaseline affective instability positively predicted the likelihood of having lifetime major depressive episodes (MDE) and first-time MDEs, as well as depressive symptoms up to five years later. However, affective instability did not predict remission or having more depressive symptoms over time. These findings held when controlling for neuroticism. LimitationsWe only assessed affective instability at the baseline, did not investigate specific mechanisms or recurrence, and focused on middle-age and older adults. ConclusionsOur findings replicate and extend prior work by showing that affective instability is differentially related to multiple aspects of MDD's course and remains an important predictor of MDD even in older age. We discuss implications for the role of affective instability in MDD across the lifespan.

Clinical Implications

HomeHypertensionVol. 71, No. 6Clinical Implications Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBClinical Implications Originally published9 May 2018https://doi.org/10.1161/HYPERTENSIONAHA.118.11323Hypertension. 2018;71:955Biological Sex Modulates Aldosterone Levels (p 1083)Download figureDownload PowerPointSex differences in cardiovascular disease exist, with women being at greater risk than men for some hypertension-related cardiovascular diseases such as increased left ventricular hypertrophy. Salt sensitivity of blood pressure, the change in systolic blood pressure between high- and low-salt diet, is a risk factor for cardiovascular morbidity and mortality. In this study of 1592 normotensive and hypertensive individuals who participated in the Hypertensive Pathotype Consortium, women had increased salt sensitivity of blood pressure and increased blood pressure and aldosterone responses to angiotensin II as compared with men. In an animal model of aldosterone-dependent cardiovascular injury, female compared with male rodents had increased cardiovascular injury with increased aldosterone levels; mineralocorticoid receptor blockade was equally effective in both sexes in preventing the damage. These sex differences likely contribute to the increased salt sensitivity of blood pressure and to increased aldosterone-mediated cardiovascular disease in women compared with men. Thus, as compared with men, women are likely to receive a greater cardiovascular risk reduction from mineralocorticoid receptor blockade.MitoQ Treatment and Vascular Function With Aging (p 1056)Download figureDownload PowerPointAdvancing age is the primary risk factor for cardiovascular disease. The development of vascular dysfunction, including vascular endothelial dysfunction and stiffening of the large elastic arteries (aorta and carotid arteries), is a major mechanism of increased cardiovascular disease risk with aging. Excessive production of reactive oxygen species by mitochondria has emerged as a key driver of vascular dysfunction with aging. Results of preclinical studies from our laboratory demonstrate that 4 weeks of oral supplementation with the mitochondria-targeted antioxidant MitoQ ameliorates age-related endothelial dysfunction and aortic stiffening in mice. In this issue of Hypertension we report the successful translation of these preclinical findings to humans. We show that 6 weeks of supplementation with MitoQ is safe and well tolerated and improves vascular endothelial function in healthy late middle-aged and older adults. We present data from a unique functional bioassay suggesting that the mechanism of action for the improvement in endothelial function with MitoQ supplementation involves a reduction in mitochondrial reactive oxygen species-associated suppression of endothelium-dependent dilation. We also show that MitoQ treatment reduces aortic stiffness in individuals exhibiting age-related aortic stiffening and that MitoQ supplementation decreases plasma concentrations of oxidized low-density lipoprotein, a circulating marker of oxidative stress. Collectively, these findings indicate that mitochondria-targeted therapies such as MitoQ may hold promise for reducing mitochondrial-derived oxidative stress, improving vascular function and decreasing cardiovascular disease risk with aging.Media/Lumen Reference Values in Small Arteries (p 1193)Download figureDownload PowerPointSmall artery remodeling is an early feature of target organ damage in hypertension and retains a negative prognostic value. The gold standard for its assessment, media/lumen ratio (M/L), can be obtained by tissue biopsies. In this article, a cohort of 291 individuals with or without cardiovascular risk factors was pooled from 4 Italian centers to establish age- and sex-specific reference values and to explore M/L relationship with risk factors. M/L reference values obtained in a sufficiently large healthy population are useful in pathophysiological studies to establish the impact of classical and emerging risk factors on the microvasculature as well as the effect of treatment. Indeed, not only blood pressure, but also body mass index, cholesterol, smoking, and blood glucose were associated with increased M/L, highlighting especially the role of metabolic factors in inducing microvascular damage. From a clinical perspective, microvascular alterations are increasingly recognized as crucial mechanisms of cardiovascular and cerebrovascular disease, and they can be reversed by appropriate treatment. A better comprehension of microvascular damage accrual with age and risk factors may thus help identify novel treatment targets. Furthermore, the identification of a different impact of risk factors on M/L in the 2 sexes suggests a possible explanation for the well-known sex differences in the pathophysiology of cardiovascular disease, thus opening a novel pathway to personalized medicine. Previous Back to top Next FiguresReferencesRelatedDetails June 2018Vol 71, Issue 6 Advertisement Article InformationMetrics © 2018 American Heart Association, Inc.https://doi.org/10.1161/HYPERTENSIONAHA.118.11323 Originally publishedMay 9, 2018 PDF download Advertisement

Health Insurance and Poverty in Trajectories of Out-of-Pocket Expenditure among Low-Income Middle-Aged Adults.

