The Role of Physical Function in the Association between Physical Activity and Gait Speed in Older Adults: A Mediation Analysis

Adequate levels of physical function (PF) are essential for vulnerable older adults to perform their daily tasks safely and remain autonomous. Our objective was to explore the mediating role of PF in the relationship between physical activity (PA) and gait speed (GS) in a large sample of older adults from the north of Brazil. This is a cross-sectional study that analyzed 697 older adults (mean age 70.35 ± 6.86 years) who participated in the project "Health, Lifestyle, and Physical Fitness in Older Adults in Amazonas" (SEVAAI). PA was assessed using the Baecke Questionnaire, PF using the Senior Fitness Test, and GS using the 50-foot Walk Test. Mediation pathways were analyzed to test the possible mediating role of PF between specific PA domains (PA-total score, PA-housework, PA-sport, PA-leisure) and GS. Regarding PA-total, the analysis showed that high-performance GS was partially mediated in approximately 19% by better PF performance. Moreover, the PF could partially mediate the association between PA-sport and PA-leisure with GS, at levels of approximately 9% and 46%, respectively. An inverse relationship was observed between PA-housework (sedentary lifestyle) and GS. This association was partially mediated to an extent of approximately 9% by better PF performance. We conclude that PF plays a crucial role in mediating the association between PA and GS among vulnerable older adults.

Higher levels of neuroticism in older adults predict lower executive functioning across time: the mediating role of perceived stress

Neuroticism has been associated with individual differences across multiple cognitive functions. Yet, the literature on its specific association with executive functions (EF) in older adults is scarce, especially using longitudinal designs. To disentangle the specific influence of neuroticism on EF and on coarse cognitive functioning in old adulthood, respectively, we examined the relationship between neuroticism, the Trail Making Test (TMT) and the Mini-Mental State Examination (MMSE) in a 6-year longitudinal study using Bayesian analyses. Data of 768 older adults (M age = 73.51 years at Wave 1) were included in a cross-lagged analysis. Results showed no cross-sectional link between neuroticism and TMT performance at Wave 1 and no longitudinal link between neuroticism at Wave 1 and MMSE at Wave 2. However, neuroticism at Wave 1 predicted TMT performance at Wave 2, indicating that the more neurotic participants were, the lower they performed on the TMT six years later. Additional analyses showed that this relation was fully mediated by participants' perceived stress. Our results suggest that the more neurotic older adults are the more stress they may perceive six years later, which in turn negatively relates to their EF. In sum, this study demonstrates that neuroticism may lead to lower EF in older age across six years. It further suggests older adults' perceived stress as mediator, thereby providing novel insights into the mechanisms underlying this relation. Possible intervention approaches to counter these effects are discussed.

Cognitive functions and physical activity in aging when energy is lacking

Declines in subjective energy availability and cognitive functions could explain the decrease in physical activity observed across aging. However, how these factors interact remains unknown. Based on the theory of effort minimization in physical activity (TEMPA), we hypothesized that cognitive functions may help older adults to maintain physical activity even when energy availability is perceived as insufficient. This study used data of 104,590 adults from 21 European countries, from the Survey of Health, Ageing and Retirement in Europe (SHARE), including 7 measurement occasions between 2004 and 2017. Cognitive functions were assessed with verbal fluency and delayed recall, using the verbal fluency test and the 10-word delayed recall test. Physical activity and subjective energy availability were self-reported. Results of linear mixed-effects models revealed that cognitive functions moderated the associations between subjective energy availability and physical activity. Moreover, as adults get older, cognitive functions became critical to engage in physical activity regardless the availability of perceived energy. Sensitivity and robustness analyses were consistent with the main results. These results suggest that cognitive functions may help older adults to maintain regular physical activity even when energy for goal pursuit becomes insufficient, but that the protective role of cognitive functions becomes critical at older age, irrespective of the state of perceived energy.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10433-021-00654-2.

