Hair Heavy Metals and Food Consumption in Residents of Chengdu: Factors, Food Contribution, and Health Risk Assessment

Heavy metal pollution is one of the most pressing issues threatening food security and human health. This study assesses heavy metal (chromium, cadmium, copper, zinc, nickel, and lead) exposure via hair metal concentrations in Chengdu residents, reflecting metal intake from food consumption. From June 2020 to February 2021, a sampling survey was conducted on residents' hair (n=182) and food (n=301) in six main urban areas of Chengdu. The concentrations of heavy metals in hair and food were analyzed by inductively coupled plasma mass spectrometry, and the results showed that the residents of Chengdu City had high hair concentrations of Cd (0.17±0.03 mg kg-1) and Zn (293±21.3 mg kg-1). Gender significantly affected the hair Cr, Zn, and Ni concentrations. Based on the survey results obtained from Chengdu City residents, the habits and diet structure are assessed for the influence of six heavy metals in the hair of the residents. Adolescents' (13-18 years old) hair had significantly higher Pb concentrations than adults (19-59 years old). The concentration of Ni in hair was affected by perming and dyeing habits. For dietary exposure, cereals and meat were the main contributors to the residents' daily intake of heavy metals. The bioaccessibility of Cr, Cd, Cu, Zn, Ni, and Pb in food was 2.45-74.67%, 10.6-78.7%, 13.4-82.5%, 8.89-89.2%, 7.70-85.1%, and 15.4-86.2%, respectively. In health risk evaluation based on the bioaccessible fraction of six heavy metals, the hazard quotient of each heavy metal in food was less than 1, indicating no potential non-carcinogenic risk.

Exploring the influence of anthropomorphic appearance on usage intention on online medical service robots (OMSRs): A neurophysiological study

Online medical service robots (OMSRs) are becoming increasingly important in the medical industry, and their design has become a highly focused issue. This study investigated the neuroeconomics underlying the formation of usage intention, specifically evaluating the impact of anthropomorphic appearance and age on users' intentions to use OMSRs. Event-related potentials were used to analyze electroencephalography signals recorded from participants. This study found that OMSRs with a low anthropomorphic appearance induced larger P200 and P300 amplitudes, resulting in increased attentional resources compared to OMSRs with a moderate or high anthropomorphic appearance. OMSRs with moderate anthropomorphic appearances captured more attention and elicited larger P200 and P300 than those with high anthropomorphic appearances. Regarding age characteristics, OMSRs with senior features attracted more attention and induced larger P200 and P300 amplitudes. In terms of usage intention, compared to the others, users demonstrate a stronger usage intention towards the low anthropomorphism of OMSRs. Additionally, compared to the senior ones, users also exhibit a stronger usage intention toward a young appearance of OMSRs. These findings provide valuable insights for robot designers and practitioners to improve the appearance of OMSRs.

Do abnormal screening results for chronic diseases motivate inactive people to start exercising? A community-based prospective cohort study in Changhua, Taiwan

OBJECTIVE

Exercise improves health, but illnesses can cause changes in exercise behavior, including starting or stopping. This study investigated the effects of chronic disease screening on inactive individuals' exercise behavior and analyzed the impact of age and chronic disease history on this relationship using stratified analysis.

METHODS

Using a community-based prospective observational cohort design and data from the Changhua Community-Based Integrated Screening (CHCIS) dataset from 2005 to 2020, we examined 12,038 people who were screened at least twice and self-reported having never exercised at their first screening. Changes in exercise behavior were classified as "initiating exercise" and "remaining inactive." We obtained chronic disease screening results from CHCIS records, which included measurements of waist circumference, blood glucose, blood pressure, triglycerides, and high-density lipoproteins. SAS version 9.4 was used for COX proportional hazards regression.

RESULTS

The findings indicated that abnormal waist circumference and blood pressure increased the likelihood of initiating exercise compared to normal results. Age stratification showed that those aged 40-49 with abnormal results were more likely to start exercising than normal participants, but not those under 40 or over 65. When stratified by chronic disease history, abnormal screening results correlated with exercise initiation only in groups without chronic disease history, except for those with a history of hyperlipidemia.

CONCLUSIONS

This is the first study to demonstrate that abnormal screening results may influence exercise initiation in individuals who have never exercised, and this association varies by screening item, age, and disease history.

Epidemiological age-based differences in traumatic spinal cord injury patients: A multicenter study based on 13,334 inpatients

CONTEXT

Compared with younger traumatic spinal cord injury (TSCI) patients, the elderly had longer delays in admission to surgery, higher proportion of incomplete injury, and longer hospital stays. However, in China, the country with the largest number of TSCI patients, there have been no large-scale reports on their age differences.

OBJECTIVES

To explore the age-based differences among TSCI inpatients, focusing on the demographic and clinical characteristics, treatment status, and economic burden.

METHODS

We collected the medical records of 13,334 inpatients with TSCI in the 30 hospitals of China, from January 1, 2013 to December 31, 2018. Trends are expressed as annual percentage changes (APCs) and 95% confidence intervals (CIs).

RESULTS

A total of 13,334 inpatients were included. Both the number and proportion of the elderly showed an increasing trend. The APC of the number and proportion in patients ≥85 years were 39.5% (95% CI, 14.3 to 70.3; P < 0.01) and 30.5% (95% CI, 8.6 to 56.9; P < 0.01), respectively. Younger patients were more likely to undergo decompression surgery, and older patients were more likely to receive high-dose methylprednisolone sodium succinate/methylprednisolone (MPSS/MP). Of the patients ≥85 years, none underwent decompression surgery within 8 h, and only 1.4% received a high dose of MPSS/MP within 8 h after injury. Elderly patients had lower hospitalization costs than younger. The total and daily medical costs during hospitalization of patients ≥85 years were 8.06 ± 18.80 (IQR: 5.79) and 0.61 ± 0.73 (IQR: 0.55) thousands dollars, respectively.

CONCLUSIONS

As the first study to focus on age differences of TSCI patients in China, this study found many differences, in demographic and clinical characteristics, treatment status, and economic costs, between older and younger TSCI patients. The number and proportion of elderly patients increased, and the rate of early surgery for elderly patients is low.

1 km of living area: age differences in the association between neighborhood environment perception and self-rated health among Chinese people

OBJECTIVES

This study aimed to explore the age differences in the relationship between neighborhood environment perception and self-rated health among Chinese people.

STUDY DESIGN

This is cross-sectional study.

METHODS

The participants were 2,631 residents aged 18 and above from 2021 Chinese General Social Survey (CGSS). Self-rated health was reported by residents. Neighborhood environment was measured by respondents' subjective perception of 1 km living area. Ordered logit regression models were used to examine the relationship between neighborhood environment perception and self-rated health.

RESULTS

In summary, 42.08% were classified as young adults, and 57.92% were classified as middle-aged and older adults. Young adults with higher perception of neighborhood social environment were more likely to perceive good health. Neighborhood built environment was significantly associated with self-rated health among middle-aged and older adults.

CONCLUSION

The neighborhood environment is an important predictor of the health of its residents. Neighborhood environmental modifications should be tailored to meet the needs of different age groups, promoting health equity.

Role of polyunsaturated fatty acids in Japanese patients with coronary spastic angina

BACKGROUND

n-3 polyunsaturated fatty acids (PUFAs) reduce the risk of ischemic heart disease. However, there are few reports of a relationship between n-3 PUFAs and coronary spastic angina (CSA). This study aimed to assess the age-dependent role of serum levels of fatty acid in patients with CSA.

METHODS AND RESULTS

We enrolled 406 patients who underwent ergonovine tolerance test (ETT) during coronary angiography for evaluation of CSA. All ETT-positive subjects were diagnosed as having CSA. We categorized the patients by age and results of ETT as follows: (1) young (age ≤ 65 years) CSA-positive (n = 32), (2) young CSA-negative (n = 134), (3) elderly (age > 66 years) CSA-positive (n = 36), and (4) elderly CSA-negative (n = 204) groups. We evaluated the serum levels of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid, and dihomo-gamma-linolenic acid. In the young groups, the serum levels of EPA (64.3 ± 37.7 μg/mL vs. 49.4 ± 28.8 μg/mL, p = 0.015) and DHA (135.7 ± 47.6 μg/mL vs. 117.4 ± 37.6 μg/mL, p = 0.020) were significantly higher in the CSA-positive group than in the CSA-negative group, respectively. However, this was not the case with elderly groups. In the multivariate analysis in young groups, the serum levels of EPA (p = 0.028) and DHA (p = 0.049) were independently associated with the presence of CSA, respectively.

CONCLUSION

Our results suggested that the higher serum levels of EPA and/or DHA might be involved in the pathophysiology of CSA in the young population but not in the elderly population.