To assess the effects of longitudinal patterns of health insurance and poverty on out-of-pocket expenditures among low-income late middle-aged adults. Six waves (2002-2012) of the Health and Retirement Study, in combination with RAND Center for the Study of Aging data, were used. A random coefficient regression analysis was conducted in a multilevel growth curve framework to estimate the impact of health insurance and poverty on out-of-pocket expenditures. At baseline, individuals with private insurance or unstable coverage were more likely to have out-of-pocket expenditures and financial burdens than public insurance holders. Over time, the poor who had no insurance, unstable coverage, or insurance type change had higher out-of-pocket expenditures; private coverage holders had higher odds of financial burden. Unstable insurance coverage had a discernible effect on the long-term, out-of-pocket expenditures among low-income adults. Findings have an important policy implication to protect poor late middle-aged population; as this population enters old age, the high financial burden it faces may exacerbate persistent socioeconomic health disparity among older people with unstable insurance coverage.

Evaluation of ¡Vivir Mi Vida! to improve health and wellness of rural-dwelling, late middle-aged Latino adults: results of a feasibility and pilot study of a lifestyle intervention.

Rural-dwelling Latino adults experience higher rates of chronic disease compared with their urban counterparts, a disparity exacerbated by limited access to healthcare services. Very few lifestyle interventions exist that are both culturally sensitive and compatible for delivery within a non-metropolitan primary care context. Participants were 37 Latino, Spanish-speaking adults aged 50-64-years-old, recruited from a rural health clinic in the Antelope Valley of California. ¡Vivir Mi Vida! was delivered by a community health worker-occupational therapy team over a 16-week period. Subjective health, lifestyle factors, and cardiometabolic measures were collected pre- and post-intervention. Follow-up interviews and focus groups were held to collect information related to the subjective experiences of key stakeholders and participants.FindingsParticipants demonstrated improvements in systolic blood pressure, sodium and saturated fat intake, and numerous patient-centered outcomes ranging from increased well-being to reduced stress. Although participants were extremely satisfied with the program, stakeholders identified a number of implementation challenges. The findings suggest that a tailored lifestyle intervention led by community health workers and occupational therapists is feasible to implement in a primary care setting and can improve health outcomes in rural-dwelling, late middle-aged Latinos.

Mitochondrial‐Targeted Antioxidant (MitoQ) Improves Vascular Function in Healthy Late Middle‐Aged and Older Adults

Excess reactive oxygen species production by mitochondria (mtROS) is a key mechanism of vascular dysfunction with aging. Our laboratory has shown that supplementation with the mitochondrial‐targeted antioxidant MitoQ improves vascular endothelial function by reducing mtROS and ameliorates arterial stiffening in old mice, but the effects in humans are unknown. Here we sought to translate our preclinical findings to humans, while also determining the safety and efficacy of MitoQ. Twenty healthy late middle‐aged and older adults (60–79 years) with impaired endothelial function (baseline brachial artery flow‐mediated dilation [FMD] &lt;6%) underwent six weeks of oral supplementation with MitoQ (20 mg/day) or placebo in a randomized, placebo‐controlled, double‐blind, crossover design study. MitoQ was well tolerated, and no treatment‐related serious adverse events occurred. Plasma MitoQ concentrations were higher after the treatment vs. placebo period (P&lt;0.05). Brachial artery FMD was 42% higher after MitoQ vs. placebo (P&lt;0.05); this improvement was associated with complete amelioration of tonic mtROS‐related suppression of endothelial function (assessed as the increase in FMD with acute 160 mg dose of MitoQ, n=9, P&lt;0.05). Aortic stiffness (carotid‐femoral pulse wave velocity [PWV]) was lower after MitoQ vs. placebo (P&lt;0.05) in participants with elevated baseline levels (carotid‐femoral PWV &gt;7.60 m/s, n=11). Plasma oxidized low‐density lipoprotein, a marker of oxidative stress, also was lower after MitoQ vs. placebo (P&lt;0.05), whereas participant characteristics, endothelium‐independent dilation (sublingual nitroglycerin) and circulating markers of inflammation were not different (all P&gt;0.1). These findings in humans support earlier preclinical observations and suggest that MitoQ and other therapeutic strategies targeting mtROS may hold promise for treating age‐related vascular dysfunction.Support or Funding InformationClinicaltrials.gov Identifier: NCT02597023Funding: Supported by NIH R21 AG049451, T32 AG000279, F32 AG053009, Colorado CTSA UL1 TR001082 and an industry contract with MitoQ Limited.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Acute Effects of Tai Chi Training on Cognitive and Cardiovascular Responses in Late Middle-Aged Adults: A Pilot Study.

