The association between cannabis use and cardiovascular outcomes among U.S. Adults, 2020-2023.

Chronic medical diseases and depressive symptoms in Europe: A study using representative data from 275,009 individuals in the third wave of the European Health Interview Survey (EHIS-3).

Key factors of depression in middle-aged and older adults based on social-ecological systems theory: an interpretable machine learning approach.

The similarities and differences of multiple chronic diseases risk factors across depressive symptoms trajectories among middle-aged and older Chinese adults: A 10-year longitudinal cohort study.

Allostatic load and biological aging among middle aged adults.

Trajectories of depressive symptoms and incident diabetes risk among middle-aged and older adults: A longitudinal cohort study.

Spatial and temporal patterns and determinants of chronic disease multimorbidity among middle-aged and older adults in China: Evidence from two longitudinal cohort studies.

Global burden of type 1 diabetes in adults aged 40-64: trends from 1990 to 2021 and projections to 2036.

Association between anxiety, stress, and cognition in middle-aged adults at risk for Alzheimer's disease: Results from the Healthy Brain Project.

Joint effects of sleep duration and depressive symptoms on the risk of cardiovascular disease and mediating role of depressive symptoms in middle-aged and older Chinese adults: A nationwide prospective cohort study

Stagnating declines in cardiovascular disease mortality in the United States expanded the black-white life expectancy gap.

ABSTRACT Background The rapid development of digital infrastructure has the potential to affect public health, particularly among middle-aged and older adults. However, the causal relationship between digital infrastructure and physical health remains underexplored, especially in non-Western contexts. Objectives This study investigates the causal effect of digital infrastructure development on the physical health of middle-aged and older adults in China, using panel data from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2020) and a DID approach based on the Broadband China pilot policy. Methods We construct a quasi-natural experiment using the Broadband China policy to examine its impact on physical health. The DID model analyzes health outcomes before and after the policy, focusing on physical health and health-related expenditures. Subgroup analyses are conducted by age and education. Results The findings show that (1) Digital infrastructure is associated with modest improvements in physical health, reflected in a small reduction in activity limitations; (2) Health behaviors – such as slightly increased physical exercise and marginally higher health-related spending – partially mediate these effects; (3) The relative benefits are more pronounced among older adults and those with lower education; (4) Digital infrastructure may help partially reduce health inequalities, particularly among individuals with poorer baseline health. Conclusion Digital infrastructure is associated with modest improvements in physical health among middle-aged and older adults, partly through promoting healthier behaviors. It may contribute to reducing health disparities and offer policy implications for enhancing health equity, particularly among vulnerable populations.

ABSTRACT Background: As a significant traumatic event, widowhood may increase the risk of depression among middle-aged and older adults. Understanding how depressive symptoms evolve during this transition is therefore essential, as it provides critical insights for developing timely and targeted interventions to alleviate depressive symptoms in widowed individuals. Objective: This study explores the development of depressive symptoms before and after widowhood using longitudinal data from four multinational cohorts. Methods: We analysed 3766 individuals aged 45 or older from longitudinal databases in the US, UK, China, and Korea, who reported their marital status as widowed in any wave of interviews after 2010. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D). This study employed cross-lagged panel network analysis to examine the associations between depressive symptoms before and after widowhood, as well as to identify the most susceptible and influential symptoms. Results: Higher ‘Could not get going’ at pre-widowhood was associated with greater ‘Fear or sad’ at post-widowhood (β = 0.148). ‘Depressed mood’ (predictability = 0.406) was the most susceptible symptom by other symptoms after widowhood. ‘Exhaust’ (influence = 0.392) exerted the strongest influence on other symptoms in the cross-lagged network. Conclusion: This study elucidated the mechanisms of influences among depressive symptoms before and after widowhood through network analysis of integrated multinational databases, identifying the most influential symptoms during this dynamic phase. The findings emphasize the importance of early identification and intervention for specific depressive symptoms in widowed individuals. They provide valuable insights for clinical practice and public health strategies, which can help reduce the psychological burden of widowhood.

This study examines variations in age-related changes in Korean adults’ skills, focusing on the role of ICT skill use. We estimated age-skill profiles from individual changes in literacy and numeracy skills using PIAAC data(1st & 2nd). Our analysis compare average age-related decline observed across OECD average is considerably steeper in Korea, where adults face higher risks in participation in adult education and experience an earlier onset of skill decline. Graphical analyses furthur show that the first-cycle curves consistently lie above those of the second cycle, indicating that the rate of decline in literacy and numeracy skills has accelerated in the more recent cycle. Regression models were estimated to find out ICT skill use can diminish spped of skill decline with aging. In Korea, among high ICT-use groups remains steeper slope than the OECD average. These findings suggest that lower initial skill levels, characteristics of the work environment, and limited opportunities for adult learning may jointly account for Korea’s sharper decline. The study highlights the need to strengthen lifelong learning systems and provide targeted support to help maintain basic skills and ICT competencies, particularly among middle-aged and older adults.

