Development of a healthy ageing index in Latin American countries - a 10/66 dementia research group population-based study.

BACKGROUND: Our population is ageing and in 2050 more than one out of five people will be 60 years or older; 80% of whom will be living in a low-and-middle income country. Living longer does not entail living healthier; however, there is not a widely accepted measure of healthy ageing hampering policy and research. The World Health Organization defines healthy ageing as the process of developing and maintaining functional ability that will enable well-being in older age. We aimed to create a healthy ageing index (HAI) in a subset of six low-and-middle income countries, part of the 10/66 study, by using items of functional ability and intrinsic capacity. METHODS: The study sample included residents 65-years old and over (n = 12,865) from catchment area sites in Cuba, Dominican Republic, Peru, Venezuela, Mexico and Puerto Rico. Items were collected by interviewing participants or key informants between 2003 and 2010. Two-stage factor analysis was employed and we compared one-factor, second-order and bifactor models. The psychometric properties of the index, including reliability, replicability, unidimensionality and concurrent convergent validity as well as measurement invariance per ethnic group and gender were further examined in the best fit model. RESULTS: The bifactor model displayed superior model fit statistics supporting that a general factor underlies the various items but other subdomain factors are also needed. The HAI indicated excellent reliability (ω = 0.96, ωΗ = 0.84), replicability (H = 0.96), some support for unidimensionality (Explained Common Variance = 0.65) and some concurrent convergent validity with self-rated health. Scalar measurement invariance per ethnic group and gender was supported. CONCLUSIONS: A HAI with excellent psychometric properties was created by using items of functional ability and intrinsic capacity in a subset of six low-and-middle income countries. Further research is needed to explore sub-population differences and to validate this index to other cultural settings

Dietary fat intake and risk of disabling hearing impairment: a prospective population-based cohort study

Purpose: To examine the associations of specific dietary fats with the risk of disabling hearing impairment in the UK Biobank study. Methods: This cohort study investigated 105,592 participants (47,308 men and 58,284 women) aged ≥ 40 years. Participants completed a minimum of one valid 24-h recall (Oxford Web-Q). Dietary intake of total fatty acids, polyunsaturated fatty acids (PUFA), saturated fatty acids (SFA), and monounsaturated fatty acids (MUFA) was assessed at baseline. Functional auditory capacity was measured with a digit triplet test (DTT), and disabling hearing impairment was defined as a speech reception threshold in noise > − 3.5 dB in any physical exam performed during the follow-up. Results: Over a median follow-up of 3.2 (SD: 2.1) years, 832 men and 872 women developed disabling hearing impairment. After adjustment for potential confounders, including lifestyles, exposure to high-intensity sounds, ototoxic medication and comorbidity, the hazard ratios (HRs), and 95% confidence interval (CI) of disabling hearing function, comparing extreme quintiles of intakes were 0.91 (0.71–1.17) for total fat, 1.09 (0.83–1.44) for PUFA, 0.85 (0.64–1.13) for SFA and 1.01 (0.74–1.36) for MUFA among men. Among women, HRs comparing extreme intakes were 0.98 (0.78–1.24) for total fat, 0.69 (0.53–0.91) for PUFA, 1.26 (0.96–1.65) for SFA, and 0.91 (0.68–1.23) for MUFA. Replacing 5% of energy intake from SFA with an equivalent energy from PUFA was associated with 25% risk reduction (HR: 0.75; 95% CI: 0.74–0.77) among women. Conclusions: PUFA intake was associated with decreased risk of disabling hearing function in women, but not in menUK Biobank was established by the Wellcome Trust medical charity, Medical Research Council, Department of Health, Scottish Government and the Northwest Regional Development Agency. It has also had funding from the Welsh Government, British Heart Foundation, Cancer Research UK, and Diabetes UK. This work was supported by FIS grants 19/319 and 20/1040, (Instituto de Salud Carlos III, State Secretary of R + D + I and FEDER/FSE

Relationship between subjective well-being and healthy lifestyle behaviours in older adults: a longitudinal study

