Health In Later Life Research Articles

PERCEIVED SOCIOECONOMIC STATUS, PRODUCTIVE SOCIAL ENGAGEMENT, AND SUBJECTIVE HEALTH: LONGITUDINAL STUDY IN TAIWAN

Abstract Productive social engagement (PSE) has been identified as a crucial factor in promoting subjective health in later life. However, there has been limited focus on how perceived socioeconomic status (SES) among older adults mediates this relationship over the long term. This study employed data from the Taiwan Longitudinal Study on Aging to examine a sample of 2,865 individuals aged 55 or above from 2011 to 2015. By employing a path analysis, this study tested the hypothesized effects developed from active aging theory and social capital theory. Results indicates that : 1. Higher levels of PSE and perceived SES predicted higher subjective health within the same wave, both in T1 and T2. 2. Perceived SES mediated the relationship between PSE and subjective health only in T1. Also, the effect of T1 PSE on T2 PSE operated through T1perceived SES. 3. T1 PSE positively predicted T2 subjective health through T1 perceived SES and T2 perceived SES over the time. This study sheds light on the mechanism linking PSE, perceived SES, and subjective health. The findings suggest that higher perceived SES is associated with more PSE in a four-year interval, which in turn predicts higher subjective health. This indicates that social capital may facilitate older adults’ access to PSE over time. Future research should investigate the role of perceived SES and how it interacts with objective and subjective physical well-being in later life. Interventions should target ways to help older adults access opportunities for engaging in productive activities to improve their health.

BIODEMOGRAPHY OF AGING, CELEBRATING JAMES W. VAUPEL, PHD

Abstract James W. Vaupel, PhD (1945 – 2022), was an international leader in demography and aging research and a pioneer in the field of biodemography. He was a highly creative researcher and very entrepreneurial in the development of new interdisciplinary research environments. This symposium highlights a few of the biodemographic research areas that Dr. Vaupel has been a catalyst for. Denmark was Dr. Vaupel’s home country during the last third of his life, and Dr. Christensen reports on findings from Danish nationwide genetic-epidemiological studies on twins and the oldest old: familial influence on aging phenotypes, cohort differences in health among the oldest old, associations of early life events with late life health, as well as tongue-in-cheek research on perceived age and teeth. Dr. Alberts discusses the ‘invariant rate of aging’ hypothesis that was developed by Vaupel and others. She presents comparative analyses from multiple nonhuman primate populations showing that, while life expectancy can continue to improve, we probably can’t slow the demographic rate of aging. Dr. Campos presents evidence from a wild baboon population in Kenya that glucocorticoid levels—biological markers of stress responses—are strong prognostic indicators of survival and may be key explanations of life span disparities. Dr. Carey presents key discoveries from large-scale studies involving the Mediterranean fruit fly. These include the slowing of mortality at older ages, context-specific sex mortality differentials, a behavioral biomarker for morbidity, dietary conditions for maximizing lifespan versus reproduction and a stationary population identity whereby life lived equals life left.

MULTIFACETED LINKS BETWEEN SOCIAL RELATIONSHIPS AND THE DISABLEMENT PROCESS IN LATER LIFE

Abstract While a negative association between social relationships and physical limitations or disability has been reported persistently, the possible reciprocal relationships and pathways through which social relationships affect physical function and disability remain to be explored. This study used longitudinal data from the US Health and Retirement Study (HRS) and the National Social Life, Health, and Aging Project (NSHAP) to examine the multifaceted links between different dimensions of social relationships and physical limitations/disability among older adults in the US. We used Structural Equation Models to explore pathways between social relationships and physical limitations in the HRS and longitudinal residual change models to examine the effects of social relationships on changes in physical limitations between two waves in NSHAP. Results show that for men, greater social integration may lower subsequent physical limitations, whereas, for women, social support may prevent declines in physical function. For both genders, greater physical limitations and disability significantly lower subsequent social integration. This work tested the potential causal benefits of the social relationship hypothesis and selection processes and incorporated different aspects of social relationships. As such, our findings advance the explanations of the association between social relationships and later-life health and help better understand the determinants of the disablement process.

