Birmingham Study Research Articles

The Changing Face of Allotments: Findings from a Comprehensive Birmingham Study

The Changing Face of Allotments: Findings from a Comprehensive Birmingham Study

Evaluation of ophthalmic healthcare professional-led keratoconus management service in the United Kingdom: the Birmingham and Midland Eye Centre (BMEC) study

Evaluation of ophthalmic healthcare professional-led keratoconus management service in the United Kingdom: the Birmingham and Midland Eye Centre (BMEC) study

The impact of multi-decadal changes in VOC speciation on urban ozone chemistry: a case study in Birmingham, United Kingdom

Abstract. Anthropogenic non-methane volatile organic compounds (VOCs) in the United Kingdom have been substantially reduced since 1990, which is, in part, attributed to controls on evaporative and vehicle tailpipe emissions. Over time, other sources with a different speciation (for example, alcohols from solvent use and industry processes) have grown in both relative importance and, in some cases, in absolute terms. The impact of this change in speciation and the resulting photochemical reactivities of VOCs are evaluated using a photochemical box model constrained by observational data during a summertime ozone event (Birmingham, UK) and apportionment of sources based on the UK National Atmospheric Emission Inventory (NAEI) data over the period 1990–2019. Despite road transport sources representing only 3.3 % of UK VOC emissions in 2019, road transport continued being the sector with the largest influence on the local O3 production rate (P(O3)). Under case study conditions, the 96 % reduction in road transport VOC emissions that has been achieved between 1990 and 2019 has likely reduced daytime P(O3) by ∼ 1.67 ppbv h−1. Further abatement of fuel fugitive emissions was modeled to have had less impact on P(O3) reduction than abatement of VOCs from industrial processes and solvent use. The long-term trend of increased emissions of ethanol and methanol has somewhat weakened the benefits of reducing road transport emissions, increasing P(O3) by ∼ 0.19 ppbv h−1 in the case study. Abatement of VOC emissions from multiple sources has been a notable technical and policy success in the UK, but some future benefits (from an ozone perspective) of the phase-out of internal combustion engine passenger cars may be offset if domestic and commercial solvent use of VOCs continue to increase.

Impact of Legislation on Brominated Flame Retardant Concentrations in UK Indoor and Outdoor Environments: Evidence for Declining Indoor Emissions of Some Legacy BFRs.

Concentrations of polybrominated diphenyl ethers, hexabromocyclododecane (HBCDD), and novel brominated flame retardants (NBFRs) were measured in indoor dust, indoor air, and outdoor air in Birmingham, UK. Concentrations of ΣBFRs ranged from 490 to 89,000 ng/g, 46-14,000 pg/m3, and 22-11,000 pg/m3, respectively, in UK indoor dust, indoor air, and outdoor air. BDE-209 and decabromodiphenyl ethane (DBDPE) were the main contributors. The maximum concentration of DBDPE (10,000 pg/m3) in outdoor air is the highest reported anywhere to date. In contrast with previous studies of outdoor air in Birmingham, we observed significant correlations between concentrations of tri- to hepta-BDEs and HBCDD and temperature. This may suggest that primary emissions from ongoing use of these BFRs have diminished and that secondary emissions (e.g., evaporation from soil) are now a potentially major source of these BFRs in outdoor air. Conversely, the lack of significant correlations between temperature and concentrations of BDE-209 and DBDPE may indicate that ongoing primary emissions from indoor sources remain important for these BFRs. Further research to clarify the relative importance of primary and secondary sources of BFRs to outdoor air is required. Comparison with earlier studies in Birmingham reveals significant (p < 0.05) declines in concentrations of legacy BFRs, but significant increases for NBFRs over the past decade. While there appear minimal health burdens from BFR exposure for UK adults, dust ingestion of BDE-209 may pose a significant risk for UK toddlers.

