Sitting as a moral practice: Older adults' accounts from qualitative interviews on sedentary behaviours.

Amidst public health campaigns urging people to sit less as well as being more physically active, this paper investigates how older adults make sense of their sedentary behaviour. Using an accounts framework focusing on how people rationalise their sitting practices, we analysed data from 44 qualitative interviews with older adults. All interviewees had received information about sedentary behaviour and health, visual feedback on their own objectively measured sitting over a week and guidance on sitting less. Participants used accounts to position sitting as a moral practice, distinguishing between 'good' (active/'busy') and 'bad' (passive/'not busy') sitting. This allowed them to align themselves with acceptable (worthwhile) forms of sitting and distance themselves from other people whose sitting they viewed as less worthwhile. However, some participants also described needing to sit more as they got older. The findings suggest that some public health messaging may lead to stigmatisation around sitting. Future sedentary behaviour guidelines and public health campaigns should consider more relatable guidelines that consider the lived realities of ageing, and the individual and social factors that shape them. They should advocate finding a balance between sitting and moving that is appropriate for each person.

Childhood neurodevelopmental markers and risk of premature mortality: Follow-up to age 60-65 years in the Aberdeen Children of the 1950s study.

BACKGROUND: Individual neurodevelopmental disorders are associated with premature mortality. Little is known about the association between multiple neurodevelopmental markers and premature mortality at a population level. The ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations) approach considers multiple neurodevelopmental parameters, assessing several markers in parallel that cluster, rather than considering individual diagnostic categories in isolation. OBJECTIVES: To determine whether childhood neurodevelopmental markers, including reduced intellectual functioning, are associated with all-cause premature mortality. METHODS AND PROCEDURES: In a general population cohort study (n = 12,150) with longitudinal follow up from childhood to middle age, Cox proportional hazard models were used to study the associations between childhood neurodevelopmental markers (Rutter B scale and IQ) and premature all-cause mortality. OUTCOMES AND RESULTS: The cognitive measures and 21 of the 26 Rutter B items were significantly associated with premature mortality in bivariate analyses with hazard ratios from 1.24 (95% CI 1.05-1.47) to 2.25 (95% CI 1.78-2.90). In the final adjusted model, neurodevelopmental markers suggestive of several domains including hyperactivity, conduct problems and intellectual impairment were positively associated with premature mortality and improved prediction of premature mortality. CONCLUSIONS: A wide range of neurodevelopmental markers, including childhood IQ, were found to predict premature mortality in a large general population cohort with longitudinal follow up to 60-65 years of age. IMPLICATIONS: These findings highlight the importance of a holistic assessment of children with neurodevelopmental markers that addresses a range of neurodevelopmental conditions. Our findings could open the door to a shift in child public mental health focus, where multiple and/or cumulative markers of neurodevelopmental conditions alert clinicians to the need for early intervention. This could lead to a reduction in the risk of broad health outcomes at a population level.

Associations of Socioeconomic Deprivation and Preterm Birth With Speech, Language, and Communication Concerns Among Children Aged 27 to 30 Months.

Importance: Successful acquisition of language is foundational for health and well-being across the life course and is patterned by medical and social determinants that operate in early life. Objective: To investigate the associations of neighborhood disadvantage, gestational age, and English as first language with speech, language, and communication concerns among children aged 27 to 30 months. Design, Setting, and Participants: This cohort study used birth data from the National Health Service maternity electronic medical record linked to the Child Health Surveillance Programme for preschool children. The cohort included 28 634 children in the United Kingdom (NHS Lothian, Scotland) born between January 2011 and December 2014 who were eligible for a health review at age 27 to 30 months between April 2013 and April 2016. Data analysis was conducted between January 2018 and February 2019. Exposures: The associations of neighborhood deprivation (using the Scottish Index of Multiple Deprivation 2016 quintiles), gestational age, and whether English was the first language spoken in the home with preschool language function were investigated using mutually adjusted logistic regression models. Main Outcomes and Measures: Speech, language, and communication (SLC) concern ascertained at age 27 to 30 months. Results: Records of 28 634 children (14 695 [51.3%] boys) with a mean (SD) age of 27.7 (2.2) months were matched. After excluding records with missing data, there were 26 341 records. The prevalence of SLC concern was 13.0% (3501 of 26 963 children with SLC data). In fully adjusted analyses, each 1-week increase in gestational age from 23 to 36 weeks was associated with an 8.8% decrease in the odds of a child having an SLC concern reported at 27 months (odds ratio, 0.92; 95% CI, 0.90-0.93). The odds of a child for whom English is not the first language of having SLC concern at age 27 to 30 months were 2.1-fold higher than those for a child whose first language is English (OR, 2.09; 95% CI, 1.66-2.64). The odds ratio for having an SLC concern among children living in the most deprived neighborhoods, compared with the least deprived neighborhoods, was 3.15 (95% CI, 2.79-3.56). The estimated probabilities for preterm children having an SLC concern were highest for those living in the most deprived areas. Conclusions and Relevance: This study found that SLC concerns at age 27 to 30 months are common and independently associated with increasing levels of neighborhood deprivation and lower gestational age. Policies that reduce childhood deprivation could be associated with improved preschool language ability and potentially avoid propagation of disadvantage across the life course, including for children born preterm.

