Sex/gender and socioeconomic differences in modifiable risk factors for dementia

Both sex/gender and socioeconomic differences have been reported in the prevalence of modifiable risk factors for dementia. However, it remains unclear whether the associations between modifiable risk factors for dementia and incident dementia differ by sex/gender or socioeconomic status. This study aimed to investigate sex/gender and socioeconomic differences in the associations of modifiable risk factors with incident dementia using a life-course perspective. We used data from the English Longitudinal Study of Ageing (2008/2009 to 2018/2019). A total of 8,941 individuals were included [mean (standard deviation) age, 66.1 ± 9.8 years; 4,935 (55.2%) were women]. No overall sex/gender difference in dementia risk was found. Dementia risk was higher among those who experienced childhood deprivation [hazard ratio (HR) = 1.51 (1.17; 1.96)], lower occupational attainment [HR low versus high = 1.60 (1.23; 2.09) and HR medium versus high = 1.53 (1.15; 2.06)], and low wealth [HR low versus high = 1.63 (1.26; 2.12)]. Though different associations were found among the subgroups, there might be a sex/gender difference in dementia risk only for low cognitive activity, suggesting a higher risk for women [HR = 2.61 (1.89; 3.60)] compared to men [HR = 1.73 (1.20; 2.49)]. No consistent socioeconomic differences in modifiable dementia risk were found. A population-based approach that tackles inequalities in dementia risk profiles directly may be more effective than individual approaches in dementia prevention

The association between adolescent mental health and oral health behavior: The Luxembourg Health Behavior in School-Aged Children study

Oral health remains a global health problem. Mental health has been linked to oral health behavior. However, studies among adolescents in high-income countries are limited. This study aimed to investigate the association between adolescent mental health and well-being with regular toothbrushing. We used data from the 2018 Luxembourg Health Behavior in School-Aged Children study (n = 7,561; n = 3,896 [51.5%] girls; mean [standard deviation] age = 14.9 [2.1] years). Multiple logistic regression analyses were performed to assess the associations of self-reported stress levels, life-satisfaction, somatic health complaints, and psychological health complaints with regular toothbrushing (≥2 daily). Analyses were adjusted for gender, age, family affluence, family structure, migration background, daily sugar consumption, smoking behavior, and general health. 70.5% of the adolescents regularly brushed their teeth. Adolescents who reported higher levels of stress (odds ratio [OR], 95% confidence interval [CI]; 0.97 [0.95;0.99] per one-point increase), low life-satisfaction (OR = 0.92 [0.89;0.95] per one-point increase), and psychological health complaints (OR = 0.95 [0.91;0.99] per complaint) were less likely to regularly brush their teeth. No association was found between somatic health complaints and regular toothbrushing (OR = 1.00 [0.94;1.06] per complaint). Adolescents with poor mental health and well-being are less likely to regularly brush their teeth and may have an increased risk for oral diseases. Interventions focused on lifestyle modification in adolescents with mental health problems should include regular toothbrushing to prevent dental caries and other oral diseases

Risk and protective factors for cognitive decline in Brazilian lower educated older adults: A 15-year follow-up study using group-based trajectory modelling.

peer reviewed[en] BACKGROUND: Patterns of cognitive change and modifiable factors for cognitive decline versus stable cognitive trajectories have rarely been described in lower-educated older adults. OBJECTIVES: We aimed to identify long-term trajectories of cognitive functioning and possible factors associated with cognitive decline. DESIGN AND PARTICIPANTS: We used data from 1,042 adults aged ≥ 60 participating in the Health, Welfare and Aging Study (SABE), São Paulo, Brazil, without cognitive impairment at baseline. Data were collected across four waves (2000-2015). Group-based trajectory modelling was used to identify cognitive trajectories. Associations with socioeconomic variables, childhood background, lifestyle, and cardiovascular risk factors were explored using weighted multinomial logistic regressions. MEASUREMENTS: The abbreviated Mini-Mental State Examination was used to measure cognition. RESULTS: Three cognitive trajectories were identified: stable (n= 754, 68.6%), mild-decline (n= 183, 20.8%), and strong-decline (n= 105, 10.7%). At baseline, respondents in the strong-decline group were more likely to be older than those with stable and mild-decline trajectories. Furthermore, participants in both the mild and strong-decline groups were more likely to have no schooling, be divorced/separated, receive less than 4 monthly wages, and be underweight (BMI < 18.5) compared to the stable group. Finally, the mild-decline group was more likely to have lived in rural areas during childhood than participants located in a stable trajectory. CONCLUSIONS: Our findings suggest that interventions to reduce cognitive decline for low-educated older adults might include strategies addressing inequalities and improving modifiable risk factor burden.3. Good health and well-being10. Reduced inequalitie