This study explored the immediate effects of Tai Chi (TC) training on attention and meditation, perceived stress level, heart rate, oxygen saturation level in blood, and palmar skin temperature in late middle-aged adults. Twenty TC practitioners and 20 nonpractitioners volunteered to join the study. After baseline measurements were taken, the TC group performed TC for 10 minutes while their cognitive states and cardiovascular responses were concurrently monitored. The control group rested for the same duration in a standing position. Both groups were then reassessed. The participants' attention and meditation levels were measured using electroencephalography; stress levels were measured using Perceived Stress Scale; heart rate and blood oxygenation were measured using an oximeter; and palmar skin temperature was measured using an infrared thermometer. Attention level tended to increase during TC and dropped immediately thereafter (p < 0.001). Perceived stress level decreased from baseline to posttest in exclusively the TC group (p = 0.005). Heart rate increased during TC (p < 0.001) and decreased thereafter (p = 0.001). No significant group, time, or group-by-time interaction effects were found in the meditation level, palmar skin temperature, and blood oxygenation outcomes. While a 10-minute TC training could temporarily improve attention and decrease perceived stress levels, it could not improve meditation, palmar skin temperature, or blood oxygenation among late middle-aged adults.

Factors Affecting the Successful Aging of Late Middle-Aged Adults

Factors Affecting the Successful Aging of Late Middle-Aged Adults

Secular trends in the prevalence of major and subthreshold depression among 55-64-year olds over 20 years.

Studying secular trends in the exposure to risk and protective factors of depression and whether these trends are associated with secular trends in the prevalence of depression is important to estimate future healthcare demands and to identify targets for prevention. Three birth cohorts of 55-64-year olds from the population-based Longitudinal Aging Study Amsterdam were examined using identical methods in 1992 (n = 944), 2002 (n = 964) and 2012 (n = 957). A two-stage screening design was used to identify subthreshold depression (SUBD) and major depressive disorder (MDD). Multinomial logistic regression analyses were used to identify secular trends in depression prevalence and to identify factors from the biopsychosocial domains of functioning that were associated with these trends. Compared with 1992, MDD became more prevalent in 2002 (OR 1.90, 95% CI 1.10-3.28, p = 0.022) and 2012 (OR 1.80, 95% CI 1.03-3.14, p = 0.039). This was largely attributable to an increase in the prevalence of chronic diseases and functional limitations. Socioeconomic and psychosocial improvements, including an increase in labor market participation, social support and mastery, hampered MDD rates to rise more and were also associated with a 32% decline of SUBD-rates in 2012 as compared with 2002 (OR 0.68, 95% CI 0.48-0.96, p = 0.03). Among late middle-aged adults, there is a substantial net increase of MDD, which is associated with deteriorating physical health. If morbidity and disability continue to increase, a further expansion of MDD rates may be expected. Improving socioeconomic and psychosocial conditions may benefit public health, as these factors were protective against a higher prevalence of both MDD and SUBD.

Indirect health-related social control and psychological functioning in Singaporeans with diabetes

We examined indirect health-related social control and the underlying mechanisms of its association with psychological functioning in patients with type 2 diabetes. Singaporean late middle-aged and older adults (N = 199) completed questionnaires measuring indirect social control, self-efficacy, internal diabetes locus of control, and psychological functioning. We used a bootstrapping approach and structural equation modeling to analyze the data. Results showed that indirect social control was associated with diabetes-related emotional distress and depressive symptoms via the mediator of internal diabetes locus of control, but self-efficacy did not mediate this relationship. More specifically, indirect social control was positively associated with higher internal diabetes locus of control, which, in turn, had a negative impact on diabetes-related emotional distress and depressive symptoms.

Loneliness and social isolation among young and late middle-age adults: Associations with personal networks and social participation

ABSTRACTObjective: Associations between social networks and loneliness or social isolation are well established among older adults. Yet, limited research examines personal networks and participation on perceived loneliness and social isolation as distinct experiences among younger adults. Accordingly, we explore relationships among objective and subjective measures of personal networks with loneliness and isolation, comparing a younger and older cohort.Methods: The UC Berkeley Social Networks Study offers unique cohort data on young (21–30 years old, n = 472) and late middle-age adults’ (50–70 years old, n = 637) personal network characteristics, social participation, network satisfaction, relationship status, and days lonely and isolated via online survey or in-person interview. Negative binomial regression models were used to examine associations between social network characteristics, loneliness, and isolation by age group.Results: Young adults reported twice as many days lonely and isolated than late middle-age adults, despite, paradoxically, having larger networks. For young adults, informal social participation and weekly religious attendance were associated with fewer days isolated. Among late middle-age adults, number of close kin and relationship status were associated with loneliness. Network satisfaction was associated with fewer days lonely or isolated among both age groups.Conclusion: Distinct network characteristics were associated with either loneliness or isolation for each cohort, suggesting network factors are independently associated with each outcome, and may fluctuate over time. Network satisfaction was associated with either loneliness or isolation among both cohorts, suggesting perceptions of social networks may be equally important as objective measures, and remain salient for loneliness and isolation throughout the life course.