Positive and negative well-being and objectively measured sedentary behaviour in older adults: evidence from three cohorts.

BACKGROUND: Sedentary behaviour is related to poorer health independently of time spent in moderate to vigorous physical activity. The aim of this study was to investigate whether wellbeing or symptoms of anxiety or depression predict sedentary behaviour in older adults. METHOD: Participants were drawn from the Lothian Birth Cohort 1936 (LBC1936) (n = 271), and the West of Scotland Twenty-07 1950s (n = 309) and 1930s (n = 118) cohorts. Sedentary outcomes, sedentary time, and number of sit-to-stand transitions, were measured with a three-dimensional accelerometer (activPAL activity monitor) worn for 7 days. In the Twenty-07 cohorts, symptoms of anxiety and depression were assessed in 2008 and sedentary outcomes were assessed ~ 8 years later in 2015 and 2016. In the LBC1936 cohort, wellbeing and symptoms of anxiety and depression were assessed concurrently with sedentary behaviour in 2015 and 2016. We tested for an association between wellbeing, anxiety or depression and the sedentary outcomes using multivariate regression analysis. RESULTS: We observed no association between wellbeing or symptoms of anxiety and the sedentary outcomes. Symptoms of depression were positively associated with sedentary time in the LBC1936 and Twenty-07 1950s cohort, and negatively associated with number of sit-to-stand transitions in the LBC1936. Meta-analytic estimates of the association between depressive symptoms and sedentary time or number of sit-to-stand transitions, adjusted for age, sex, BMI, long-standing illness, and education, were ß = 0.11 (95% CI = 0.03, 0.18) and ß = - 0.11 (95% CI = - 0.19, -0.03) respectively. CONCLUSION: Our findings indicate that depressive symptoms are positively associated with sedentary behavior. Future studies should investigate the causal direction of this association.

Hypertension Development by Midlife and the Roles of Premorbid Cognitive Function, Sex, and Their Interaction.

Higher early-life cognitive function is associated with better later-life health outcomes, including hypertension. Associations between higher prior cognitive function and less hypertension persist even when accounting for socioeconomic status, but socioeconomic status-hypertension gradients are more pronounced in women. We predicted that differences in hypertension development between sexes might be associated with cognitive function and its interaction with sex, such that higher early-life cognitive function would be associated with lower hypertension risk more in women than in men. We used accelerated failure time modeling with the National Longitudinal Study of Youth 1979. Cognitive function was assessed in youth, when participants were aged between 14 and 21 years. Of 2572 men and 2679 women who completed all assessments, 977 men and 940 women reported hypertension diagnoses by 2015. Socioeconomic status in youth and adulthood were investigated as covariates, as were components of adult socioeconomic status: education, occupational status, and family income. An SD of higher cognitive function in youth was associated with reduced hypertension risk (acceleration factor: c=0.97; 95% CI, 0.96-0.99; P=0.001). The overall effect was stronger in women (sex×cognitive function: c=0.97; 95% CI, 0.94-0.99; P=0.010); especially, higher functioning women were less at risk than their male counterparts. This interaction was itself attenuated by a sex by family income interaction. People with better cognitive function in youth, especially women, are less likely to develop hypertension later in life. Income differences accounted for these associations. Possible causal explanations are discussed.

The role of physical and mental multimorbidity in suicidal thoughts and behaviours in a Scottish population cohort study.