BackgroundFrailty is a major public health issue that impairs the quality of life and health outcomes of middle-aged and older adults. Changes in sleep patterns may play a critical role in the development of frailty. However, studies on the relationship between nighttime sleep duration trajectories and frailty risk remain limited. This study aimed to explore this association and provide preliminary evidence for frailty prevention and intervention.MethodsData were obtained from 8083 participants aged ≥ 45 years in the China Health and Retirement Longitudinal Study (CHARLS), assessed at four time points over seven years. Latent class trajectory modeling was applied to identify distinct nighttime sleep duration trajectories. Frailty was measured using a frailty index comprising 32 health deficits. Logistic regression was used to evaluate the associations between sleep trajectories and frailty.ResultsThis study identified two nighttime sleep duration trajectories: normal stable trajectory group, encompassing 7137 (88.2%) individuals, and short with gradual increasing trajectory group, including 946 (11.7%) individuals. Compared with normal stable trajectory group, participants in short with gradual increasing trajectory group had a significantly higher incidence of frailty. Furthermore, after adjusting for covariates, this association remained statistically significant, although the effect size was modest.ConclusionsLong-term exposure to short sleep may be associated with an elevated risk factor for frailty in middle-aged and older adults. Given the modest effect sizes observed, these findings should be interpreted as exploratory and part of a work-in-progress model. Continuous monitoring of sleep duration may still offer insights for early screening and prevention of frailty.

Clinical efficacy of personalized 3D-printed modular navigation templates in assisting Femoral Neck System implantation for femoral neck fractures in young and middle-aged adults.

Renewed interest in the Ross procedure, driven by compelling evidence of superior long-term outcomes, has led to increased international use. This review outlines a comprehensive framework for understanding the Ross procedure within the broader context of aortic valve replacement. Topics include procedural overview, patient selection and contraindications, diagnostic imaging, technical modifications to promote durability, clinical outcomes, postoperative management, and future directions. The Ross procedure remains the only valve replacement strategy capable of restoring life expectancy in selected young and middle-aged adults, making it an imperative option for multidisciplinary consideration.

BackgroundThe objective of this study was to explore the longitudinal relationship between the volume and intensity of physical activity (PA) and their combined risk for cognitive impairment (CI).MethodsThe study included 10,174 participants from the 2011-2018 CHARLS cohort. Pennsylvania and CI were assessed using self-reported questionnaires. Statistical analyses were performed using the Cox regression model.ResultsAfter adjusting for all covariates, the risk of CI was 14% lower in subjects with physical activity volume (PAV) ≥600 Metabolic Equivalent of Task (MET)-min/week compared to those with insufficient PA (HR: 0.86). The risk was reduced by 38% for subjects with PAV of 1800−2999 MET-min/week (HR: 0.62). Regarding the intensity of PA, the risk of CI was reduced by 25% for a proportion of 0.25–0.5 of (moderate to vigorous PA) MVPA to PAV (HR: 0.75) compared to a proportion of 0–0.25. Regardless of PAV, the risk of CI was lowest when the proportion of moderate to vigorous PA(MVPA) to PAV was 0.25–0.5, and 0.5–0.75 for the proportion of light-intensity physical activity (LPA) to PAV.ConclusionThe PAV 1800−2999 MET-min/week and maintaining a proportion of LPA to PAV of 0.5–0.75, or a proportion of MVPA to PAV of 0.25–0.5, are more effective in reducing the risk of CI. Policy implications should prioritize tailored physical activity strategies for individuals over 65, emphasizing low-intensity activities, safe high-intensity training, and the development of accessible urban facilities, in line with WHO guidelines.

Adherence to a Planetary Health Diet and Risk of Chronic Kidney Disease: A Longitudinal Cohort Study From the UK Biobank.

BackgroundEmerging evidence suggests gut microbiota modulation may influence neurocognitive function through the gut-brain axis. Although preliminary studies indicate probiotics’ potential benefits for mild cognitive impairment (MCI), well-designed randomized controlled trials remain limited. This protocol paper describes a rigorously designed, registered clinical trial investigating the effects of targeted probiotic supplementation on cognitive and physiological outcomes in MCI participants.MethodsA total of 110 middle-aged and older participants aged 55–80 years with MCI were scheduled to be included in the study, and randomized in a 1:1 ratio to either a probiotic group receiving supplementation consisting of Lactiplantibacillus plantarum ST-III, Lacticaseibacillus rhamnosus KF7, and Lacticaseibacillus paracasei BD5115, or a placebo group with maltodextrin for 12 months. All the participants, researchers, and analysts will remain blinded to the information regarding group allocation in the study. The primary outcome will be the effect of probiotic supplementation on cognitive function, measured by Montreal Cognitive Assessment (the Chinese Beijing Version). The secondary outcomes will include the impact of probiotic supplementation on digestive health, sleep health, facial aging, fundus conditions, olfactory and auditory function, body composition, bone density, and muscle function. Brain magnetic resonance imaging and wearable device including continuous glucose monitor and smart band will also be employed.DiscussionThis study will provide some new insights on how probiotic supplementation could impact cognitive function and other aging-related physiological functions in MCI adults and explore the potential underlying mechanisms. The findings may inform the development of strategies to delay cognitive decline by modulating the gut-brain axis in this high-risk population.Trial registrationChiCTR2400084594.