Examining the Association Between Rurality and Positive Childhood Experiences Among a National Sample

Purpose The present study examines the association between rurality and positive childhood experiences (PCEs) among children and adolescents across all 50 states and the District of Columbia. Recent work has quantified the prevalence of PCEs at the national level, but these studies have been based on public use data files, which lack rurality information for 19 states. Methods Data for this cross-sectional analysis were drawn from 2016 to 2018 National Survey of Children\u27s Health (NSCH), using the full data set with restricted geographic data (n = 63,000). Descriptive statistics and bivariate analyses were used to calculate proportions and unadjusted associations. Multivariable regression models were used to examine the association between residence and the PCEs that were significant in the bivariate analyses. Findings Rural children were more likely than urban children to be reported as having PCEs: volunteering in their community (aOR 1.29; 95% CI 1.18-1.42), having a guiding mentor (aOR 1.75; 95% CI 1.45-2.10), residing in a safe neighborhood (aOR 1.97; 95% CI 1.54-2.53), and residing in a supportive neighborhood (aOR 1.10; 95% CI 1.01-1.20) than urban children. Conclusions The assessment of rural-urban differences in PCEs using the full NSCH is a unique opportunity to quantify exposure to PCEs. Given the higher baseline rate of PCEs in rural than urban children, programs to increase opportunities for PCEs in urban communities are warranted. Future research should delve further into whether these PCEs translate to better mental health outcomes in rural children

Cognitive Complaints in Age-Related Chronic Conditions: A Systematic Review

Introduction Cognitive complaints in older adults may be indicative of progressive cognitive decline including Alzheimer’s disease (AD), but also occur in other age-related chronic conditions, complicating identification of early AD symptoms. To better understand cognitive complaints in aging, we systematically reviewed the evidence to determine their prevalence and characterization among older adults with the most common age-related chronic conditions. Methods This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the review protocol was prospectively registered with PROSPERO (ID: CRD42020153147). Searches were conducted in PubMed, CINAHL, PsycINFO, Web of Science, and ProQuest Dissertations & Theses A&I in June 2020. Two members of the review team independently determined article eligibility for inclusion and conducted quality appraisal. A narrative synthesis of results was used to integrate findings across studies and draw conclusions regarding the strength of the evidence in each chronic condition category. Results Thirty-seven articles met eligibility criteria and were included in the review. Conditions represented were diabetes (n = 20), heart disease (n = 13), hypertension (n = 10), chronic lung disease (n = 5), arthritis (n = 4), heart failure (n = 2), and hyperlipidemia (n = 2). In addition, 16 studies included a measure of multimorbidity. Overall, there was a higher prevalence of cognitive complaints in individuals with higher multimorbidity, including a potential dosedependent relationship. Findings for specific conditions were inconsistent, but there is evidence to suggest that cross-sectionally, older adults with diabetes, heart disease, chronic lung disease, and arthritis have more cognitive complaints than those without these conditions. Conclusion There is strong evidence demonstrating that cognitive complaints are more common in older adults with higher multimorbidity, but little research examining these associations over time. Improving our understanding of the longitudinal trajectory of cognitive complaints, multimorbidity, and objective cognition in older age is an important area for future research