BACKGROUND: Physical illness and mental disorders play a significant role in fatal and non-fatal suicidal behaviour. However, there is no clear evidence for the effect of physical and mental illness co-occurrence (multimorbidity) in suicidal ideation and attempts. The aim of the current study was to investigate, whether physical/mental health multimorbidity predicted suicidal thoughts and behaviours as outcomes. METHODS: Data from the West of Scotland Twenty-07 cohort were analysed. Twenty-07 is a multiple cohort study following people for 20 years, through five waves of data collection. Participants who responded to past-year suicidal thoughts and suicide attempt items were grouped into four distinct health-groups based on having: (1) neither physical nor mental health condition (controls); (2) one or more physical health condition; (3) one or more mental health condition and; (4) multimorbidity. The role of multimorbidity in predicting suicidal ideation and suicide attempts was tested with a generalised estimating equation (GEE) model and odds ratios (ORs) and 95% CIs are presented. Whether the effect of multimorbidity was stronger than either health condition alone was also assessed. RESULTS: Multimorbidity had a significant effect on suicidal thoughts and suicide attempts, compared to the control group, but was not found to increase the risk of either suicide-related outcomes, more than mental illness alone. CONCLUSIONS: We identified an effect of physical/mental multimorbidity on risk of suicidal thoughts and suicide attempts. Considering that suicide and related behaviour are rare events, future studies should employ a prospective design on the role of multimorbidity in suicidality, employing larger datasets.

What Do Older People Do When Sitting and Why? Implications for Decreasing Sedentary Behavior.

BACKGROUND AND OBJECTIVES: Sitting less can reduce older adults' risk of ill health and disability. Effective sedentary behavior interventions require greater understanding of what older adults do when sitting (and not sitting), and why. This study compares the types, context, and role of sitting activities in the daily lives of older men and women who sit more or less than average. RESEARCH DESIGN AND METHODS: Semistructured interviews with 44 older men and women of different ages, socioeconomic status, and objectively measured sedentary behavior were analyzed using social practice theory to explore the multifactorial, inter-relational influences on their sedentary behavior. Thematic frameworks facilitated between-group comparisons. RESULTS: Older adults described many different leisure time, household, transport, and occupational sitting and non-sitting activities. Leisure-time sitting in the home (e.g., watching TV) was most common, but many non-sitting activities, including "pottering" doing household chores, also took place at home. Other people and access to leisure facilities were associated with lower sedentary behavior. The distinction between being busy/not busy was more important to most participants than sitting/not sitting, and informed their judgments about high-value "purposeful" (social, cognitively active, restorative) sitting and low-value "passive" sitting. Declining physical function contributed to temporal sitting patterns that did not vary much from day-to-day. DISCUSSION AND IMPLICATIONS: Sitting is associated with cognitive, social, and/or restorative benefits, embedded within older adults' daily routines, and therefore difficult to change. Useful strategies include supporting older adults to engage with other people and local facilities outside the home, and break up periods of passive sitting at home.

Intelligence in youth and health behaviours in middle age.

OBJECTIVE: We investigated the association between intelligence in youth and a range of health-related behaviours in middle age. METHOD: Participants were the 5347 men and women who responded to the National Longitudinal Survey of Youth 1979 (NLSY-79) 2012 survey. IQ was recorded with the Armed Forces Qualification Test (AFQT) when participants were aged 15 to 23 years of age. Self-reports on exercise (moderate activity, vigorous activity, and strength training), dietary, smoking, drinking, and oral health behaviours were recorded when participants were in middle age (mean age = 51.7 years). A series of regression analyses tested for an association between IQ in youth and the different health related behaviours in middle age, while adjusting for childhood socio-economic status (SES) and adult SES. RESULTS: Higher IQ in youth was significantly associated with the following behaviours that are beneficial to health: being more likely to be able to do moderate cardiovascular activity (Odds Ratio, 95% CI) (1.72, 1.35 to 2.20, p < .001) and strength training (1.61, 1.37 to 1.90, p < .001); being less likely to have had a sugary drink in the previous week (0.75, 0.71 to 0.80, p < .001); a lower likelihood of drinking alcohol heavily (0.67, 0.61 to 0.74, p < .001); being less likely to smoke (0.60, 0.56 to 0.65, p < .001); being more likely to floss (1.47, 1.35 to 1.59, p < .001); and being more likely to say they "often" read the nutritional information (1.20, 1.09 to 1.31, p < .001) and ingredients (1.24, 1.12 to 1.36, p < .001) on food packaging compared to always reading them. Higher IQ was also linked with dietary behaviours that may or may not be linked with poorer health outcomes (i.e. being more likely to have skipped a meal (1.10, 1.03 to 1.17, p = .005) and snacked between meals (1.37, 1.26 to 1.50, p < .001) in the previous week). An inverted u-shaped association was also found between IQ and the number of meals skipped per week. Higher IQ was also linked with behaviours that are known to be linked with poorer health (i.e. a higher likelihood of drinking alcohol compared to being abstinent from drinking alcohol (1.58, 1.47 to 1.69, p < .001)). A u-shaped association was found between IQ and the amount of alcohol consumed per week and an inverted u-shaped association was found between IQ and the number of cigarettes smoked a day. Across all outcomes, adjusting for childhood SES tended to attenuate the estimated effect size only slightly. Adjusting for adult SES led to more marked attenuation but statistical significance was maintained in most cases. CONCLUSION: In the present study, a higher IQ in adolescence was associated with a number of healthier behaviours in middle age. In contrast to these results, a few associations were also identified between higher intelligence and behaviours that may or may not be linked with poor health (i.e. skipping meals and snacking between meals) and with behaviours that are known to be linked with poor health (i.e. drinking alcohol and the number of cigarettes smoked). To explore mechanisms of association, future studies could test for a range of health behaviours as potential mediators between IQ and morbidity or mortality in later life.