Future eco-hydrological dynamics: Urbanization and climate change effects in a changing landscape: A case study of Birmingham's river basin

The global challenges of water availability and quality are driven by land use and climate changes, further exacerbated by global warming. Altered Land Use and Land Cover (LULC) due to urbanization, deforestation, and agriculture triggers many environmental issues to eco-hydrological systems, which are already profoundly impacted by shifting climate patterns. The Upper Black Warrior River Basin in Birmingham, Alabama, is a prime example of how converting forests into urban areas impairs water quality and increases surface runoff due to impermeable surfaces. This study delved into the temporal and spatial alterations in eco-hydrologically relevant flows, considering individual and combined climate change scenarios and LULC transformation. The Soil and Water Assessment Tool (SWAT) served as the modeling platform, calibrated (2016–2022) and validated (2011–2015) at a daily time scale. Five distinct scenarios were crafted to portray eco-hydrology's past, present, and future responses (runoff and river nutrients) to climate and LULC variations. The model demonstrated strong performance for discharge and predicted increased runoff in future periods, which is attributed to the anticipated warmer, wetter winters and hotter, drier summers characterized by more intense rainfall events. Notably, the study unveiled the adverse impact of climate change on monthly nitrates leaching into surface runoff, with the lowest levels predicted during May to September coinciding with reduced precipitation. Conversely, human activity positively impacts runoff, especially in FMC, which has a higher deforestation rate (42.8%) and increased runoff compared to VC. The study also emphasized the significant link between flow and nutrient concentration, highlighting the dominant role of nonpoint sources in contributing to these inputs. These findings have significant implications for local stakeholders, necessitating considering the potential consequences of integrated climate change and urbanization on eco-hydrology. Effective management strategies, such as improved land use practices and reduced nutrient leaching, must be implemented to minimize these impacts.

Emergency contraception in a historic southern city: Mystery caller study in Birmingham, Alabama

BackgroundAlabama's Human Life Protection Act (the Act) signed in 2019 became law in 2022, making provision of abortion a felony offense. ObjectiveIn 2020, we assessed the accessibility of emergency contraception (EC) pills in Birmingham, Alabama prior to the Act's enactment given the probable increased need for EC access due to abortion criminalization. Study designPharmacy staff were asked about availability, price, location, and identification requirements to obtain EC. ResultsOf 69 pharmacies, 59% had levonorgestrel EC and none had ulipristal acetate EC available. ConclusionThere are persistent barriers to EC accessibility that should be addressed as abortion is increasingly restricted.

“Braking bad”: The influence of haptic feedback and tram driver experience on emergency braking performance

Trams are experiencing a resurgence with worldwide network expansion driven by the need for sustainable and efficient cities. Trams often operate in shared or mixed-traffic environments, which raise safety concerns, particularly in hazardous situations. This paper adopts an international, mixed-methods approach, conducted through two interconnected studies in Melbourne (Australia) and Birmingham (UK). The first study involved qualitative interviews, while the second was an experimental study involving a virtual reality (VR) simulator and haptic master controller (i.e., speed lever). In tram operations, master controllers play a critical role in ensuring a smooth ride, which directly influences passenger safety and comfort. The objective was to understand how a master control system, enhanced with additional haptic feedback, could improve tram driver braking performance and perceptions in safety-critical scenarios. Interview results indicate that the use of the emergency brake is considered the final or ultimate choice by drivers, and their driving experience is a moderating factor in limiting its application. Combined with the experimental results, this paper highlights how implementing haptic feedback within a master controller can reduce the performance disparity between novice and experienced tram drivers.

Restricted life-space mobility impacts physical but not mental quality of life in older cancer survivors.

