Middle Adulthood Research Articles

Narrating lives across 16 years: Developmental trajectories of coherence and relations to well-being in a lifespan sample.

The ability to narrate a life coherently develops first in adolescence, but little is known about its course across adulthood and into old age. Also, the potential association of life narrative coherence with well-being has never been studied. Our aim was to investigate lifespan development of coherence and associations with well-being using data from the longitudinal MainLife study. A total of 172 urban Germans (8-80 years; 87 females) narrated their lives up to six times across 16 years (N = 803 brief entire life narratives). Most were highly educated, and the proportion of a migration background was typical for the local population. Life narratives were rated for three types of global coherence (temporal, causal-motivational, and thematic) and coded for two types of autobiographical arguments (stability maintaining and change engendering). Multilevel models were used to investigate their lifespan development and relations to well-being. While most life narrative measures increased up to emerging adulthood and then remained stable, thematic coherence continued to increase into middle adulthood. Only change-engendering autobiographical arguments slowly decreased from midlife onward. Unexpectedly, neither autobiographical arguments nor global coherence correlated significantly with well-being. Data exploration suggested an association between thematic coherence and self-continuity. We conclude that life narrative coherence may only be related to well-being if samples include cases with more extreme noncoherence (e,g., clinical disorders). Our findings add to understanding the development of the life story across the lifespan, especially in older age, and suggest studying relations of coherence, self-continuity, and well-being specifically in life crises and in clinical samples. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

“We Are Not Lazy (Rather We Persevere) But Please…”: The Resilience of Homeless Filipino Youths in the Covid-19 Pandemic

The COVID-19 pandemic has transformed and changed individuals and communities across the globe, particularly vulnerable populations such as homeless youths. This exploratory qualitative research study through a descriptive phenomenological lens delves into the resilience of homeless Filipino youths (N = 10) in Tacloban City, Philippines, during the pandemic, examining their ability to adapt and thrive amidst the crisis toward their relative well-being. Results showed that homeless youths have complex and unaddressed needs and challenges, such as longing for parental love, suffering from social discrimination and mental stress, receiving no government services, and thinking and feeling of suicide. Nonetheless, homeless youths exhibited remarkable resilience, employing differentiated or collective coping mechanisms like developing and strengthening friendship and family relations while believing in God to navigate the pandemic’s disruptions and thus meet resolutions across the tensions surrounding resilience. The paper contributes to developing informed policies and programs tailored to the immediate and long-term needs of homeless youths. Future research may conduct follow-up or longitudinal studies on the dynamics of homelessness and the resilience of the same or related social groups in post-pandemic while transitioning into middle adulthood and beyond.

Age, period and cohort effects of heavy episodic drinking by sex/gender and socioeconomic position in Canada, 2000-2021.

Heavy episodic drinking (HED) trends have not been comprehensively examined in Canada. We measured age, period and birth cohort trends in HED in Canada by sex/gender and socioeconomic position. We analyzed repeat cross-sectional data from the 10 provinces in the Canadian Community Health Surveys from 2000 to 2021 using hierarchical cross-classified random effects logistic regression. 1 167 831 respondents aged 12+ . HED was defined as 4+ standard drinks for women or 5+ for men at least monthly in the past 12 months. Socioeconomic position was measured using household income and education. We observed steeper HED decreases in young adult men (aged 18-29) than women (by 14.4% and 8.7%, respectively, from 2015 to 2021) and HED increases in middle adult women (ages 50-64) (by 8.0% from 2000 to 2014). Sex/gender-specific age-period-cohort models revealed strong age and birth cohort effects. In women and men, respectively, HED peaked in young adulthood (18.2% and 33.8%) and decreased with age, and HED was greatest in the 1980-1989 cohort (20.7% and 35.8%) and decreased in the most recent cohort born in 1990-2009 (15.6% and 19.8%), particularly in men. Higher household incomes had greater HED across age, periods and cohorts, while trends varied by education. Compared with lower education groups, people with a bachelor's degree or above had the lowest HED in middle adulthood. People with a bachelor's degree or above had low HED in earlier cohorts, which converged with other education groups in recent cohorts due to a pronounced HED increase, particularly in women. The sex/gender gap in heavy episodic drinking (HED) appears to be converging in Canada: current young adult men are reducing HED, while high-risk cohorts of women are aging into middle adulthood with greater HED. Recent birth cohorts with a bachelor's degree or above experienced pronounced HED increases, which among women suggests greater educational attainment contributes to the converging gender gap in HED.