Contributions of modifiable risk factors to increased dementia risk in depression

BackgroundIndividuals with depression have an increased dementia risk, which might be due to modifiable risk factors for dementia. This study investigated the extent to which the increased risk for dementia in depression is explained by modifiable dementia risk factors. MethodsWe used data from the English Longitudinal Study of Ageing (2008-2009 to 2018-2019), a prospective cohort study. A total of 7460 individuals were included [mean(standard deviation) age, 65.7 +/- 9.4 years; 3915(54.7%) were women]. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale-8 (score &gt;= 3) or self-reported doctor's diagnosis. Ten modifiable risk factors for dementia were combined in the 'LIfestyle for BRAin health' (LIBRA) score. Dementia was determined by physician diagnosis, self-reported Alzheimer's disease or the shortened version of the Informant Questionnaire on Cognitive Decline in the Elderly (average score &gt;= 3.38). Structural equation modelling was used to test mediation of LIBRA score. ResultsDuring 61 311 person-years, 306 individuals (4.1%) developed dementia. Participants aged 50-70 years with depressive symptoms had higher LIBRA scores [difference(s.e.) = 1.15(0.10)] and a 3.59 times increased dementia risk [HR(95% CI) = 3.59(2.20-5.84)], adjusted for age, sex, education, wealth and clustering at the household level. In total, 10.4% of the dementia risk was mediated by differences in LIBRA score [indirect effect: HR = 1.14(1.03-1.26)], while 89.6% was attributed to a direct effect of depressive symptoms on dementia risk [direct effect: HR = 3.14(2.20-5.84)]. ConclusionsModifiable dementia risk factors can be important targets for the prevention of dementia in individuals with depressive symptoms during midlife. Yet, effect sizes are small and other aetiological pathways likely exist

Problematische Nutzung sozialer Medien von Kindern und Jugendlichen im Schulalter in Luxembourg – Ergebnisse der HBSC Umfrage 2018

Insbesondere unter Jugendlichen hat die Nutzung sozialer Medien in den letzten Jahren zugenommen. Wenn die Nutzung Merkmale einer Sucht aufweist (z.B. Gewöhnung und sozialer Rückzug), dann wird von einer problematischen Nutzung sozialer Medien gesprochen – im Folgenden PSMU genannt. Dieser Kurzbericht gibt einen Überblick darüber, wie häufig PSMU unter luxemburgischen Schülern vorkommt und welche Merkmale mit einem höheren Risiko für PSMU einhergehen. Dazu wurden Daten der luxemburgischen Health Behavior in School-aged Children (HBSC)-Studie 2018 ausgewertet, an der 8 687 Jugendliche im Alter von 11 bis 18 Jahren teilnahmen. Laut dieser Umfrage liegt die Häufigkeit von PSMU in dieser Altersgruppe bei 5,9 %. Eine Reihe von Merkmalen aus den Bereichen Soziodemografie, soziale Unterstützung, Wohlbefinden und Mediennutzung wurden als potenzielle Risikofaktoren untersucht. PSMU tritt häufiger bei Mädchen und jüngeren Schülern sowie bei Schülern mit Migrationshintergrund auf. Bei Schülern, die bei beiden Elternteilen aufwachsen, ist PSMU seltener im Vergleich zu Schülern, die bei Alleinerziehenden oder in anderen Familienkonstellationen aufwachsen. Ein Vergleich der Risikofaktoren hat ergeben, dass das Alter, Cybermobbing, Stress, psychosomatische Beschwerden, eine Vorliebe für Online-Interaktion und die Intensität der Kommunikation über elektronische Medien die wichtigsten Risikofaktoren sind. Das Risiko für einen problematischen Umgang mit sozialen Medien ist somit höher bei jüngeren Schülern; Schülern, die andere online mobben; gestressten Schülern; Schülern mit häufigen psychosomatischen Beschwerden; Schülern, die Online-Kommunikation gegenüber einer Kommunikation in der realen Welt vorziehen sowie Schülern, die elektronische Medien generell häufig nutzen. Speziell zur Prävention von PSMU haben sich noch keine Maßnahmen etabliert, aber es gibt gut erforschte Maßnahmen zur Prävention von Internetsucht, die sich in abgewandelter Form möglicherweise auch bei PSMU eignen

