Measures of MRI Brain Biomarkers in Middle Age According to Average Modified Mediterranean Diet Scores Throughout Young and Middle Adulthood

BACKGROUND

The Mediterranean diet (MedDiet) has been linked with better cognitive function and brain integrity.

OBJECTIVE

To examine the association of modified Mediterranean diet (mMedDiet) scores from early through middle adulthood in relation to volumetric and microstructural midlife MRI brain measures. Assess the association of mMedDiet and brain measures with four cognitive domains. If variables are correlated, determine if brain measures mediate the relationship between mMedDiet and cognition.

METHODS

618 participants (mean age 25.4±3.5 at year 0) of the Coronary Artery Risk Development in Young Adults (CARDIA) study were included. Cumulative average mMedDiet scores were calculated by averaging scores from years 0, 7, and 20. MRI scans were obtained at years 25 and 30. General linear models were used to examine the association between mMedDiet and brain measures.

RESULTS

Higher cumulative average mMedDiet scores were associated with better microstructural white matter (WM) integrity measured by fractional anisotropy (FA) at years 25 and 30 (all ptrend <0.05). Higher mMedDiet scores at year 7 were associated with higher WM FA at year 25 (β= 0.003, ptrend = 0.03). Higher mMedDiet scores at year 20 associated with higher WM FA at years 25 (β= 0.0005, ptrend = 0.002) and 30 (β= 0.0003, ptrend = 0.02). mMedDiet scores were not associated with brain volumes. Higher mMedDiet scores and WM FA were both correlated with better executive function, processing speed, and global cognition (all ptrend <0.05). WM FA did not mediate the association between mMedDiet scores and cognition.

CONCLUSIONS

mMedDiet scores may be associated with microstructural WM integrity at midlife.

The Association Between Immune-Related Conditions Across the Life-Course and Provoked Vulvodynia

Vulvodynia, impacts up to 8% of women by age 40, and is hypothesized to manifest through an altered immune-inflammatory response. To test this hypothesis, we identified all women born in Sweden between 1973 and 1996 diagnosed with localized provoked vulvodynia (N76.3) and/or vaginismus (N94.2 or F52.5) between 2001 and 2018. We matched each case to two women from the same birth year with no vulvar pain ICD codes. As a proxy for immune dysfunction, we used Swedish Registry data to capture 1) immunodeficiencies, 2) single organ and multiorgan autoimmune conditions, 3) allergy and atopies, and 4) malignancies involving immune cells across the life course. Women with vulvodynia, vaginismus or both were more likely to experience immune deficiencies (OR 1.8, 95% CI, 1.2-2.8), single organ (OR 1.4, 95% CI, 1.2-1.6) and/or multi-organ (OR 1.6, 95% CI, 1.3-1.9) immune disorders, and allergy/atopy conditions (OR 1.7, 95% CI, 1.6-1.8) compared to controls. We observed greater risk with increasing numbers of unique immune related conditions (1 code: OR = 1.6, 95% CI, 1.5-1.7; 2 codes: OR = 2.4, 95% CI, 2.1-2.9; 3 or more codes: OR = 2.9, 1.6-5.4). These findings suggest that women with vulvodynia may have a more compromised immune system either at birth or at points across the life course than women with no vulvar pain history. PERSPECTIVE: Women with vulvodynia are substantially more likely to experience a spectrum of immune related conditions across the life course. These findings lend support to the hypothesis that chronic inflammation initiates the hyperinnervation that causes the debilitating pain in women with vulvodynia.

Cumulative health disadvantages: an empirical study of the health and mobility of the first cohort of migrant workers in China

Background

The study aimed to understand the factors affecting the health and healthcare of the first cohort of migrant workers in China using the concept of the cumulative disadvantage framework.

Methods

Data from the China Migrants Dynamic Survey (2017) were used to analyze the process of cumulative disadvantage of health and healthcare among migrant workers. The study also analyzed the spatial lag problem between localized medical insurance policies and healthcare accessibility.

Results

The results revealed a significant negative association between the mobility of the first cohort of migrant workers and their health status. Long-term exposure to hazardous work had a greater negative impact on their health. Chinese migrant workers faced significant obstacles in accessing healthcare due to the lack of portability in health insurance.