Older cancer survivors often value quality of life (QOL) over survival. Life-space mobility (LSM), defined as the individual's spatial geographic mobility range, is an important QOL indicator in older adults with chronic illnesses; however, this relationship is unexplored in older cancer survivors. We examined the longitudinal associations and causal relationships between LSM and QOL in 153 older cancer survivors (≥65 years) from the University of Alabama at Birmingham (UAB) Study of Aging. LSM was assessed using the UAB Life-Space Assessment-Composite score (LSA-C), and QOL was assessed by the SF-12 Mental Component Score (MCS12) and Physical Component Score (PCS12) at 0 (study entry), 6, 18, 36, 54, and 72 months. We examined the causal relationship between LSM and QOL using a cross-lagged panel model (CLPM). The cohort (n = 153) was 76 years old on average and predominantly White (58%), female (58%), and married (55%). Longitudinal analyses found LSM decreased over time (p < 0.0001), and this decrease was associated with decreased QOL (PCS12, p < 0.0001, MCS12, p < 0.0001). In the CLPM causal analysis, lower LSM resulted in worse PCS12 (p < 0.001), but not worse MSC12. Restricted LSM resulted in worse physical QOL over 72 months in a sample of 153 older cancer survivors. Developing and evaluating interventions to preserve greater LSM could be a promising approach to improving QOL.

Initial validation of the university of Alabama Birmingham study of aging life-space assessment in older adults with multiple sclerosis

BackgroundOlder adults with multiple sclerosis (OAMS) have declines in walking and physical performance that may erode community mobility defined as the spatial extent of mobility in one's daily life and environment. ObjectiveThis study provided the first application and validation of the University of Alabama Birmingham Study of Aging Life-Space Assessment (UAB LSA) as a measure of community mobility in OAMS. MethodsThe sample included 97 OAMS and 108 healthy controls (HCs) who completed baseline assessments as part of an ongoing, longitudinal study. The primary assessments included the UAB LSA and timed 25-foot walk (T25FW), short physical performance battery (SPPB), global health score (GHS), and geriatric depression scale (GDS) in both OAMS and HCs, and patient determined disease steps (PDDS) scale in only OAMS. ResultsOAMS had significantly lower UAB LSA scores than HCs (p < .001). UAB LSA scores had strong correlations with T25FW(rs = –.641) and SPPB(rs = 0.507) in OAMS, and moderate correlations in HCs (rs = –.300 & rs = 0.384). The correlations between UAB LSA and GHS and GDS scores were significant, but small in OAMS (rs = –.239 & rs = –.231), and not statistically significant in HCs (rs = –.009 & rs = –.166). There was a strong correlation between UAB LSA and PDDS scores in the OAMS sample (rs = –.605). ConclusionWe provided initial evidence for UAB LSA scores as a measure of community mobility in OAMS.

Impact of an INtervention to increase MOBility in older hospitalized medical patients (INTOMOB): Study protocol for a cluster randomized controlled trial

BackgroundLow mobility during an acute hospitalization is frequent and associated with adverse effects, including persistent functional decline, institutionalization and death. However, we lack effective interventions to improve mobility that are scalable in everyday practice. The INTOMOB trial – INtervention to increase MOBility in older hospitalized medical patients – will test the effect of a multilevel intervention to improve mobility of older hospitalized patients on functional mobility.MethodsThe INTOMOB multicenter superiority parallel cluster randomized controlled trial will enroll in total 274 patients in Swiss hospitals. Community-dwelling adults aged ≥ 60 years, admitted to a general internal medicine ward with an anticipated length of hospital stay of ≥ 3 days, will be eligible for participation. Unit of randomization will be the wards. A multilevel mobility intervention will be compared to standard of care and target the patients (information and exercise booklets, mobility diary, iPad with exercise videos), healthcare professionals (e-learning, oral presentation, mobility checklist), and environment (posters and pictures on the wards). The primary outcome will be life-space level, measured by the University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA), at 30 days after enrollment. The LSA is a measure of functional mobility, i.e., how far participants move from bedroom to outside town. Secondary outcomes include, among others, LSA at 180 days, mobility and falls during hospitalization, muscle strength at discharge, and falls, emergency room visits, readmissions, and death within 180 days.DiscussionThis study has the potential to improve outcomes of older hospitalized patients through an intervention that should be scalable in clinical practice because it fosters patient empowerment and does not require additional resources. The tools provided to the patients can help them implement better mobility practices after discharge, which can contribute to better functional outcomes. The choice of a functional patient-reported outcome measure as primary outcome (rather than a “simple” objective mobility measure) reinforces the patient-centeredness of the study.Trial registrationclinicaltrials.gov (NCT05639231, released on December 19 2022); Swiss National Clinical Trial Portal (SNCTP000005259, released on November 28 2022).