Objectives: People who report better subjective well-being tend to be healthier in their daily behaviours. The objective of this study is to assess whether different components of subjective well-being are prospectively associated with different healthy lifestyle behaviours and to assess whether these associations differ by age. Method: A total of 1,892 participants aged 50+ living in Spain were interviewed in 2011–12 and 2014–15. Life satisfaction was measured with the Cantril Self-Anchoring Striving Scale. Positive and negative affect were assessed using the Day Reconstruction Method. Physical activity was assessed with the Global Physical Activity Questionnaire version 2. The remaining healthy lifestyle behaviours were self-reported. Generalised Estimating Equations (GEE) models were run. Results: Not having a heavy episodic alcohol drinking was the healthy lifestyle behaviour most fulfilled (97.97%), whereas the intake of five or more fruits and vegetables was the least followed (33.12%). GEE models conducted over the 50–64 and the 65+ age groups showed that a higher life satisfaction was significantly related to a higher physical activity in both groups. Relationships between a higher negative affect and presenting a lower level of physical activity, and a higher positive affect and following the right consumption of fruits and vegetables and being a non-daily smoker, were only found in the older group. Conclusion: The relationship between subjective well-being and healthy lifestyle behaviours was found fundamentally in those aged 65+ years. Interventions focused on incrementing subjective well-being would have an impact on keeping a healthy lifestyle and, therefore, on reducing morbidity and mortalityEU Horizon 2020 Framework Programme for Research and Innovation (635316) European Community’s Seventh Framework Programme (FP7/2007-2013, 223071) Spanish Ministry of Science and Innovation ACI-Promociona (ACI2009-1010) Instituto de Salud Carlos III-FIS (PS09/00295, PS09/01845, PI12/01490, PI13/00059, PI16/00218, PI16/01073) European Union European Regional Development Fund (ERDF) “A Way to Build Europe” Instituto de Salud Carlos III Centro de Investigación Biomédica en Red de Salud Mental “Contratos predoctorales para Formación de Personal Investigador, FPI-UAM”, Universidad Autónoma de Madrid, Spain Ayudas para la Formación de Profesorado Universitario (FPU15/02634) Ajuts per a la Incorporació de Científics i Tecnòleg

Positive affect is inversely associated with mortality in individuals without depression

Background: Some studies have analyzed the relation between well-being and mortality but none of them have attempted to disentangle the differential influence that positive affect, negative affect, and evaluative well-being might have on mortality using a longitudinal design in the general population and measuring independently and accurately each component of well-being. The aim of the present study is to assess the association of these well-being components with mortality after adjusting for health and other lifestyle factors and to analyze whether this association is different in people with and without depression. Methods: A nationally representative sample of 4753 people from Spain was followed up after 3 years. Analyses were performed with Cox regression models among the total sample and separately in people with and without depression. Results: In the analyses adjusted for age, sex, and years of education, all three well-being variables showed separately a statistically significant association with mortality. However, after adjustment for health status and other confounders including the other well-being components, only positive affect remained as marginally associated with a decreased risk of mortality in the overall sample [HR = 0.87; 95% CI = 0.73-1.03], in particular among individuals without depression [HR = 0.82; 95% CI = 0.68-0.99]. Conclusion: Positive affect is inversely associated with mortality in individuals without depression. Future research should focus on assessing interventions associated with a higher level of positive affect.The research leading to these results has received funding from the European Union Horizon 2020 Framework Programme for Research and Innovation under grant agreement 635316 (ATHLOS Project), from the European Community’s Seventh Framework Programme (FP7/2007-2013) under grant agreement number 223071 (COURAGE in Europe), from the Spanish Ministry of Science and Innovation ACI- Promociona (ACI2009-1010), from the Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) Mental Health and Disability Instruments Library Platform, and from the Instituto de Salud Carlos III-FIS research grants PS09/00295, PS09/01845, PI12/01490, and PI13/00059. Projects PI12/01490 and PI13/00059 have been co-funded by the European Union European Regional Development Fund (ERDF) “A Way to Build Europe.” The study was supported by the Instituto de Salud Carlos III Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM). NMM is supported by the programme “Contratos predoctorales para Formación de Personal Investigador, FPI-UAM,” Universidad Autónoma de Madrid, Spai

Multi-country evaluation of affective experience: validation of an abbreviated version of the day reconstruction method in seven countries

Background The Day Reconstruction Method (DRM) was developed to assess affective states as measures of experienced well-being. The present study aimed to validate an abbreviated version of the DRM in a representative sample of the population in seven countries (China, Ghana, India, Mexico, Russia, South Africa, and Spain), and to examine whether there are country differences in affect and in the relationships among the activities based on the similarity of the affect associated with each of them. Methods Interviews were conducted with 47,222 non-institutionalized adults from seven countries, using an abbreviated version of the DRM. A cluster analysis was carried out to classify activities on the basis of the similarity of the associated affect. In each country, the factorial structure of the affect adjectives was tested through Confirmatory Factor Analysis. Internal consistency and construct validity were also assessed. Moreover, the differences in affect across countries and the diurnal cycles of affect were evaluated. Results The DRM showed adequate psychometric properties regarding reliability and construct validity in all countries. Respondents from Ghana and South Africa reported more positive net affect whereas Indian respondents reported less positive net affect. Most of the countries showed a similar diurnal variation of affect, which tended to improve throughout the day. Conclusions The results show that this abbreviated version of the DRM is a useful tool for multi-country evaluation of experienced well-being

