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In order to reduce the spread of SARS-CoV-2, much of the US was placed under social distancing guidelines during March 2020. We characterized risk perceptions and adherence to social distancing recommendations in March 2020 among US adults aged 18+ in an online survey with age and gender quotas to match the general US population (N = 713). We used multivariable logistic and linear regression to estimate associations between age (by generational cohort) and these outcomes. The median perceived risk of infection with COVID-19 within the next month was 32%, and 65% of individuals were practicing more social distancing than before the outbreak. Baby Boomers had lower perceived risk than Millennials (-10.6%, 95% CI: -16.2%, -5.0%), yet were more frequently social distancing (OR = 1.64; 95% CI: 1.05, 2.56). Public health outreach should focus on raising compliance with social distancing recommendations, especially among high risk groups. Efforts to address risk perceptions alone may be inadequate.

Information seeking is an important behavior for cancer prevention and control, but inequalities in the communication of information about the disease persist. Conceptual models have suggested that low health literacy is a barrier to information seeking, and that fatalistic beliefs about cancer may be a mediator of this relationship. Cancer fatalism can be described as deterministic thoughts about the external causes of the disease, the inability to prevent it, and the inevitability of death at diagnosis. This study aimed to examine the associations between these constructs and sociodemographic factors, and test a mediation model using the American population-representative Health Information and National Trends Survey (HINTS 4), Cycle 3 (n = 2,657). Approximately one third (34%) of the population failed to answer 2/4 health literacy items correctly (limited health literacy). Many participants agreed with the fatalistic beliefs that it seems like everything causes cancer (66%), that one cannot do much to lower his or her chances of getting cancer (29%), and that thinking about cancer makes one automatically think about death (58%). More than half of the population had “ever” sought information about cancer (53%). In analyses adjusted for sociodemographic characteristics and family cancer history, people with limited health literacy were less likely to have ever sought cancer information (odds ratio [OR] = 0.63; 0.42-0.95) and more frequently endorsed the belief that “there’s not much you can do . . .” (OR = 1.61; 1.05-2.47). This fatalistic belief partially explained the relationship between health literacy and information seeking in the mediation model (14% mediation). Interventions are needed to address low health literacy and cancer fatalism to increase public interest in cancer-related information.

BackgroundAlthough being employed during midlife is positively associated with cognitive function in later life, little is known with respect to cumulative trajectories or durations of time spent in different kinds of work.MethodsWe investigated the relationships between employment trajectory from ages 31 years to 50 years and cognitive skills at ages 50–78 years among 2521 adults in the US Panel Study of Income Dynamics from 1968 to 2016. Sequence analysis was used to identify prototypical employment trajectories, capturing employment status and high versus lower job skill level at each year of age from 31 years to 50 years. Adjusted and weighted logistic regression was used to estimate relationships between employment trajectory and performance on each of four cognitive tests representing numerical reasoning, verbal reasoning, health literacy and financial literacy. Dose–response relationships between the duration of high-skill employment and cognitive skills were examined.ResultsSeven prototypical employment trajectories were identified, the most common being consistently lower skill employment (44%; 1105/2521). Consistently high-skill and fluctuating skill trajectories were associated with high numerical reasoning scores (OR=1.54, 95% CI 0.99 to 2.40; OR=2.52, 95% CI 1.39 to 4.58, respectively), compared with consistently lower skill employment. There was a dose–response relationship between duration of high-skill employment and numerical reasoning (OR=1.17; 95% CI 1.06 to 1.28), plateauing after approximately 4 years of high-skill employment.ConclusionsSequence analysis of exposure trajectories is a novel method for life course epidemiology that accounts for exposure timing, duration and ordering. Our results using this method indicate that the duration may be more important than the timing of high-skill midlife employment for later-life numerical reasoning skills.

Poor mental health associated with the COVID-19 pandemic may prompt the utilization of various coping behaviors, including alcohol use. We aimed to investigate the relationships between mental health symptomatology and self-reported changes in alcohol consumption at the onset of the pandemic. Data were from the nationwide COVID-19 Coping Study of US adults aged ≥55 in April and May 2020 (n = 6548). We used population-weighted multivariable-adjusted multi-nomial logistic regression models to estimate odds ratios (ORs) for the associations between mental health (of depression, anxiety, and loneliness, each) and self-reported increased alcohol consumption (vs. no change in consumption). One in ten adults (717/6548; 11%) reported an increase in their alcohol consumption in the past week compared to their usual pre-COVID-19 drinking. Mental health symptomatology was associated with increased drinking since the pandemic onset (depression: OR = 2.66, 95% CI: 1.99–3.56; anxiety: OR = 1.80, 95% CI: 1.34–2.42; loneliness: OR = 2.45, 95% CI: 1.83–3.28). Participants who screened positive for all three mental health outcomes were substantially more likely to report increased alcohol consumption since the onset of the pandemic (OR = 3.87, 95% CI: 2.52–5.96, vs. no mental health outcomes). This study demonstrates potentially harmful changes in alcohol intake among middle-to-older aged adults experiencing mental health symptomatology during the early months of the COVID-19 pandemic.