The spatial reordering of poverty and crime: A study of Glasgow and Birmingham (United Kingdom), 2001/2 to 2015/16

Across developed polities, there is growing evidence of the spatial reordering of poverty and of its detrimental impact on the life chances of poorer people. This paper extends this body of research, via a comparative case study of two cities in the United Kingdom, by unravelling the interplay of policies shaping the changing morphology of poverty. It progresses to examine the significance of the changing centralisation and segregation of poverty on neighbourhood inequalities in the exposure to crime, probing the relevance of urban criminological tool sets to account for the spatial patterning of crime. It achieves this through interweaving fifteen years of data on poverty and police recorded crime with accounts of the policies and interventions that have sought to reshape and address their manifestation. Though the cities exhibit distinct trajectories, we find evidence of both the decentralisation of poverty and of decreasing segregation in contrast to previous studies. Poverty and crime patterns are converging in the neighbourhoods closest to, but less so in the neighbourhoods furthest away from, city centres. We discuss the relevance of these findings for research seeking to understand the spatial reordering of poverty and neighbourhood inequality in the exposure to crime.

Differentiating Semi-Volatile and Solid Particle Events Using Low-Cost Lung-Deposited Surface Area and Black Carbon Sensors

Low-cost particle sensors have proven useful in applications such as source apportionment, health, and reactivity studies. The benefits of these instruments increase when used in parallel, as exemplified with a 3-month long deployment in an urban background site. Using two lung-deposited surface area (LDSA) instruments, a low-cost method was developed to assess the solid component of an aerosol by applying a catalytic stripper to the inlet stream of one LDSA instrument, resulting in only the solid fraction of the sample being measured (LDSAc). To determine the semi-volatile fraction of the sample, the LDSAC was compared to the LDSA without a catalytic stripper, thus measuring all particles (LDSAN). The ratio of LDSA (LDSAC/LDSAN) was used to assess the fraction of solid and semi-volatile particles within a sample. Here, a low ratio represents a high fraction of semi-volatile particles, with a high ratio indicating a high fraction of solid particles. During the 3-month urban background study in Birmingham, UK, it is shown that the LDSA ratios ranged from 0.2–0.95 indicating a wide variation in sources and subsequent semi-volatile fraction of particles. A black carbon (BC) instrument was used to provide a low-cost measure of LDSA to BC ratio. Comparatively, the LDSA to BC ratios obtained using low-cost sensors showed similar results to high-cost analyses for urban environments. During a high LDSAC/LDSAN ratio sampling period, representing high solid particle concentrations, an LDSA to BC probability distribution was shown to be multimodal, reflecting urban LDSA to BC ratio distributions measured with laboratory-grade instrumentation. Here, a low-cost approach for data analyses presents insight on particle characteristics and insight into PM composition and size, useful in source apportionment, health, and atmospheric studies.

Pet Ownership and Mental and Physical Health in Older White and Black Males and Females.