Financial Reasons for Working beyond the Statutory Retirement Age: Risk Factors and Associations with Health in Late Life

Despite an increasing trend of working life prolongation, little is known about the risk factors for financial reasons for working beyond the statutory retirement age (SRA), and how these reasons relate to health. The present study examined (1) the determinants of working beyond the SRA, (2) the workers' self-reported reasons for working beyond the SRA, and (3) the association between these reasons and health in late life. Cross-sectional data of 1241 individuals from the Swiss survey "Vivre/Leben/Vivere" were analyzed. The results showed that people with a low level of education and with a low income have an 80% higher risk of working beyond the SRA for financial reasons than for other reasons (p < 0.001). Moreover, self-rated health was not significantly associated with working beyond the SRA for financial reasons but was significantly associated with education and income (p < 0.01). In conclusion, while previous studies have already identified financial difficulties as one important reason for working beyond the SRA, the present study indicated the socioeconomic factors that are crucial for increasing the risk for working beyond the SRA. Thus, our results help to guide the adaptation of social policies for better maintaining and promoting the health of particularly vulnerable older workers.

Predictive Modeling of Injury Risk Based on Body Composition and Selected Physical Fitness Tests for Elite Football Players

Injuries are one of the most significant issues for elite football players. Consequently, elite football clubs have been consistently interested in having practical, interpretable, and usable models as decision-making support for technical staff. This study aimed to analyze predictive modeling of injury risk based on body composition variables and selected physical fitness tests for elite football players through a sports season. The sample comprised 36 male elite football players who competed in the First Portuguese Soccer League in the 2020/2021 season. The models were calculated based on 22 independent variables that included players' information, body composition, physical fitness, and one dependent variable, the number of injuries per season. In the net elastic analysis, the variables that best predicted injury risk were sectorial positions (defensive and forward), body height, sit-and-reach performance, 1 min number of push-ups, handgrip strength, and 35 m linear speed. This study considered multiple-input single-output regression-type models. The analysis showed that the most accurate model presented in this work generates an error of RMSE = 0.591. Our approach opens a novel perspective for injury prevention and training monitorization. Nevertheless, more studies are needed to identify risk factors associated with injury prediction in elite soccer players, as this is a rising topic that requires several analyses performed in different contexts.

Life-course socioeconomic conditions, multimorbidity and polypharmacy in older adults: A retrospective cohort study

Socioeconomic conditions across the life course may contribute to differences in multimorbidity and polypharmacy in old age. However, whether the risk of multimorbidity changes during ageing and whether life-course socioeconomic conditions are associated with polypharmacy remain unclear. We investigated whether disadvantaged childhood socioeconomic conditions (CSCs) predict increased odds of multimorbidity and polypharmacy in older adults, whether CSCs remain associated when adjusting for adulthood socioeconomic conditions (ACSs), and whether CSCs and ACSs are associated cumulatively over the life course. We used data for 31,432 participants (multimorbidity cohort, mean [SD] age 66·2[9] years), and 21,794 participants (polypharmacy cohort, mean age 69·0[8.9] years) from the Survey of Health, Ageing, and Retirement in Europe (age range 50-96 years). We used mixed-effects logistic regression to assess the associations of CSCs, ASCs, and a life-course socioeconomic conditions score (0-8; 8, most advantaged) with multimorbidity (≥2 chronic conditions) and polypharmacy (≥5 drugs taken daily). We found an association between CSCs and multimorbidity (reference: most disadvantaged; disadvantaged: odds ratio (OR) = 0·79, 95% confidence interval (CI) 0·70-0·90; middle: OR = 0·60; 95%CI 0·53-0·68; advantaged: OR = 0·52, 95%CI 0·45-0·60, most advantaged: OR = 0·40, 95%CI 0·34-0·48) but not polypharmacy. This multimorbidity association was attenuated but remained significant after adjusting for ASCs. The life-course socioeconomic conditions score was associated with multimorbidity and polypharmacy. We did not find an association between CSCs, life-course socioeconomic conditions, and change in odds of multimorbidity and polypharmacy with ageing. Exposure to disadvantaged socioeconomic conditions in childhood or over the entire life-course could predict multimorbidity in older age.