Neutron-star mergers were recently confirmed as sites of rapid-neutron-capture (r-process) nucleosynthesis 1 – 3 . However, in Galactic chemical evolution models, neutron-star mergers alone cannot reproduce the observed element abundance patterns of extremely metal-poor stars, which indicates the existence of other sites of r-process nucleosynthesis 4 – 6 . These sites may be investigated by studying the element abundance patterns of chemically primitive stars in the halo of the Milky Way, because these objects retain the nucleosynthetic signatures of the earliest generation of stars 7 – 13 . Here we report the element abundance pattern of the extremely metal-poor star SMSS J200322.54−114203.3. We observe a large enhancement in r-process elements, with very low overall metallicity. The element abundance pattern is well matched by the yields of a single 25-solar-mass magnetorotational hypernova. Such a hypernova could produce not only the r-process elements, but also light elements during stellar evolution, and iron-peak elements during explosive nuclear burning. Hypernovae are often associated with long-duration γ-ray bursts in the nearby Universe 8 . This connection indicates that similar explosions of fast-spinning strongly magnetized stars occurred during the earliest epochs of star formation in our Galaxy. Observations of an extremely metal-poor star suggest that rapidly rotating massive stars with large magnetic fields were a source of r-process elements in the early Universe.

We examined the relationships between neighborhood characteristics, cumulative genetic risk for Alzheimer's disease (polygenic scores for Alzheimer's disease), and cognitive function using data from the Health and Retirement Study (2008-2020, age > 50). Baseline perceived neighborhood characteristics were combined into a subjective neighborhood disadvantage index. Cognitive function was assessed at baseline and measured biennially over a 10-year follow-up period. Analyses were stratified by genetic ancestry. Cox proportional hazard models analyzed associations between neighborhood characteristics, Alzheimer's disease polygenic scores, and their interactions on cognitive impairment. In the European ancestries sample, a one standard deviation higher score on the subjective neighborhood disadvantage index was associated with a higher hazard of any cognitive impairment (HR:1.09; CI:1.03-1.15), cognitive impairment without dementia (HR:1.08; CI:1.03-1.14), and dementia (HR:1.13; CI:1.03-1.24). Similarly, a one standard deviation increase in Alzheimer's disease polygenic score was associated with a higher risk of cognitive impairment (HR:1.10; CI:1.05-1.16) and cognitive impairment without dementia (HR:1.10; CI:1.05-1.16) but not dementia (HR:1.05; CI:0.96-1.16). No significant interactions were found. Evidence in African ancestries were directionally similar but imprecise and inconclusive due to limited precision and cross-ancestry polygenic score transferability. Subjective neighborhood disadvantage index and Alzheimer's disease polygenic score were independently associated with incident cognitive impairment. Preventing dementia by addressing modifiable risk factors is essential.

PurposeWe investigated the relationships between physical isolation at home during the period when many US states had shelter-in-place orders and subsequent longitudinal trajectories of depression, anxiety, and loneliness in older adults over a 6 month follow-up.MethodsData were from monthly online questionnaires with US adults aged ≥ 55 in the nation-wide COVID-19 Coping Study (April through October 2020, N = 3978). Physical isolation was defined as not leaving home except for essential purposes (0, 1–3, 4–6, and 7 days in the past week), measured at baseline (April–May). Outcomes were depressive symptoms (8-item Center for Epidemiological Studies Depression Scale), anxiety symptoms (5-item Beck Anxiety Inventory), and loneliness (3-item UCLA loneliness scale), measured monthly (April–October). Multivariable, population- and attrition-weighted linear mixed-effects models assessed the relationships between baseline physical isolation with mental health symptoms at baseline and over time.ResultsPhysical isolation (7 days versus 0 days in the past week) was associated with elevated depressive symptoms (adjusted β = 0.85; 95% CI 0.10–1.60), anxiety symptoms (adjusted β = 1.22; 95% CI 0.45–1.98), and loneliness (adjusted β = 1.06; 95% CI 0.51–1.61) at baseline, but not with meaningful rate of change in these mental health outcomes over time. The symptom burden of each mental health outcome increased with increasing past-week frequency of physical isolation.ConclusionDuring the early COVID-19 pandemic, physical isolation was associated with elevated depressive symptoms, anxiety symptoms, and loneliness, which persisted over time. These findings highlight the unique and persistent mental health risks of physical isolation at home under pandemic control measures.