Differential Impact of Transient and Chronic Loneliness on Health Status. A Longitudinal Study

Loneliness is associated with worse health status out-comes. Yet, the present study is one of the first to identify howpatterns of loneliness (transient and chronic) are associated withhealth over time.Design:A total of 2,390 individuals were inter-viewed in 2011–2012 and 2014–2015 in a follow-up study con-ducted over a nationally representative sample of Spain. Afterconfirming a longitudinal relationship between loneliness andhealth status, a growth curve mixture modeling was used toexamine health trajectories.Main outcome measures:The three-item UCLA Loneliness Scale was used to assess loneliness. Healthstatus was measured with self-reported questions regarding tendomains (vision, mobility, and self-care, among others), and sevenmeasured tests (including grip strength, walking speed and imme-diate and delayed verbal recall).Results:A quarter of participantswere lonely at baseline. Both the group of transient and chronicloneliness showed a negative significant relationship with healthstatus at follow-up, (b¼ 0.063 andb¼ 0.075 respectively,p<0.001). Nevertheless, the health status did not change acrosstime in any group.Conclusion:People experiencing chronic lone-liness had the worst health status. Different patterns of lonelinesscould benefit from the appropriate interventionsThis work was supported by the EU Horizon 2020 Framework Programme for Research andInnovation [635316 (ATHLOS Project)], by the European Community’s Seventh FrameworkProgramme (FP7/2007-2013) under agreement number 223071 (COURAGE in Europe), by theSpanish Ministry of Science and Innovation ACI-Promociona (ACI2009-1010), and by the Institutode Salud Carlos III-FIS research grants [PS09/00295, PS09/01845, PI12/01490, PI13/00059, PI16/00218 and PI16/01073]. Projects PI12/01490, PI13/00059, PI16/00218 and PI16/01073 have beenco-funded by the European Union European Regional Development Fund (ERDF)‘A Way toBuild Europe’. The work was also supported by the Instituto de Salud Carlos III Centro deInvestigaci on Biom edica en Red de Salud Mental (CIBERSAM). ST is supported by theFoundation for Education and European Culture (IPEP), the Sara Borrell postdoctoral programme(reference no. CD15/00019 from the Instituto de Salud Carlos III (ISCIII–Spain) and the Fondo190N. MART IN-MAR IA ET AL.Europeo de Desarrollo Regional (FEDER). NMM is supported by the programme‘Contratos pre-doctorales para Formaci on de Personal Investigador, FPI-UAM’, Universidad Aut onoma deMadrid, Spai

Social determinants, health status and 10-year mortality among 10,906 older adults from the English longitudinal study of aging: the ATHLOS project

BACKGROUND: In either rich or poor countries, people's health widely depends on the social conditions in which they live and work - the social determinants of health. The aim of the present work was to explore the association of educational and financial status with healthy aging and mortality. METHODS: Data from the English Longitudinal Study of Aging (ELSA) were studied (n = 10,906 participants, 64 ± 11 years, 55% women). A set of 45 self-reported health items and measured tests were used to generate a latent health metric reflecting levels of functioning referred to as health metric (higher values indicated better health status). Overall mortality after 10-years of follow-up (2002-2012) was recorded. RESULTS: Both education and household wealth over time were positively associated with the health metric (p < 0.001) and negatively with overall mortality (p < 0.001). Lifestyle behaviors (i.e., physical activity, smoking habits and alcohol consumption) mediated the effect of education and household wealth on the health metric and the latter mediated their effect on overall mortality. CONCLUSIONS: In conclusion, reducing socioeconomic disparities in health by improving the access to education and by providing financial opportunities should be among the priorities in improving the health of older adults. KEYWORDS: Education; Financial status; Health; Healthy aging; Mortality; Social determinants; Socioeconomi

Consumption of food fried in olive oil and unhealthy aging in a Mediterranean country