The Role of Cognitive Performance and Physical Functions in the Association between Age and Gait Speed: A Mediation Study

Simple Summary

Age and mobility are interrelated. In this context, cognitive performance (CP) and physical functions (PF) play a mediating role. However, these concepts are multifaceted, and their interrelationships need further investigations. Thus, our study aims (1) to investigate the association between CP and PF with GS and (2) to examine whether CP and PF mediate the association between age and GS in a large sample of older Brazilian adults. The findings show that low levels of CP and PF were associated with a greater chance of the older individual presenting a slow GS. Moreover, the mediation model indicated that CP and PF mediated, by approximately 12% and 98%, respectively, the association between age and GS.

Abstract

Introduction: With vulnerable aging, gait speed (GS) undergoes progressive changes, becoming slower. In this process, cognitive performance (CP) and physical function (PF) both play an important role. This study aims (1) to investigate the association between CP and PF with GS and (2) to examine whether CP and PF mediate the association between age and GS in a large sample of Brazilian older adults. Methods: A cross-sectional study analyzed 697 individuals (mean age 70.35 ± 6.86 years) from the state of Amazonas. The CP was evaluated by the COGTEL test battery, PF by the Senior Fitness Test battery, and GS with the 50-foot Walk Test. Results: Older adults with a lower CP and PF had a 70% and 86% chance of slow GS, respectively. When CP and PF were placed simultaneously as mediators, the direct effect estimated by the model revealed a non-significant relationship between age and GS. Specifically, CP and PF mediated the association between age and GS, at approximately 12% and 98%, respectively. Conclusions: CP and PF show the potential to estimate GS performance among older adults. Moreover, CP and PF indicated a negative and direct association between age and slow GS, especially PF.

Exploring the Role of Physical Activity in Mediating the Association between Educational Level and Health-Related Quality of Life in an Adult Lifespan Sample from Madeira Island

Background: People more socioeconomically vulnerable tend to have a poorer health-related quality of life (HRQoL). Studies are trying to analyse the factors that may condition this relationship, including physical activity (PA), which may influence the relationship between socioeconomic status (SES) and HRQoL. This study aimed to analyse the relationship between SES and HRQoL through specific domains of PA. Methods: A total of 381 adults (≥18 years) from the Autonomous Region of Madeira completed the measurements. Mediation analyses using bootstrapping methods adjusted for confounding variables were performed to relate SES and HRQoL; the latter was evaluated using the physical component score (PCS) of the SF-12, the mental component score (MCS) of the SF-12, and the total score in the SF-12 questionnaire (SF-12 score), through physical activity. Results: Educational level was positively related to PCS and SF-12 score. Leisure-time PA (not including sports PA) and PA at work, as single mediating variables, did not mediate the relationship between SES and HRQoL. The total PA suppressed the socioeconomic gradient of HRQoL by 8–10%, 39–46%, and 15–16%, respectively, for the PCS, MCS, and the SF-12 score; sports PA mediated the relationship by 13–16%, 50%, and 15–21%, respectively. Conclusions: The results suggest that sports PA contributes to reducing the socioeconomic gradient of HRQoL.

Profiling Distinctive Inflammatory and Redox Responses to Hydrogen Sulfide in Stretched and Stimulated Lung Cells