Conclusion

The study emphasizes the urgent need for addressing the structural barriers hindering healthcare access and outcomes for migrant workers. It is crucial to promote a more equitable and sustainable healthcare system in China to ensure migrant workers' health and well-being.

Sex bias in mortality risk changes over the lifespan of bottlenose dolphins

Research on sex biases in longevity in mammals often assumes that male investment in competition results in a female survival advantage that is constant throughout life. We use 35 years of longitudinal data on 1003 wild bottlenose dolphins (Tursiops aduncus) to examine age-specific mortality, demonstrating a time-varying effect of sex on mortality hazard over the five-decade lifespan of a social mammal. Males are at higher risk of mortality than females during the juvenile period, but the gap between male and female mortality hazard closes in the mid-teens, coincident with the onset of female reproduction. Female mortality hazard is non-significantly higher than male mortality hazard in adulthood, resulting in a moderate male bias in the oldest age class. Bottlenose dolphins have an intensely male-competitive mating system, and juvenile male mortality has been linked to social competition. Contrary to predictions from sexual selection theory, however, male-male competition does not result in sustained male-biased mortality. As female dolphins experience high costs of sexual coercion in addition to long and energetically expensive periods of gestation and lactation, this suggests that substantial female investment in reproduction can elevate female mortality risk and impact sex biases in lifespan.

Breastfeeding Duration and Timing of Bottle Supplementation: Associations with Body Mass Index from Childhood to Young-Adulthood

Evidence for the association between breastfeeding (BF) duration and later body mass index (BMI) is inconsistent. We explored how BF duration and BF type (exclusive or partial) related to BMI from childhood to young adulthood in a Chilean cohort. Infants were recruited at 6 months between 1994 and 1996 in Santiago, Chile (n = 821). Mothers reported date of first bottle and last BF; anthropometry was measured at 1, 5, 10, 16, and 23 years. We tested whether: (1) type of BF at 6 months (none, partial, exclusive) and (2) duration of exclusive BF (<1 month, 1 to <3 months, 3 to <6 months, and ≥6 months) related to BMI. At 6 months, 35% received both breastmilk and formula ("partial BF") and 38% were exclusively breastfed. We found some evidence of an association between longer BF and lower BMI z-scores at young ages but observed null effects for later BMI. Specifically, BF for 3 to <6 months compared to <1 month related to lower BMI z-scores at 1 and 5 years (both p < 0.05). Our results are in partial accordance with others who have not found a protective effect of longer BF for lower BMI.

Digital Technologies for Women's Pelvic Floor Muscle Training to Manage Urinary Incontinence Across Their Life Course: Scoping Review

BACKGROUND

Women with urinary incontinence (UI) may consider using digital technologies (DTs) to guide pelvic floor muscle training (PFMT) to help manage their symptoms. DTs that deliver PFMT programs are readily available, yet uncertainty exists regarding whether they are scientifically valid, appropriate, and culturally relevant and meet the needs of women at specific life stages.

OBJECTIVE

This scoping review aims to provide a narrative synthesis of DTs used for PFMT to manage UI in women across their life course.

METHODS

This scoping review was conducted in accordance with the Joanna Briggs Institute methodological framework. A systematic search of 7 electronic databases was conducted, and primary quantitative and qualitative research and gray literature publications were considered. Studies were eligible if they focused on women with or without UI who had engaged with DTs for PFMT, reported on outcomes related to the use of PFMT DTs for managing UI, or explored users' experiences of DTs for PFMT. The identified studies were screened for eligibility. Data on the evidence base for and features of PFMT DTs using the Consensus on Exercise Reporting Template for PFMT, PFMT DT outcomes (eg, UI symptoms, quality of life, adherence, and satisfaction), life stage and culture, and the experiences of women and health care providers (facilitators and barriers) were extracted and synthesized by ≥2 independent reviewers.