HEALTH AFTER AGE 50: THE ROLE OF ADULT CHILDREN’S EDUCATION FOR OLDER PARENTS’ FRAILTY IN EUROPE

Abstract Social stratification research has shown that family background can significantly impact a child’s life chances. However, intergenerational transmission of (dis-)advantages is a two-way process, because parental investment in children may be reciprocated later in life. Particularly, very little is known about the importance of adult children’s socio-economic resources on ageing parents’ well-being – what has been called the effect of the “social foreground” on later-life health. This study aims to investigate whether and how adult offspring’s educational attainments are associated with parents’ health. This study uses dyadic panel data from all the available waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) (i.e., from 2004 to 2020). The sample is composed of 89,752 parents (210,999 parent-child dyads, 250,605 observations) aged 50 or older living in 29 different European countries. Our preliminary results from random intercept linear regression models show that child education is negatively associated with the 40-item Frailty Index (FI) among parents. This association is particularly strong among lower-educated parents (especially mothers). These findings highlight the importance of considering the socio-economic resources of adult children when examining the health and well-being of older adults. This suggests that public investments in younger generations’ education may benefit older generations as well. In developing future analyses, we plan to focus on identifying the potential generative mechanisms behind this relationship and exploring potential policy interventions to support ageing parents and their families.

SOCIAL INEQUITIES AND THE IMPAIRMENT PARADOX IN LATER LIFE

Abstract Research on health across the life course consistently documents widening racial and socioeconomic disparities from childhood through adulthood, followed by stabilization or convergence in later life. This pattern appears to contradict expectations set by cumulative (dis)advantage (CAD) theory. Informed by the punctuated equilibrium perspective, we examine the relationship between midlife health and subsequent health change and mortality and consider the impact of earlier socioeconomic exposures on observed disparities. Using the Health and Retirement Study, we characterize the functional impairment histories of a nationally representative sample of 8464 older adults between 1994 and 2016. We employ nonparametric and discrete outcome multinomial logistic regression to examine the competing risks of mortality, health change, and attrition. As expected, exposures to disadvantages are associated with poorer functional health in midlife and mortality. However, we find that a higher number of functional limitations in midlife is negatively associated with the accumulation of subsequent limitations for White men and women and for Black women, and the impact of educational attainment, occupation, wealth, and marriage on later-life health differs across race and gender groups. We conclude that the observed stability or convergence in later-life functional health disparities is not a departure from the dynamics posited by CAD, but rather a result of the differential impact of racial and socioeconomic inequities on mortality and health at older ages. Higher exposure to disadvantages and a lower protective impact of advantageous exposures lead to higher mortality among Black Americans, a pattern which masks persistent health inequities later in life.

FRAILTY AND DEVELOPMENT ACROSS INDIAN STATES

Abstract Introduction Frailty, a common syndrome of vulnerability among older adults, provides insight into the overall health of aging populations. Life-course influences play an important role in late-life health, but the role of social and economic development has not been well-explored. We study these indicators at the state level in the Longitudinal Aging Study in India (LASI). Methods: Participants in LASI were adults aged 45 years or older from 2017-19 in 35 of 36 states and union territories. Frailty was assessed by a 48-item deficit accumulation frailty index (FI). Robust was defined as FI of 0 to 0.1, pre-frail was >0.1 – 0.2, mildly frail >0.2 – 0.3, moderately frail >0.3 – 0.4, and severely frail was >0.4. Development indicators were GDP per capita, infant mortality rate (IMR), and literacy rate in 1981 and 2018 (2011 for literacy), from the Reserve Bank of India. Associations were assessed using beta regression. Results IMR in 1981 had a small but significant association with frailty (OR 1.00 [1.00-1.00]). For GDP per capita and literacy, 1981 values were associated with greater frailty (1.15 [1.10-1.21] and 1.01 [1.01-1.01] respectively). However, 2018/2011 values were associated with lower frailty (0.94 [0.93-0.95] and 0.99 [0.99-1.00]). These associations were similar after stratifying by age group. Discussion Associations between frailty and state-level development varied both by indicator and by time of assessment. Sensitivity to the environment these indicators measure – such as IMR – may differ by age. Whether that sensitivity leads to protection or vulnerability may also change with age.