Hydrogen sulfide (H2S) protects against stretch-induced lung injury. However, the impact of H2S on individual cells or their crosstalk upon stretch remains unclear. Therefore, we addressed this issue in vitro using relevant lung cells. We have explored (i) the anti-inflammatory properties of H2S on epithelial (A549 and BEAS-2B), macrophage (RAW264.7) and endothelial (HUVEC) cells subjected to cycling mechanical stretch; (ii) the intercellular transduction of inflammation by co-culturing epithelial cells and macrophages (A549 and RAW264.7); (iii) the effect of H2S on neutrophils (Hoxb8) in transmigration (co-culture setup with HUVECs) and chemotaxis experiments. In stretched epithelial cells (A549, BEAS-2B), the release of interleukin-8 was not prevented by H2S treatment. However, H2S reduced macrophage inflammatory protein-2 (MIP-2) release from unstretched macrophages (RAW264.7) co-cultured with stretched epithelial cells. In stretched macrophages, H2S prevented MIP-2 release by limiting nicotinamide adenine dinucleotide phosphate oxidase-derived superoxide radicals (ROS). In endothelial cells (HUVEC), H2S inhibited interleukin-8 release and preserved endothelial integrity. In neutrophils (Hoxb8), H2S limited MIP-2-induced transmigration through endothelial monolayers, ROS formation and their chemotactic movement. H2S induces anti-inflammatory effects in a cell-type specific manner. H2S limits stretch- and/or paracrine-induced inflammatory response in endothelial, macrophage, and neutrophil cells by maintaining redox homeostasis as underlying mechanism.

Cognitive Reserve Mediates the Relation between Neighborhood Socio-Economic Position and Cognitive Decline

<b><i>Introduction:</i></b> We investigated the mediating role of leisure activity engagement as marker of cognitive reserve in the relation between neighborhood socio-economic position (SEP) and cognitive decline over 6 years. <b><i>Methods:</i></b> The study analyzed longitudinal data from 897 older adults who participated in the two waves (2011 and 2017) of the Vivre-Leben-Vivere (VLV) survey in Switzerland (<i>M</i> = 74.33 years in the first wave). Trail Making Test parts A and B were administered in both waves. Leisure activity engagement was assessed during interviews. Neighborhood SEP was derived from the Swiss Neighborhood Index of Socio-Economic Position (Swiss-SEP), provided by the Swiss National Cohort (SNC). <b><i>Results:</i></b> Latent change score modeling revealed that 42.5% of the relationship between higher neighborhood SEP and smaller cognitive decline was mediated via a higher frequency of leisure activities in the first wave. <b><i>Conclusion:</i></b> Neighborhood SEP constitutes an important contextual factor potentially influencing the pathways of cognitive reserve accumulation and, therefore, should be taken into account to better understand their effects on cognitive decline in old age.

Associations of Physical Activity and Television Viewing With Depressive Symptoms of the European Adults

Background: While mentally passive sedentary behavior such as television viewing (TV) is often related with depressive symptoms, some research shows that physical activity (PA) may attenuate this association. Thus, this study aimed to examine the associations between TV, PA, and depressive symptoms, considering sociodemographic covariates.

Methods: A sample of 29,285 adults (13,943 men; 15,342 women) with a mean age of 50.9 ± 17.4 years (50.6 ± 17.3 men; 51.1 ± 17.5 women) from the European Social Survey agreed to be respondents for this study. Data for sociodemographic variables, TV watching, PA, and depressive symptoms were self-reported. Different statistical procedures were conducted to provide evidence for the association between study variables. ANCOVA was used to analyze the association between TV watching and depressive symptoms. Linear regression analysis was conducted to analyze the association between PA and depressive symptoms. General Linear Model was performed to analyze the association of TV watching and on depressive symptoms, controlling for PA.

Results: European adults who responded watching more than 2 h per day showed higher scores for depressive symptoms. Higher participation in PA was negatively and significantly associated with depressive symptoms in men (β = −0.15, 95% CI: −0.18, −0.13), and women (β = −0.23, 95% CI: −0.26, −0.21). Men spending 1–2 h/day TV watching and engaging in PA ≥ 5 days/week presented the lowest scores on depressive symptoms. The lowest scores on depressive symptoms was observed in women engaging 2–4 days/week in PA and spending <1 h/day in TV watching.

Conclusions: More time spent in TV watching is related with increased scores on depressive symptoms. However, regular PA participation can weaken this association.