Pet ownership literature remains mixed regarding associations with mental and physical health outcomes among older adults. The present study investigates the relationship between pet ownership and depression, health, and physical activity in an older adult sample balanced by sex (male/female), race (White/Black), and urban/rural status. Participants were adults aged 65+ recruited between 1999 and 2001 in the University of Alabama at Birmingham Study of Aging. Participants completed the Geriatric Depression Scale, a single-item self-reported health measure, and a physical activity questionnaire. Dog owners reported better subjective health and were more likely to walk for exercise as compared to non-pet owners. Cat owners did not differ from non-pet owners in terms of self-reported health or walking. White participants were more likely than Black participants to report ownership of a pet. No relationships were found between pet ownership and symptoms of depression. Findings were not influenced by sex, race, or geographical location. Dog ownership may be associated with positive physical health behaviors and subjective health perceptions. Additional research focused on mechanisms and cognitive impact is needed. Although there may be physical health benefits of dog ownership, adopting a pet should not be viewed as a simplistic solution to alleviating depression in older adults.

&lt;i&gt;Cultural Studies&lt;/i&gt; as a Political Practice

The phenomenon of politicization of humanitarian scientific thought is becoming increasingly noticeable in the modern philosophical, cultural and political science. Scientists and philosophers belonging to political parties are nothing new in the history of science. Today, however, this kind of division into separate groups reveals not only ideological, but also a pronounced political character. The example of the Western European, English-speaking humanitarian academic community appears to be particularly indicative in this regard. Apparently, the conflict between the increasingly radicalized left and right discourses within the English-speaking academic community is entering an active phase. To understand the nature of this confrontation, it is necessary both to consider these discourses as separate phenomena, and to delve into their historical roots. The political discourse of the New Left is most clearly revealed in the program of the so-called cultural studies that appeared among post-war English Marxist intellectuals and later took root in the USA. The term was popularized by Herbert Richard Hoggart a British academic who specialized in sociology, English literature, and British popular culture. In 1964 he founded the Center for Contemporary Cultural Studies in Birmingham (CCCS). The history of CCCS is strongly associated with the name of Stuart Henry Hall, who was Hoggart's assistant and headed the Center since 1971. The connection between political action and cultural studies permeates the entire history of this field of knowledge. The very formation of the discipline and its institutionalization in the UK were influenced by such political and cultural events as the post-war Americanization of English popular culture, the spread of telecommunications, the new era of multiculturalism in Britain, and new critical theories. At the same time, many post-war European countries, such as Germany and France, showed interest in research, which ultimately shaped the apparatus of cultural studies. Within the framework of this program, we can see an increasingly nature perspective on culture that combines the Marxist view on the problem of culture and the sociological one but is not reduced to either of them. In this kind of paradigm, culture is understood as a consequence of people's social actions, and at the same time, as a certain system that fixes the ways of implementing these relations. This approach differs from both classical Marxism facosed on economic relations between people and from structural functionalism, in which the concepts of society and culture are almost synonymous. The author states that the discourse of the New Left and the program of cultural studies are different manifestations of a single methodological approach or worldview. At present, this is the dominant worldview in the Western academic community. The article examines the history and main methodological guidelines of this type of cultural studies, as well as today's criticism of this approach.

Stimulated Insulin Secretion Predicts Changes in Body Composition Following Weight Loss in Adults with High BMI