PROTECTING COGNITION AND INCREASING EQUITY THROUGH “COGNITIVE IMPACT ASSESSMENTS”

Abstract Today’s societies are characterized by increasing complexity, in which unimpaired cognitive performance is vital to navigate and participate, as well as to retain independence at older ages. Addressing the challenge of improving population brain health has mostly been considered from a dementia risk reduction perspective as identified by the Lancet Commission on dementia. However, risk factors with immediate harm to cognitive functioning, such as shift work or insufficient sleep are currently not explicitly accounted for. As exposure to these risk factors accumulates across the life course, we can expect substantial consequences for later-life brain health. We argue that, in policy and practice, systematic measures should be introduced to protect individuals from harms to their everyday cognitive functioning, and enable them to optimize cognitive performance throughout the life course. On behalf of the international multidisciplinary BRAINHEALTH-POLICY group, we explore the concept of a ‘cognitive footprint’ of policies with exemplars from current legislation and policy that either implicitly affect cognition, or explicitly address effects on individuals’ cognition. We suggest recommendations for systematic pre-intervention ‘cognitive impact assessments’ in fields such as medicine, where drug trials should include cognition as important secondary endpoint, and work, where labour laws should explicitly account for possibly harmful effects of certain work conditions to cognition. Besides immediate protective effects, we expect ‘cognitive impact assessments’ to have potential for long-term cognitive benefits on a population level as well as improve brain health equity by enabling individuals to reach optimum cognitive performance, with associated wider health benefits.

ARE INEQUALITIES IN HEART DISEASE CHARACTERIZED BY INTERGENERATIONAL EDUCATIONAL ATTAINMENT?

Abstract Intergenerational patterns in educational attainment are associated with later-life heart health. Yet, whether the association between intergenerational education patterns and adult heart disease varies by cohort and gender is unclear despite the increasing importance of education for health, especially among women. Informed by a life-course perspective, this study aims to further contextualize the link between education and heart disease in time and across groups. Using data from the Health and Retirement Study, a nationally representative panel survey of adults over the age of 50, we examine how patterns in intergenerational education are associated with heart disease prevalence (n=31,141) and incidence from 1998 to 2018 (person-year observations=253,521) and whether these patterns vary by gender and cohort. Overall, individuals characterized by stable-high education (i.e., parent and respondent have at least some college education) consistently had the lowest prevalence and incidence of heart conditions, whereas those with low adult education, regardless of parent’s education, had the highest risk of heart conditions. Findings also indicate that the effects of intergenerational education patterns on adult heart disease were most pronounced for women and the younger cohorts compared to men and older cohorts, respectively. For example, women and the youngest cohort (born 1954-1967) with upward and stably high intergenerational education had the most favorable heart disease outcomes, whereas the same groups with downward intergenerational education experienced the highest heart disease prevalence. Our findings demonstrate the importance of contextualizing how intergenerational educational attainment influences later-life heart conditions by considering variations by gender and cohort.