Better Subjective Sleep Quality Partly Explains the Association Between Self-Reported Physical Activity and Better Cognitive Function

Background: Physical activity has been associated with better cognitive function and better sleep quality. Yet, whether the beneficial effect of physical activity on cognitive function can be explained by an indirect pathway involving better sleep quality is unclear. Objective: To investigate whether sleep quality mediates the association between physical activity and cognitive function in adults 50 years of age or older. Methods: 86,541 community-dwelling European adults were included in the study. Physical activity and sleep quality were self-reported. Indicators of cognitive function (immediate recall, delayed recall, verbal fluency) were assessed using objective tests. All measures were collected six times between 2004 and 2017. The mediation was tested using multilevel mediation analyses. Results: Results showed that self-reported physical activity was associated with better self-reported sleep quality, which was associated with better performance in all three indicators of cognitive function, demonstrating an indirect effect of physical activity on cognitive function through sleep quality. The mediating effect of sleep quality accounted for 0.41%, 1.46%, and 8.88% of the total association of physical activity with verbal fluency, immediate recall, and delayed recall, respectively. Conclusion: These findings suggest that self-reported sleep quality partly mediates the association between self-reported physical activity and cognitive function. These results need to be confirmed by device-based data of physical activity and sleep quality.

The Relationship between Different Large-Sided Games and Official Matches on Professional Football Players' Locomotor Intensity

Large-sided games (LSG) are commonly used in the training contexts for providing either technical/tactical or locomotor/physiological stimuli. Despite natural similarities with the official match, the locomotor profile seems to be different, which must be considered by the coaches to identify compensatory strategies for achieving the ideal dose of training. The aim of this study was two-fold: (1) to investigate the locomotor demands imposed by LSGs and the official matches; and (2) to compare the effect of different pitch sizes’ LSG conditions in the locomotor demands. This study followed an observational design. Sixteen professional football players from the same team (26.3 ± 3.0 years old) were included. The study was conducted over four weeks. The same GK + 10 × 10 + GK play format with different pitch sizes (i.e., area per player ranging between 195 m2 to 291 m2) was analyzed. Three official matches were also collected in which the 10 most demanding minutes were considered for further comparisons. Only the same players who participated in matches were considered in comparison with the LSG. The data were obtained using a 10-Hz global positioning system technology. Total distance (TD) and mechanical work (MW) scores increased 20% and 23%, respectively, between the smallest and biggest pitch sizes (p < 0.001). There was a significant difference in locomotor intensity metrics between opponents from different positions on the table (p = 0.001). The biggest LSG (i.e., 291 m2 per player) was the only one that required similar levels of locomotor intensity as required in the official full match. The present study demonstrates that LSG pitch size variation requires different locomotor intensities. Bigger pitch sizes cause an increase in TD and MW. In addition, considering the position on the table, the level of opponents induces different TD covered. Finally, the largest LSG simulates the official match more accurately.

In Older Adults, Perceived Stress and Self-Efficacy Are Associated with Verbal Fluency, Reasoning, and Prospective Memory (Moderated by Socioeconomic Position)

Despite evidence that stress relates negatively to cognitive functioning in older adults, little is known how appraisal of stress and socioeconomic meso-level factors influence different types of cognitive functions in older adults. Here, we assess the relationship between perceived stress (PSS scale) and a battery of cognitive functions, including prospective memory in 1054 older adults (65+). A moderator analysis assessed whether this relationship varies with neighborhood socioeconomic status using an area-based measure of Socioeconomic Position (SEP). Perceived stress was associated with worse processing speed, verbal fluency, and inductive reasoning. The perceived self-efficacy subscale of the PSS is related to better performance in these measures. Higher self-efficacy was also associated with better prospective memory; this relationship was more pronounced for people with high neighborhood SEP. These findings indicate that not only do perceived stress and perceived self-efficacy relate to cognitive functioning in older age but also that neighborhood SEP is a moderator of this relationship.

The association between physical activity and mental health during the first year of the COVID-19 pandemic: a systematic review

INTRODUCTION

The Coronavirus disease-19 (COVID-19) pandemic affected countries worldwide and has changed peoples' lives. A reduction in physical activity and increased mental health problems were observed, mainly in the first year of the COVID-19 pandemic. Thus, this systematic review aims to examine the association between physical activity and mental health during the first year of the COVID-19 pandemic.