RESULTS

In total, 89 papers were included (n=45, 51% primary and n=44, 49% supplementary) involving studies from 14 countries. A total of 28 types of DTs were used in 41 primary studies, including mobile apps with or without a portable vaginal biofeedback or accelerometer-based device, a smartphone messaging system, internet-based programs, and videoconferencing. Approximately half (22/41, 54%) of the studies provided evidence for or testing of the DTs, and a similar proportion of PFMT programs were drawn from or adapted from a known evidence base. Although PFMT parameters and program compliance varied, most studies that reported on UI symptoms showed improved outcomes, and women were generally satisfied with this treatment approach. With respect to life stage, pregnancy and the postpartum period were the most common focus, with more evidence needed for women of various age ranges (eg, adolescent and older women), including their cultural context, which is a factor that is rarely considered. Women's perceptions and experiences are often considered in the development of DTs, with qualitative data highlighting factors that are usually both facilitators and barriers.

CONCLUSIONS

DTs are a growing mechanism for delivering PFMT, as evidenced by the recent increase in publications. This review highlighted the heterogeneity in types of DTs, PFMT protocols, the lack of cultural adaptations of most of the DTs reviewed, and a paucity in the consideration of the changing needs of women across their life course.

Examination of potentially modifiable dementia risk factors across the adult life course: The Framingham Heart Study

INTRODUCTION

We examined for associations between potentially modifiable risk factors across the adult life course and incident dementia.

METHODS

Participants from the Framingham Heart Study were included (n = 4015). Potential modifiable risk factors included education, alcohol intake, smoking, body mass index (BMI), physical activity, social network, diabetes, and hypertension. Cox models were used to examine associations between each factor and incident dementia, stratified by early adult life (33-44 years), midlife (45-65 years), and late life (66-80 years).

RESULTS

Increased dementia risk was associated with diabetes (hazard ratio [HR] = 1.62; 95% confidence interval [CI] = 1.07-2.46) and physical inactivity (HR = 1.57; 95% CI = 1.12-2.20) in midlife, and with obesity (HR = 1.76; 95% CI = 1.08-2.87) in late life. Having multiple potential modifiable risk factors in midlife and late life was associated with greater risk.

DISCUSSION

Potentially modifiable risk factors individually have limited impact on dementia risk in this population across the adult life course, although in combination they may have a synergistic effect.

HIGHLIGHTS

Diabetes and physical inactivity in midlife is associated with increased dementia risk. Obesity in late life is associated with increased dementia risk. Having more potentially modifiable risk factors in midlife and late life is associated with greater dementia risk.

Children of immigrants: Racial assortative mating and the transition to adulthood

Few studies have followed immigrant-origin individuals from adolescence to adulthood or examined their spousal choices. Using longitudinal data from Add Health, we present a life-course model that examines the differences in racial assortative mating between children of immigrants and non-immigrants. The results reveal substantial variation in racial endogamy from generation to generation. Racial endogamy was highest in the third generation, but this is due entirely to high racial endogamy among whites. Out-marriage was most pronounced among first- and second-generation immigrants. Our life-course approach shows that the effects of race and generation on intermarriage were mediated by family background (e.g. language proficiency and residence) and educational attainment (at time of marriage), a finding largely indicative of processes of marital assimilation that unfold over time and generation. Evidence of acculturation and structural assimilation, however, could not fully account for the large, persistent, and uneven effects of race and generation on interracial marriage.

Social Isolation: An Unequally Distributed Health Hazard

Social isolation is a potent predictor of poor health, mortality, and dementia risk. A great deal of research across national contexts provides causal evidence for these linkages and identifies key explanatory mechanisms through which isolation affects health. Research on social isolation recognizes that some people are more likely than others to be isolated, but over the past several decades, researchers have focused primarily on the consequences of isolation for health rather than a systematic assessment of the social conditions that foster isolation over the life course. In this article, we review the available evidence on inequities in social isolation and develop a conceptual framework to guide future research on structural systems that fuel social isolation over the life course. Future work in this area has the potential to identify root causes of inequality in social isolation, as well as targeted policy levers to reduce isolation in vulnerable populations.

A Review of the Relationship between Socioeconomic Status Change and Health

OBJECTIVES

This review aimed to identify and synthesize the existing literature on the effects of socioeconomic status (SES) changes on health.

