Spanish Adults Research Articles

Limitations in Activities of Daily Living among Older Adults with COPD, Asthma, or Asthma-COPD Overlap Residing in Spain.

Activities of daily living (ADL) may be limited by the presence of chronic diseases, and limitations in ADL contribute to an increased risk of falling. In people with asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap (ACO), ADL may be affected owing to poor asthma control and COPD ventilatory limitations. The aim of this study was to establish the differing prevalence of limitations in ADL among older Spanish adults with chronic respiratory diseases (COPD, asthma, and ACO). Data from the Spanish National Health Survey were analyzed. The sample was composed of 944 older adults aged ≥65 years and with a positive diagnosis of COPD (n = 502), asthma (n = 241), or ACO (n = 201). Five basic activities of daily living (BADL) and seven instrumental activities of daily living (IADL) were studied. Frequency and percentages were used to describe sample characteristics and limitations of ADL. Significant differences were analyzed using chi-square tests. Results revealed a significant higher number of older adults with COPD (34.8%) and asthma (32.5%) without limitations in doing hard housework in comparison to ACO (17.8%). Regarding meal preparation, a higher percentage of asthmatics without difficulties (77.7%) and a lower percentage with many difficulties (2.6%) were observed in comparison to ACO (64.8%-10.2%). No differences were found in BADL, with approximately 80-90% without limitations. It seems that limitations in IADL vary according to the type of chronic pulmonary diseases, but further research is needed to clarify why differences were found only for preparing meals and hard housework. These findings should be considered in the design of interventions to promote ADL in older adults with respiratory disease.

Measuring symptoms of obsessive-compulsive and related disorders using a single dimensional self-report scale.

Obsessions and compulsions are heterogenous but can be classified into obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder (HD), hair-pulling disorder (HPD), and skin-picking disorder (SPD). OCD is in itself heterogenous, with symptoms clustering around four major symptom dimensions: contamination/cleaning, symmetry/ordering, taboo obsessions, and harm/checking. No single self-report scale captures the full heterogeneity of OCD and related disorders, limiting assessment in clinical practice and research on nosological relations among the disorders. To provide a single self-report scale of OCD and related disorders that respects the heterogeneity of OCD, we expanded the DSM-5-based Obsessive-Compulsive and Related Disorders-Dimensional Scales (OCRD-D) so that is also includes the four major symptom dimensions of OCD. A psychometric evaluation and an exploration of the overarching relations among the dimensions were conducted using an online survey which was completed by 1,454 Spanish adolescents and adults (age span = 15-74 years). Approximately 8 months after the initial survey, 416 participants completed the scale again. The expanded scale showed excellent internal psychometric properties, adequate test-retest correlations, known groups validity, and correlations in the expected directions with well-being, depression/anxiety symptoms, and satisfaction with life. The higher-order structure of the measure indicated that harm/checking and taboo obsessions formed a common disturbing thoughts factor and that HPD and SPD formed a common body-focused repetitive behaviors factor. The expanded OCRD-D (OCRD-D-E) shows promise as a unified way to assess symptoms across the major symptom dimensions of OCD and related disorders. The measure may be useful in clinical practice (e.g., screening) and research, but more research on construct validity, incremental validity, and clinical utility is needed.

The influence of meaningful activities in the quality of life and functional autonomy of adults with intellectual disability: A prospective study during the COVID-19 pandemic.

The COVID-19 pandemic might negatively impact the quality of life and functional autonomy of Spanish adults with intellectual disability, and meaningful activities could prevent this negative progression. This is a prospective cohort study in Spanish adults with intellectual disability during the COVID-19 pandemic. Quality of life, functional autonomy and functional independence were measured. The meaningful activities studied were structured-leisure, community self-management, and occupational and physical activities. Seventy-three participants were included in the study. Quality of life and functional autonomy significantly deteriorated during the COVID-19 pandemic (all p > .001). Greater participation in community self-management activities before COVID-19 was associated with less detriment to quality of life (ß=-.312; p=.008), while greater participation in occupational and physical activities was associated with less detriment to the performance of instrumental activities (ß=-.317; p=.016; and ß=-.285; p=.030, respectively). People with intellectual disability living in residential homes experienced a decrease in their quality of life and functional autonomy during the COVID-19 pandemic. Their involvement in community self-management activities and physical and occupational activities before the pandemic had preventive effects on the detriment to the quality of life and functional autonomy.