EFFECTS OF HIGH-INTENSITY AQUATIC EXERCISE ON INFLAMMATION AND COGNITION IN OLDER ADULTS WITH MCI

Abstract Exercise shows immune benefits in older adults and can reduce the risk of late-life cognitive impairment and dementia. This study sought to explore the effects of high-intensity aquatic-based exercise on older adults with mild cognitive impairment (MCI), specifically by examining changes in inflammatory plasma protein concentrations and cognitive performance. A secondary data analysis was conducted on 20 healthy volunteers (mean age 68.2 ±7.75 years) who participated in 6 months of supervised aquatic exercise training. Participants completed a battery of neuropsychological assessments and whole blood draws at pre- and post-intervention. Plasma protein concentration levels were attained using the Olink Target96 Inflammation panel [Uppsala, Sweden]. Mixed effects models assessed the effects of protein concentration change scores on selected cognitive outcomes, while controlling for age. Results indicated that following the exercise intervention, significant changes in two inflammatory-related proteins (Extracellular newly identified receptor for advanced glycation end-products binding protein [EN-RAGE]; Interleukin-20 receptor subunit alpha [IL-20RA]) were associated with improved verbal memory and processing speed endpoints. Specifically, decreased EN-RAGE concentrations resulted in significantly improved delayed verbal memory scores (parameter estimate= -0.893, p= .023), while increased IL-20RA concentrations led to better task completion (parameter estimate= 2.145, p= .030). These findings demonstrate the cognitive benefits of aquatic-based exercise for older adults and those with MCI, and suggest these effects are mediated by alterations in pro- and anti-inflammatory protein markers such as EN-RAGE and IL-20RA. Larger studies are warranted to replicate these findings, and to further explore the role of activity-induced inflammatory changes on late-life brain health.

CHILDHOOD ADVERSITY IS ASSOCIATED WITH MENTAL HEALTH BUT NOT COGNITIVE DECLINE IN OLDER ADULTS

Abstract Objective The aim of this study was to examine the association between childhood adversity and mental health and cognition in older adults. Methods The sample included older Australian adults from the Personality and Total Health (PATH) Through Life Project (N = 2551). Childhood adversity was measured using a 17-item scale of domestic adversities (e.g., poverty, neglect, physical abuse, verbal abuse) and modelled using cumulative risk analysis (LCA). Mental health was measured using four validated depression and anxiety questionnaires and cognitive impairment was determined by a clinically validated algorithmic diagnostic criteria. The association between childhood adversity and late-life mental health was estimated using generalised additive models, and the association with cognition utilised multiple logistic regressions. Models were adjusted for gender, race, and education. Results Generalised additive models indicated that a greater number of cumulative adversities were associated with poorer scores on all four mental health measures. No notable interactions between ACEs and gender were observed. In contrast, there was no association between childhood adversity and cognitive impairment in any of the tested logistic regression models. No gender differences were observed and no interactions with education or genotype were found. Conclusion Consistent with prevailing literature, our study provides additional evidence for the enduring effects of domestic childhood adversity on anxiety and depression in older adulthood. Furthermore, the absence of associations between early adversity and cognitive impairment indicates that other factors might play a more prominent role in determining late-life cognitive outcomes.

JUST THE TWO OF US? THE PSYCHOLOGICAL IMPACT OF MARITAL DISSOLUTION ON CHILDLESS OLDER ADULTS

Abstract An estimated 15% of U.S. adults ages 55+ are childless, with this proportion projected to increase among future cohorts. Of the 15 million childless older adults today, 40 percent are married – challenging the notion that childlessness is the domain of never married persons only. Little is known about the experiences of childless older adults who become widowed or divorced, and whether they suffer poorer mental health than their peers with children. Widowed and divorced persons lack the support of children yet may possess other resources or strengths as they age on their own. We use data from the 2016 and 2018 waves of the Health and Retirement Study (N = 16244) to evaluate whether parental status (childless, any living biological child(ren), stepchild(ren) only, all child(ren) now deceased) moderates the association between marital status (married, cohabiting, divorced/separated, widowed) and mental health (depressive symptoms, and social and emotional loneliness) and whether these patterns differ by gender. Multivariate moderation analyses show that childless widowed men and divorced men who lost a child to death have dramatically higher levels of social loneliness, relative to other men. Childlessness does not moderate the effect of marital status on loneliness or depressive symptoms among women. However, widowed and divorced women with stepchildren only evidence significantly higher depression and emotional loneliness. We discuss implications for understanding late-life mental health, underscoring that childlessness does not uniformly compromise mental health among unmarried persons, and that some parent-child relations (especially step-relations) may be a source of stress rather than solace.