Subcortical volume in middle-aged adults with fetal alcohol spectrum disorders.

Studies of youth and young adults with prenatal alcohol exposure (PAE) have most consistently reported reduced volumes of the corpus callosum, cerebellum and subcortical structures. However, it is unknown whether this continues into middle adulthood or if individuals with PAE may experience premature volumetric decline with aging. Forty-eight individuals with fetal alcohol spectrum disorders (FASD) and 28 healthy comparison participants aged 30 to 65 participated in a 3T MRI session that resulted in usable T1-weighted and T2-weighted structural images. Primary analyses included volumetric measurements of the caudate, putamen, pallidum, cerebellum and corpus callosum using FreeSurfer software. Analyses were conducted examining both raw volumetric measurements and subcortical volumes adjusted for overall intracranial volume (ICV). Models tested for main effects of age, sex and group, as well as interactions of group with age and group with sex. We found the main effects for group; all regions were significantly smaller in participants with FASD for models using raw volumes (P's < 0.001) as well as for models using volumes adjusted for ICV (P's < 0.046). Although there were no significant interactions of group with age, females with FASD had smaller corpus callosum volumes relative to both healthy comparison females and males with FASD (P's < 0.001). As seen in children and adolescents, adults aged 30 to 65 with FASD showed reduced volumes of subcortical structures relative to healthy comparison adults, suggesting persistent impact of PAE. Moreover, the observed volumetric reduction of the corpus callosum in females with FASD could suggest more rapid degeneration, which may have implications for cognition as these individuals continue to age.

Childbearing beyond 40: Exploring the psychological state of expectant women through qualitative research

ABSTRACT This study explores the psychological state of middle-aged women who conceived through assisted reproductive technology, focusing on improving their antenatal mental health. The study employed a qualitative research design, utilizing an in-depth interview method to gather data from 16 expectant mothers in middle adulthood. Participants were recruited through purposive sampling applying the maximum variance technique, and data analysis was conducted using an inductive interpretive phenomenology approach. The qualitative analysis yielded 12 subthemes, grouped into two main themes: the psychological consequences and advantages of middle-aged pregnancy. The study revealed that regret, guilt, parental concerns, anticipatory anxiety, past trauma, and health-related anxiety contribute to psychological distress, while dissipation from childlessness, emotional preparedness, and support during life stages positively impact mental health. Antenatal care, prenatal counseling, spousal support, and education may help women mitigate distress and fully enjoy their pregnancy.

Sociodemographic, Health, and Lifestyle-Related Characteristics Associated With the Commencement and Completion of a Web-Based Lifestyle Educational Program for People With Multiple Sclerosis: Randomized Controlled Trial.