METHODS

A review was conducted using Medline, Cochrane library, and CINAHL (Cumulative Index to Nursing and Allied Health Literature). All longitudinal or cross-sectional studies that examined links between changes to SES across different time periods and measured health outcomes were included. Screening was conducted using select inclusion and exclusion criteria in order of title, abstract, and full text. Two independent reviewers assessed the quality of the full text articles using the Downs and Black checklist.

RESULTS

Our literature search led to 2719 peer reviewed articles, 2639 of which were title screened after duplicates were removed. A total of 117 abstracts and 12 full text articles were screened. Overall, findings from 11 articles form the basis of this review. Eight different types of measures of changes to SES were identified. These include education, occupation, economic security, income sufficiency, home ownership, car ownership, health insurance, and marital status. Assessed outcomes included measures related to physical health, cardiovascular disease, mental health, and oral health. A large proportion of studies found that an SES change impacts health. Evidence suggests that those with consistently high SES have the best health outcomes, followed by those who report their SES change from low to high (upward social mobility). Evidence on the relative health effects for those who report their SES change from high to low (downward social mobility) compared to those who report consistently low SES is inconsistent.

CONCLUSION

Current evidence suggests that an SES change has an impact on an individual's health. More research on the effects of SES changes on health outcomes in adulthood is needed and can inform various areas of health research including health resiliency and development. Future studies should focus on individual SES indicators and their effects on health outcomes at multiple points throughout life.

Lifetime vicarious experiences of major discrimination and depressive symptoms among middle-aged and older black adults

OBJECTIVES

Racial disparities in later-life depression among Americans are well-documented. Perceived discrimination has been linked to depressive symptoms among aging Black adults, but little research has considered how vicarious exposure to discrimination shapes the mental health of middle-aged and older Black adults.

METHODS

A subsample of Black adults aged 50-69 years (N = 273) were drawn from the Nashville Stress and Health Study. Lifetime vicarious exposures to major discrimination were assessed. Additionally, multivariate linear regression was employed to examine the association between vicarious experiences of major discrimination and depressive symptoms.

RESULTS

Once the Black adults in the sample had reached ages 50 and older, the most common discriminatory events that they had vicariously experienced in their lifetime occurred as a result of their loved ones' unfair interactions with law enforcement and the job market, respectively. Furthermore, our findings revealed that vicarious experiences of major discrimination were associated with higher levels of depressive symptoms among middle-aged and older Black adults.

CONCLUSION

Vicarious, as well as personal, exposures to discrimination shape the mental health of Black Americans over the lifespan. The secondhand effects of discrimination must be considered for interventions aimed at reducing the mental health consequences of racism-related adversity as Black adults age.

Biomarkers of aging through the life course: A Recent Literature Update

Purpose of review

The development of biomarkers of aging has greatly advanced epidemiological studies of aging processes. However, much debate remains on the timing of aging onset and the causal relevance of these biomarkers. In this review, we discuss the most recent biomarkers of aging that have been applied across the life course.

Recent findings

The most recently developed aging biomarkers that have been applied across the life course can be designated into three categories: epigenetic clocks, epigenetic markers of chronic inflammation, and mitochondrial DNA copy number. While these have been applied at different life stages, the development, validation, and application of these markers has been largely centered on populations of older adults. Few studies have examined trajectories of aging biomarkers across the life course. As the wealth of molecular and biochemical data increases, emerging biomarkers may be able to capture complex and system-specific aging processes. Recently developed biomarkers include novel epigenetic clocks; clocks based on ribosomal DNA, transcriptomic profiles, proteomics, metabolomics, and inflammatory markers; clonal hematopoiesis of indeterminate potential gene mutations; and multi-omics approaches.

Summary

Attention should be placed on aging at early and middle life stages to better understand trajectories of aging biomarkers across the life course. Additionally, novel biomarkers will provide greater insight into aging processes. The specific mechanisms of aging reflected by these biomarkers should be considered when interpreting results.

