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Trajectories network analysis of chronic diseases among middle-aged and older adults: evidence from the China Health and Retirement Longitudinal Study (CHARLS)
Given the increased risk of chronic diseases and comorbidity among middle-aged and older adults in China, it is pivotal to identify the disease trajectory of developing chronic multimorbidity and address the temporal correlation among chronic diseases.
The data of 15895 participants from the China Health and Retirement Longitudinal Study (CHARLS 2011 - 2018) were analyzed in the current study. Binomial tests and the conditional logistic regression model were conducted to estimate the associations among 14 chronic diseases, and the disease trajectory network analysis was adopted to visualize the relationships.
The analysis showed that hypertension is the most prevalent disease among the 14 chronic conditions, with the highest cumulative incidence among all chronic diseases. In the disease trajectory network, arthritis was found to be the starting point, and digestive diseases, hypertension, heart diseases, and dyslipidemia were at the center, while memory-related disease (MRD), stroke, and diabetes were at the periphery of the network.
With the chronic disease trajectory network analysis, we found that arthritis was prone to the occurrence and development of various other diseases. In addition, patients of heart diseases/hypertension/digestive disease/dyslipidemia were under higher risk of developing other chronic conditions. For patients with multimorbidity, early prevention can preclude them from developing into poorer conditions, such as stroke, MRD, and diabetes. By identifying the trajectory network of chronic disease, the results provided critical insights for developing early prevention and individualized support services to reduce disease burden and improve patients' quality of life.
Journal Article
Genes, Gender Inequality, and Educational Attainment
Women’s opportunities have been profoundly altered over the past century by reductions in the social and structural constraints that limit women’s educational attainment. Do social constraints manifest as a suppressing influence on genetic indicators of potential, and if so, did equalizing opportunity mean equalizing the role of genetics? We address this with three cohort studies: the Wisconsin Longitudinal Study (WLS; birth years 1939 to 1940), the Health and Retirement Study, and the National Longitudinal Study of Adolescent Health (Add Health; birth years 1975 to 1982). These studies include a “polygenic score” for educational attainment, providing a novel opportunity to explore this question. We find that within the WLS cohort, the relationship between genetics and educational outcomes is weaker for women than for men. However, as opportunities changed in the 1970s and 1980s, and many middle-aged women went back to school, the relationship between genetic factors and education strengthened for women as they aged. Furthermore, utilizing the HRS and Add Health, we find that as constraints limiting women’s educational attainment declined, gender differences in the relationship between genetics and educational outcomes weakened. We demonstrate that genetic influence must be understood through the lens of historical change, the life course, and social structures like gender.
Journal Article
Fitness after 40 : your strong body at 40, 50, 60, and beyond
\"Includes a 6-week total-body workout program.\"
Book
Post-traumatic stress disorder symptoms and risk of hypertension over 22 years in a large cohort of younger and middle-aged women
Post-traumatic stress disorder (PTSD) has been linked to hypertension, but most research on PTSD and hypertension is cross-sectional, and potential mediators have not been clearly identified. Moreover, PTSD is twice as common in women as in men, but understanding of the PTSD-hypertension relationship in women is limited. We examined trauma exposure and PTSD symptoms in relation to incident hypertension over 22 years in 47 514 civilian women in the Nurses' Health Study II.
We used proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for new-onset hypertension (N = 15 837).
PTSD symptoms assessed with a screen were modestly associated with incident hypertension in a dose-response fashion after adjusting for potential confounders. Compared to women with no trauma exposure, women with 6-7 PTSD symptoms had the highest risk of developing hypertension (HR 1.20, 95% CI 1.12-1.30), followed by women with 4-5 symptoms (HR 1.17, 95% CI 1.10-1.25), women with 1-3 symptoms (HR 1.12, 95% CI 1.06-1.18), and trauma-exposed women with no symptoms (HR 1.04, 95% CI 1.00-1.09). Findings were maintained, although attenuated, adjusting for hypertension-relevant medications, medical risk factors, and health behaviors. Higher body mass index and antidepressant use accounted for 30% and 21% of the PTSD symptom-hypertension association, respectively.
Screening for hypertension and reducing unhealthy lifestyle factors, particularly obesity, in women with PTSD may hold promise for offsetting cardiovascular risk.
Journal Article
Comfort and Attitudes Towards Robots Among Young, Middle‐Aged, and Older Adults: A Cross‐Sectional Study
Purpose
To explore the social impact of, comfort with, and negative attitudes towards robots among young, middle‐aged, and older adults in the United States.
Design
Descriptive, cross‐sectional. Conducted in 2014–2015 in an urban area of the western United States using a purposive sample of adults 18 years of age or older.
Methods
Respondents completed a survey that included the Negative Attitudes Toward Robots Scale (NARS) and two questions taken or modified from the European Commission's Autonomous System 2015 Report. Analyses were conducted to compare perceptions and demographic factors by age groups (young adults:18–44, middle‐aged adults: 45–64, and older adults: >65 years old).
Findings
Sample included 499 individuals (n = 322 age 18–44 years, n = 50 age 45–64 years, and n = 102 age 65–98 years). There were no significant differences between age groups for 9 of the 11 items regarding social impact of robots and comfort with robots. There were no significant differences by age groups for 9 of the 14 items in the NARS. Among those items with statistically significant differences, the mean scores indicate similar sentiments for each group.
Conclusions
Older, middle‐aged, and younger adults had similar attitudes regarding the social impact of and comfort with robots; they also had similar negative attitudes towards robots. Findings dispel current perceptions that older adults are not as receptive to robots as other adults. This has implications for nurses who integrate supportive robots in their practice.
Clinical Relevance
Nurses working in clinical and community roles can use these findings when developing and implementing robotic solutions. Understanding attitudes towards robots can support how, where, and with whom robots can be used in nursing practice.
Journal Article
Beauty 40+ : 24 looks to feel beautiful
A guide to beauty for mature women covers age-appropriate makeup looks, with twenty-five step-by-step, illustrated instructions, and offers beauty advice, essential tools, and helpful tips for beauty care from head to toe.
Book
Psychiatric Co-occurring Symptoms and Disorders in Young, Middle-Aged, and Older Adults with Autism Spectrum Disorder
Although psychiatric problems are less prevalent in old age within the general population, it is largely unknown whether this extends to individuals with autism spectrum disorders (ASD). We examined psychiatric symptoms and disorders in young, middle-aged, and older adults with and without ASD (N
max
= 344, age 19–79 years, IQ > 80). Albeit comparable to other psychiatric patients, levels of symptoms and psychological distress were high over the adult lifespan; 79 % met criteria for a psychiatric disorder at least once in their lives. Depression and anxiety were most common. However, older adults less often met criteria for any psychiatric diagnosis and, specifically, social phobia than younger adults. Hence, despite marked psychological distress, psychiatric problems are also less prevalent in older aged individuals with ASD.
Journal Article