Digital health interventions increase access to multiple sclerosis (MS)-related knowledge for people living with MS; however, our understanding of factors associated with engagement in web-based learning is limited. This study aims to examine associations between participant sociodemographic, health, and lifestyle-related characteristics and the commencement and completion of the Multiple Sclerosis Online Course (MSOC) in a randomized controlled trial (RCT). An intervention course was developed based on the Overcoming MS Program-an evidence-based lifestyle modification program for MS, and a standard care course was developed based on international MS website information. An RCT was conducted to compare the effectiveness of the intervention course versus the standard care course in improving health outcomes in people living with MS. Participant data were collected from a baseline survey. Associations between baseline participant characteristics and MSOC commencement and completion, respectively, were assessed using multivariate log-binomial regression. Overall, 1893 participants enrolled in the RCT, and 45.27% (n=857) completed the baseline survey: 23.5% (n=444) in the intervention course and 21.8% (n=413) in the standard care course. Of these 857 participants, 631 (73.6%) commenced the standard care course or intervention course, and 49.1% (218/444) and 54.2% (224/413) completed the intervention course and standard care course, respectively. University education, partnered relationship status, and higher mental and physical quality of life were associated with 19%, 12%, 20%, and 22% higher rates of course commencement, respectively. Clinically significant fatigue was associated with a 10% reduction in the likelihood of commencement. Strongest associations with intervention course completion included middle and older adulthood, male sex, fatigue, and preexisting adherence to a diet program, with 96%, 27%, 24%, and 19% higher rates of completion observed, respectively, whereas higher self-efficacy was associated with up to 35% lower intervention course completion. Associations with standard care course completion included practicing meditation (20% higher completion), whereas employment was associated with 22% lower completion. Sociodemographic and clinical factors, as well as lifestyle-related factors, were important factors in MSOC commencement and completion. These data may help guide the design and enhancement of digital health interventions tailored for people living with MS. Australian New Zealand Clinical Trials Registry ACTRN12621001605886; https://tinyurl.com/2vyve9p9. RR2-10.1186/s12883-023-03298-0.

Adulthood weight changes, body mass index in youth, genetic susceptibility and risk of atrial fibrillation: a population-based cohort study

BackgroundEpidemiological evidence on weight change and atrial fibrillation (AF) remains limited and inconsistent. Previous studies on body mass index (BMI) in youth and AF rarely considered subsequent BMI. This study aimed to assess the associations of AF with weight change and BMI in youth, as well as modified effect by genetic susceptibility of AF.MethodsThe study included 21,761 individuals (mean age 57.8 years) from the Malmö Diet and Cancer cohort. Weight information was obtained at three time points, including recalled weight at age 20 years, measured weight at baseline (middle adulthood), and reported weight at 5-year follow-up examination (late middle adulthood). A weighted genetic risk score of AF was created using 134 variants.ResultsDuring a median follow-up of 23.2 years, a total of 4038 participants developed AF. The association between weight change from early to middle adulthood and AF risk was modified by sex (Pinteraction = 0.004); weight loss was associated with a lower AF risk in females, but not in males. Conversely, weight gain was positively associated with AF risk in a linear manner in females, whereas increased AF risk appeared only when weight gain exceeded a threshold in males. Participants with weight gain of > 5 kg from middle to late middle adulthood had a 19% higher risk of AF relative to those with stable weight, whereas weight loss showed a null association. Compared to individuals with a lower BMI at age 20 years, those with a BMI above 25 kg/m2 had an increased risk of AF (HR = 1.14; 95% CI: 1.02–1.28), after controlling for baseline BMI; this association was more pronounced in males or those with a lower genetic risk of AF.ConclusionsWeight gain in middle adulthood was associated with higher AF risk. Weight loss from early to middle adulthood, but not from middle to late middle adulthood, was associated with a lower risk of AF only in females. Higher BMI in youth was associated with an increased risk of AF, particularly among males or those with a lower genetic risk of AF.

Individual socioeconomic status, neighborhood disadvantage, and cognitive aging: A longitudinal analysis of the CLSA.