METHODS

In July 2021, a search was applied to PubMed, Scopus, and Web of Science. Eligibility criteria included cross-sectional, prospective, and longitudinal study designs and studies published in English; outcomes included physical activity and mental health (e.g., depressive symptoms, anxiety, positive and negative effects, well-being).

RESULTS

Thirty-one studies were included in this review. Overall, the studies suggested that higher physical activity is associated with higher well-being, quality of life as well as lower depressive symptoms, anxiety, and stress, independently of age. There was no consensus for the optimal physical activity level for mitigating negative mental symptoms, neither for the frequency nor for the type of physical activity. Women were more vulnerable to mental health changes and men were more susceptive to physical activity changes.

CONCLUSION

Physical activity has been a good and effective choice to mitigate the negative effects of the COVID-19 pandemic on mental health during the first year of the COVID-19 pandemic. Public health policies should alert for possibilities to increase physical activity during the stay-at-home order in many countries worldwide.

How Welfare Regimes Moderate the Associations Between Cognitive Aging, Education, and Occupation

OBJECTIVES

Previous studies have shown the importance of individual markers of cognitive reserve, such as education and occupation, for cognitive health in old age. However, there has been only little investigation so far on how this relationship varies across contexts.

METHODS

We analyzed data from the Survey of Health, Ageing, and Retirement in Europe, using second-order latent growth models, to assess the moderating role of welfare regimes on the relationship between education and occupation skill level in explaining overall cognitive functioning and decline in old age. Our sample includes 13 European countries using data from 5 regular waves of the survey (2004-2007 and 2011-2015) and 2 retrospective ones (2008-2009 and 2017). Cognitive functioning was modeled as a latent variable measured by immediate and delayed recall, verbal fluency, and numeracy.

RESULTS

74,193 participants were included from the survey. Our analysis showed that the association of education with cognition was weaker overall in Scandinavian countries, but stronger in Southern European countries, relative to Bismarckian ones. However, educational differences in the decline of cognition were more pronounced only in Scandinavian compared to Bismarckian countries. Additionally, higher-skilled occupations in Scandinavian countries had better overall functioning compared to the same occupations in Bismarckian countries, but there was no difference in the decline in cognitive functioning.

DISCUSSION

Our findings indicate that the associations of cognitive functioning and its decline with individuals' cognitive reserve markers (education and occupational skill level) vary according to welfare regimes, showing the importance of contextual factors in cognitive aging processes.

Effects of Exercise during Pregnancy on Postpartum Depression: A Systematic Review of Meta-Analyses

Simple Summary

Postpartum depression (PPD) is a public health problem. Exercise is a nonpharmacologic alternative to deal with PPD. This study conducted a systematic review of previous meta-analyses and an exploratory pooled analysis regarding the effects of exercise on depressive symptoms among women during the postpartum period. We searched for previous meta-analyses of experimental studies. Of the 52 records selected, we included five in the analyses, because they were focused on PPD. From the results, it was clear that exercise had a significant but small effect on depressive symptoms. This study shows that exercise is effective in reducing PPD symptoms.

Abstract

Postpartum depression (PPD) is a public health issue. Exercise is a nonpharmacologic alternative to deal with PPD. This study conducted a systematic review of previous meta-analyses and an exploratory pooled analysis regarding the effects of exercise on depressive symptoms among women during the postpartum period. We searched for previous meta-analyses of randomised controlled trials on PubMed, Web of Science and Scopus, date of inception to 31 May 2021. The methodological quality was assessed using the Assessment of Multiple Systematic Reviews 2 (AMSTAR2) instrument. We pooled the standardised mean differences from the selected studies. Of the 52 records screened, five were included. The results revealed a significant moderate effect of exercise on depressive symptoms among women during the postpartum period (SMD = −0.53; 95% CI: −0.80 to −0.27, p < 0.001). The pooled effect of the five meta-analyses established that exercise had a significant, small effect on depressive symptoms (SMD = −0.41; 95% CI: −0.50 to −0.32, p < 0.001). Our study indicates that exercise is effective in reducing PPD symptoms. Compared with traditional control approaches (psychosocial and psychological interventions), exercise seems have a superior effect on PPD symptoms. The implications of the present synthesis of past meta-analytical findings to guide health policies and research are discussed.