BackgroundThe aim of obesity treatment is to promote loss of fat relative to lean mass. However, body composition changes with calorie restriction differ among individuals. ObjectivesThe goal of this study was to test the hypothesis that insulin secretion predicts body composition changes among young and middle-age adults with high BMI (in kg/m2) following major weight loss. MethodsExploratory analyses were conducted with pre-randomization data from 2 large feeding trials: the Framingham, Boston, Bloomington, Birmingham, and Baylor study (FB4; n = 82, 43.9% women, BMI ≥27) and the Framingham State Food Study [(FS)2; n = 161, 69.6% women, BMI ≥25]. Participants in the 2 trials consumed calorie-restricted moderate-carbohydrate or very-low-carbohydrate diets to produce 12–18% weight loss in ∼14 wk or 10–14% in ∼10 wk, respectively. We determined insulin concentration 30 min after a 75-g oral glucose load (insulin-30) as a measure of insulin secretion and HOMA-IR as a measure of insulin resistance at baseline. Body composition was determined by DXA at baseline and post–weight loss. Associations were analyzed using general linear models with adjustment for covariates. ResultsIn FB4, higher insulin-30 was associated with a smaller decrease in fat mass (0.441 kg per 100 μIU/mL increment in baseline insulin-30; P = 0.005; –1.20-kg mean difference between the first compared with the fifth group of insulin-30) and a larger decrease in lean mass (–0.465 kg per 100 μIU/mL; P = 0.004; 1.27-kg difference). Participants with higher insulin-30 lost a smaller proportion of weight loss as fat (–3.37% per 100 μIU/mL; P = 0.003; 9.20% difference). Greater HOMA-IR was also significantly associated with adverse body composition changes. Results from (FS)2 were qualitatively similar but of a smaller magnitude. ConclusionsBaseline insulin dynamics predict substantial individual differences in body composition following weight loss. These findings may inform understanding of the pathophysiological basis for weight regain and the design of more effective obesity treatment. Registered at http://www.clinicaltrials.gov clinicaltrials.gov as NCT03394664 and NCT02068885.

INtrinsic Capacity and its RElAtionship With Life-SpacE Mobility (INCREASE): a cross-sectional study of community-dwelling older adults in Singapore

ObjectivesTo examine the association of intrinsic capacity (IC) with life-space mobility (LSM) among community-dwelling older adults and to determine whether age and gender modify this relationship.DesignCross-sectional study.SettingPublic housing blocks, senior...

Attitudes Toward COVID-19 Illness and COVID-19 Vaccination among Pregnant Women: A Cross-Sectional Multicenter Study during August-December 2020.

The aim of the study was to evaluate pregnant women's attitudes toward COVID-19 illness and vaccination and identify factors associated with vaccine acceptability. This was a cross-sectional survey among pregnant women enrolled in a prospective COVID-19 cohort study in Salt Lake City, UT, Birmingham, AL, and New York, NY, from August 9 to December 10, 2020. Women were eligible if they were 18 to 50 years old and <28 weeks of gestation. Upon enrollment, women completed surveys regarding concerns about COVID-19 illness and likelihood of getting COVID-19 vaccine if one were available during pregnancy. Vaccine acceptability was defined as a response of "very likely" or "somewhat likely" on a 4-point Likert scale. Factors associated with vaccine acceptability were assessed with multivariable logistic regression. Of 939 pregnant women eligible for the main cohort study, 915 (97%) consented to participate. Among these 915 women, 39% self-identified as White, 23% Black, 33% Hispanic, and 4% Other. Sixty-two percent received an influenza vaccine last season. Seventy-two percent worried about getting sick with COVID-19. If they were to get sick, 92% worried about harm to their pregnancy and 80% about harm to themselves. Only 41% reported they would get a vaccine. Of women who were unlikely to get vaccinated, the most frequently cited concern was vaccine safety for their pregnancy (82%). Non-Hispanic Black and Hispanic women had lower odds of accepting a vaccine compared with non-Hispanic White women (adjusted odds ratios [aOR] 0.4, 95% CI 0.2-0.6 for both). Receipt of influenza vaccine during the previous season was associated with higher odds of vaccine acceptability (aOR 2.1, 95% CI 1.5-3.0). Although most pregnant women worried about COVID-19 illness, <50% were willing to get vaccinated during pregnancy. Racial and ethnic disparities in plans to accept COVID-19 vaccine highlight the need to prioritize strategies to address perceived barriers among groups at high risk for COVID-19. · Less than half of pregnant patients stated they would get a COVID-19 vaccine.. · Protecting their baby was the most common reason for acceptance and refusal of the COVID-19 vaccine.. · Patients of minority race/ethnicity and those without prior influenza vaccination were less likely to accept the COVID-19 vaccine..