Reaction times match IQ for major causes of mortality: Evidence from a population based prospective cohort study.

INTRODUCTION: The association of premorbid cognitive ability with all-cause mortality is now well established. However, since all-cause mortality is relatively uninformative about aetiology, evidence has been sought, and is beginning to accumulate, for associations with specific causes of mortality. Likewise, the underlying causal pathways may be illuminated by considering associations with different measures of cognitive ability. For example, critics of IQ type measures point to possible cultural or social biases and there is, consequently, a need for more culturally neutral measures such as reaction times. We examine the associations of cognitive ability with major causes of mortality, including: cardiovascular disease, cancer and respiratory disease and compare the results for a standard IQ test, the Alice Heim 4 (AH4), with those for simple and four-choice reaction times. METHODS: Data were derived from the oldest cohort of the West of Scotland Twenty-07 Study. Participants were randomly sampled from the Central Clydeside Conurbation, a mainly urban area centred on Glasgow city. At baseline, aged 56, they were interviewed in their homes by trained interviewers; the AH4 was administered and reaction times measured using a portable electronic device. Vital status was ascertained via linkage to the NHS central register. Cox regression was used in SAS 9.4 for the main analyses. Adjustments were made for sex, smoking status and social class. RESULTS: Full data on AH4, RT and covariates were available for 1350 out of 1551. During 29 years of follow-up, there were 833 deaths: 279 cardiovascular disease (CVD) (168 CHD; 68 stroke); 291 cancer; 97 respiratory disease; 42 digestive disease; and 39 dementia. The 85 remaining deaths were a heterogeneous mixture with no cause accounting for more than 14.AH4 scores were associated with most major causes. Digestive disease and dementia had similar effect sizes but were not significant. Within cardiovascular disease, there was an association with coronary heart disease but not stroke. The association with cancer was primarily due to those cancers related to smoking.RT measures were mostly associated with the same causes of death. Where significant, effects were in the same directions and of similar magnitude. That is, lower AH4 scores, longer reaction times, and more variable reaction times were all associated with increased mortality risk from the major causes of death. A summary measure of RT outperformed the AH4 for most causes. CONCLUSION: The association between intelligence with mortality from the major causes is also seen with reaction times. That effect sizes are of similar magnitude is suggestive of a common cause. It also implies that the association of cognitive ability with mortality is unlikely to be due to any social, cultural or educational biases that are sometimes ascribed to intelligence measures.

Cognitive ability does not predict objectively measured sedentary behavior: Evidence from three older cohorts.

Higher cognitive ability is associated with being more physically active. Much less is known about the associations between cognitive ability and sedentary behavior. Ours is the first study to examine whether historic and contemporaneous cognitive ability predicts objectively measured sedentary behavior in older age. Participants were drawn from 3 cohorts (Lothian Birth Cohort, 1936 [LBC1936] [n = 271]; and 2 West of Scotland Twenty-07 cohorts: 1950s [n = 310] and 1930s [n = 119]). Regression models were used to assess the associations between a range of cognitive tests measured at different points in the life course, with sedentary behavior in older age recorded over 7 days. Prior simple reaction time (RT) was significantly related to later sedentary time in the youngest, Twenty-07 1950s cohort (p = .04). The relationship was nonsignificant after controlling for long-standing illness or employment status, or after correcting for multiple comparisons in the initial model. None of the cognitive measures were related to sedentary behavior in either of the 2 older cohorts (LBC1936, Twenty-07 1930s). There was no association between any of the cognitive tests and the number of sit-to-stand transitions in any of the 3 cohorts. The meta-analytic estimates for the measures of simple and choice RT that were identical in all cohorts (n = 700) were also not significant. In conclusion, we found no evidence that objectively measured sedentary time in older adults is associated with measures of cognitive ability at different time points in life, including cognitive change from childhood to older age. (PsycINFO Database Record

Maternal and offspring intelligence in relation to BMI across childhood and adolescence.