Relationships between Physical Activity Frequency and Self-Perceived Health, Self-Reported Depression, and Depressive Symptoms in Spanish Older Adults with Diabetes: A Cross-Sectional Study.

Diabetes is one of the most prevalent noncommunicable diseases in the world. This disease can affect both physical and mental health in the population. This study analyzed the prevalence of Self-Perceived Health (SPH), self-reported depression, and depressive symptoms in comparison with the Physical Activity Frequency (PAF) reported by Spanish older adults with diabetes. A cross-sectional study was carried out with data from 2799 self-reported diabetic participants, all of whom were residents of Spain, aged 50-79 years, and included in the European Health Surveys carried out in Spain (EHIS) both in 2014 and 2020. The relationships between the variables were analysed with a chi-squared test. A z-test for independent proportions was performed to analyze differences in proportions between the sexes. A multiple binary logistic regression was carried out on the prevalence of depression. Linear regressions were performed on depressive symptoms and SPH. Dependent relationships were found between the SPH, self-reported depression, and depressive symptoms with PAF. Most of the very active participants reported a higher prevalence of self-reported depression. Physical inactivity increased the risk of depression, major depressive symptoms, and negative SPH.

Breakfast Size and Prevalence of Metabolic Syndrome in the European Prospective Investigation into Cancer and Nutrition (EPIC) Spanish Cohort.

Recent evidence suggest that energy distribution during the daytimecould be a potential determinant for the development of metabolic syndrome (MetS). To cross-sectionally assess the association between breakfast size and the prevalence of MetS in Spanish adults. Our study included a subset of 3644 participants from the European Prospective Investigation into Cancer and Nutrition Spain study recontacted between 2017-2018. Information on diet, sociodemographic, lifestyle, sleep quality, and chronotype was collected using standardized questionnaires, while anthropometric and blood pressure data were measured in a face-to-face personal interview by a nurse. MetS was defined according to the Adult Treatment Panel III (ATPIII) definition by measuring serum levels of total cholesterol, tryglycerides and glucose. Breakfast size was calculated as: (energy from breakfast/total energy intake) * 2000 kcal. To evaluate the association between breakfast size and MetS prevalence, a multivariable logistic regression model adjusted by potential confounders was used to estimate OR and 95% CI. Prevalence of MetS in our study was 40.7%. The mean breakfast size was 306.6 * 2000 kcal (15% of the total daily energy intake), with 14 (0.4%) participants skipping breakfast. Participants in the highest quartile of breakfast size had a lower MetS prevalence compared to participants in the lowest quartile (ORQ4vsQ1 = 0.62; 95% CI = 0.51-0.76; p-trend < 0.001). No modification of the estimated ORs by sex, breakfast time, and number of eating occasions per day were observed. Our results suggest that higher breakfast size is associated with lower prevalence of MetS in Spanish adults, supporting the importance of a high energy breakfast. Further prospective studies are necessary to confirm these findings.

Prevent2Protect Project: Regulatory Focus Differences in Sexual Health Knowledge and Practices