NEW MEASURES AND POPULATION PREVALENCE OF VISION IMPAIRMENT IN NHATS

Abstract The National Health and Aging Trends Study (NHATS) is a nationally representative panel study of older U.S. adults that in 2021 (Round 11) added to its annual protocol a suite of objective visual function measures consisting of distance visual acuity, near visual acuity, and contrast sensitivity tests. These measures were developed to approximate clinical gold-standard tests, while allowing for administration on a tablet in participants’ homes. The tests were found to have good agreement with clinical gold-standards based on their limits of agreement, correlations, and lack of systematic bias between tests. In the initial 2021 fielding of the NHATS visual function measures, 27.8% (25.5%-30.1%) of U.S. adults over age 70 had one or more visual impairment (VI) (distance VI: 10.3% [8.9%-11.7%]; near VI: 22.3% [20.3%-24.3%]; contrast sensitivity impairment: 10.0% [8.5%-11.4%]), and the prevalence was highest among those who were older, had less education, lower income, and were of Hispanic ethnicity and non-White race. Additionally, the adjusted prevalence ratio for dementia was significantly higher among those with each type of VI compared to those with normal vision (moderate/severe distance VI=1.72 [1.26-2.35]; any near VI=1.40 [1.16-1.69]-; contrast sensitivity impairment =1.31 [1.04-1.66]). Since few other national studies of older adults include objective visual function measures, NHATS now serves as a vital resource for the study of vision epidemiology and the impact of VI and blindness on later-life health outcomes and trajectories.

Associations between plasma metal/metalloid mixtures and the risk of central obesity: A prospective cohort study of Chinese adults

Central obesity has increased rapidly over the past decade and posed a substantial disease burden worldwide. Exposure to metals/metalloids has been acknowledged to be involved in the development of central obesity through regulation of cortisol, insulin resistance, and glucocorticoid receptor reduction. Despite the importance, it is lack of prospective study which comprehensively evaluate the relations between multiple metals exposure and central obesity. We explored the prospective associations of plasma metal concentrations with central obesity in a prospective study of the Dongfeng-Tongji cohort. The present study included 2127 participants with a 6.87-year mean follow-up duration. We measured 23 plasma metal/metalloid concentrations at baseline. The associations between metals and incident central obesity were examined utilizing the Cox proportional hazard regression in single and multiple metals models. Additionally, we applied elastic net (ENET), Bayesian kernel machine regression (BKMR), plasma metal score (PMS), and quantile-based g-computation (Qgcomp) models to explore the joint associations of metal mixtures with central obesity. After adjusting potential confounders, we found significant associations of plasma manganese (Mn) and thallium (Tl) concentrations with a higher risk of central obesity, whereas plasma rubidium (Rb) concentration was associated with a lower risk of central obesity both in single and multiple metals models (all FDR <0.05). The ENET and Qqcomp models verified similar metals (Mn, Rb, and Tl) as important predictors for central obesity. The results of both BKMR model and PMS suggested cumulative exposure to metal mixtures was associated with a higher risk of central obesity. Our findings suggested that co-exposure to metals was associated with a higher risk of central obesity. This study expands our knowledge that the management of metals/metalloids exposure may be beneficial for the prevention of new-onset central obesity, which may subsequently alleviate the disease burden of late-life health outcomes.

Cohort Profile: Better Health in Late Life.