OBJECTIVE: The present study tested the association between both mothers' and offspring's intelligence and offspring's body mass index (BMI) in youth. METHOD: Participants were members of the National Longitudinal Survey of Youth 1979 (NLSY-79) Children and Young Adults cohort (n = 11,512) and their biological mothers who were members of the NLSY-79 (n = 4932). Offspring's IQ was measured with the Peabody Individual Achievement Test (PIAT). Mothers' IQ was measured with the Armed Forces Qualification Test (AFQT). A series of regression analyses tested the association between IQ and offspring's BMI by age group, while adjusting for pre-pregnancy BMI and family SES. The analyses were stratified by sex and ethnicity (non-Black and non-Hispanic, Black, and Hispanic). RESULTS: The following associations were observed in the fully adjusted analyses. For the non-Blacks and non-Hispanics, a SD increment in mothers' IQ was negatively associated with daughters' BMI across all age-groups, ranging from ß = -0.12 (95% CI -0.22 to -0.02, p = 0.021) in late childhood, to ß = -0.17 (95% C.I. -0.27 to -0.07, p = 0001), in early adolescence and a SD increment in boys' IQ was positively associated with their BMI in early adolescence ß = 0.09 (95% CI 0.01-0.18, p = 0.031). For Blacks, there was a non-linear relationship between mothers' IQ and daughters' BMI across childhood and between girls' IQ and BMI across adolescence. There was a positive association between mothers' IQ and sons' BMI in early adolescence (ß = 0.17, 95% CI 0.02-0.32, p = 0.030). For Hispanic boys, there was a positive IQ-BMI association in late childhood (ß = 0.19, 95% CI 0.05-0.33, p = 0.008) and early adolescence (ß = 0.17, 95% CI 0.04-0.31, p = 0.014). CONCLUSION: Mothers' IQ and offspring's IQ were associated with offspring's BMI. The relationships varied in direction and strength across ethnicity, age group and sex. Obesity interventions may benefit from acknowledging the heterogeneous influence that intelligence has on childhood BMI.

Intelligence and all-cause mortality in the 6-Day Sample of the Scottish Mental Survey 1947 and their siblings: testing the contribution of family background.

Background: Higher early-life intelligence is associated with a reduced risk of mortality in adulthood, though this association is apparently hardly attenuated when accounting for early-life socio-economic status (SES). However, the use of proxy measures of SES means that residual confounding may underestimate this attenuation. In the present study, the potential confounding effect of early-life SES was instead accounted for by examining the intelligence-mortality association within families. Methods: The association between early-life intelligence and mortality in adulthood was assessed in 727 members of the 6-Day Sample of the Scottish Mental Survey 1947 and, for the first time, 1580 of their younger siblings. These individuals were born between 1936 and 1958, and were followed up into later life, with deaths recorded up to 2015. Cox regression was used to estimate the relative risk of mortality associated with higher IQ scores after adjusting for shared family factors. Results: A standard-deviation advantage in IQ score was associated with a significantly reduced mortality risk [hazard ratio = 0.76, p < 0.001, 95% confidence interval (CI) (0.68-0.84)]. This reduction in hazard was only slightly attenuated by adjusting for sex and shared family factors [hazard ratio = 0.79, p = 0.002, 95% CI (0.68-0.92)]. Conclusions: Although somewhat conservative, adjusting for all variance shared by a family avoids any potential residual confounding of the intelligence-mortality association arising from the use of proxy measures of early-life SES. The present study demonstrates that the longevity associated with higher early-life intelligence cannot be explained by early-life SES or within-family factors.

The relationship between intelligence and reaction time varies with age: Results from three representative narrow-age age cohorts at 30, 50 and 69 years.