There are likely many contributors to variation in the rate of cognitive decline in middle and late adulthood, including individual and neighborhood socio-economic factors. This study examines whether individual socio-economic factors, namely income and wealth, correlate with cognitive decline, in part, through neighborhood-level social and material disadvantage. Using the three waves of data collection from the Canadian Longitudinal Study on Aging (CLSA), this study included 51,338 participants between the age of 45 and 85 years at baseline (51% female). Individual socio-economic status (SES) was assessed by annual household income and by the current value of savings and investments. Neighborhood disadvantage was measured by area-based material and social deprivation indices. Cognition was measured at each wave using verbal fluency, mental alternations, and delayed word recall. Latent change score models, incorporating direct and indirect pathways, were constructed to estimate the indirect effect of individual SES on cognitive change through area-level disadvantage. Multi-group models were constructed on the basis of age-group (45-64 years; 65-74 years; or 75+ years) to allow for varying estimates across age. Among 45-64-year-olds, income and wealth had indirect effects on initial cognitive level and on rate of cognitive decline through material disadvantage (standardized indirect effects = 0.01, p < 0.001), but only wealth had an indirect effect through social disadvantage (p = 0.019). Among 65-74-year-olds, income and wealth had indirect effects on initial cognitive level (p < 0.01) but not on rate of cognitive decline (p > 0.05), and among 75+ year-olds, no indirect effects were observed (p > 0.05). Wealth and income had direct effects, independent of neighborhood disadvantage, on cognition in all age groups (p < 0.05). Among middle-aged adults, greater individual SES may mitigate cognitive decline, in part, by allowing individuals to live in more materially and socially advantaged neighborhoods.

Cognitive Outcomes in Young Adults with Primary Arterial Hypertension: The Role of Cardiovascular Risk Factors and Hypertension-Mediated Organ Damage.

Background and Objectives: We aimed to explore the association between cognitive performance and markers of hypertension-mediated organ damage (HMOD) in young adults with hypertension. Materials and Methods: A group of adults aged 16 to 45 years with primary arterial hypertension completed a battery of paper-pencil as well as computer-based neuropsychological tests across all major cognitive domains. They also underwent office and ambulatory 24 h blood pressure, intima-media thickness measurements, heart ultrasound, and laboratory analysis of their lipid profile, blood uric acid concentration, and urine albumin-creatinine ratio. Associations between cognitive test results and markers of HMOD were explored through correlation analysis and age-, sex-, and body mass index-adjusted linear regression modeling. Results: Seventy-six individuals (62, 81.6% male) aged 36.5 years (interquartile range 18.4 to 42.0 years) were enrolled. After adjusting for age, sex, and body mass index in linear regression models, worse categorical fluency was associated with higher left ventricular mass (βst = -0.264, p = 0.043) and worse performance in a task of sustained attention-with higher left ventricular mass index (βst = -0. 304, p = 0.016). Worse phonemic fluency was related to higher pulse pressure (βst = -0.241, p = 0.049) in the respective model. Better strategy use in the task of spatial working memory was linked to higher daytime mean diastolic blood pressure (βst = -0.343 p = 0.017). Conclusions: Performance among young adults with hypertension across selected cognitive domains was inversely associated with pulse pressure, markers of left ventricular damage, and directly associated with daytime diastolic blood pressure. Our study suggests that the previously reported relationship between cognitive and cardiovascular markers in hypertension exists earlier than in middle or late adulthood.

How do school experiences in adolescence affect educational investment in adulthood? The case of parental investment in private tutoring in Germany

AbstractThis article examines the role of parents’ school experiences in adolescence on their educational investment strategies for their own children in middle adulthood. We focus our analysis on the parents’ decision to organize private tutoring (also called shadow education) for their children. Previous international research largely agrees that families with a high socioeconomic status (SES) are more likely to invest in tutoring to achieve competitive advantages in the educational race for higher credentials and maintain a high social status. In Germany, however, recent studies suggest that tutoring in Germany primarily serves underperforming children from les educated families to acquire relatively higher school degrees by compensating the higher demands of academic school tracks. We propose a theoretical decision model based on rational choice and life course theory incorporating psychological factors related to school performance of the parents (such as performance anxiety and ability self-concept) and operationalize four components that are intended to explain the (un)equal use of tutoring: (1) children’s school background, (2) parents’ cost and (3) benefit considerations, as well as (4) parents’ school biography. In addition, we hypothesize on the intergenerational transmission of performance-related factors from parents to their children and how this affects SE investment. We test our hypotheses quantitatively through logit regressions and a structural equation model using unique longitudinal data for 558 families (parents and their children) from the German “LifE” study (1979–2012). Our study produced two key findings: On the one hand, the parents’ previous school performance plays a direct role in the extent to which they themselves are able to provide their children with the necessary support in the event of poor performance. On the other hand, the performance-related experiences of the parents during school are to a certain extent transmitted to their children and thus influence their grades, ability self-concept and performance anxiety. These factors, in turn, are decisive for the decision to organize SE. Our findings indicate that instead of reducing the decision-making process for SE to absolute dimensions of student performance and parents’ SES and related cost-benefit calculations, dynamic factors behind this family decision related to intergenerational transmission and individual characteristics should be considered.