Humans are living longer and may develop multiple chronic diseases in later life. The Better Health in Late Life cohort study aims to improve our understanding of the risks and outcomes of multimorbidity in the Danish population. A randomly-selected sample of Danish residents who were 50-65 years of age received a questionnaire and an invitation to participate in this study. Respondents completed an online survey between October 2021 and January 2022 which addressed topics that included self-assessed health, mental health, sleep, specific medical conditions, use of painkillers, diet, alcohol consumption, smoking, physical activity, and body composition. This information was linked to the Danish health and social registries (some established in 1943 and onwards) that maintain data on filled prescriptions, hospital records, socioeconomic status, and health care utilization. Responses were received from 115,431 of the 301,244 residents invited to participate (38%). We excluded respondents who answered none of the questions as well as those who provided no information on sex or indicated an age other than 50-65 years. Of the 114,283 eligible respondents, 54.8% were female, 30.3% were overweight, and 16.7% were obese. Most participants reported a weekly alcohol consumption of less than seven units and 13.3% were current smokers; 5.2% had a history of hospitalization for solid cancer, and 3.0%, 2.3%, 2.0%, and 0.9% reported chronic pulmonary disease, diabetes, stroke, and myocardial infarction, respectively. The most frequently filled prescriptions were for medications used to treat the nervous system and cardiovascular diseases (38.1% and 37.4%, respectively).

Multiple socioeconomic risks and cognitive impairment among older men and women in India.

Socioeconomic status (SES) is negatively associated with innumerable health outcomes, including cognitive functioning. Yet much remains undiscovered about SES patterns in later-life cognition in low-and middle-income countries (LMICs). The purpose of this study was to examine the association between separate and combined socioconomic risks and cognitive impairment among older adults in India. Further, given gender disparities in later life cognitive functioning and SES, the study examines the associations between socioeconomic risks and cognitive impairment separately, for older men and women. Data come from the 2017-18, first wave of the Longitudinal Aging Study in India (LASI), with 31,464 older adults aged 60years and above. Cognitive impairment was assessed using multiple broad measures of memory, orientation, arithmetic function, and visuo-spatial construction skills. We present descriptive statistics along with cross-tabulation of the outcome variable. Additionally, binary logistic regression analysis was used to test the association between outcome and explanatory variables. SES is measured using education, paid work status, and household wealth measured using monthly per-capita consumption expenditure (MPCE). A proportion of 7.14% of the older men and 20.03% of older women reported cognitive impairment. The odds of cognitive impairment were higher among uneducated older men and women, and older men and women in lowest wealth quintile. Surprisingly, older women without current or prior work history report lower odds of cognitive impairment compared to their peers in labor force. While odds of cognitive impairment are higher among non-working older men, this association is not statistically significant. In older men, the odds of cognitive impairment were 5.34, 7.14, and 13.05 times higher with one, two, and three risk factors, respectively, compared with those with no risk exposure. A similar trend was observed for women but with comparatively lower odds. Our findings underscore the need to distinguish between varying elements of SES to construct "upstream" health policies and programs that redistribute resources. In particular, the findings support the use of multiple SES indicators in identifying older adults most susceptible to cognitive deficits, and planning gender-based interventions to improve cognitive health in late life.

Childhood community advantage and late‐life brain health among a racially/ethnically diverse cohort

AbstractBackgroundMany studies associate late‐life community disadvantage with worse late‐life brain health. It is unknown if childhood community disadvantage is associated with late‐life brain health in racially/ethnically diverse populations.MethodKHANDLE and STAR are racially/ethnically diverse harmonized cohorts of older members of Kaiser Permanente Northern California. A random subset of participants (N = 411) underwent 3T MRI; regional brain volumes and white matter integrity were measured. Stabilized inverse probability weights were estimated to account for imaging selection based on study, race/ethnicity, baseline age, and sex/gender. Residence at birth was geocoded and linked to historical Area Deprivation Indices (ADI) from the Neighborhood Atlas. ADI is a nationally ranked percentile, where higher scores represent greater relative community disadvantage. Weighted general linear models investigated associations between continuous ADI (rescaled so 1 unit = a change of 10 percentile points of national ADI rankings) and imaging measures among participants age 65+. Separate weighted models examined associations between national ADI quintiles grouped for analysis as &lt;20th percentile (the most advantaged quintile), 20th‐79th percentiles (middle 3 quintiles) and &gt; = 80 (most disadvantaged quintile) and imaging measures.ResultCompared with the complete KHANDLE/STAR cohorts, the imaging sample was younger with larger proportions of Latino adults and STAR participants (Table 1). Among the imaging sample, those with ADI&gt; = 80 were older, had lower educational attainment, were more likely to be Black and less likely to be White or Asian when compared with those with ADI&lt;20. Increases in continuous ADI were associated with worse brain health, including lower gray matter volume (β = ‐0.05, 95% CI = ‐0.08, ‐0.02), larger lateral ventricle (β = 0.06, 95% CI = 0.02, 0.10), and larger white matter hyperintensities (β = 0.06, 95% CI = 0.03, 0.08; Table 2, Model Set 1). In models examining categorical ADI, those with ADI&gt; = 80 (least advantaged communities) had significantly worse brain health across all measures and those with ADI = 20‐79 had larger white matter hyperintensities when compared with those with ADI&lt;20 (ref = most advantaged quintile; Table 2, Model Set 2).ConclusionCommunity disadvantage in childhood is associated with worse brain health in late life. Future work will explore the potential pathways (e.g., individual education attainment; midlife cardiovascular risks) that may explain these associations.