BACKGROUND: Reaction time (RT) has played a prominent part in research on mental ability for over a century. Throughout this time a number of questions have been repeatedly posed: what is the relationship of RT to general mental ability, and is this the same for simple and choice RT? Does the relationship change with age? How important is RT variability compared with mean values? Here we examine these questions in three population representative cohorts. METHODS: Participants were drawn from the West of Scotland Twenty-07 study, a longitudinal population based study designed to investigate socially structured health inequalities. At the fourth wave of data collection, part I of the Alice Heim 4 (AH4) test of general intelligence was administered, and reaction times were measured using a portable device. Means and standard deviations were recorded for simple and 4-choice reaction time. Full data were available for 2196 participants, comprising 714 aged 30 years, 813 aged 50, and 669 aged 69. RESULTS: Correlations of simple RT means with AH4 scores were - 0.27, - 0.30 and - 0.32, for age 30, 50 and 69, respectively; and - 0.44, - 0.47 and - 0.53 for 4-choice RT. The underlying relationships showed evidence of non-linearity, particularly for simple RT, with stronger association at lower AH4 scores. This was more pronounced with age. RT variability was correlated with the mean at 0.57, 0.57, 0.58 for simple RT; and 0.53, 0.53, 0.47 for choice RT. Residuals from regressing the RT variability on the mean showed no association with AH4 in the case of simple RT but a weak association for choice RT which decreased with age. CONCLUSIONS: There is a strong correlation of RT means with general mental ability which increases with age. The underlying relationship is complex for SRT. RT variability shows little association with mental ability when its dependence on the mean is removed. Combining samples with disparate ages may overestimate the association.

Relationships between socioeconomic position and objectively measured sedentary behaviour in older adults in three prospective cohorts.

OBJECTIVES: To investigate whether sedentary behaviour in older adults is associated with a systematic and comprehensive range of socioeconomic position (SEP) measures across the life course. SEP measures included prospective measures of social class, income, educational qualifications and parental social class and contemporaneous measures of area deprivation. SETTING: Glasgow and the surrounding (West of Scotland) combined with Edinburgh and the surrounding area (the Lothians). PARTICIPANTS: Community-dwelling adults aged around 79, 83, and 64 years from, respectively, the Lothian Birth Cohort 1936 (LBC1936) (n=271) and the 1930s (n=119) and 1950s (n=310) cohorts of the West of Scotland Twenty-07 study. PRIMARY OUTCOME MEASURE: Sedentary behaviour was measured objectively using an activPAL activity monitor worn continuously for 7 days and used to calculate percentage of waking time spent sedentary. RESULTS: Among retired participants, for most cohort and SEP combinations, greater social disadvantage was associated with increased sedentary time. For example, in the Twenty-07 1930s cohort, those most deprived on the Carstairs measure spent 6.5% (95% CI 0.3 to 12.7) more of their waking time sedentary than the least deprived. However, for employed people, the relationship between SEP and sedentary behaviour was much weaker. For example, in terms of social class differences, among the retired, the most disadvantaged spent 5.7% more waking time sedentary (95% CI 2.6% to 87%), whereas among the employed, there was effectively no difference (-0.5%; 95% CI -9.0 to 8.0). CONCLUSIONS: Diverse SEP measures were associated with increased sedentary behaviour among retired people. There was little evidence for a relationship between SEP measures and sedentary behaviour among employed older adults. Prior to retirement, the constraints of the workplace may be masking effects that are only apparent at weekends.

Childhood intelligence in relation to major causes of death in 68 year follow-up: prospective population study.

Objectives To examine the association between intelligence measured in childhood and leading causes of death in men and women over the life course.Design Prospective cohort study based on a whole population of participants born in Scotland in 1936 and linked to mortality data across 68 years of follow-up.Setting Scotland.Participants 33 536 men and 32 229 women who were participants in the Scottish Mental Survey of 1947 (SMS1947) and who could be linked to cause of death data up to December 2015.Main outcome measures Cause specific mortality, including from coronary heart disease, stroke, specific cancer types, respiratory disease, digestive disease, external causes, and dementia.Results Childhood intelligence was inversely associated with all major causes of death. The age and sex adjusted hazard ratios (and 95% confidence intervals) per 1 SD (about 15 points) advantage in intelligence test score were strongest for respiratory disease (0.72, 0.70 to 0.74), coronary heart disease (0.75, 0.73 to 0.77), and stroke (0.76, 0.73 to 0.79). Other notable associations (all P<0.001) were observed for deaths from injury (0.81, 0.75 to 0.86), smoking related cancers (0.82, 0.80 to 0.84), digestive disease (0.82, 0.79 to 0.86), and dementia (0.84, 0.78 to 0.90). Weak associations were apparent for suicide (0.87, 0.74 to 1.02) and deaths from cancer not related to smoking (0.96, 0.93 to 1.00), and their confidence intervals included unity. There was a suggestion that childhood intelligence was somewhat more strongly related to coronary heart disease, smoking related cancers, respiratory disease, and dementia in women than men (P value for interactions <0.001, 0.02, <0.001, and 0.02, respectively).Childhood intelligence was related to selected cancer presentations, including lung (0.75, 0.72 to 0.77), stomach (0.77, 0.69 to 0.85), bladder (0.81, 0.71 to 0.91), oesophageal (0.85, 0.78 to 0.94), liver (0.85, 0.74 to 0.97), colorectal (0.89, 0.83 to 0.95), and haematopoietic (0.91, 0.83 to 0.98). Sensitivity analyses on a representative subsample of the cohort observed only small attenuation of the estimated effect of intelligence (by 10-26%) after adjustment for potential confounders, including three indicators of childhood socioeconomic status. In a replication sample from Scotland, in a similar birth year cohort and follow-up period, smoking and adult socioeconomic status partially attenuated (by 16-58%) the association of intelligence with outcome rates.Conclusions In a whole national population year of birth cohort followed over the life course from age 11 to age 79, higher scores on a well validated childhood intelligence test were associated with lower risk of mortality ascribed to coronary heart disease and stroke, cancers related to smoking (particularly lung and stomach), respiratory diseases, digestive diseases, injury, and dementia.