ABSTRACT BACKGROUND Low health literacy is common among aging patients and is a risk factor for morbidity and mortality. We aimed to describe health literacy decline during aging and to investigate the roles of cognitive function and decline in determining health literacy decline. METHODS Data were from 5,256 non-cognitively impaired adults aged ≥ 52 years in the English Longitudinal Study of Ageing. Health literacy was assessed using a four-item reading comprehension assessment of a fictitious medicine label, and cognitive function was assessed in a battery administered in-person at baseline (2004–2005) and at follow-up (2010–2011). RESULTS Overall, 19.6 % (1,032/5,256) of participants declined in health literacy score over the follow-up. Among adults aged ≥ 80 years at baseline, this proportion was 38.2 % (102/267), compared to 14.8 % (78/526) among adults aged 52–54 years (OR = 3.21; 95 % CI: 2.26–4.57). Other sociodemographic predictors of health literacy decline were: male sex (OR = 1.20; 95 % CI: 1.04–1.38), non-white ethnicity (OR = 2.42; 95 % CI: 1.51–3.89), low educational attainment (OR = 1.58; 95 % CI: 1.29–1.95 for no qualifications vs. degree education), and low occupational class (OR = 1.67; 95 % CI: 1.39–2.01 for routine vs. managerial occupations). Higher baseline cognitive function scores protected against health literacy decline, while cognitive decline (yes vs. no) predicted decline in health literacy score (OR = 1.59; 95 % CI: 1.35–1.87 for memory decline and OR = 1.56; 95 % CI: 1.32–1.85 for executive function decline). CONCLUSIONS Health literacy decline appeared to increase with age, and was associated with even subtle cognitive decline in older non-impaired adults. Striking social inequalities were evident, whereby men and those from minority and deprived backgrounds were particularly vulnerable to literacy decline. Health practitioners must be able to recognize limited health literacy to ensure that clinical demands match the literacy skills of diverse patients.

Metal–organic microporous materials 1 , 2 , 3 , 4 (MOMs) have attracted wide scientific attention owing to their unusual structure and properties, as well as commercial interest due to their potential applications in storage 5 , 6 , 7 , 8 , 9 , separation 10 , 11 and heterogeneous catalysis 12 , 13 . One of the advantages of MOMs compared to other microporous materials, such as activated carbons, is their ability to exhibit a variety of pore surface properties such as hydrophilicity and chirality, as a result of the controlled incorporation of organic functional groups into the pore walls 11 , 13 , 14 , 15 . This capability means that the pore surfaces of MOMs could be designed to adsorb specific molecules; but few design strategies for the adsorption of small molecules have been established so far. Here we report high levels of selective sorption of acetylene molecules as compared to a very similar molecule, carbon dioxide, onto the functionalized surface of a MOM. The acetylene molecules are held at a periodic distance from one another by hydrogen bonding between two non-coordinated oxygen atoms in the nanoscale pore wall of the MOM and the two hydrogen atoms of the acetylene molecule. This permits the stable storage of acetylene at a density 200 times the safe compression limit of free acetylene at room temperature.

Alzheimer’s disease and related dementias (ADRD) are a growing global health concern, with burdens projected to expand rapidly in the coming decades. Since cognitive decline typically precedes ADRD, it is crucial to identify interventions that may help slow cognitive decline and reduce ADRD risk. We used a quasi-experimental design, exploiting exogenous expansions of South Africa’s Older Persons Grant for men, to estimate its impact on memory decline and ADRD risk in the rural Mpumalanga province of South Africa. We found that expanded pension eligibility was associated with slower memory decline for men who were eligible to receive the pension 5 years earlier [β = 0.027 SD, 95% CI = 0.023, 0.031], as well as for men who were eligible to receive the pension 1−4 years earlier [β = 0.009 SD, 95% CI = 0.004, 0.013]. We also found a 5.2 percentage point lower probability of dementia for men who were eligible for pension 5 years earlier [95% CI = −0.062, −0.032] and a 4.8 percentage point lower probability of dementia for men who became eligible to receive pension 1−4 years earlier [95% CI = −0.062, −0.032]. These findings demonstrate that beyond the policy intent of cash transfers to strengthen individual and household livelihoods, an important further benefit lies in promoting healthy cognitive aging in low- and middle- income countries.