Can emotional acceptance buffer the link between executive functioning and mental health in late life?

Emotional acceptance is thought to play an important role in protecting mental health. However, few studies have examined emotional acceptance among older adults who may experience declines in functioning, including executive functioning. The present laboratory-based study examined whether emotional acceptance and (to determine specificity) detachment and positive reappraisal moderated links between executive functioning and mental health symptoms in a sample of healthy older adults. Emotion regulation strategies were measured using questionnaire-based measures (using established questionnaires) as well as performance-based measures (instructing individuals to use emotional acceptance, detachment, and positive reappraisal in response to sad film clips). Executive functioning was measured using a battery of working memory, inhibition, and verbal fluency tasks. Mental health symptoms were measured using questionnaires to assess anxiety and depressive symptoms. Results showed that (a) emotional acceptance moderated the link between executive functioning and mental health such that lower executive functioning predicted higher levels of anxiety and depressive symptoms at low but not at high levels of emotional acceptance. Moderation effects tended to be (b) stronger for emotional acceptance compared to the other emotion regulation strategies (though not all comparisons were statistically significant). Findings were (c) robust when controlling for age, gender, and education for questionnaire-based (but not performance-based) emotional acceptance. These findings contribute to the literature on emotion regulation specificity and highlight the mental health benefits of emotional acceptance in the face of low executive functioning. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Association of periodontal condition with cognitive impairment and the mediating role of accelerated biological aging among US older adults

AbstractBackgroundIncreasing evidence has shown the associations between periodontitis and cognitive impairment or dementia; however, few studies have explored the role of accelerated biological aging that affects this association. Biological aging is the gradual and progressive decline in system integrity that occurs with advancing age. In this study, we examined the mediating effect of biological aging on the association between periodontal conditions and cognitive impairment in US older adults.MethodWe analyzed data from 2,186 participants aged 60 and older from the US National Health and Nutrition Examination Survey 2011‐2014. Data included sociodemographic, behavioral, and health‐related characteristics, periodontal status (measured by mean clinical attachment loss and pocket depth), blood‐chemistry measures of biological age (using KDM‐biological age and PhenoAge algorithms), and cognitive functioning (measured by Digit Symbol Substitution Test). We created an accelerated biological aging measure using residuals from regressing each blood‐chemistry measure on chronological age. The biological ages’ residual discrepancies with chronological age were defined as the biological age accelerations (BAA). Mediation analysis, weighted for complex survey design, assessed the effect of BAA on the association between periodontal conditions and cognitive functioning.ResultAfter adjusting for covariates, participants with periodontitis exhibited greater KDM BAA (β [SE] = ‐0.40 [0.17]), PhenoAge BAA (β [SE] = ‐0.57 [0.21]), and lower level of cognitive function (β [SE] = ‐1.50 [0.33]) than those without periodontitis. Both KDM and PhenoAge BAA were significantly associated with lower cognitive functioning (β [SE] = ‐0.27 [0.10] and β [SE] = ‐0.29 [0.07]), mediating 11.0% and 9.7% of the total effects of periodontitis on cognitive functioning, respectively. Furthermore, KDM and PhenoAge BAA mediated 11.7% and 5.8% of the association between mean pocket depth and DSST, respectively.ConclusionOur findings suggest that periodontitis is partially associated with worse cognitive functioning through accelerating the biological aging process. Efforts to improve oral health or slow biological aging have the potential to help reserve cognitive health in later life.