Gender differences in oral health among prisoners: a cross-sectional study from Taiwan

BACKGROUND

The prevalence of oral diseases among Taiwanese prisoners has rarely been investigated. This study aimed to estimate the gender-specific prevalence of oral disease in a sample of Taiwanese prisoners.

METHODS

We included 83,048 participants from the National Health Insurance (NHI) Program. Outcomes were measured using the clinical version of the International Classification of Diseases, Ninth Revision (ICD-9-CM). For prevalence, we provide absolute values and percentages. We also performed a χ2 test to assess sex and age group differences in the percentage of disease in the oral cavity, salivary glands, and jaw.

RESULTS

The prevalence rate of oral diseases was 25.90%, which was higher than that of the general population. The prevalence of oral diseases in female prisoners was higher than that in male prisoners (p < 0.001), and the prevalence of oral diseases in prisoners aged ≤ 40 was higher than that of prisoners aged > 40. Among all cases of diagnosed oral diseases, the top three diseases were dental hard tissue diseases (13.28%), other cellulitis and abscesses (9.79%), and pruritus and related conditions (2.88%), respectively. The prevalence of various oral diseases in female prisoners was significantly higher than that in male prisoners.

CONCLUSION

Oral disease is common among Taiwanese prisoners. Female prisoners had a higher prevalence of oral, salivary gland, and jaw diseases than male prisoners. Therefore, early prevention and appropriate treatment are required and also a need for gender-specific oral disease products given the differences in the prevalence of oral disease among male and female prisoners.

Affective Norms for Chinese Words of Typical Life Scenes Rated by Older Adults (ANCO)

The present study provides an affective norm collected from older adults for 1,050 Chinese words that are closely related to the typical life scenes commonly encountered by older adults. Data were collected for key affective dimensions of valence and arousal using the method of adapted Self-Assessment Manikin (Bradley & Lang, 1994) in a paper-and-pencil procedure. The results showed that the current database (ANCO) was of high reliability and validity. Valence and arousal were in an asymmetrically quadratic relationship in the valence-by-arousal space; i.e., older adults rated negative words as the highest arousing, followed by positive and neutral words. In addition, by comparing affective ratings of the shared words between the present norm collected from older Chinese adults and previous norms collected from young Chinese adults (Wang et al., 2008; Yao et al., 2017; Yu et al., 2016), we found that compared with young adults, older ones perceived negative words as more negative and more arousing, and perceived positive words as more positive and less arousing. ANCO can serve as a valuable source of information for age-related affective research and help explicate the effects of emotion on linguistic and cognitive processes.

Age and gender differences in misperceptions of body shape in a Taiwanese population

OBJECTIVES

Most studies of body size perception have been performed in adolescents, and most focus on gender differences in accurate perception of body size. This study investigated misperceptions of body sizes among males and females at different stages of adulthood in Taiwan.

DESIGNS

In-person home interviews were used to proportionally and randomly select 2095 adult men and women to answer the East Asian Social Survey. Participants were divided into 18-39, 40-64, and 65 + age groups. The main variables analyzed were self-perceived body size and standardized BMI.

RESULTS

Women, unlike men, were more likely to misperceive their body size as being overweight (OR = 2.92; p < .001). People with higher self-perceived social status were less likely to misperceive themselves as overweight (OR = 0.91; p = .01). People with college educations were 2.35 times more likely to overestimate their body size as being heavier than they were (p < .001) and less likely to underestimate it as being thinner than they were (OR = 0.45; p < .001). Women 18-35 and 36-64 years old were 6.96 and 4.31 times more likely (p < .001) to misperceive themselves as being overweight than women 65 or older, who were more likely to misperceive themselves as being too thin. There were no significant differences in body size misperceptions among the three age groups of adult men (p > .05). We found no different significant discrepancies between self-perceived body size and actual BMI between the older men and women (p = .16). However, younger and middle-aged men were 6.67 and 3.1 times more likely to misperceive themselves as being too thin than women in their same age groups (OR = 0.15 and OR = 0.32, respectively).

CONCLUSIONS

Age and gender affect self-perceptions of body size in Taiwan. Overall, women are more likely than men to misperceive themselves as being too big, and men are more likely than women to misperceive themselves as too thin. Older women, however, were more likely to misperceive themselves as being too thin. Clinicians and health educators should know that people's perceptions and concerns regarding their body size vary by age and gender.

[Consultations by senior physicians in general and abdominal surgery for other medical disciplines over 10 years at a tertiary center-Is a fast time-consuming processing necessary? : Spectrum of clinical findings, diagnoses and treatment decision making]

BACKGROUND

The challenges of an adequate, efficient and rational medical treatment and care of patients are always associated with an interprofessional activity of several specialist disciplines.

AIM

The spectrum of variable diagnoses and the profile of surgical decision-making with further surgical measures within the framework of senior physician consultation in general and visceral surgery for neighboring medical disciplines were analyzed on a representative patient cohort over a defined observational time period.

PATIENTS AND METHODS

All consecutive patients (n = 549 cases) were documented as part of a clinical systematic prospective single center observational study at a tertiary center using a computer-based patient registry over 10 years (1 October 2006-30 September 2016). The data were analyzed with respect to the spectrum of clinical findings, diagnoses, treatment decisions and the influencing factors as well as gender and age differences and time-dependent developmental trends using χ2-tests and U‑tests.

RESULTS (KEY POINTS)

The predominant discipline for requests for surgical consultation was cardiology (19.9%) followed by surgical disciplines (11.8%) and gastroenterology (11.3%). Disorders of wound healing (7.1%) and acute abdomen (7.1%) were predominant in the diagnostic profile. In 11.7% of the patients the indications for immediate surgery were derived, whereas in 12.9% elective surgery was recommended. The conformity rate of suspected and definitive diagnoses was only 58.4%.

CONCLUSION

The surgical consultation work is an important mainstay of a sufficient and especially timely clarification of surgically relevant questions in nearly all medical institutions and especially in a center. This serves i) the quality assurance of surgery in the clinical care of patients with need of additional interdisciplinary needs for surgical treatment in the daily practice of general and abdominal surgery in research on clinical care, ii) clinical marketing and monetary aspects in the sense of patient recruitment and iii) last but not least to provide emergency care of patients. Due to the high proportion of 12% of subsequent emergency operations, which were derived from requests for general and visceral surgical consultations, such requests must be processed promptly during working hours.

Association between depressive symptoms and the risk of all-cause and cardiovascular mortality among US adults

Depression is a preventable and treatable mental health condition. Therefore, there are important clinical implications for identifying people with the highest mortality risk in a nationally representative sample. This study included 26,207 participants aged ≥18 years from the 2005-2014 National Health and Nutrition Examination Survey in USA. We investigated the association between depressive symptoms (defined as Patient Health Questionnaire 9 scores ≥10) and all-cause and cardiovascular disease (CVD) mortalities, adjusted for multiple factors (sociodemographic in Model 1, behavioral added in Model 2, and metabolic syndrome added in Model 3) and stratified by age and sex. During an average follow-up of 69.15 months (standard deviation [SD] 34.45), 1872 (7.3%) participants had died (person-years in the non-depressive and depressive groups, 12.12/1000 and 16.43/1000, respectively). Depressive symptoms increased all-cause (crude hazard ratio [HR] 1.37, 95% confidence interval [CI], 1.33-1.58) and CVD mortalities (crude HR 1.64, 95% CI, 1.20-2.24). Although the significance of all-cause mortality and CVD mortality was maintained in Models 1 (HR 1.58 and 2.08) and 2 (HR 1.48 and 1.79), it was not maintained in Model 3. Current smoking and lower physical activity were associated with reduced strength of the association between depression and all-cause mortality risk. The effect of depression on mortality risk was particularly pronounced in middle-aged men and older women. Our findings suggest that depressive symptoms increase mortality risk, even after adjusting for behavioral factors. Depression-induced mortality risk is particularly high among middle-aged men and older women.

Trends in emergency department visits for suicide attempts before and during the COVID-19 pandemic in Korea: A nationwide study, 2016-2021

BACKGROUND

There is increasing concern that the effects of the COVID-19 pandemic will result in excess suicides by increasing known risk factors, such as suicide attempts. However, evidence on the long-term impacts of COVID-19 on suicide attempts is lacking. We aimed to assess the short- and long-term effects of the COVID-19 pandemic on patients with suicide attempts in emergency departments (EDs) and to evaluate age- and sex-specific differences.

METHOD

We conducted nationwide cross-sectional study among patients with suicide attempts in the ED from 2016 to 2021. The trend test were used to determine whether study subjects were affected by changes in ED visits for suicide attempts. We estimated the average annual percentage change (APC) stratified by sex and age groups.