Social protection expenditure on health in later life in 20 European countries: Spending more to reduce health inequalities

BACKGROUND

This study aims to examine whether higher social protection expenditure reduces the negative association of life-course socioeconomic disadvantages with subjective and objective health status and trajectories in later life.

METHODS

We used SHARE data from participants living in 20 European countries aged 50 to 96. Seven waves allowed to examine the trajectories of health inequalities in later life. We used linear mixed-effects models stratified by sex to examine the association between life-course socioeconomic disadvantage and subjective (self-rated health, SRH, N = 55,443) and objective (grip strength, N = 54,718) health. Cross-level interactions between net social protection expenditure as percentage of gross domestic product and life-course socioeconomic disadvantage tested for the moderating effect of social expenditures on the association of disadvantage with SRH and grip strength in later life.

FINDINGS

Higher social protection expenditure reduced socioeconomic health inequalities in both men and women for grip strength, and in women but not men for SRH. For SRH, the health-inequality-reducing effect of social protection expenditure became weaker with increasing age. This was not observed in grip strength. Some separate expenditure functions (disability, family and children) were found to have inequality-widening effects in men's and women's SRH, which were either offset or overcompensated by the other functions. No inequality-widening effects were observed in grip strength.

INTERPRETATION

Higher social spending reduces life-course socioeconomic inequalities in women's subjective health and in men's and women's objective health. However, some specific social protection policies may have the unintentional effect of increasing inequalities in people's evaluation of their own health.

Total Synthesis via Biomimetic Late-Stage Heterocyclization: Assignment of the Relative Configuration and Biological Evaluation of the Nitraria Alkaloid (±)-Nitrabirine

The racemic total synthesis of nitrabirine (5) together with its previously undescribed epimer 2-epi nitrabirine (5') is accomplished via a six-step route based on a biomimetic late-stage heterocyclization. This allowed the assignment of the relative configuration of nitrabirine by the lanthanide-induced shifts (LIS) experiment, which was later on confirmed by X-ray diffraction of obtained single crystals. Furthermore, oxidation studies demonstrated that the direct N-oxidation of nitrabirine does not yield nitrabirine N-oxide as reported earlier. In contrast, the reaction of hydrogen peroxide with nitrabirine (5) yields the salt 24', whereas 2-epi nitrabirine (5') surprisingly leads to a previously uncharacterized product 22 under the same conditions. Finally, a Fischer indole reaction gave access to novel tetracyclic nitrabirine derivatives 26a-d. A comprehensive biological evaluation of nitrabirine (5), 2-epi nitrabirine (5'), and all derivatives synthesized in this study revealed general biofilm dispersal effects against Candida albicans. Moreover, specific compounds showed moderate antibacterial activities as well as potent cytotoxic activities.

Grip strength as a predictor of depressive symptoms among vulnerable elderly Europeans with musculoskeletal conditions

The present study aimed to investigate the grip strength (GS) discrimination capacity and cutoffs points for depressive symptoms among vulnerable elderly individuals with musculoskeletal conditions. The Survey of Health, Aging, and Retirement in Europe wave 6 was analyzed. GS was measured by a handgrip dynamometer, and EURO-D scale was used to assess depressive symptoms. GS cutoff values for depressive symptoms were calculated using the receiver operating characteristics curve. 2206 participants, mean age 74.0 (73.7-74.3), 78.8% with osteoarthritis/other rheumatism, enrolled in the study. Sensitivity varies between 0.44 (men, ≥ 85 years) and 0.82 (men, 75-84 years), and specificity varying between 0.35 (women, 75-84 years) and 0.70 (men 75-84 years). GS is associated with depressive symptoms just for women and it is not possible to use a GS cutoff point for screening depressive symptoms for vulnerable men and women with musculoskeletal conditions over the age of 65 years.