The Influence of Neighbourhoods and the Social Environment on Sedentary Behaviour in Older Adults in Three Prospective Cohorts.

Sedentary behaviour is an emerging risk factor for poor health. This study aimed to identify ecological determinants of sedentary behaviour, for which evidence is currently scarce. The study participants were community dwelling adults from, respectively, the Lothian Birth Cohort 1936 (n = 271, mean age 79) and the 1930s (n = 119, mean age 83) and 1950s (n = 310, mean age 64) cohorts of the West of Scotland Twenty-07 study. The outcome measure, percentage of waking time spent sedentary (sedentary time), was measured using an activPAL activity monitor worn continuously for seven days. Potential determinants included objective and subjective neighbourhood measures such as natural space, crime, social cohesion and fear of crime. Other determinants included measures of social participation such as social support, social group membership and providing care. Results from multivariable regression analyses indicated that providing care was associated with reduced sedentary time in retired participants in all cohorts. Fear of crime and perceived absence of services were associated with increased sedentary time for retired 1950s cohort members. Higher crime rates were associated with increased sedentary time in all cohorts but this was not significant after adjustment for socio-demographic characteristics. Most other neighbourhood and social participation measures showed no association with sedentary time.

Intelligence in youth and mental health at age 50.

BACKGROUND: Few cognitive epidemiology studies on mental health have focused on the links between pre-morbid intelligence and self-reports of common mental disorders, such as depression, sleep difficulties, and mental health status. The current study examines these associations in 50-year-old adults. METHODS: The study uses data from the 5793 participants in the National Longitudinal Survey of Youth 1979 cohort (NLSY-79) who responded to questions on mental health at age 50 and had IQ measured with the Armed Forces Qualification Test (AFQT) when they were aged between 15 and 23 years in 1980. Mental health outcomes were: life-time diagnosis of depression; the mental component score of the 12-item short-form Health Survey (SF-12); the 7-item Center for Epidemiological Studies Depression Scale (CES-D); and a summary measure of sleep difficulty. RESULTS & CONCLUSION: Higher intelligence in youth is associated with a reduced risk of self-reported mental health problems at age 50, with age-at-first-interview and sex adjusted Bs as follows: CES-depression (B = - 0.16, C.I. - 0.19 to - 0.12, p < 0.001), sleep difficulties (B = - 0.11, C.I. - 0.13 to - 0.08, p < 0.001), and SF-12 mental health status (OR = 0.78, C.I. 0.72 to 0.85, p < 0.001; r = - 0.03 p = 0.075). Conversely, intelligence in youth is linked with an increased risk of receiving a diagnosis of depression by the age of 50 (OR 1.11, C.I. 1.01 to 1.22, p = 0.024; r = 0.03, p = 0.109). No sex differences were observed in the associations. Adjusting for adult SES accounted for most of the association between IQ and the mental health outcomes, except for having reported a diagnosis of depression, in which case adjusting for adult SES led to an increase in the size of the positive association (OR = 1.32, C.I. 1.16 to 1.51, p < 0.001).

Relationship Between Blood Pressure Values, Depressive Symptoms, and Cardiovascular Outcomes in Patients With Cardiometabolic Disease.