RESULTS

The number of ED visits related to suicide attempts increased from 27,581 in 2016 to 37,719 in 2021. In particular, it decreased immediately after the COVID-19 pandemic but increased again in 2021. We identified that the average APC increased by 6.8 % overall, 1.6 % among males, and 10.8 % among females. Moreover, the APC of trend sharply increased in patients aged 10s and 20s. The in-hospital mortality was 3.6 % for females, compared to 9.5 % for males, which showed sex differences.

LIMITATIONS

Other information such as severity of injury, interpersonal relationships were not available. This study was limited to confirming causal relationship based on a descriptive study.

CONCLUSIONS

The incidence of suicide attempts in ED has increased in Korea. In particular, there was a sharp increase among women, adolescents and young adults. Patient-tailored treatment and preventive medical system for suicide attempts is important.

Prevalence of skin diseases in Taiwan prisons: a population-based study

BACKGROUND

The prevalence of skin diseases among prisoners in Taiwan has rarely been investigated. This study aimed to estimate the prevalence of skin diseases by sex in a sample of prisoners in Taiwan.

METHODS

We included 83,048 participants from the National Health Insurance Program. The outcomes were measured using the clinical version of the International Classification of Diseases, Ninth Revision. For prevalence, we presented absolute values as well as percentages. We also conducted an X² test to assess sex differences and age group differences in the percentages of skin and subcutaneous tissue diseases.

RESULTS

The prevalence of skin diseases was 42.25%, higher than that in the general population. The prevalence of skin diseases among male prisoners was higher than that among female prisoners (p < 0.001), and the prevalence of skin diseases among prisoners who were ≤ 40 was higher than that among prisoners who were > 40. Among all cases diagnosed with skin disease, the top three diseases were contact dermatitis and other types of eczema, cellulitis and abscess, pruritus, and related conditions. Male prisoners had a significantly higher prevalence of all types of skin diseases than female prisoners.

CONCLUSIONS

Skin diseases are common in prisoners in Taiwan. Therefore, early prevention and appropriate treatment are needed. Male-specific skin products are also needed, given the differences in the prevalence of skin diseases among male and female prisoners.

Comparisons of violence exposure within and across contexts in predicting depression among Chinese children and adolescents

BACKGROUND

Existing research has identified violence exposure as a risk factor for depression among children and adolescents. To date, however, we know little about whether these associations are influenced by the forms (witnessing and victimization) of violence exposure across different contexts (family, school, and community).

OBJECTIVE

The present study thus aimed to compare the effects of two forms of violence exposure across and within three contexts. Sex and age differences were also tested in the above associations.

PARTICIPANTS AND SETTING

Participants (N = 906, 52.4 % boys, T1: M_age = 11.03) were children and adolescents recruited from elementary and junior schools in Zhejiang Province, China.

METHODS

All participants were asked to complete questionnaires about their experiences of various types of violence exposure and depression at two time points with a 12-month interval. SPSS and Mplus were used to analyze the data.

RESULTS

Considering the comparison within contexts, witnessing family violence was a more influential predictor than family violence victimization while school violence was the opposite. As for the comparison across contexts, no significant differences were found in the effects of different violence victimization, while the effect of witnessing family violence and community violence were more influential than witnessing school violence. No significant sex differences in the above associations were found. However, community violence victimization was more negatively related to depression among adolescents compared with children.

CONCLUSIONS

The associations between violence exposure and depression are influenced by the forms and contexts of violence as well as age groups.

Age differences in factors affecting fear of falling among community-dwelling older adults: A cross-sectional study

Our objective was to explore the determining factors of fear of falling (FOF) in community-dwelling older adults of different ages. A total of 541 community-dwelling older adults aged 65 years and older were investigated and separated into a younger group (n=347) and an older group (n=194). FOF was measured and possible factors affecting FOF were investigated. The prevalence of high FOF in the older group was significantly higher than that in the younger group. Poor sleep quality, low muscle strength, and multimorbidity were independent risk factors for high FOF in the younger group. While poor gait and balance were independent risk factors for high FOF, other factors, such as sex, marital status, education level, drinking status, cognitive ability, and muscle strength were also found to have a significant association with high FOF in the older group. Therefore, differential prevention strategies for high FOF should be considered for community-dwelling older adults of different ages.

Influence of emotional stimuli on metacognition: A study in arithmetic

We investigate the role of negative emotional stimuli on direct and indirect metacognition, and document age-related differences in this role during adulthood. Participants were presented with negative or neutral pictures while asked to select which of two available strategies was the better strategy to find approximate estimates of two-digit multiplication problems. Following each strategy selection, participants provided either a direct (confidence judgment; Expt. 1) or an indirect (opt-out judgment; Expt. 2) evaluation of their strategy choice. Negative emotional stimuli decreased metacognitive accuracy for arithmetic strategy selection, but only when indirect metacognitive measures were collected. No differences were found when direct metacognitive judgments were requested. The effects of emotional stimuli on indirect metacognition and lack of effects on direct metacognition were found in both young and older adults. These findings have important implications for our understanding of the mechanisms underlying the effects of emotion on metacognition in young and older adults.

Word recall process and physiological activation in the tip-of-the-tongue state: Comparison of young and middle-aged groups

To clarify the feeling of knowing a name but not being able to recall it, known as having a "tip-of-the-tongue" (TOT) experience, we proposed a TOT model consisting of three stages combining a face recognition model and autonomic sympathetic nerve activity. Since TOT increases with age, we compared two age groups: young (N = 27, M = 20.4 ± 1.5 years) and middle-aged (N = 29, M = 58.5 ± 8.0 years). Experiment 1 showed that successfully naming low-frequency common names increased the skin conductance response (SCR) value, and the time to reach the maximum SCR value was longer. Experiment 2 was a naming task for face photographs. The younger group showed higher SCR values during successfully naming, while the middle-aged group showed similar SCR values for successfully naming and experiencing TOT. Both groups had the longest time to reach maximum SCR in TOT. In this study, physiological arousal of TOT was not affected by aging.

Problematic Internet use and academic engagement during the COVID-19 lockdown: The indirect effects of depression, anxiety, and insomnia in early, middle, and late adolescence

BACKGROUND

During the COVID-19 pandemic, the transition of online learning introduces challenges for adolescents to engage in learning. The increased access and persistent Internet use could heighten the risk of problematic Internet use (PIU) that has been increasingly recognized as a risk factor for academic engagement. This study aims to investigate the direct and indirect relationships between PIU and academic engagement through psychopathological symptoms (i.e., depression, anxiety, insomnia) in early, middle, and late adolescence.

METHODS

In all, 4852 adolescents (51.5% females; M_age = 13.80 ± 2.38) from different regions of Chinese mainland participated in the study and completed questionnaires.

RESULTS

Depression and then insomnia as well as anxiety and then insomnia mediated the relationship between PIU and academic engagement. Anxiety exhibited a double-edged effect, that is, a positive relation with academic engagement directly and a negative relation with academic engagement indirectly through insomnia. Multigroup analyses showed that the indirect effects of PIU on academic engagement through depression and subsequent insomnia in middle and late adolescence were stronger than that in early adolescence, whereas the direct effect in early adolescence was stronger than that in middle adolescence.

LIMITATION

This study was cross-sectional in design and relied upon self-report measures.

CONCLUSION

These findings improve the understandings of how PIU relates to academic engagement through psychopathological symptoms and highlight developmental differences of adolescence.

Influence of smartphone use motives on smartphone addiction during the COVID-19 epidemic in China: the moderating effect of age

With the development of science and technology, the phenomenon of smartphone addiction has become very common. However, smartphone addiction has adverse consequences. To date, few studies have examined psychological crises and smartphone use motives during the coronavirus disease 2019 (COVID-19) pandemic according to age. Therefore, this study aimed to examine the influences of different types of smartphone use motives on smartphone addiction and explore the moderating effect of age on adolescents and adults. A total of 1346 participants (600 adults and 746 adolescents) completed questionnaires on their motives for smartphone use and smartphone addiction. Results indicated significant positive correlations between smartphone use motives and smartphone addiction. In the moderation model, mood regulation, social relations, pastime, and conformity significantly and directly predicted smartphone addiction; however, perceived enjoyment did not. Age played a moderating role in the prediction of smartphone addiction. Teenagers and adults have different motives for smartphone use, and different motives have different effects on adolescents and adults. Adolescents have higher coping motivation and conformity motivation than adults, and for adolescents, perceived pleasure motivation has a significant impact on smartphone addiction. For adults, perceived pleasure and social relationship motivation have a significant impact on smartphone addiction. Therefore, interventions for smartphone addiction can be developed by investigating the motives of use among different people, and age should be considered when developing interventions for smartphone addiction.