How Social Roles Affect Sleep Health during Midlife

This study draws on role theory and the life course perspective to examine how sleep health (duration, quality, and latency) is shaped by social role accumulation (number of roles), role repertoires (role combinations), and role contexts among middle-aged adults. We also examine how the relationships between social roles and sleep health are gendered. We use data from the National Longitudinal Survey of Youth 1979 Cohort (N = 7,628). Results show that role accumulation is associated with less sleep and decreased insomnia symptoms, and that role repertoires also impact sleep (e.g., parenthood leads to diminished sleep quantity and quality). There is also evidence that contextual factors related to employment history, marital quality, and parenthood affect sleep health. Furthermore, results reveal that several of the relationships between social roles and sleep are gendered. Taken together, findings demonstrate the utility of examining links between multiple dimensions of social roles and sleep health.

Dynamic work trajectories and their interplay with family over the life course

This review examines major bodies of literature, interrelated but usually considered separately, focused on work trajectories and their intersections with family dynamics through the life course. It begins with a consideration of the life course paradigm, which draws attention to the temporal dimensions of human lives, and recently developed analytic techniques that are well-suited to empirical investigation of life course transitions and trajectories over time. The review proceeds to examine empirical research on work career mobility (including both inter- and intra-generational mobility) measured as either trajectories of continuous outcomes or sequences of categorical outcomes, and their long-term consequences for socioeconomic attainment. Work-family trajectories are then addressed, focusing on the impacts of family on work, notably expressed in the motherhood wage penalty, and how family structure and processes affect long-term labor market outcomes. Research documents considerable heterogeneity in work-family dynamics over the life course across social groups with unequal resources. The review concludes with an assessment of the interplay of work and family trajectories studied longitudinally and makes recommendations for future research. It is argued that while extant studies of the work-family interface are compatible with, and sometimes deliberately reflect, a life course perspective, these bodies of research would benefit from more fully incorporating the life course principles of "agency" and "time and place".

What's Your Pension Story? Women's Perspectives during the COVID-19 Pandemic on Their Old-Age Pension Status, Past and Present

This study examines the present and retrospective views of mothers who are nearing or are at retirement age regarding their economic status, pension planning, and perceptions of state pension policy. The paper addresses gaps in the literature on the cross-intersections of employment history, vulnerable economic retirement status, and marital and parental status, thereby adopting a life course perspective. Based on in-depth interviews of thirty-one mothers (ages 59-72) during the COVID-19 pandemic, the findings revealed five themes-economic abuse: an unequal distribution of pension funds following divorce; regrets over past choices; COVID-19 and pensions; the state's responsibility for old-age economic security; and knowledge is important, and I can help others. The study concludes that the majority of women at these ages perceive their current economic situation as a product of insufficient familiarity with pension plans, while voicing opinions about the state's irresponsibility regarding people of retirement age.

Casting shadows: later-life outcomes of stature

The central question in this special issue is a relatively new one in anthropometric history: how did body height affect the life course? This raises the issue of whether such an effect merely captures the underlying early-life conditions that impact growth, or whether some independent effect of stature can be discerned. Further, the effects of height on later-life outcomes need not be linear. These effects may also differ by gender, by context (time and place), and among life course domains such as occupational success, family formation or health in later life. The ten research articles in this issue use a plethora of historical sources on individuals, such as prison and hospital records, conscript records, genealogies and health surveys. These articles employ a variety of methods to distinguish between early-life and later-life effects, between intra- and intergenerational processes and between biological and socio-economic factors. Importantly, all articles discuss the impact of the specific context on their results to understand these effects. The overall conclusion is that independent later-life outcomes of height are rather ambiguous, and seem to stem more from the perception of physical strength, health and intelligence associated with height than from height itself. This special issue also reflects on intergenerational effects of the later-life outcomes of height. As populations have grown taller, it is possible that height and later-life outcomes have formed a 'virtuous cycle', resulting in taller, healthier and wealthier populations. So far, however, our research offers little support for this hypothesis.

Association of change in cardiovascular risk factors with incident dementia

INTRODUCTION

We evaluated whether better cardiovascular health at midlife and improvement of cardiovascular health within midlife were associated with dementia risk.