Transcatheter Pulmonary Valve Replacement in Middle and Late Adulthood

Transcatheter pulmonary valve replacement (TPVR) is now frequently performed in patients with adult congenital heart disease. As the life expectancy of the population with adult congenital heart disease continues to improve, more patients will require pulmonary valve intervention. This study details the short-term and midterm clinical outcomes of patients aged ≥40 years who underwent TPVR. We performed an institutional retrospective cohort study that included patients aged ≥40 years who underwent TPVR (and clinical follow-up) from January 1, 2012 to January 1, 2024. Descriptive analyses, Kaplan-Meier survival analysis, and Cox proportional hazard modeling were used to determine outcomes and risk factors affecting survival. The study included 67 patients, and median age at TPVR was 48 years (43 to 57). Median hospital length of stay after TPVR was 1 day (1 to 3); periprocedural complications occurred in 5 patients, and acute kidney injury occurred in 1 patient. Median duration of follow-up was 3.5 years (0.1 to 9.7). There were 9 total deaths, and 1-, 3-, and 5-year Kaplan-Meier survival after TPVR was 95%, 91%, and 82%, respectively. Moderate or worse right ventricular dysfunction was present in 22 patients before TPVR and in 20 patients after TPVR. Inpatient status before TPVR negatively affected survival (hazard ratio 24.7, 3.3 to 186.1, p = 0.002). In conclusion, TPVR was performed in patients aged ≥40 years with favorable periprocedural and midterm follow-up outcomes including survival, but right ventricular dysfunction did not improve, and further exploration of the ideal timing of TPVR in this age group is warranted.

Genotype and X-chromosome inactivation are associated with disease severity in females with X-linked Alport syndrome.

Male patients with X-linked Alport syndrome (XLAS) generally develop end-stage kidney disease in early or middle adulthood and show distinct genotype-phenotype correlations. Female patients, however, show various phenotypes ranging from asymptomatic to severe with no genotype-phenotype correlations. However, the factors affecting the severity of XLAS in female patients are unclear. Since X-chromosome inactivation (XCI) affects the severity of certain female X-linked diseases, we investigated whether genotype and XCI were associated with XLAS severity in female patients in a large Japanese cohort. Among 139 female patients with genetically diagnosed XLAS at our institution, we conducted XCI analysis on peripheral blood leukocytes using the human androgen receptor assay method and analyzed two cohorts. In 74 adult female patients, we evaluated the correlation between kidney function (creatinine-estimated glomerular filtration rate [Cr-eGFR] optimized for Japanese individuals) and genotype/XCI using multivariable linear regression analysis, and in 65 pediatric female patients, we evaluated the correlation between kidney function (Cr-eGFR optimized for Japanese individuals) and genotype/XCI using multivariable linear regression analysis. We also investigated the correlation between the development of proteinuria (urine protein-to-creatinine ratio above normal for the patient's age) and genotype/XCI using multivariable Cox proportional hazard analysis. In adult female patients, XCI pattern was significantly associated with Cr-eGFR (regression coefficient estimate = -0.53, P=0.004), whereas genotype was not (P=0.892). In pediatric female patients, both genotype and XCI pattern were significant independent risk factors for the development of proteinuria (hazard ratio [HR], 3.702; 95% confidence interval [CI], 1.681-8.150; P=0.001 and HR, 1.043; 95% CI, 1.061-1.070; P=0.001, respectively), whereas both genotype and XCI pattern were not associated with Cr-eGFR (P=0.20, P=0.67, respectively). Genotype and XCI are factors associated with the severity in females with XLAS.