Online health management continuance and the moderating effect of service type and age difference: A meta-analysis

Numerous empirical studies have been carried out to explore factors of online health management continuance. However, results were not unified. We thus conducted a meta-analysis to identify influential factors and potential moderators. A systematic literature search was performed in nine databases (PubMed, Web of Science, the Cochrane Library, Ovid of JBI, CINAHL, Embase, CNKI, VIP, and CBM) published up to December 2020 in the English or Chinese language. Meta-analysis of combined effect size, heterogeneity, moderator analysis, publication bias assessment, and inter-rater reliability was conducted. Totally 41 studies and 12 pairwise relationships were identified. Confirmation, perceived usefulness, satisfaction, information quality, service quality, perceived ease of use, and trust were all critical predictors. Service type and age difference showed their moderating effects respectively. The perceived usefulness was more noteworthy in medical service than health and fitness service. The trust was more noteworthy in young adults. The results confirmed the validity and robustness of the Expectation Confirmation Model, Information Systems Success Model, and trust theory in online health management continuance. Moderators included but are not limited to age difference and service type. The elderly research in the healthcare context and other analytical methods such as qualitative comparative analysis should be applied in the future.

Effect of age and sex on the associations between potential modifiable risk factors and both type 2 diabetes and impaired fasting glycaemia among West African adults

Background

Type 2 diabetes mellitus (T2DM) is becoming one of the leading causes of morbidity and mortality worldwide, including among Africans. Knowledge of the association between traditional risk factors and both diabetes and pre-diabetes, and whether these differ by age and sex, is important for designing targeted interventions. However, little is known about these associations for African populations.

Methods

The study used data from WHO STEPS surveys, comprising 15,520 participants (6,774 men and 8,746 women) aged 25–64 years, from 5 different West African countries, namely Burkina Faso (4,711), Benin (3,816), Mali (1,772), Liberia (2,594), and Ghana (2,662). T-test and chi-square tests were used to compare differences in the prevalence of traditional risk factors for both sexes. Multinomial logistic regression was conducted to ascertain the relative risks (RR) and 95% confidence intervals (CI) for both T2DM and impaired fasting glucose (IFG) relating to each risk factor, including obesity [defined by BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR)], high blood pressure (HBP), fruit and vegetable consumption, physical inactivity, alcohol consumption, and smoking. Models for each of these traditional risk factors and interactions with age and sex were fitted.

Results

Factors associated with T2DM and IFG were age, obesity [defined by BMI, WC, WHtR, and WHR], HBP, smoking, physical inactivity, and fruit and vegetable consumption (p < 0.05). Analysis of interaction effects showed few significant differences in associations between risk factors and T2DM according to age or sex. Significant interaction with age was observed for HBP*age and T2DM [RR; 1.20, 95% CI: (1.01, 1.42)) (p = 0.04)], WHtR*age and T2DM [RR; 1.23, 95% CI: (1.06, 1.44) (p = 0.007)] and WHR*age and IFG [RR: 0.79, 95% CI: (0.67, 0.94) (p = 0.006)]. Some interactions with age and sex were observed for the association of alcohol consumption and both IFG and T2DM, but no clear patterns were observed.

Conclusion

The study found that with very few exceptions, associations between traditional risk factors examined and both IFG and T2DM did not vary by age or sex among the West African population. Policies and public health intervention strategies for the prevention of T2DM and IFG should target adults of any age or sex in West Africa.

Age-Related Differences of Rumination on the Loneliness-Depression Relationship: Evidence From a Population-Representative Cohort

Background and Objectives

This study examined the association of loneliness with depressive symptoms across various age groups. Loneliness is a significant risk factor for precipitating depressive symptoms. Rumination, a mechanism that underpins depression, can become intense when a person feels lonely. In addition, age is a major factor associated with changes in mental and physical health. Thus, the importance of rumination and age in moderating the loneliness-depression link were investigated.

Research Design and Methods

This cross-sectional study was conducted during the acute phase of the coronavirus disease 2019 pandemic in Hong Kong (February 27 to March 17, 2020). A population-representative sample of 1,972 people (1,107 females; 18-92 years of age) was recruited and interviewed via telephone through random digit dialing. This sample included 394 younger adults (18-30 years), 1,106 middle-aged adults (31-64 years), and 472 older adults (65 years or above). Respondents reported depressive symptoms, subjective loneliness, state rumination, and sociodemographic factors.

Results

Loneliness and rumination were positively associated with depressive symptoms, and they significantly interacted in predicting cognitive-affective symptoms. Further analysis of age showed that the interaction was significant only in middle-aged adults and older adults. Both rumination and age interacted with loneliness, respectively, in predicting cognitive-affective symptoms.

Discussion and Implications

These findings indicate that the strength of the association between loneliness and the cognitive-affective symptoms of depression depends on rumination levels and age. An intervention to regulate rumination offers a feasible direction for health care and social care aimed at improving older adults' mental health.

Major depressive symptoms and escalation of drinking among new drinkers in the United States: Variations across sex and age groups

BACKGROUND

Heavy episodic drinking is common in the United States (US) and causes substantial burden to individuals and the society. The transition from first drinking to first heavy drinking episode is a major milestone in the escalation of drinking. There is limited evidence about whether major depressive symptoms predict the progression from drinking to heavy drinking and potential variations across age, sex, and depressive symptoms. In this study, we aim to estimate the association between history of major depressive symptoms and the risk of first heavy drinking episode among new drinkers in the US.

METHODS

Study population was US non-institutionalized civilian new drinkers 12 years of age and older who had their first drink during the past 12 months drawn from the National Survey on Drug Use and Health. History of major depressive symptoms and alcohol drinking behaviors were assessed via audio-computer-assisted self-interviews. Logistic regressions and structural equation modeling were used for analysis.

RESULTS

Depressed mood and/or anhedonia predicted the transition from the first drink to a heavy drinking episode among underage female new drinkers, whereas null associations were found among males and female new drinkers who had their first drink at 21 and later. Among new drinkers with depressed mood and/or anhedonia, low mood or energy positively predicted the progression to a heavy drinking episode among late-adolescent boys, but negatively among late-adolescent girls; neurovegetative symptoms positively predicted the progression to a heavy drinking episode among young adult new drinkers.

CONCLUSIONS

The relationships linking major depressive symptoms and the transition from drinking to first heavy drinking episode vary across age, sex, and depressive symptoms.

Age dependent association between remnant cholesterol and cardiovascular disease

Background and aims

High remnant cholesterol is associated with cardiovascular disease (CVD), but whether CVD risk attributable to remnant cholesterol vary between young and later adults remains unknown. The study aimed to assess age differences in the association between remnant cholesterol and CVD.

Methods

This prospective study included 95 663 participants without CVD and lipid-lowering treatment at baseline, including 16 254 young adults (age 18-39 years) and 79 409 later adults (age ≥40 years). Individuals were grouped by clinically meaningful remnant cholesterol concentrations of <0.50, 0.50-0.99, 1.00-1.49, and ≥1.50 mmol/L. Multivariable Cox regressions were performed to calculate hazard ratio (HR).

Results

During a median follow-up of 11.01 years, 164 incident CVD were identified in young adults, and 6081 cases in later adults. After multivariate adjustment, the association between remnant cholesterol and CVD was more pronounced in young adults than later adults (P for interaction=0.0019), the HR was 2.24 (95% confidence interval [CI], 1.45-3.47) for young individuals with remnant cholesterol ≥1.50 mmol/L, compared to individuals with remnant cholesterol <0.50 mmol/L, while the corresponding HR was 1.21 (95% CI, 1.13-1.29) for later adults. Furthermore, the population attributable risk percentage for remnant cholesterol < 1.50 vs ≥ 1.50 mmol/L was also higher in young (14.8%) than later adults (4.2%).

Conclusions

Despite a lower incidence risk of CVD among young adults compared later adults, the stronger association and greater attributable risk of remnant cholesterol among young adults highlight the importance of preventive efforts across the adult life course.

Characteristics of immune and inflammatory responses among different age groups of pediatric patients with COVID-19 in China

BACKGROUND

Severe cases of coronavirus disease 2019 (COVID-19) among pediatric patients are more common in children less than 1 year of age. Our aim is to address the underlying role of immunity and inflammation conditions among different age groups of pediatric patients.

METHODS

We recruited pediatric patients confirmed of moderate COVID-19 symptoms, admitted to Wuhan Children's Hospital from January 28th to April 1st in 2020. Patients were divided into four age groups (≤ 1, 1-6, 7-10, and 11-15 years). Demographic information, clinical characteristics, laboratory results of lymphocyte subsets test, immune and inflammation related markers were all evaluated.