METHODS

Two longitudinal population-based studies were used: Atherosclerosis Risk in Communities (ARIC) (n = 11,460/visits at ages 54 and 60), and Age, Gene/Environment Susceptibility (AGES)-Reykjavik (n = 3907/visit at age 51). A cardiovascular health score (range 0-12/0-14, depending on diet availability) including six/seven items was calculated at each visit, with weight assigned to each item as poor (0), intermediate (1), or ideal (2). Cardiovascular health was defined as low (score 0-4/0-5), intermediate (5-7/6-9), or high (8-12/10-14). Incident dementia was ascertained through linkage to health records and with neuropsychological examinations.

RESULTS

Midlife high compared to low cardiovascular health (hazard ratios [HRs]: for ARIC: 0.60 [95% confidence interval: 0.52, 0.69]); for AGES-Reykjavik: 0.83 [0.66, 0.99] and improvement of cardiovascular health score within midlife (HR per one-point increase: ARIC: 0.94 [0.92, 0.96]) were associated with lower dementia risk.

DISCUSSION

Better cardiovascular health at midlife and improvement of cardiovascular health within midlife are associated with lower dementia risk.

HIGHLIGHTS

Cardiovascular health and dementia were studied in two large cohort studies. Better cardiovascular health at midlife relates to lower dementia risk. Improvement of cardiovascular health within midlife relates to lower dementia risk. Promotion of cardiovascular health at midlife can help to reduce dementia risk.

Life-Course Mobility in Socioeconomic Position and High Depressive Symptoms Among Young Black Women: The SELF Study

BACKGROUND

Current literature on the association between mobility in socioeconomic position (SEP) and depression demonstrates mixed findings, with variation in the benefits of upward SEP by racial group and ethnic background. No study has examined life-course SEP mobility and depressive symptoms among Black women in the United States.

METHODS

Our cohort included 1,612 Black women enrolled in the Study of Environment, Lifestyle and Fibroids between 2010 and 2012 and followed for 5 years. We used data on socioeconomic indicators at childhood and adulthood and used latent class analysis to create a life-course SEP mobility measure (persistently low, downward, upward, and persistently high). Using the 11-item Center for Epidemiologic Studies Depression Scale (CES-D), we assessed high (≥9) versus low depressive symptoms. Multivariable log risk models were used to produce risk ratios (RRs) and 95% confidence intervals (CIs).

RESULTS

Of the participants, 37% had high depressive symptoms. Persistently low (RR, 1.56; 95% CI, 1.31-1.86) and downward (RR, 1.36; 95% CI, 1.14-1.63) SEP mobility was associated with high depressive symptoms after adjustment for age, adult social support, and marital status. There was evidence of an effect measure modification by adult social support, with a stronger association among those who reported high adult social support compared with low adult social support.

CONCLUSIONS

These findings suggest directing mental health resources to people experiencing low SEP at any stage in life, especially those with low SEP in adulthood, to aid in the management of depressive symptoms.

Does Public Health Emergency Experience Have an Impact on Individual Reactions during COVID-19?

Local historical experience in public health emergencies has been perceived to largely affect COVID-19's social influence. Specifically, individuals' personal experience in public health emergencies would likely have an impact on their reactions to the next similar event. Herein, we combined life course and risk analysis frameworks to explore how individuals' experiences influence current risk perception and protective behaviors. We collected 1000 questionnaires of random network samples in six Chinese provinces of different risk levels from 29 April to 8 May 2020, and used the propensity score matching (PSM) model and multivariable linear regression to process the data. We categorized individual public emergency experience into three patterns: (1) having ever witnessed a public health emergency, (2) having ever experienced a public health emergency, and (3) currently experiencing a public health emergency. The study indicates that individuals' experiences had significant positive effects on protective behaviors against COVID-19. The average effects of the three patterns on behaviors were 0.371 (p < 0.001), 0.898 (p < 0.001) and 0.319 (p < 0.05), respectively. The study also shows that for those experiencing any one pattern, the effect of risk perception on protective behaviors appeared null in the early stage of the pandemic. We propose the potential interactive mechanism of risk factors in the life course at the individual level. Academically, this study develops the risk theory of perception and behavior and expands the application of the life course approach in the public health arena. Practically, our research indicates that public health emergency experiences are valuable for responding to a future pandemic and normalizing prevention policies.