The way people perceive risks and make decisions about their health is regulated by two motivational systems—prevention of harm or promotion of pleasure. People more focused on prevention strive to avoid negative outcomes and enact more health-protective behaviors. In contrast, people more focused on promotion strive to attain positive outcomes and take more risks with their health. Building upon recent evidence extending this framework to sexual behaviors and health, we conducted a pre-registered online survey (OSF) with Portuguese and Spanish adults (N = 742; Mage = 31.42, SD = 9.16) to examine whether self-reported STI knowledge and sexual health practices differ based on predominant regulatory focus. This study was part of the Prevent2Protect project (OSF). Results showed that prevention-focused participants had heard about more STIs and retrieved more of their knowledge from scientific sources but had been tested for fewer STIs in the past. In contrast, promotion-focused participants indicated they had specific knowledge about more STIs, retrieved more of their knowledge from medical and peer sources, and had been tested for more STIs in the past. They also reported more frequent STI testing, using free testing facilities or asking their family practice doctor to get tested, more routine sexual health check-ups, and more use of other contraceptive methods, such as birth control pills. These results remained unchanged after controlling for demographic differences. Overall, our findings showed that different motives in sexuality shape sexual health knowledge and sexual health practices.

Normative scores for attentional tests used by the Spanish consortium for ageing normative data (SCAND) study: Trail Making Test, Digit Symbol and Letter Cancellation

Objective: This paper reports normative data for different attentional tests obtained from a sample of middle-aged and older native Spanish adults and considering effects of age, educational level and sex. Method: 2,597 cognitively intact participants, aged from 50 to 98 years old, participated voluntarily in the SCAND consortium studies. The statistical procedure included conversion of percentile ranges into scaled scores. The effects of age, education and sex were taken into account. Linear regressions were used to calculate adjusted scaled scores. Results: Scaled scores and percentiles corresponding to the TMT, Digit Symbol and Letter Cancellation Task are shown. Additional tables show the values to be added to or subtracted from the scaled scores, for age and education in the case of the TMT and Letter Cancellation Task measures, and for education in the case of the Digit Symbol subtest. Conclusions: The current norms provide clinically useful data for evaluating Spanish people aged 50 to 98 years old and contribute to improving detection of initial symptoms of cognitive impairment.

Comparative understanding and preference of Nutri-Score and NutrInform Battery in a sample of Spanish consumers.

Interpretive front-of-pack labels (FoPLs) are supported by World Health Organization as an important policy tool to promote healthy diets. At present, various FoPLs formats co-exist in the European Union (EU). However, as part of the Farm to Fork strategy published in 2020, the European Commission stated that it would propose a single mandatory FoPL. The aim of this study was to analyze Spanish consumers' preference and objective understanding of Nutri-Score and NutrInform, two FoPLs that are currently the subject of debate in the EU. In a representative sample of 1026 Spanish adults (50% women, mean age ± SD = 46 ± 14 years), objective understanding was assessed by asking participants to identify the healthiest food products in three food categories (breakfast products, breakfast cereals and added fats). The preference dimensions were tested by asking participants about the perceived helpfulness of the FoPL in discriminating the nutritional quality of food products (subjective understanding) and their overall assessment of the FoPL's ease of use, informativeness, trust and liking (perception). In terms of objective understanding, Nutri-Score was significantly associated with an increase in consumers' ability to identify healthier food products across all food categories compared with NutrInform [OR (odds ratio) = 19.1 [14.2-25.7], P < 0.0001]. On the preference dimension, Nutri-Score was perceived as significantly easier to use and was more liked than NutrInform (standardized principal component analysis dimension, respectively, 0.32 ± 1.58 vs. -0.29 ± 1.66, P < 0.0001 and 0.080 ± 1.18 vs. -0.072 ± 1.17, P = 0.039). This study provides new evidence to support Nutri-Score in comparison with NutrInform in Spanish consumers, on both objective understanding and preference aspects.

Vaccination against Community-Acquired Pneumonia in Spanish Adults: Practical Recommendations by the NeumoExperts Prevention Group.