RESULTS

Analysis included 217/241 (90.0%) of patients with moderate clinical stage disease. Average recovery time of children more than 6 years old was significantly shorter than of children younger than 6 years (P = 0.001). Reduced neutrophils and increased lymphocytes were significantly most observed among patients under 1 year old (P < 0.01). CD19+ B cells were the only significantly elevated immune cells, especially among patients under 1 year old (cell proportion: n = 12, 30.0%, P < 0.001; cell count: n = 13, 32.5%, P < 0.001). While, low levels of immune related makers, such as immunoglobulin (Ig) G (P < 0.001), IgA (P < 0.001), IgM (P < 0.001) and serum complement C3c (P < 0.001), were also mostly found among patients under 1 year old, together with elevated levels of inflammation related markers, such as tumor necrosis factor γ (P = 0.007), interleukin (IL)-10 (P = 0.011), IL-6 (P = 0.008), lactate dehydrogenase (P < 0.001), and procalcitonin (P = 0.007).

CONCLUSION

The higher rate of severe cases and long course of COVID-19 among children under 1 year old may be due to the lower production of antibodies and serum complements of in this age group.

Association between different obesity phenotypes and hypothyroidism: a study based on a longitudinal health management cohort

PURPOSE

Obese individuals have an increased risk of hypothyroidism. This study investigated the sex-specific association between obesity phenotypes and the development of hypothyroidism.

METHODS

The study population was derived from a health management cohort in Shandong Provincial Hospital from 2012 to 2016. In total, 9011 baseline euthyroid adults were included and classified into four groups according to obesity phenotype: metabolically healthy nonobese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy nonobese (MUNO), and metabolically unhealthy obese (MUO). The median follow-up time was 1.92 (1.00-2.17) years. Incidence density was evaluated and a generalized estimation equation method was used to investigate the associations between obesity phenotypes and the development of hypothyroidism.

RESULTS

The incidence densities of hypothyroidism in males with a consistent obesity phenotype were 12.19 (8.62-16.76), 15.87 (11.39-21.56), 14.52 (6.74-27.57), and 19.88 (14.06-27.34) per 1000 person-years in the MHNO, MHO, MUNO, and MUO groups, respectively. After adjusting for confounding factors, compared with the MHNO phenotype, the MHO, MUNO, and MUO phenotypes were independent risk factors for developing hypothyroidism in males. In the subgroup analysis, the MHO and MUO phenotypes were independent risk factors for developing hypothyroidism in males under 55 years, while the MUNO phenotype was an independent risk factor in males over 55 years. The MHO, MUNO, and MUO phenotypes were not independent risk factors for hypothyroidism in females.

CONCLUSION

Both obesity and metabolic abnormities are associated with a higher risk of hypothyroidism in males. The underlying mechanism of the sex and age differences in this association needs further investigation.

Pain, symptom distress, and pain barriers by age among patients with cancer receiving hospice care: Comparison of baseline data

OBJECTIVES

Age group differences have been reported for pain and symptom presentations in outpatient and inpatient oncology settings, but it is unknown if these differences occur in hospice. We examined whether there were differences in pain, symptom distress, pain barriers, and comorbidities among three age groups (20-64 years, 65-84 years, and 85+) of hospice patients with cancer.

MATERIALS AND METHODS

Participants were recruited from two hospices. Half were women; 49% White and 34% Black. 42% were 20-64 y, 43% 65-84 y, and 15% 85+ y. We analyzed baseline data for 230 hospice patients with cancer (enrolled 2014-2016, mean age 68.2 ± 14.0, 20-100 years) from a stepped-wedge randomized controlled trial. Measures were the Average pain intensity (API, 0-10: current, least and worst pain intensity during the past 24 h), Symptom Distress Scale (SDS, 13-65), Barriers Questionnaire-13 (BQ-13, 0-5), and comorbid conditions. Descriptive, bivariate association, and multiple regression analyses were performed.

RESULTS

Mean API scores differed (p < .001) among the three age groups (5.6 ± 2.0 [20-64 years], 4.7 ± 2.0 [65-84 years], and 4.4 ± 1.8 [85+], as did the mean SDS scores (36.1 ± 7.3, 33.5 ± 8.1, and 31.6 ± 6.6, p = .004). BQ-13 mean scores (2.6 ± 0.9, 2.7 ± 0.8, and 2.5 ± 0.7) and comorbidities were not significantly different across age groups. In multiple regression analyses, age-related differences in API and SDS remained significant after adjusting for gender, race, cancer, palliative performance score, and comorbidities. Comorbidities were positively associated with SDS (p = .046) but not with API (p = .64) in the regression model.

CONCLUSION

Older hospice patients with cancer reported less pain and symptoms than younger patients, but all groups reported similar barriers to pain management. These findings suggest the need for age- and race-sensitive interventions to reduce pain and symptom distress levels at life's end.

Body mass index and mild cognitive impairment among rural older adults in China: the moderating roles of gender and age

BACKGROUND

Evidence concerning the association between body mass index (BMI) and cognitive function among older people is inconsistent. This study aimed to investigate gender and age as moderators in association between BMI and mild cognitive impairment (MCI) among rural older adults.

METHODS

Data were derived from the 2019 Health Service for Rural Elderly Families Survey in Shandong, China. In total, 3242 people aged 60 years and above were included in the analysis. Multilevel mixed-effects logistic regression was used to examine the moderating roles of gender and age, then further to explore the relationship between BMI and MCI.

RESULTS

There were 601 (18.5%) participants with MCI. Compared with normal BMI group, low BMI group had a higher risk of MCI among older people [adjusted odds ratio (aOR) = 2.08, 95% confidence interval (CI): 1.26-3.44], women (aOR = 2.06, 95% CI: 1.35-3.12), or the older elderly aged ≥75 years old (aOR = 3.20, 95% CI: 1.34-7.45). This effect remained statistically significant among older women (aOR = 3.38, 95% CI: 1.69-6.73). Among older men, elevated BMI group had a higher risk of MCI (aOR = 2.32, 95% CI: 1.17-4.61) than normal BMI group.

CONCLUSIONS

Gender and age moderated the association between BMI and MCI among Chinese rural older adults. Older women with low BMI were more likely to have MCI, but older men with elevated BMI were more likely to have MCI. These findings suggest rural community managers strengthen the health management by grouping the weight of older people to prevent the risk of dementia.

Effects of sources of social support and resilience on the mental health of different age groups during the COVID-19 pandemic

BACKGROUND

A pandemic is a very stressful event, especially for highly vulnerable people (e.g., older adults). The purpose of the current study was to investigate the main and interactive relationships of social support and resilience on individual mental health during the COVID-19 pandemic across three age groups: emerging adults, adults, and older adults.

METHODS

A survey was conducted with 23,192 participants aged 18-85. Respondents completed a questionnaire, including items on the COVID-19-related support they perceived from different sources, the abbreviated version of the Connor-Davidson Resilience Scale, and the Mental Health Inventory.

RESULTS

Latent profile analysis identified five profiles of social support, and the patterns of potential profiles were similar in all groups. However, category distribution in the five profiles was significantly different among the age groups. Furthermore, analysis using the BCH command showed significant differences in mental health among these profiles. Lastly, interactive analyses indicated resilience had a positive relationship with mental health, and social support served as a buffer against the negative impact of low resilience on mental health.

CONCLUSIONS

This study provides quantitative evidence for socioemotional selectivity theory (SST) and enables several practical implications for helping different age groups protecting mental health during pandemic.

Spousal age difference and its effect on contraceptive use among sexually active couples in Ethiopia: evidence from the 2016 Ethiopia demographic and health survey

BACKGROUND

Age difference among spouses can be considered as an indicator of the nature of the marital bond, and influences the couple's fertility expectations. The age difference is one of the features of the traditional African marriage system. However, the likelihood that women use of contraceptives and spousal age differences is not well studied. Thus, this study was to examine the spousal age difference on contraceptive use.

OBJECTIVE

This study was aimed to examine spousal age differences and its effect on contraceptive use among sexually active couples in Ethiopia.

METHODS

The related variables for this study were extracted from Ethiopian Demographic and Health Survey 2016 data. IBM SPSS statistics version 20 software was used for analysis. Logistic regression was conducted to see the association between spousal age difference and contraceptive use. All analyses were adjusted for sample weights.