Placental weight percentile curves in a Danish population.

The role of the placenta is to transport oxygen and nutrients to the fetus, and a well-functioning placenta is vital to fetal health. Our aim was to develop placental weight percentile curves adjusted by gestational age, and stratified by major maternal comorbidities. The study was a population study in a Danish cohort. Data was drawn from The Medical Birth Register and the National Patient Register. We included singleton births with a gestational age of 22 + 0 to 42 + 6 weeks. We excluded multiple pregnancies, stillbirths and retained placentas. A total of 611 418 placentas were included. Percentile line graphs were created in groups of all placentas, hypertensive disorders and diabetic disorders. Tables and figures are presented for placental weight percentile curves according to gestational age for all placentas, hypertensive disorders and diabetic disorders, respectively. Placental weight was generally higher in the diabetic placentas, and lower in the hypertensive placentas. These percentile curves may serve as a reference for other populations, and may be useful for other studies investigating the role of the placenta in relation to pregnancy outcomes, and health in later life.

The association between air pollution and dementia: results from the Cognitive Function and Ageing Study II and Wales

AbstractBackgroundAir pollution has been recognised as one of the key modifiable risk factors for dementia. In the UK, there is a lack of evidence from population‐based cohort studies including older people from different backgrounds and living environments. Using two multicentre ageing cohorts in England and Wales, the aim of this study is to investigate the potential impact of air pollution on dementia in later life.MethodThis study was based on the Cognitive Function and Ageing Study (CFAS) II (2008‐2011) and Wales (2011‐2013), two longitudinal studies of people aged 65 or above across five centres in England (Cambridgeshire, Newcastle upon Tyne, Nottingham) and Wales (Gwynedd, Neath Port Talbot). A two‐year follow‐up wave was carried out for both studies. Dementia was identified using the Geriatric Mental State and its diagnostic algorithm, Automated Geriatric Examination for Computer Assisted Taxonomy (GMS‐AGEACT). Based on the participants’ postcodes at the baseline, exposure to four air pollutants in 2012, including nitrogen dioxide (NO2), ozone (O3), particulate matter with a diameter ≤10 microns (PM10) and ≤2.5 microns (PM2.5), was estimated using the Community Multiscale Air Quality pollution modelling at a resolution of 20×20 m. Multistate modelling was used to investigate the effects of air pollution exposure on risk of developing dementia over the follow‐up period, incorporating mortality (from national death certification) and adjusting for age, sex, education, study centre and area deprivation.ResultAmong the 11329 participants in CFAS II (N = 7753) and Wales (N = 3576), the median exposure was 17.7 (IQR = 11.6) µg/m3 for NO2, 43.8 (IQR = 11.1) µg/m3 for O3, 15.5 (IQR = 3.1) µg/m3 for PM10 and 10.1 (IQR = 2.8) µg/m3 for PM2.5 and large variation was observed across the five centres. Per unit increase in NO2 exposure was associated with a higher risk of dementia in CFAS II (HR: 1.07; 95%CI: 1.03, 1.12) but not the Welsh cohort (HR: 0.93; 95%CI: 0.86, 1.00) after adjustment. For the other air pollutants, the associations were unclear.ConclusionOur study suggests limited evidence for the impacts of air pollution on dementia. Other environmental factors may influence individual exposure to air pollution and altogether have a complex effect on cognitive health in later life.