Interactional Effects Between Relational and Cognitive Reserves on Decline in Executive Functioning

OBJECTIVES

The present study set out to investigate associations of cognitive reserve (as indicated by education) and relational reserve (as indicated by the family network size and indices of emotional support) to decline in executive functioning over 6 years as measured by changes in Trail Making Test (TMT) completion time in older adults and whether education and network size interacted with age and sex as covariates with respect to this longitudinal association.

METHOD

We analyzed data from 897 participants tested on TMT parts A and B in two waves 6 years apart. The mean age in the first wave was 74.33 years. Participants reported information on their family networks and their level of education.

RESULTS

Latent change score modeling testing for moderation effects revealed a significant interaction of network size in the first wave of data assessment with education. Specifically, for lower levels of cognitive reserve (-1 SD of education), the longitudinal association between relational reserve in the first wave and subsequent changes in executive functioning was not significant. In contrast, for higher levels of cognitive reserve (+1 SD of education), a higher relational reserve in the first wave significantly predicted a smaller subsequent increase in TMT completion time from the first to the second wave (i.e., a smaller decline in executive functioning).

DISCUSSION

The present longitudinal study provides evidence for the interaction between cognitive and relational reserves. This confirms the hypothesis that reserves from different domains are intertwined and their combined effects contribute to less cognitive decline in old age.

A Systematic Review of the Association Between Muscular Fitness and Telomere Length Across the Adult Lifespan

This study aimed to systematically review the association between telomere length (TL) and muscular fitness. In October 2020, an articles search was applied to PubMed, Scopus, and Web of Science. Eligibility criteria included: cross-sectional, prospective, and experimental study design; outcomes included TL; results expressed the relationship between muscular fitness and TL; studies published in English, Portuguese, or Spanish. Nine studies were included in the review. Results from the four prospective studies are mixed. In one study, the changes in TL were associated with grip strength. Another study concluded that longer mid-life TL was associated with increased grip strength later in life. However, in the other two studies, the association between TL and sarcopenia was not strong. Nevertheless, longer TL was associated with a slower decline in grip strength in older people. From the four cross-sectional studies, three indicated that TL was associated with muscular fitness. On the other hand, in a study with powerlifters, TL remained within the range of values found in subjects with no history of regular strength training, supporting the notion that muscular fitness was not associated with TL. The cross-sectional and prospective studies showed that the relationship between TL and muscular fitness is not conclusive. It seems that there is a positive association between TL and muscular fitness in middle-aged and older adults. However, among younger adults, this relationship was not observed.

Bidirectional Association between Physical Activity and Dopamine Across Adulthood-A Systematic Review

Physical activity (PA) may influence the secretion of neurotransmitters and thereby have positive consequences for an individual’s vulnerability (i.e., reducing anxiety and depressive symptoms). This systematic review aims to analyse the potential bidirectional effects of exercise on dopamine from young adulthood to old age. The article search was conducted in PubMed, Scopus, and Web of Science in December 2020. The inclusion criteria were longitudinal and experimental study design; outcomes included dopamine and exercise; effect of exercise on dopamine and vice versa; adults; and articles published in English, Portuguese, or Spanish. Fifteen articles were included in the review. We observed robust findings concerning the potential effects of PA on dopamine, which notably seem to be observable across a wide range of participants characteristics (including age and sex), a variety of PA characteristics, and a broad set of methods to analyse dopamine. By contrast, regarding the potential effects of dopamine on PA, findings were mixed across studies. Thus, there are robust effects of physical exercise on dopamine. These findings further strengthen the idea that innovative approaches could include PA interventions for treating and preventing mental disorders. Therefore, it seems that PA is a potential alternative to deal with mental health issues.