Association between weight change and serum anti-aging protein α-Klotho: a cross-sectional study in middle-aged and older adults

The relationship of weight change has extended to accelerated ageing, yet little is known about the association between weight change and anti-aging protein α-Klotho. This study included 10,972 subjects from the National Health and Nutrition Examination Survey 2007–2016. Participants were measured body weight and height at baseline and recalled weight at young adulthood and middle adulthood. α-Klotho concentrations were quantified. Generalized linear regression models were used to assess the association between weight change and α-Klotho. Across adulthood, maximal overweight, non-obese to obese, and stable obesity were consistently associated with lower serum Klotho levels. Compared with participants who remained at normal weight, from middle to late adulthood, participants experiencing maximal overweight, moving from the non-obese to obese, and maintaining obesity had 27.97 (95% CI: − 46.57 to − 9.36), 39.16 (95% CI: − 61.15 to − 17.18), and 34.55 (95% CI: − 55.73 to − 13.37) pg/ml lower α-Klotho, respectively; similarly, from young to late adulthood, those had 29.21 (95% CI: − 47.00 to − 11.42) , 34.14 (95% CI: − 52.88 to − 15.40), and 36.61 (95% CI: − 65.01 to − 8.21) lower, respectively. Interestingly, from middle to late adulthood, the absolute weight change values of 590 participants who changed from obese to non-obese were negatively associated with serum α-Klotho. Each 1 kg of weight loss during the process of changing from obese to non-obese brought about a relative increase in α-Klotho levels of 3.03 pg/ml. The findings suggest the potential role of weight management across adulthood for aging.

Neighborhood Socioeconomic Disadvantage Across the Life Course and Premature Mortality

There are consistent data demonstrating that socioeconomic disadvantage is associated with risk of premature mortality, but research on the relationship between neighborhood socioeconomic factors and premature mortality is limited. Most studies evaluating the association between neighborhood socioeconomic status (SES) and mortality have used a single assessment of SES during middle to older adulthood, thereby not considering the contribution of early life neighborhood SES. To investigate the association of life course neighborhood SES and premature mortality. This cohort study included Black and White participants of the multicenter Atherosclerosis Risk in Communities Study, a multicenter study conducted in 4 US communities: Washington County, Maryland; Forsyth County, North Carolina; Jackson, Mississippi; and the northwestern suburbs of Minneapolis, Minnesota. Participants were followed up for a mean (SD) of 18.8 (5.7) years (1996-2020). Statistical analysis was performed from March 2023 through May 2024. Participants' residential addresses during childhood, young adulthood, and middle adulthood were linked with US Census-based socioeconomic indicators to create summary neighborhood SES scores for each of these life epochs. Neighborhood SES scores were categorized into distribution-based tertiles. Premature death was defined as all-cause mortality occurring before age 75 years. Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs. Among 12 610 study participants, the mean (SD) age at baseline was 62.6 (5.6) years; 3181 (25.2%) were Black and 9429 (74.8%) were White; and 7222 (57.3%) were women. The lowest, compared with the highest tertile, of neighborhood SES score in middle adulthood was associated with higher risk of premature mortality (HR, 1.28; 95% CI, 1.07-1.54). Similar associations were observed for neighborhood SES in young adulthood among women (HR, 1.25; 95% CI, 1.00-1.56) and neighborhood SES in childhood among White participants (HR, 1.25; 95% CI, 1.01-1.56). Participants whose neighborhood SES remained low from young to middle adulthood had an increased premature mortality risk compared with those whose neighborhood SES remained high (HR, 1.25; 95% CI, 1.05-1.49). In this study, low neighborhood SES was associated with premature mortality. The risk of premature mortality was greatest among individuals experiencing persistently low neighborhood SES from young to middle adulthood. Place-based interventions that target neighborhood social determinants of health should be designed from a life course perspective that accounts for early-life socioeconomic inequality.