In the adult population, community-acquired pneumonia (CAP) is a serious disease that is responsible for high morbidity and mortality rates, being frequently associated with multidrug resistant pathogens. The aim of this review is to update a practical immunization prevention guideline for CAP in Spain caused by prevalent respiratory pathogens, based on the available scientific evidence through extensive bibliographic review and expert opinion. The emergence of COVID-19 as an additional etiological cause of CAP, together with the rapid changes in the availability of vaccines and recommendations against SARS-CoV-2, justifies the need for an update. In addition, new conjugate vaccines of broader spectrum against pneumococcus, existing vaccines targeting influenza and pertussis or upcoming vaccines against respiratory syncytial virus (RSV) will be very useful prophylactic tools to diminish the burden of CAP and all of its derived complications. In this manuscript, we provide practical recommendations for adult vaccination against the pathogens mentioned above, including their contribution against antibiotic resistance. This guide is intended for the individual perspective of protection and not for vaccination policies, as we do not pretend to interfere with the official recommendations of any country. The use of vaccines is a realistic approach to fight these infections and ameliorate the impact of antimicrobial resistance. All of the recently available scientific evidence included in this review gives support to the indications established in this practical guide to reinforce the dissemination and implementation of these recommendations in routine clinical practice.

Association between GHQ-12, Duke-UNC-11, Physical Activity, and Self-Perceived Health in Spanish Adults with Cancerous Tumours: A Cross-Sectional Study.

In Spain, people who have overcome some type of cancer have significantly worse self-perceived health (SPH) and higher rates of depression than people who have never suffered any type of cancer. to explore the relationships among physical activity levels (PAL), perceived social support (PSS), and SPH in terms of mental health and its dimensions in Spanish adults with cancerous tumours. A correlational study rooted in the National Health Survey 2017 for adults was carried out, including 627 Spanish residents who reported having malignant tumours. A dependent association was found between PAL and SPH (p &lt; 0.001). The mental health mean score decreased as PAL increased for the total sample and for both sexes, separately (p &lt; 0.001). Low reverse associations were also observed between PAL and mental health (rho: -0.274; p &lt; 0.001), successful coping (rho: -0.239; p &lt; 0.001) and self-confidence (rho: -0.264; p &lt;0.001). Moreover, PSS weakly and inversely correlates with mental health (r: -0.225; p &lt; 0.001), successful coping (r: -0.218; p &lt; 0.001) and self-confidence (r: -0.231; p &lt; 0.001). A binary logistic model showed that active and very active people presented less threat of poor SPH, as did people with higher PSS (p &lt; 0.001). Greater levels of physical activity are associated with larger mean scores in the three dimensions of mental health, perceived social support and self-perceived health in people with cancerous tumours.

Health-related lifestyle assessment among Spanish adults from 22 to 72 years

ObjectiveThe objective of this paper has focused on assessing the level of health-related lifestyle acquired in Spanish adults in the Spanish cities of Albacete and Murcia, and analyzing the existing differences according to sex and age. Material and methodsOn a sample of 788 subjects aged between 22 and 72, the Health-related Lifestyle Assessment Scale was applied, consisting of 52 items and structured in 7 dimensions that explained a total variance of 66.87% and a Cronbach’s alpha of 0.894. ResultsA percentage of 12 of the adults surveyed have a healthy lifestyle, 53% show a trend to health and 35% poor or unhealthy. Pearson’s χ2 tests show a positive and significant association of women with health and a trend of significant improvement in lifestyle with age. The inferential data (t-Student tests and one-factor ANOVA) confirm these differences according to gender and age. ConclusionsIt is necessary to promote preventive programs to improve health in the habits of the population, especially in the 35% that show a poor or unhealthy level of lifestyle.

Assessment of the eating habit in the health-related lifestyle among Spanish adults from 22 to 72 years of age

Introduction: eating habits are one of the main predictors of health within a person lifestyle. The assessment of these habits will be essential to confirm health-related habits and orientate behaviors of risk for health. Objectives: to assess the eating habits within the health-related lifestyle among Spanish adults from 22 to 72 years of age. Methods: the Health-Related Lifestyle Assessment Scale (E-VEVSA) was applied to a sample of 788 subjects between the ages of 22 and 72. This scale is made up of 52 items and structured in seven dimensions, among which the healthy eating habit was evaluated, which explained a variance of 8.67 % of the total scale (66.87 %) and a Cronbach's alpha of 0.794 for a total alpha of 0.894. Results: sixteen percent of the adults surveyed have healthy eating habits, 68.3 % tend towards health and 15.7 % are unhealthy. Pearson's 2 tests show a positive and significant association of women with healthy eating habits and a significant improvement with age. The inferential data (Student's t-tests and one-factor ANOVA) confirm these differences according to gender and age. Conclusions: it is necessary to promote preventive programs to improve eating habits in the adult population, especially in the 15.7 % that have an unhealthy level of nutrition in their lifestyle.