The authors studied the joint effect of blood pressure (BP) and depression on the risk of major adverse cardiovascular outcome in patients with existing cardiometabolic disease. A cohort of 35,537 patients with coronary heart disease, diabetes, or stroke underwent depression screening and BP measurement recorded concurrently. The authors used Cox's proportional hazards to calculate risk of major adverse cardiovascular event (MACE; myocardial infarction/heart failure/stroke or cardiovascular death) over 4 years associated with baseline BP and depression. A total of 11% (3939) had experienced a MACE within 4 years. Patients with very high systolic BP (160-240 mm Hg; hazard ratio, 1.28) and depression (hazard ratio, 1.22) at baseline had significantly higher adjusted risk. Depression had a significant interaction with systolic BP in risk prediction (P=.03). Patients with a combination of high systolic BP and depression at baseline had 83% higher adjusted risk of MACE, as compared with patients with reference systolic BP without depression. Patients with cardiometabolic disease and comorbid depression may benefit from closer monitoring of systolic BP.

Has Childhood Smoking Reduced Following Smoke-Free Public Places Legislation? A Segmented Regression Analysis of Cross-Sectional UK School-Based Surveys.

INTRODUCTION: Smoke-free legislation has been a great success for tobacco control but its impact on smoking uptake remains under-explored. We investigated if trends in smoking uptake amongst adolescents differed before and after the introduction of smoke-free legislation in the United Kingdom. METHODS: Prevalence estimates for regular smoking were obtained from representative school-based surveys for the four countries of the United Kingdom. Post-intervention status was represented using a dummy variable and to allow for a change in trend, the number of years since implementation was included. To estimate the association between smoke-free legislation and adolescent smoking, the percentage of regular smokers was modeled using linear regression adjusted for trends over time and country. All models were stratified by age (13 and 15 years) and sex. RESULTS: For 15-year-old girls, the implementation of smoke-free legislation in the United Kingdom was associated with a 4.3% reduction in the prevalence of regular smoking (P = .029). In addition, regular smoking fell by an additional 1.5% per annum post-legislation in this group (P = .005). Among 13-year-old girls, there was a reduction of 2.8% in regular smoking (P = .051), with no evidence of a change in trend post-legislation. Smaller and nonsignificant reductions in regular smoking were observed for 15- and 13-year-old boys (P = .175 and P = .113, respectively). CONCLUSIONS: Smoke-free legislation may help reduce smoking uptake amongst teenagers, with stronger evidence for an association seen in females. Further research that analyses longitudinal data across more countries is required. IMPLICATIONS: Previous research has established that smoke-free legislation has led to many improvements in population health, including reductions in heart attack, stroke, and asthma. However, the impacts of smoke-free legislation on the rates of smoking amongst children have been less investigated. Analysis of repeated cross-sectional surveys across the four countries of the United Kingdom shows smoke-free legislation may be associated with a reduction in regular smoking among school-aged children. If this association is causal, comprehensive smoke-free legislation could help prevent future generations from taking up smoking.

Salivary Immunoglobulin A Secretion Rate Is Negatively Associated with Cancer Mortality: The West of Scotland Twenty-07 Study.

Immunoglobulins are essential for combating infectious disease although very high levels can indicate underlying pathology. The present study examined associations between secretory immunoglobulin A (sIgA) in saliva and mortality rates in the general population. Participants were 639 adults from the eldest cohort of the West of Scotland Twenty-07 Study aged 63 years at the time of saliva sampling in 1995. From unstimulated 2-minute saliva samples, saliva volume and S-IgA concentration were measured, and S-IgA secretion rate determined as their product. Mortality data were tracked for 19 years. Cox proportional hazard models were applied to compute hazard ratios (HR) for all-cause mortality from sIgA secretion rate. Associations were adjusted for gender, assay batch, household occupational group, smoking, medication usage, and self-reported health. There was a negative association between log sIgA secretion rate and all-cause mortality, HR = 0.81, 95%CI = 0.73-0.91, p < .001. Further analysis of specific causes of mortality revealed that the all-cause association was due to an underlying association with cancer mortality and in particular with cancers other than lung cancer. The HR for non-lung cancer was 0.68 (95%CI = 0.54 to 0.85) implying a 32% reduction in mortality risk per standard deviation rise in log sIgA secretion rate. Effects were stronger for men than women. For deaths from respiratory diseases, sIgA secretion had a non-linear relationship with mortality risk whereby only the very lowest levels of secretion were associated with elevated risk. SIgA concentration revealed a similar but weaker pattern of association. In the present study, higher secretion rates of sIgA were associated with a decreased risk of death from cancer, specifically non-lung cancer, as well as from respiratory disease. Thus, it appears that sIgA plays a protective role among older adults, and could serve as a marker of mortality risk, specifically cancer mortality.