Hierarchical tricarboxylic acid cycle regulation by hepatocyte arginase 2 links the urea cycle to oxidative metabolism

Urea cycle impairment and its relationship to obesity and inflammation remained elusive, partly due to the dramatic clinical presentation of classical urea cycle defects. We generated mice with hepatocyte-specific arginase 2 deletion (Arg2LKO) and revealed a mild compensated urea cycle defect. Stable isotope tracing and respirometry revealed hepatocyte urea and TCA cycle flux defects, impaired mitochondrial oxidative metabolism, and glutamine anaplerosis despite normal energy and glucose homeostasis during early adulthood. Yet during middle adulthood, chow- and diet-induced obese Arg2LKO mice develop exaggerated glucose and lipid derangements, which are reversible by replacing the TCA cycle oxidative substrate nicotinamide adenine dinucleotide. Moreover, serum-based hallmarks of urea, TCA cycle, and mitochondrial derangements predict incident fibroinflammatory liver disease in 106,606 patients nearly a decade in advance. The data reveal hierarchical urea-TCA cycle control via ARG2 to drive oxidative metabolism. Moreover, perturbations in this circuit may causally link urea cycle compromise to fibroinflammatory liver disease.

Loneliness Trajectories and Chronic Loneliness Around the World.

We examine cross-national variation in (a) loneliness trajectories and (b) the association between common social risk factors and chronic loneliness in middle and older adulthood. Using longitudinal data, we assess the country-level prevalence of loneliness trajectories (chronic, transitory, and no loneliness) and the extent of common social risk factors for loneliness (living alone, widowhood, divorce, no grandchildren, having chronic conditions, and never working) among adults 50 and older in 20 countries covering 47% of the global population in this age bracket. Additionally, we compare how the associations between social risk factors and chronic loneliness vary across countries. We find considerable variation in the prevalence of chronic loneliness cross-nationally, ranging between 4% (Denmark) and 15% (Greece) of adults 50 and older. Living arrangements have the most consistent association with the likelihood of chronic loneliness across countries, with those ever living alone having an 8% higher likelihood of chronic loneliness on average across countries, with a range of 2%-25%. Additionally, those who never report working and those with chronic conditions have a higher likelihood of chronic loneliness across more than a third of the countries. These results suggest that policies and interventions targeted to middle age and older adults living alone and with limited work histories or with chronic conditions are critical in reducing the public health challenges of chronic loneliness.

Antrodia camphorata Supplementation during Early Life Alters Gut Microbiota and Inhibits Young-Onset Intestinal Tumorigenesis in APC1638N Mice Later in Life.

Young-onset colorectal cancer is an increasing concern worldwide due to the growing prevalence of Westernized lifestyles in childhood and adolescence. Environmental factors during early life, particularly early-life nutrition, significantly contribute to the increasing incidence. Recently, there have been reports of beneficial effects, including anti-inflammation and anti-cancer, of a unique fungus (Antrodia camphorate, AC) native to Taiwan. The objective of this study is to investigate the impact of AC supplementation in early life on the development of young-onset intestinal tumorigenesis. APC1638N mice were fed with a high-fat diet (HF) at 4-12 weeks of age, which is equivalent to human childhood/adolescence, before switching to a normal maintenance diet for an additional 12 weeks up to 24 weeks of age, which is equivalent to young to middle adulthood in humans. Our results showed that the body weight in the HF groups significantly increased after 8 weeks of feeding (p < 0.05). Following a switch to a normal maintenance diet, the change in body weight persisted. AC supplementation significantly suppressed tumor incidence and multiplicity in females (p < 0.05) and reduced IGF-1 and Wnt/β-catenin signaling (p < 0.05). Moreover, it altered the gut microbiota, suppressed inflammatory responses, and created a microenvironment towards suppressing tumorigenesis later in life.