RESULTS

Out of the 7268 selected women for contraceptive usage questions, one fourth (25.3%) of them were between ages 25 and 29 and in almost all 7061 (98.4%) of them there was spousal age differences, 1555 (21.4%) of them were from poor socioeconomic group. Nearly all 7184 (98.8%) of them knew contraceptive method. However, among those sexually active in the last 4 weeks only two in five (41.2%) were using a contraceptive method. Spousal age difference was found to be significant factor and women older than their spouses were (AOR: 1.771, 95%CI: 1.276, 2.459) more likely and women having spouse's age difference greater than 10 years were 1.2% (AOR: .988, 95%CI: .848, 1.150) less likely to use contraception compared to those age difference is ten or less than years respectively. Also, women who were living in urban areas (AOR: 1.482, 95%CI: 1.161 to 1.890), current working status (AOR: 1.170; 95%CI: 1.033 to 1.325), from richest economic category (AOR: 2.560; 95%CI: 2.000 to 3.278) husband's education, couples' fertility preference (AOR: 1.233; 95%CI: 1.070 to 1.420) were contraception use predictors. Similarly, being Muslim by religion (AOR: .579 95%CI: 0.496 to 0.675) and husband based decision for their health care use were (AOR: .847, CI: .729 to .985) less likely to use contraception.

CONCLUSION AND RECOMMENDATION

This study found association between spousal age differences and contraceptive use. Similarly, women's age, age difference, place of residence, religion, current working status, socioeconomic, husband's education, living children and current pregnancy, the couples' fertility preference and who decides on health care use were found to be predictors of contraceptive use. Strengthening strategies for improving women's educational status, socio-economic and demographic that will help to limit the age differences and improve contraceptive use. Further study, including qualitative is recommended to dig out the why components and better understand this finding.

Intraday weather conditions can influence self-report of depressive symptoms

The weather is arguably one of the most common topics in daily conversation. However, it is also a well-known factor in psychiatric problems worldwide such as depression, where particularly elders and females are prone to the condition. Previous studies have mostly focused on the association between long-term climate/season change and depressive symptoms to test the belief that people feel depressed when the weather is bad. Yet, little is known about the relationship between intraday weather conditions and depressive symptoms. This study aimed to decompose this association and explore age and gender differences in depressive symptoms' report under different intraday weather conditions. We analyzed data with a total sample size of 20,987 individuals aged 15-96 years obtained via the China Labor-force Dynamic Survey (CLDS) project in 2016. The surveyors filled in the intraday weather conditions (i.e., sunny, cloudy, overcast, light rain, moderate rain, and heavy rain) in the questionnaire with depression being self-reported using the Center for Epidemiologic Studies Depression (CES-D) Scale. In the survey, 17.3% [95% confidence interval (CI) = 16.8%, 17.8%] individuals were assessed to have depressive symptoms (CES-D scores >15). Overcast day was the peak weather condition for depressive symptoms, while gender and age differences of depressive symptoms were biggest in the weather condition of moderate rain. Multivariate logistic regression revealed that female and middle-old age individuals were more likely to report having depressive symptoms, and people under overcast day were more likely to report having depressive symptoms compared to under sunny day [odds ratio (OR) = 1.25, 95%CI = 1.11, 1.39]. This intraday weather conditions-depression link was significant in males and middle-old age individuals but not in females and youngsters.

Future time perspective drives younger and older adults to continue investing in failing activities

Inspired by socioemotional selectivity theory, we investigated age differences in further investment in failing situations by considering goal type and future time perspective. In Experiment 1, 32 younger and 30 older adults reported their likelihood of continued investing following an unsuccessful investment. Older adults were more willing to invest with emotional goals as opposed to knowledge and unspecified goals, while younger adults showed a greater willingness to invest with emotional and knowledge goals rather than unspecified goals. In Experiment 2, another sample of 32 younger and 34 older adults completed the same decision tasks as those in Experiment 1. After future time perspective restriction, the younger adults made decisions resembling Experiment 1's older adults, while after future time perspective expansion, the older adults behaved like Experiment 1's younger adults. These results indicate that future time perspective modification could reverse participants' goal prioritisation, manifesting in differential willingness to pursue further investment in decision scenarios with different goals. Our results represent important steps towards understanding the mechanism of older and younger adults' further investment in failing situations and illustrate that forging connections between the lifespan theory of motivation and further investment decision is critical for understanding adults' decision behaviours.

Rigorous Correction of Sagittal Vertical Axis Is Correlated With Better ODI Outcomes After Extensive Corrective Fusion in Elderly or Extremely Elderly Patients With Spinal Deformity

STUDY DESIGN

Retrospective analysis of a prospectively collected consecutive case series.

OBJECTIVES

To determine the effect of spinopelvic correction on clinical outcomes and discuss the approach to target alignment in elderly or extremely elderly spinal deformity patients.

SUMMARY OF BACKGROUND DATA

Age-dependent target alignment during corrective fusion surgery in elderly patients remains controversial. Age-related target spinal alignment should be examined based on the outcomes data of patients with fused, nonphysiological spines.

METHODS

Consecutive adult spinal deformity (ASD) patients aged 45 years or older who underwent thoracolumbar corrective fusion of at least five levels were included. Spinopelvic radiographic parameters, health-related quality of life (Oswestry Disability Index [ODI]), and the scores on a numeric rating scale of low back pain were investigated before and after the operation. The patients were stratified into three groups according to age as follows: Middle-Age, 45-64 years; Elderly, 65-74 years; and Extremely Elderly, ≥75 years. We also stratified the patients into three groups according to lumber lordosis (LL) as follows: ideal (within ±5° of ideal LL), moderate (between -5° and -20° of ideal LL), and under (under ideal LL by -20°).

RESULTS

A total of 149 patients (Middle-Age, 38; Elderly, 68; and Extremely Elderly, 43) were included in this study. No significant difference was observed in any of the radiographic parameters in each age group. The ODI and numeric rating scale scores of the ideal-correction group at two years after surgery were significantly better than those of the undercorrection group across all ages. A significant correlation with ODI was observed between sagittal spinopelvic parameters in the Elderly and Extremely Elderly groups. A stronger correlation was observed in the Extremely Elderly group compared with the Elderly group.

CONCLUSIONS

Rigorous realignment of sagittal vertical axis is correlated with ODI outcomes, especially in very elderly patients.

LEVEL OF EVIDENCE

Level 4.

Exploratory, cognitive, and depressive-like behaviors in adult and pediatric mice exposed to controlled cortical impact

Objective

Sequelae of behavioral impairments associated with human traumatic brain injury (TBI) include neurobehavioral problems. We compared exploratory, cognitive, and depressive-like behaviors in pediatric and adult male mice exposed to controlled cortical impact (CCI).

Methods

Pediatric (21 to 25 days old) and adult (8 to 12 weeks old) male C57Bl/6 mice underwent CCI at a 2-mm depth of deflection. Hematoxylin and eosin staining was performed 3 to 7 days after recovery from CCI, and injury volume was analyzed using ImageJ. Neurobehavioral characterization after CCI was performed using the Barnes maze test (BMT), passive avoidance test, open-field test, light/dark test, tail suspension test, and rotarod test. Acutely and subacutely (3 and 7 days after CCI, respectively), CCI mice showed graded injury compared to sham mice for all analyzed deflection depths.

Results

Time-dependent differences in injury volume were noted between 3 and 7 days following 2-mm TBI in adult mice. In the BMT, 2-mm TBI adults showed spatial memory deficits compared to sham adults (P<0.05). However, no difference in spatial learning and memory was found between sham and 2-mm CCI groups among pediatric mice. The open-field test, light/dark test, and tail suspension test did not reveal differences in anxiety-like behaviors in both age groups.

Conclusion

Our findings revealed a graded injury response in both age groups. The BMT was an efficient cognitive test for assessing spatial/non-spatial learning following CCI in adult mice; however, spatial learning impairments in pediatric mice could not be assessed.

Age as a Moderator of Social Skills Intervention Response Among Korean Adolescents with Autism Spectrum Disorder

Few studies have investigated the effect of age on treatment effectiveness of evidence-based social skills training in autism spectrum disorder (ASD) adolescents. This study evaluated the effectiveness of Program for the Education and Enrichment of Relational Skills (PEERS^®) in different ages of ASD adolescents. A total of 110 ASD adolescents aged 11-19 years were divided into early, middle, and late adolescence groups, and the changes in outcome measures following intervention were compared among the three groups. We found that the improvements in social competence after PEERS^® were significant, but the treatment effects were not significantly different among the three age groups. The findings suggest that PEERS^® is beneficial for ASD adolescents regardless of patient age and adolescence stage.

Breastfeeding duration of different age groups and its associated factors among Chinese women: a cross-sectional study

Background

The current situation of breastfeeding in China has been discussed in many articles, and a declining trend of breastfeeding duration has been confirmed. The associations between various socioeconomic, reproductive factors and breastfeeding duration have been discussed as well. However, there remains a lack of evidence on breastfeeding duration amongst different age groups.

Methods

Data was extracted from the baseline of a large cohort study: a sample of 300,000 adult women born in the 1930s’ through 1970s’ from 10 geographically distinct regions was obtained. The breastfeeding duration was assumed by breastfeeding duration of the first child. Different age groups were categorized by 10-year age groups, and they were born in 1930–1938, 1939–1948, 1949–1958, 1959–1968, and 1969–1974. Multivariable linear regression was used to evaluate the associations between breastfeeding duration and sociodemographic, and reproductive factors (i.e.: different age groups, education, household size, use of oral contraceptive pills, age at menarche, and age at first birth).