Determination of Total Mercury in Spanish Samples of Baby Food, Fast Food, and Daily Meal

This study determined the levels of total mercury in Spanish samples of baby food, fast food, and daily meal, which people of different ages consume, to evaluate potential toxicological risks through the contribution to the tolerable daily intake (TDI). The total mercury concentrations were determined in thirteen commercial baby foods for infants 6 to 12 months old, six types of fast foods prepared for children, and nine canteen menus prepared for adults. Samples were analyzed using a direct mercury analyzer, and the following concentration ranges were found: baby food (0.57-41.9 µg kg–1), fast food (0.54-68 µg kg–1), and adult menus (0.43-638 µg kg–1). The recovery of different amounts of spiked mercury ranged from 98.6 to 104.9%, and the method’s accuracy was checked with an analysis of different certified reference materials. The limits of detection and quantification obtained were 0.1 and 0.3 µg kg–1, respectively, with a relative standard deviation of up to 11%. The contribution of the samples to the TDI varied as follows: baby food (0.3-28%), fast food (0.5-102%), and adult menus (0.3-396%). Therefore, it was concluded that total mercury daily intake does not pose risks for Spanish children and adults if tuna is not included on their menu.

Life Domains and Lifestyle of Older Adults Living in a Nursing Home: A Pilot Study.

Although the preventive occupational therapy intervention program Lifestyle Redesign® has proven to be effective in maintaining and improving the health and quality of life of older adults, a similar program has not yet been culturally adapted to the Spanish population. As a preliminary step in developing a lifestyle intervention tailored to healthy Spanish older adults living in a nursing home (Lifestyle Choice; originally in Spanish "Elección de Estilo de Vida"), we aimed to identify and describe the life domains of this population and determine overlap with content areas addressed in the Lifestyle Redesign® program. An observational cross-sectional study was carried out using quantitative methods, including 30 healthy older adult residents in the "Virgen del Prado" nursing home in Talavera de la Reina (Toledo), based on the development of a questionnaire and a survey. Six life domains were identified: self-care, sleep and rest, mobility, personal safety, health maintenance, spirituality, and free time usage. The results of this study reveal important overlaps with content areas of Lifestyle Redesign®, suggesting that it may be feasible to develop a lifestyle intervention ("Elección de Estilo de Vida") tailored to the sociocultural features of the healthy Spanish population over 65 years old living in nursing homes.

Changes in reading habits during COVID-19 confinement in Spain (Cambios en los hábitos lectores durante el confinamiento por COVID-19 en España)

ABSTRACT During the COVID-19 pandemic, the Spanish population remained confined for almost two months, leading to new academic, work and leisure routines. This study analysed the reading habit changes during confinement and their relationship with the type of reading, gender, age and audiovisual consumption in 4,013 Spanish adults who responded to an online survey on their reading habits taking three moments as a reference: before, beginning and during the confinement. The results highlight that the reading time increased at the beginning of the confinement and remained stable throughout. By type of reading, leisure reading continued to increase, and news reading decreased compared to the beginning of the confinement, although both changes occurred in the younger population. Besides, those who used more audiovisuals were found to read more. Lastly, women read more than men and also increased their reading time to a higher extent. Assuming that reading promotes well-being and that its increase was part of an overall increase in healthy habits, we suggest that educational policies should consider this function of reading when fostering reading habits.