Performance of ACR-TIRADS in assessing thyroid nodules does not vary according to patient age.

A few studies have evaluated the performance of the American College of Radiology Thyroid Imaging Reporting And Data System (ACR-TIRADS) in pediatric and elderly patients and found differences between the latter two age groups and middle adulthood. Thus, the present study was undertaken to explore the possible variation of ACR-TIRADS performance across different ages of patients. A retrospective population undergoing thyroidectomy was selected to use histology as the reference standard. Ultrasound images were reviewed, and alignment of ACR-TIRADS with the corresponding histological diagnosis was made afterwards. Results of the age groups were compared. The ACR-TIRADS diagnostic performance was calculated considering the assessment of nodules across risk categories (i.e., from TR1 to TR5), rate of unnecessary FNAC (UN-FNAC), and rate of necessary but non-performed FNAC (NNP-FNAC). Overall, 114 patients with a total of 220 nodules (46 carcinomas) were included. The rate of UN-FNAC was 66.3%, being 93.1% in TR3, 82.1% in TR4, and 31.4% in TR5. There were 15 NNP-FNACs. No significant difference was observed between age groups in terms of sample size, nodule, cancer, and FNAC. The nodule assessment according to ACR-TIRADS categories did not vary across ages. Sensitivity and specificity recorded in three age tertiles were not significantly different. The present study shows that the performance of ACR-TIRADS is not significantly influenced by patient age.

The impact of impaired intrauterine growth on male fertility: A systematic review and meta-analysis.

Adverse intrauterine environment was believed to have deleterious effects on the gonadal function. However, the association between impaired intrauterine growth and fertility in adult males has not been established. To compare the reproductive rates of males born small for gestational age (SGA), with low birth weight (LBW) or very low birth weight (VLBW) with control groups. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was followed to search PubMed, Web of Science, Cochrane Library, and Embase databases from inception to June 16, 2023. Cohort studies investigating the reproductive rates of males born SGA, with LBW or VLBW were included. A random or fixed effects model was used for different exposures. A total of 10 studies out of 3,801 records were included. Males born SGA showed a higher risk of infertility than the control group (odds ratio, OR=0.91, 95% confidence interval, 95% CI 0.89-0.93, p=0.000). The reproductive rates of individuals born with LBW or VLBW were lower than the control group (OR=0.86, 95% CI 0.78-0.94, p=0.001; OR=0.57, 95% CI 0.40-0.81, p=0.002, respectively). Participants were further divided into two age groups of 18-35 and 35-45 years. In both subgroups, the reproductive rates were lower in males born SGA, with LBW or VLBW compared with controls. Sensitivity analysis showed the robustness of the pooled estimates among LBW and VLBW. In summary, SGA, LBW, and VLBW were associated with a higher risk of male infertility in both early and middle adulthood. Achieving optimal intrauterine growth would be helpful to prevent male infertility.

The Phenomenon Of Bullying Among Teenagers In A Thematic Hadith Perspective

Bullying has serious and long-term effects on adolescents. Victims of bullying have a higher risk of experiencing physical and psychosomatic problems such as headaches, stomachaches, and sleep problems. They are also at higher risk of internalizing problems such as anxiety and depression in young adulthood and middle adulthood. Bullying can also have a negative impact on both the victim and the bully. It can lead to physical injury, social and emotional distress, self-harm, and even death. Teens who bully others have a higher risk of drug abuse, academic problems, and experiencing violence in adolescence and adulthood. The issue of bullying becomes a big problem if it is not addressed. It is important to prevent bullying and provide support to those who are victims. The object of this research material is a case of bullying according to the hadith themes. This study uses a qualitative approach by applying the thematic method. The results of this study show that the themes of hadith can be formulated in the theoretical framework of the phenomenon of bullying in adolescents. The discussion of this study explains that bullying is not relevant to the teachings of Islam