Results

The mean breastfeeding duration (Standard Deviation) of women born in 1930–1938, 1939–1948, 1949–1958, 1959–1968, and 1969–1974 were 15.4 (9.2), 14.8 (8.2), 14.7 (8.9), 12.8 (7.2), 13.1 (7.2) months, respectively. Younger age groups, higher levels of education, and use of oral contraceptive pills were negatively associated with breastfeeding duration. In particular, the negative association with higher levels of education (for urban regions: β_{middle school} = − 1.3, β_{high school & above} = − 1.6; for rural regions: β_{middle school} = − 0.6, β_{high school & above} = − 1.2; all p < 0.0001) was found significant in both rural and urban areas, household size (β = − 0.1, p < 0.0001) and age at first birth (β = − 0.2, p < 0.0001) were negatively associated with breastfeeding duration only in urban areas, but were all positively associated with breastfeeding duration in rural areas.

Conclusions

This research demonstrated that, among Chinese women, younger age groups and higher levels of education were negatively associated with breastfeeding duration. Considering the declining trend of breastfeeding duration in China, healthcare providers need to continue advocating for breastfeeding practices. We also call for collaboration with various sectors and concerned groups to actions that promote breastfeeding-friendly environment and measures.

A decline in self-esteem in adults over 50 is not found in Japan: age differences in self-esteem from young adulthood to old age

Objective

The current research examined age differences in self-esteem in Japan from young adults aged 20 to the elderly aged 69 with a focus on self-esteem trajectories from middle age to old age. Previous research in European American cultures has indicated that self-esteem rises from young adulthood into middle age, and sharply declines starting in one’s 50s or 60s. However, it was unclear whether this sharp drop would be found in Japan. Therefore, the present research investigated whether the same age differences were present in Japan by analyzing data from a large and diverse sample.

Results

Results showed that self-esteem increases from young adulthood into middle age, consistent with previous research. However, the sharp decline after the age of 50 was not found, which is different from the pattern in European American cultures. This may be related to a finding that people in East Asian cultures show more humble attitudes toward themselves.

Effects of scheduled manual driving on drowsiness and response to take over request: A simulator study towards understanding drivers in automated driving

Because current automated vehicles have operational limitations, it is important to ensure that the fallback-ready driver is able to perform appropriately when required to take over control of the vehicle. However, time-related increase in driver drowsiness is well-known, and drowsy driving can affect response to take-over request (TOR). It was previously reported that a scheduled period of manual driving during automated driving was beneficial in maintaining driver arousal level. The present driving simulator study investigates the effects of scheduled manual driving on driver drowsiness and performance, as well as age differences therein. A total of 115 participants, whose gender was balanced and age was distributed uniformly from 20 to 70 years, drove an automated vehicle for 31 min, and a TOR was prompted before a collision event. A between-subjects design comprised two conditions: with versus without a scheduled 10-min interval of manual driving that ended 10 min before TOR. The Karolinska Sleepiness Scale and eyeblink durations estimated from electrooculograms (EOG) were used to subjectively and objectively measure participant's drowsiness. Reaction time, standard deviation of steering wheel angle, and minimum Time-to-Collison (TTC) were extracted to measure driver performance in response to TOR. The alleviating effect on drowsiness of 10-min scheduled manual driving became non-significant after another 10-min period of automated driving. Although the scheduled manual driving had no significant effect for younger drivers, older drivers reacted significantly more slowly in both steering and braking at the critical event. These findings provide essential insights for human-vehicle interactions: Scheduled manual driving cannot maintain drivers' arousal level for 10 min afterwards, and for older drivers, it would be better to avoid unnecessary task-switching between manual and automated driving.

Prevalence and predictors of depression and anxiety in adult patients with type 1 diabetes in tertiary care setting

AIMS

To determine gender and age differences in the prevalence of depression and anxiety and their predictive factors in adult patients with type 1 diabetes (DM1).

METHODS

Random sample of DM1 adult patients from a tertiary care hospital cohort. To evaluate the presence of depression and anxiety, psychological evaluation was performed using structured clinical interview (MINI). For the specific evaluation of fear of hypoglycemia (FH), FH-15 questionnaire was used.

RESULTS

339 patients [51.6% male; 38.5 ± 12.9 years; HbA_1c 7.5 ± 1.1% (58.5 ± 14.2 mmol/mol); 20.1 ± 12.0 years of DM1] met the inclusion criteria. Prevalence of depression, anxiety, and FH in men vs. women was as follows (%): depression: 15.4 vs. 33.5 (p < 0.05); anxiety: 13.7 vs. 26.2 (p < 0.05); and FH: 42.8 vs. 46.0 (p = NS). Among midlife female patients, prevalence of depression and anxiety was higher compared to male. Moreover, comorbid depressive and anxious symptoms were also higher in midlife female patients compared to age-matched male patients (3.5 vs. 14%, p < 0.05). Apart from age-related vulnerability, female gender, poor glycemic control, and microvascular and macrovascular complications were predictive factors for depressive and anxious symptomatology. Unawareness hypoglycemia and anxiety-prone personality were predictor factors for FH.

CONCLUSIONS

In adults with DM1, prevalence of depression and anxiety is higher in women. Midlife patients, in particular women, show a significantly higher prevalence of anxiety symptoms and comorbid depression and anxiety. The presence of secondary complications and sustained poor glycemic control should alert to the possibility of these mental disorders, especially in the most vulnerable age population; clinical, gender and age-related patterns could help to design more effective psychological assessment and support in adult patients with DM1.

Older adults show less interference from task-irrelevant social categories: evidence from the garner paradigm

Though age-related difference in most cognitive performance has been found, there was no previous research examining age difference in multiple social categorizations. Using faces as stimuli and Garner Selective Attention Paradigm, this study explored the different characteristics of implicit and explicit social categorization between young and older adults. The results showed that young perceivers explicitly categorized gender and age of the faces faster and more readily than older perceivers did. When young adults judged specific category (gender category in Experiment 1; age category in Experiment 2), they were interfered from the completing irrelative category; however, irrelative category could not capture older adults' attention. These results first suggest perceivers' age indeed plays an important role in multiple social categorizations.

Aging and Decision-Making: A Conceptual Framework for Future Research - A Mini-Review

Age differences in decision-making are of theoretical interest and have important practical implications, but relevant lines of work are distributed across multiple disciplines and often lack integration. The present review proposes an overarching conceptual framework with the aim of connecting disjointed aspects of this field of research. The framework builds on process models of decision-making and specifies potential mechanisms behind age effects as well as relevant moderators including task characteristics and contextual factors. After summarizing the extant literature for each aspect of the framework, compensatory mechanisms and ecological fit between different components of the model are considered. Implications for real-life decision-making, remaining research gaps, and directions for future research are discussed.

Reducing Vehicle Travel for the Next Generation: Lessons from the 2001 and 2009 National Household Travel Surveys

In the United States, per capita vehicle miles traveled (VMT) displayed a general declining trend in the new millennium. This paper focuses on identifying the factors that drove the recent VMT trend. Using sample data from the 2001 and 2009 National Household Travel Surveys (NHTS), this study investigated differences in travel patterns by age groups over time and explored factors associated with the recent decrease in per-capita VMT. The study results show that the daily auto mileage and number of auto trips significantly decreased in 2009, although the change was uneven across different age groups. Increased travel by public transit and walking and biking, along with urbanization efforts, partly explained the recent decrease in automobile use. The findings also suggest that population-specific strategies such as improving public transit services for younger people and upgrading walking facilities for the elderly may help reduce automobile travel demand. In addition, applications of information and communication technologies (ICTs) can offer promising alternatives to automobile travel.

Age differences in the takeover of vehicle control and engagement in non-driving-related activities in simulated driving with conditional automation

High-level vehicle automation has been proposed as a valuable means to enhance the mobility of older drivers, as older drivers experience age-related declines in many cognitive functions that are vital for safe driving. Recent research attempted to examine age differences in how engagement in non-driving-related activities impact driving performance, by instructing drivers to engage in mandatory pre-designed activities. While the mandatory engagement method allows a precise control of the timing and mental workload of the non-driving-related activities, it is different from how a driver would naturally engage in these activities. This study allowed younger (age 18-35, mean age=19.9years) and older drivers (age 62-81, mean age=70.4years) to freely decide when and how to engage in voluntarily chosen non-driving-related activities during simulated driving with conditional automation. We coded video recordings of participants' engagement in non-driving-related activities. We examined the effect of age, level of activity-engagement and takeover notification interval on vehicle control performance during the takeover, by comparing between the high and low engagement groups in younger and older drivers, across two takeover notification interval conditions. We found that both younger and older drivers engaged in various non-driving-related activities during the automated driving portion, with distinct preferences on the type of activity for each age group (i.e., while younger drivers mostly used an electronic device, older drivers tended to converse). There were also significant differences between the two age groups and between the two notification intervals on various driving performance measures. Older drivers benefited more than younger drivers from the longer interval in terms of response time to notifications. Voluntary engagement in non-driving-related activities did not impair takeover performance in general, although there was a trend of older drivers who were more engaged in non-driving-related activities braking harder than those with low activity-engagement during the takeover.