Minority Stress and Mental Health: A Review of the Literature

Lesbian, gay, bisexual, and transgender (LGBT) populations experience significant health disparities, theorized to result from LGBT specific minority stressors. The fully conceptualized Minority Stress Model was published more than 15 years ago. Minority stressors include external conditions and events, such as discrimination and victimization. Internal minority stressors include expectations of rejection and discrimination, concealment of minority identity, and internalizations of negative dominant cultural attitudes, beliefs, stereotypes, and values. Connection to sexual and gender minority communities is theorized to moderate the effects of minority stressors. In this integrative review, I examine two decades of research on minority stress. Based on this review, I highlight strengths and limitations of the model, and suggest next steps for moving minority stress research forward.

Urbanicity and cognitive functioning in later life

Introduction

Prior research has shown disparities in cognitive functioning across the rural-urban continuum. We examine individual- and contextual-level factors to understand how and why urbanicity shapes cognitive functioning across older adulthood.

Methods

Using a nationally representative sample from 1996 to 2016 waves of the Health and Retirement Study (HRS) and growth curve models, we assess urban-suburban-exurban differences in older adult cognitive functioning.

Results

Results demonstrate that older adult men and women living in exurban areas, and older adult men in suburban areas, have lower cognitive functioning scores compared to their urban peers. Educational attainment and marital status contribute to but do not fully explain these differences. There were no differences in the trajectory over age, suggesting that urbanicity disparities in cognition occur earlier in life, with average differences remaining the same across older adulthood.

Discussion

Differences in cognitive functioning across urbanicity are likely due to factors accumulating prior to older adulthood.

Neighbourhood deprivation across eight decades and late-life cognitive function in the Lothian Birth Cohort 1936: a life-course study

INTRODUCTION

although neighbourhood may predict late-life cognitive function, studies mostly rely on measurements at a single time point, with few investigations applying a life-course approach. Furthermore, it is unclear whether the associations between neighbourhood and cognitive test scores relate to specific cognitive domains or general ability. This study explored how neighbourhood deprivation across eight decades contributed to late-life cognitive function.

METHODS

data were drawn from the Lothian Birth Cohort 1936 (n = 1,091) with cognitive function measured through 10 tests at ages 70, 73, 76, 79 and 82. Participants' residential history was gathered with 'lifegrid' questionnaires and linked to neighbourhood deprivation in childhood, young adulthood and mid-to-late adulthood. Associations were tested with latent growth curve models for levels and slopes of general (g) and domain-specific abilities (visuospatial ability, memory and processing speed), and life-course associations were explored with path analysis.

RESULTS

higher mid-to-late adulthood neighbourhood deprivation was associated with lower age 70 levels (β = -0.113, 95% confidence intervals [CI]: -0.205, -0.021) and faster decline of g over 12 years (β = -0.160, 95%CI: -0.290, -0.031). Initially apparent findings with domain-specific cognitive functions (e.g. processing speed) were due to their shared variance with g. Path analyses suggested that childhood neighbourhood disadvantage is indirectly linked to late-life cognitive function through lower education and selective residential mobility.

CONCLUSIONS

to our knowledge, we provide the most comprehensive assessment of the life-course neighbourhood deprivation and cognitive ageing relationship. Living in advantaged areas in mid-to-late adulthood may directly contribute to better cognitive function and slower decline, whereas an advantaged childhood neighbourhood likely affects functioning through cognitive reserves.

Health, Suicidal Thoughts, and the Life Course: How Worsening Health Emerges as a Determinant of Suicide Ideation in Early Adulthood

Poor physical health places adults at greater risk for suicide ideation. However, the linkage between health and suicidal thoughts may emerge and become established during early adulthood, concomitant with other social processes underlying suicidality. Using nationally representative survey data from Waves III through V of the National Longitudinal Study of Adolescent to Adult Health (n = 8,331), we examine the emergence of health as a predictor of suicide ideation across the early adult life course (ages 18-43). We find that worsening health does not significantly predict suicide ideation until young adults approach the transition into midlife. Our findings suggest this may be due to the increasing severity of health problems, reduced social network engagement, and disruption of social responsibilities later in early adulthood. Our findings underscore the need for social science research to examine the relationship between mental and physical health from a life course perspective.