Fried food has usually shown neutral or detrimental effects on many chronic diseases, possibly depending on the type of food fried and the frying oil, but its relationship with unhealthy aging is unknown. We examined how changes in fried food consumption over a 3-year period were linked to unhealthy aging over 3 and 6 years. Methods: Prospective cohort study in Spain with 2043 individuals aged ≥60 years, recruited in 2008–2010 and followed-up to 2012 and 2015. Fried food consumption was ascertained with a validated diet history, and unhealthy aging was measured with a 52-item health deficit accumulation index. Results: Compared with participants who reduced fried food consumption, those who increased it showed less deficit accumulation over 3 years (multivariable β [95% confidence interval]: −1.45 [−2.30, −0.61]), but not over 6 years of follow-up. More 3-year deficit accumulation was observed when replacing 100 g/day of fried food with an equal amount of non-fried food (1.48 [0.59, 2.37]); corresponding values in substitution analyses were 2.03 [1.03, 3.03] for fried protein-rich food, 10.76 [5.20, 16.33] for fried eggs, and 2.06 [0.68, 3.43] for fried fish. Also, increased olive oil intake was significantly associated with less 3-year deficit accumulation (total olive oil: −1.14 [−2.07, −0.21], and olive oil with non-fried food: −0.99 [−1.89, −0.08]). Conclusions: In a Mediterranean country, where olive oil is the most common frying medium, increased fried food consumption was associated with delayed unhealthy aging over 3 years of follow-up; consumption of olive oil and fried protein-rich food (especially eggs and fish) were its main drivers. However, these associations did not generally remain after 6 yearsThis work was supported by Instituto de Salud Carlos III, State Secretary of R+D+I, and FEDER/FSE (FIS grants 16/609, 16/1512, 18/287, and 19/319); JPI-A Healthy Diet for a Healthy Life, State Secretary of R+D+I (the Salamander Project, grant number PCIN-2016-145); and the Cátedra de Epidemiología y Control del Riesgo Cardiovascular at UAM (grant number 820024

Determinants of processing speed trajectories among middle aged or older adults, and their association with chronic illnesses: The english longitudinal study of aging

The aim of this study was to identify latent groups of similar trajectories in processing speed through aging, as well as factors that are associated with these trajectories. In the context of the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project, data from the English Longitudinal Study of Aging (ELSA) (n = 12099) were analyzed. Latent groups of similar trajectories in the processing scores as well as their predictors and covariates were investigated, using group-based trajectory models (GBTM). The coefficient estimates for potential group predictors correspond to parameters of multinomial logit functions that are integrated in the model. Potential predictors included sex, level of education, marital status, level of household wealth, level of physical activity, and history of smoking, while time-varying covariates included incidence of cardiovascular disease (CVD), diabetes mellitus, depressive symptoms, and sleep disturbances. Four trajectories were identified and named after their baseline scores and shapes: High (4.4%), Middle/Stable (31.5%), Low/Stable (44.5%), and Low Decline (19.6%). Female sex, higher levels of education, mild level of physical activity, having been married, and higher level of wealth were associated with a higher probability of belonging to any of the higher groups compared to the Low/Decline that was set as reference, while presence of CVD, diabetes mellitus, and depressive symptoms were associated with lower processing speed scores within most trajectories. All the aforementioned factors might be valid targets for interventions to reduce the burden of age-related cognitive impairment.This work was supported by the five-year Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project. The ATHLOS project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 635316.ELSA is supported by NationalInstitute on Aging Grants 2R01AG7644–01A1 and2R01AG017644. BO’s work is supported by the PERIS program 2016–2020 “Ajuts per a la Incorporació de Científics i Tecnòlegs” [grant number SLT006/17/00066], with the support of the Health Department of the Generalitat de Cataluny

Association between speech reception threshold in noise and multimorbidity: The UK Biobank Study

Objective. To investigate the association between hearing function, as approached with the functional auditory capacity, and multimorbidity. Study Design. Cross-sectional study. Setting. The UK Biobank was established from 2006 to 2010 in the United Kingdom. This cross-sectional analysis included 165,524 participants who provided baseline information on hearing function. Methods. Functional auditory capacity was measured with a digit triplet test. Three categories were defined according to the speech reception threshold in noise (SRTn): normal (SRTn < −5.5 dB signal-to-noise ratio [SNR]), insufficient (SRTn ≥ −5.5 to ≤ −3.5 dB SNR) and poor hearing function (SRTn > −3.5 dB SNR). To define multimorbidity, 9 chronic diseases were considered, including chronic obstructive pulmonary disease, dementia, Parkinson's disease, stroke, cancer, depression, osteoarthritis, coronary heart disease, and diabetes; multimorbidity was defined as the coexistence of 2 or more in the same individual. Analyses were conducted using logistic models adjusted for relevant confounders. Results. Among the study participants, 54.5% were women, and the mean (range) age was 56.7 (39-72) years. The prevalence of insufficient and poor hearing function and multimorbidity was 13% and 13.2%, respectively. In comparison with having a normal SRTn, the odds ratio (95% confidence interval) of multimorbidity associated with insufficient SRTn was 1.13 (1.08- 1.18), and with poor SRTn was 1.25 (1.14-1.37). Conclusion. Insufficient and poor hearing function was associated with multimorbidity. This association suggests common biological pathways for many of the considered morbiditiesThis work was supported by Instituto de Salud Carlos III through the FIS project 20/01040 (Instituto de Salud Carlos III, State Secretary of R + D + I), and co‐funded by a European Regional Development Fund, “A way of shaping Europe.” Ellen A. Struijk holds a Ramón y Cajal contract (RYC‐ 2021‐031146‐I) from the Ministry of Science, Innovation and Universities and FEDER/FS