Menthol disrupts nicotine's psychostimulant properties in an age and sex-dependent manner in C57BL/6J mice

Menthol is a commonly used flavorant in tobacco and e-cigarettes, and could contribute to nicotine sensitivity. To understand how menthol could contribute to nicotine intake and addiction, it is important to determine whether specific mechanisms related to sex and age could underlie behavioral changes induced by menthol-laced nicotinic products. Using a validated paradigm of nicotine-dependent locomotor stimulation, adolescent and adult C57BL/6J mice of both sexes were exposed to nicotine, or nicotine laced with menthol, as their sole source of fluid, and psychostimulant effects were evaluated by recording home cage locomotor activity for ten days. Nicotine and cotinine blood levels were measured following exposure. Results show an interaction between treatment, age, and sex on liquid consumption, indicating that mice responded differently to menthol and nicotine based on their age and sex. Adult male mice greatly increased their nicotine intake when given menthol. In female mice of both age groups, menthol did not have this effect. Despite an increase in nicotine intake promoted by menthol, adult male mice showed a significant decrease in locomotion, suggesting that menthol blunted nicotine-induced psychostimulation. This behavioral response to menthol was not detected in adolescent mice of either sex. These data confirm that menthol is more than a flavorant, and can influence both nicotine intake and its psychostimulant effects. These results suggest that age- and sex-dependent mechanisms could underlie menthol's influence on nicotine intake and that studies including adolescent and adult menthol smokers of both sexes are warranted.

Sex and age differences in the expression of liver microRNAs during the life span of F344 rats

Background

Physiological factors such as age and sex have been shown to be risk factors for adverse effects in the liver, including liver diseases and drug-induced liver injury. Previously, we have reported age- and sex-related significant differences in hepatic basal gene expression in rats during the life span that may be related to susceptibility to such adverse effects. However, the underlying mechanisms of the gene expression changes were not fully understood. In recent years, increasing evidence for epigenetic mechanisms of gene regulation has fueled interest in the role of microRNAs (miRNAs) in toxicogenomics and biomarker discovery. We therefore proposed that significant age and sex differences exist in baseline liver miRNA expression, and that comprehensive profiling of miRNAs will provide insights into the epigenetic regulation of gene expression in rat liver.

Methods

To address this, liver tissues from male and female F344 rats were examined at 2, 5, 6, 8, 15, 21, 52, 78, and 104 weeks of age for the expression of 677 unique miRNAs. Following data processing, predictive pathway analysis was performed on selected miRNAs that exhibited prominent age and/or sex differences in expression.

Results

Of the 314 miRNAs found to be expressed, 214 were differentially expressed; 65 and 212 miRNAs showed significant (false discovery rate (FDR) <5% and ≥1.5-fold change) sex- and age-related differences in expression, respectively. Thirty-eight miRNAs showed 2-week-specific expression, of which 31 miRNAs were found to be encoded within the Dlk1-Dio3 cluster located on chromosome 6. This cluster has been associated with tissue proliferation and differentiation, and liver energy homeostasis in postnatal development. Predictive pathway analysis linked sex-biased miRNA expression with sexually dimorphic molecular functions and toxicological functions that may reflect sex differences in hepatic physiology and disease. The expression of miRNAs (miR-18a, miR-99a, and miR-203, miR-451) was also found to associate with specific sexually dimorphic hepatic histopathology. The expression of miRNAs involved in regulating cell death, cell proliferation, and cell cycle was found to change as the rats matured from adult to old age.

Conclusions

Overall, significant age- and sex-related differences in liver miRNA expression were identified and linked to histopathological findings and predicted functional pathways that may underlie susceptibilities to liver toxicity and disease.

Electronic supplementary material

The online version of this article (doi:10.1186/s13293-017-0127-9) contains supplementary material, which is available to authorized users.

Myocardial Rotation and Torsion in Child Growth

Background

The speckle tracking echocardiography can benefit to assess the regional myocardial deformations. Although, previous reports suggested no significant change in left ventricular (LV) torsion with aging, there are certain differences in LV rotation at the base and apex. The purpose of this study was to evaluate the change and relationship of LV rotation for torsion with aging in children.

Methods

Forty healthy children were recruited and divided into two groups of twenty based on whether the children were preschool-age (2–6 years of age) or school-age (7–12 years of age). After obtaining conventional echocardiographic data, apical and basal short axis rotation were assessed with speckle tracking echocardiography. LV rotation in the basal and apical short axis planes was determined using six myocardial segments along the central axis.

Results

Apical and basal LV rotation did not show the statistical difference with increased age between preschool- and school-age children. Apical radial strain showed significant higher values in preschool-age children, especially at the anterior (52.8 ± 17.4% vs. 34.7 ± 23.2%, p < 0.02), lateral (55.8 ± 20.4% vs. 36.1 ± 22.7%, p < 0.02), and posterior segments (57.1 ± 17.6% vs. 38.5 ± 21.7%, p < 0.01). The torsion values did not demonstrate the statistical difference between two groups.

Conclusion

This study revealed the tendency of higher rotation values in preschool-age children than in school-age children. The lesser values of rotation and torsion with increased age during childhood warrant further investigation.

Effect of age on the pharmacokinetics of polymorphic nimodipine in rats after oral administration

The previous investigation has proved that their existed pharmacokinetic difference between the different crystal forms of the polymorphic drugs after oral administration. However, no systemic investigations have been made on the change of this pharmacokinetic difference, resulted either from the physiological or from the pathological factors. In this paper, we used polymorphic nimodipine (Nim) as a model drug and investigated the effect of age difference (2- and 9-month old) on the pharmacokinetics after oral delivery in rats. As the results shown, for L-form of Nim (L-Nim), the AUC_0-24 h in 2-month-old rats was 343.68±47.15 ng·h/mL, which is 23.36% higher than that in 9-month-old rats. For H-form of Nim (H-Nim), the AUC_0-24 h in 2-month-old rats was 140.91±19.47 ng·h/mL, which is 54.64% higher than that in 9-month-old rats. The AUC_0-24 h ratio between H-Nim and L-Nim was 2.44 in 2-month-old rats and 3.06 in 9-month-old rats. Since age difference could result in unparallelled change of the absorption and bioavailability of the polymorphic drugs, the results in this experiment are of value for further investigation of crystal form selection in clinical trials and rational clinical application of the polymorphic drugs.

Societies' tightness moderates age differences in perceived justifiability of morally debatable behaviors

Research on age differences in moral judgment tends to focus on children and adolescents. The current study examined age differences in perceived justifiability of morally debatable behaviors across adulthood cross-culturally. A large cross-cultural dataset consisting of 25,142 individuals of varying ages (15-95 years old) from 20 societies was drawn from the World Values Survey. Hierarchical linear modeling was used to test age differences in perceived justifiability of morally debatable behaviors on issues pertaining to honesty and fairness as well as the moderating effect of societies' tightness. Across societies, older adults judged moral transgression less leniently than did younger adults. However, this pattern was moderated by the societies' tightness, such that age was a stronger predictor of perceived justifiability of morally debatable behaviors in loose societies relative to tight societies. The current study highlights the importance of examining moral development from the lifespan development perspective. The findings may illuminate potential mechanisms for inter-generational misunderstanding about moral issues.

Cognitive function and associated factors among older people in Taiwan: age and sex differences

PURPOSE

The aim of this study was to examine cognitive function and the risk and the protective factors by age and sex among Taiwanese older people.

METHODS

The data were from a nation-representative panel of older people in Taiwan. The participants completing both the 2003 and 2007 waves were included for analysis in this study (n=3228). Descriptive analysis and generalized linear model were applied, and the samples were stratified by age groups and by sex.

RESULTS

The factors related to higher cognitive function at the intercept included being younger, male, higher education, and doing unpaid work. At the time slope, the age effect and physical function difficulties would reduce the cognitive function across time, while education and providing informational support would increase the cognitive function across time. There were age- and sex-differences in the factors related to cognitive function, particularly on the working status and social participation.

CONCLUSION

Different health promotion strategies to target these populations should be accordingly developed.