Changes in lipidomic profile by anti-retroviral treatment regimen: An ACTG 5257 ancillary study.

High cardiovascular disease risk in people living with HIV is partly attributed to antiretroviral therapy (ART). Lipid response to ART has been extensively studied, yet, little is known how small molecule lipids respond to Integrase inhibitor-based (INSTI-based) compared to Protease inhibitor-based (PI-based) ART regimens.Ancillary study to a phase 3, randomized, open-label trial [AIDS Clinical Trial Group A5257 Study] in treatment-naive HIV-infected patients randomized in a 1:1:1 ratio to receive ritonavir-boosted atazanavir (ATV/r), ritonavir-boosted darunavir (DRV/r) (both PI-based), or raltegravir with Tenofovir Disoproxil Fumarate-TDF plus emtricitabine (RAL, INSTI-based).We examined small molecule lipid response in a subcohort of 75 participants. Lipidomic assays of plasma samples collected pre- and post-ART treatment (48 weeks) were conducted using ultra-performance liquid chromatography coupled to time-of-flight mass spectrometry. The effect of ART regimens was regressed on lipid species response adjusting for the baseline covariates (lipids, age, sex, race, CD4 level, BMI, and smoking). Results were validated in the Centers for AIDS Research Network of Integrated Clinical Systems study (N = 16).Out of 417 annotated lipids, glycerophospholipids (P = .007) and sphingolipids (P = .028) had a higher response to ATV/r and DRV/r compared to RAL. The lysophosphatidylcholine (LPCs(16:1),(17:1),(20:3)) and phosphophatidylcholine species (PCs(40:7),(38:4)) had an opposite response to RAL versus ATV/r in the discovery and validation cohort. The INSTI-based regimen had an opposite response of ceramide species ((d38:1), (d42:2)), PCs((35:2), (38:4)), phosphatidylethanolamines (PEs(38:4), (38:6)), and sphingomyelin(SMd38:1) species compared with the PI-based regimens. There were no differences observed between 2 PI-based regimens.We observed differences in response of small molecule lipid species by ART regimens in treatment-naive people living with HIV.

Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults

ObjectivesTo develop a German version of the original University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past...

The Relation Between Pet Ownership, Anxiety, and Depressive Symptoms in Late Life: Propensity Score Matched Analyses

ABSTRACT The purpose of this study was to explore the differences in anxiety and depressive symptoms between older adult pet owners and non-pet owners after accounting for various correlates. Research findings on the anxiety-relieving and antidepressant effects of late-life pet ownership are mixed and limited. This may be due in part to various characteristics that impact the likelihood of owning a pet. Propensity score matching was used to pair 169 pet owners with 169 non-pet owners aged 70–91 years who participated in the University of Alabama at Birmingham Study of Aging. One set of propensity scores was created using age, sex, race, rurality, marital status, and income, as well as self-reported health, difficulty with activities of daily living, and difficulty with instrumental activities of daily living. A second set of scores was created using age, sex, race, rurality, marital status, and income. Multiple linear regression analyses were then used to explore the relation between pet ownership status and anxiety or depressive symptoms, controlling for the other symptoms. Pet ownership was significantly associated with lower self-reported anxiety symptoms (β = –0.14) but not depressive symptoms (β = –0.03) in the data matched without health variables. When propensity score matching included health variables, pet ownership was related to neither symptoms of anxiety (β = –0.08) nor depression (β = 0.05). These results suggest that owning a pet in later life is related to fewer anxiety symptoms, over and above the impact of depressive symptoms, even after accounting for various demographic and economic covariates. However, general and functional health appear to be critical to this relation, but the direction of this relation could not be determined from our analyses (i.e., it is not clear whether the relation between pet ownership and anxiety symptoms is confounded by, mediates, or is mediated by health). This study is the first large-scale analysis to find a significant relation between pet ownership and fewer anxiety symptoms in older adults.