Fiabilidad y validez de la Escala de valoración del estilo de vida saludable adquirido (E-VEVSA) en adultos de Albacete y Murcia (España)

BackgroundLifestyle is a theoretical construct that is formed by the life habits of a subject. The analysis and objective quantification of lifestyle can have a great impact on people's health, as well as on the evolution of its status over the years. The objective of this research has been the validation of the Acquired Healthy Lifestyle Assessment Scale (E-VEVSA) in Spanish adults. MethodOn an initial sample for the exploratory tests of 248 subjects and a final sample for the confirmatory tests of 780 subjects, aged between 22 and 72 years of age. Exploratory and confirmatory psychometric tests were carried out based on the Cronbach's alpha statistic (reliability) and exploratory factorial analysis with oblique rotation (oblimin) and confirmatory with varimax rotation (construct validity), which resulted in an instrument made up of 52 items and structured in 7 dimensions: individual responsibility in health care (9 items), habits of physical-sports practice (6 items), health habits in social relationships (10 items), habit of tobacco and alcohol consumption (9 items), habit of healthy eating (7 items), psychological health habits (6 items) and daily rest and sleep habits (5 items). ResultsAll the items explained a total variance of 66.87% and a Cronbach's alpha of .894, with the partial alpha of each dimension or factor being above .700. ConclusionsThe results show psychometric tests that confirm the validity of the E-VEVSA scale as a useful instrument to measure the healthy lifestyle acquired among adults.

Association between a Mediterranean lifestyle and growth differentiation factor 15: The seniors ENRICA-2 cohort

BackgroundGrowth Differentiation Factor 15 (GDF-15) is a marker of inflammation and oxidative stress that has been associated with multiple age-related chronic diseases. Since lifestyle is key for preventing these adverse health outcomes, we examined the association between a Mediterranean lifestyle and GDF-15 serum concentrations in Spanish older adults. MethodsWe used cross-sectional data from 2502 older adults participating in the Seniors ENRICA-2 cohort. Adherence to the Mediterranean lifestyle was assessed with the 27-item MEDLIFE index, divided into three blocks: 1) “Mediterranean food consumption, 2) Mediterranean dietary habits, 3) Physical activity, rest, social habits, and conviviality”. Analyses of the association between the MEFLIFE index and GDF-15 concentrations were performed using multivariable linear regression models adjusting for the main potential confounders. ResultsThe MEDLIFE index was inversely associated with GDF-15. Compared with participants in the lowest quartile of the MEDLIFE score, GDF-15 mean percentage differences (95% CI) were −3.0% (−8.0, 2.3) for the second quartile, −8.7% (−13.0, −4.1) for the third quartile, and −10.1% (−15.0, −4.9) for the fourth quartile (p-trend<0.001). Block 3 of MEDLIFE, and particularly doing sufficient physical activity, adequate sleep duration, and participating in collective sports, was individually linked to lower concentrations of GDF-15. Results remained similar after excluding participants with cardiovascular disease, type 2 diabetes, or obesity. ConclusionsA Mediterranean lifestyle was associated with reduced levels of GDF-15, suggesting that a combination of multiple lifestyles may be an integral approach to reduce chronic inflammation and disease burden in older adults.

GDLAM and SPPB batteries for screening sarcopenia in community-dwelling Spanish older adults: Healthy-age network study