The association of white matter connectivity with prevalence, incidence and course of depressive symptoms: The Maastricht Study

BACKGROUND: Altered white matter brain connectivity has been linked to depression. The aim of this study was to investigate the association of markers of white matter connectivity with prevalence, incidence and course of depressive symptoms. METHODS: Markers of white matter connectivity (node degree, clustering coefficient, local efficiency, characteristic path length, and global efficiency) were assessed at baseline by 3 T MRI in the population-based Maastricht Study (n = 4866; mean ± standard deviation age 59.6 ± 8.5 years, 49.0% women; 17 406 person-years of follow-up). Depressive symptoms (9-item Patient Health Questionnaire; PHQ-9) were assessed at baseline and annually over seven years of follow-up. Major depressive disorder (MDD) was assessed with the Mini-International Neuropsychiatric Interview at baseline only. We used negative binominal, logistic and Cox regression analyses, and adjusted for demographic, cardiovascular, and lifestyle risk factors. RESULTS: A lower global average node degree at baseline was associated with the prevalence and persistence of clinically relevant depressive symptoms [PHQ-9 ⩾ 10; OR (95% confidence interval) per standard deviation = 1.21 (1.05-1.39) and OR = 1.21 (1.02-1.44), respectively], after full adjustment. On the contrary, no associations were found of global average node degree with the MDD at baseline [OR 1.12 (0.94-1.32) nor incidence or remission of clinically relevant depressive symptoms [HR = 1.05 (0.95-1.17) and OR 1.08 (0.83-1.41), respectively]. Other connectivity measures of white matter organization were not associated with depression. CONCLUSIONS: Our findings suggest that fewer white matter connections may contribute to prevalent depressive symptoms and its persistence but not to incident depression. Future studies are needed to replicate our findings

Cross-national time trends in adolescent body weight perception and the explanatory role of overweight/obesity prevalence

ABSTRACTIntroduction Body weight perception (BWP) is associated with health behaviors. Current evidence points to an increase over time in both actual and perceived weight status among adolescents, however there is limited evidence on time trends in BWP in cross-national samples of adolescents. Therefore, the aims of this study were to examine time trends in BWP between 2002 and 2018 among adolescents from 41 countries and regions, including gender and country differences and to explore the role of changes over time in country-level overweight/obesity prevalence in these trends.Methods Data were used from five cycles (2002, 2006, 2010, 2014, 2018) of the repeated cross-sectional Health Behavior in School-Aged Children (HBSC) study (n = 746,121; mean±standard deviation age 13.7 ± 1.6 years, 51.0% girls). Multilevel logistic models estimated cross-national linear time trends in adolescent BWP (correct perception, underestimation, or overestimation), adjusted for gender, age, and family affluence. Next, we tested whether country-level changes over time overweight/obesity prevalence could explain these trends in BWP among adolescents.Results Correct weight perception increased over time among girls, while it decreased among boys. Underestimation of weight status increased, and overestimation of weight status decreased over time among both genders, with stronger trends for girls. Furthermore, country differences in trends in both BWP and overweight/obesity were found. Changes over time in country-level overweight/obesity prevalence could not explain these trends.Conclusion The linear increase over time in correct weight perception and the decrease in overestimation may have a positive effect on unhealthy weight reduction behaviors among adolescents. However, the increase in underestimation could signal a need for interventions to strengthen correct weight perception among adolescents. Several implications for policy and practice are discussed