ObjectivesTo determine the diagnostic ability of GDLAM and SPPB batteries to classify people with sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP19). Study designThis cross-sectional study recruited 584 participants (240 men, 65.33 ± 8.68 years old). The diagnostic criteria of the EWGSOP19 for probable, confirmed and severe sarcopenia were used as the standard. Then, the Latin American Group for Maturity battery-GDLAM- and the short physical performance battery-SPPB- were measured. The ability as screening methods of these two batteries were determined by specific indicators including sensitivity, specificity, receiver operating characteristic (ROC) curve, and area under the ROC curves (AUC). Main outcome measuresAnthropometric variables (Body mass, height, triceps, thigh and calf skinfolds and relaxed arm, middle-thigh and calf girths), handgrip strength (HG), chair stand, 4 m walk, and timed-up-and-go-tests (TUG) as well as the Latin American Group for Maturity battery (GDLAM) and the short physical performance battery (SPPB) were performed. ResultsThe GDLAM battery shows a sensitivity from moderate to high (60.1–72.2 %), and specificity from moderate (57.6 %) to very high (90.7 %) to identify sarcopenia categories (probable, confirmed and severe). However, the SPPB battery shows a lack of classification ability for probable sarcopenia (AUC = 0.436; p = 0.123), confirmed sarcopenia (AUC = 0.499; p = 0.959) and severe sarcopenia (AUC = 0.484; p = 0.532). Those participants classified as probable sarcopenia or confirmed sarcopenia measured by GDLAM battery according to the cut-off points obtained in the ROC curve showed a higher probability to be in the probable sarcopenia (OR = 2.8; p = 0.001) or confirmed sarcopenia categories (OR = 10; p = 0.002), respectively, based on EWGSOP19 criteria. ConclusionsThe GDLAM screening battery showed improved properties in terms of distinguishing individuals at risk for sarcopenia from those who were not.

Parental bonding in retrospect and adult attachment style: A comparative study between Spanish, Italian and Japanese cultures.

Attachment is an innate human relational mechanism that develops progressively from early childhood, influences individuals' representations and behaviors, shapes relationships, and affects the social and cultural environment. Parental bonding refers to the ability of parents to be emotionally and behaviorally available to the child during infancy. Attachment style refers to the individual's relational attitude in close relationships that influences adult love, bonding, handling relationships, and social exploration. The role of intergenerational, cultural and developmental factors influencing the relationship between the attachment style in adulthood and the parental bonding style recalled during childhood has been debated. This study explores the relationships between recalled parental bonding, adult attachment style, and cultural background in a sample of Spanish, Italian, and Japanese adults using a cross-sectional and cross-cultural design. For this purpose, the validated versions of the Experience in Close Relationship Scale and the Parental Bonding Instrument were administered to a non-clinical population of three hundred and five participants in the three countries. Results show that the most frequent adult attachment style is the secure style, followed by the dismissing-avoidant, the preoccupied, and the fearful-avoidant style. The dismissing-avoidant style was the most frequent insecure attachment style in the Japanese sample whereas the preoccupied style was the most frequent insecure attachment style in the Italians and Spaniards. Japanese are more anchored to the memory of maternal and paternal overprotection, which is related to more avoidance in actual close relationships. Spaniard's current relationships are mildly independent of recalled parental bonding, showing an association between lower current avoidance to primary parental care. In the Italian sample, there is no significant relationship between current adult close relationships and recalled parental bonding. These results suggest that different cultural models influence adult attachment representations differently, in terms of the weight placed on attachment-related avoidance, attachment-related anxiety, care, and overprotection in infant and adult relationships.

Personal barriers to physical practice by older adults in different socio-economic locations: a qualitative study

Objective. This study was conducted to try to understand the barriers encountered by Spanish older adults participating in the study when joining programs or maintaining the practice of physical exercise based on their perceptions. Methods. Four focus groups were conducted in different socio-economic- locations with a total of 39 older adults. These settings were in a rural area, a neighborhood at risk of exclusion and an urban context of higher socioeconomic level. The methodological analysis was inductive and emergent, delimiting the statements of the study participants from the specific to the general through the coding process of grounded theory. Results. Differences between contexts on personal barriers to physical practice, the role of the family, the context and its influence on practice barriers were presented. There are socioeconomic and cultural differences between the physical environments of the four different focus groups developed in this research. The results revealed that levels of exercise and physical activity decreased with age. Conclusions. The study makes clear that the attributes of the personal domain directly affect participation in physical practice. In relation to gender differences, older adult men find fewer barriers in terms of free time after retirement, while women continue to have family and domestic responsibilities in addition to suffering from the macho culture that increases their barriers to physical exercise.