Exercise to socialize? Bidirectional relationships between physical activity and loneliness in middle-aged and older American adults.

Physical inactivity and loneliness are both associated with health risks and can affect each other through various social and behavioral mechanisms. However, current evidence on this relationship is equivocal and mostly based on cross-sectional data. This longitudinal study aimed to determine whether current levels of physical activity (moderate and vigorous intensity) and loneliness are associated with future respective states of themselves and each other. We used data from waves 6-14 (2002-2018) of the Health and Retirement Study (n = 20 134) in a mixed-effects and random-intercept cross-lagged panel model. Analysis showed that current loneliness and physical activity were associated with each future respective state. Additionally, weekly participation in moderate-intensity, but not vigorous-intensity, physical activity was associated with a lower likelihood of becoming lonely in the future (relative risk [RR] = 0.94; 95% CI, 0.90-0.99). However, changes in physical activity were not associated with deviation from a person's typical level of loneliness (for vigorous intensity, mean deviation [MD] = 0.00; 95% CI: -0.04 to 0.03; for moderate-intensity, MD = 0.01; 95% CI: -0.03 to 0.04). Loneliness was not associated with moderate- or vigorous-intensity physical activity in subsequent waves. This suggests that while lower physical activity levels can be associated with future loneliness, changing levels of physical activity has little impact on loneliness at the individual level.

Neighborhood walkability, fear and risk of falling and response to walking promotion: The Easy Steps to Health 12-month randomized controlled trial.

In older adults the relationships between health, fall-related risk factors, perceived neighborhood walkability, walking behavior and intervention impacts are poorly understood. To determine whether: i) health and fall-related risk factors were associated with perceptions of neighborhood walkability; ii) perceived environmental attributes, and fall-related risk factors predicted change in walking behavior at 12 months; and iii) perceived environmental attributes and fall-related risk factors moderated the effect of a self-paced walking program on walking behavior. Randomized trial on walking and falls conducted between 2009 and 2012 involving 315 community-dwelling inactive adults ≥ 65 years living in Sydney, Australia. Measures were: mobility status, fall history, injurious fall and fear of falling (i.e., fall-related risk factors), health status, walking self-efficacy and 11 items from the neighborhood walkability scale and planned walking ≥ 150 min/week at 12 months. Participants with poorer mobility, fear of falling, and poor health perceived their surroundings as less walkable. Walking at 12 months was significantly greater in "less greenery" (AOR = 3.3, 95% CI: 1.11-9.98) and "high traffic" (AOR = 1.98, 95% CI: 1.00-3.91) neighborhoods. The intervention had greater effects in neighborhoods perceived to have poorer pedestrian infrastructure (p for interaction = 0.036). Low perceived walkability was shaped by health status and did not appear to be a barrier to walking behavior. There appears to be a greater impact of, and thus, need for, interventions to encourage walking in environments perceived not to have supportive walking infrastructure. Future studies on built environments and walking should gather information on fall-related risk factors to better understand how these characteristics interact.

Drug-induced oral erythema multiforme. Results of a long-term retrospective study.

As reliable data on prevalence rates of drug-induced oral mucosa side effects are scarce in the medical literature, a retrospective analysis of drugs as possible inducers in 173 in-patients with either minor or major type of erythema multiforme (EM) admitted to the Erlangen University Department of Dermatology from 1970 through 1981 was carried out. In 62 of these cases precipitation by drugs was suspected by history, in 31 of them with oral mucosa involvement. In 11 out of 19 patients with mucocutaneous EM drug testing either in vivo or in vitro provided evidence for drug induction of EM.

[Drug-induced Quincke's edema of the mouth mucosa - an analysis of 33 cases]. / Arzneimittelbedingtes Quincke-Odem der Mundschleimhaut - eine Analyse von 33 Beobachtungen.

Since literature only provides us with scarce information about occurrence and etiologic conditions of oro-pharyngeal Quincke's edema, we performed a retrospective evaluation of the medical records of 4,766 in-patients between the years 1970 and 1980 with registered drug-induced cutaneous and/or mucosal side effects. Among these cases there were 187 patients (= 3.92%) showing oral side effects, 33 of them with the diagnosis of Quincke's edema on the labial, oral or pharyngeal mucosa. 30 cases revealed clinical and/or historic data about concomitant occurrence of edematous lesions also in other body sites. With all patients drug intolerance was suspected by history, yet drug testings could only prove this assumption in 24 cases. Salicylates, analgetic compounds, barbiturate, pyrazolone, and penicillin are the main etiologic factors for oral Quincke's edema.

[Adverse effects of drugs on the oral mucosa--incidence and clinical picture in clinical patients]. / Arzneinebenwirkungen an der Mundschleimhaut--Häufigkeit und Erscheinungsform in einem klinischen Krankengut.

The medical documents of 17.250 inpatients admitted to the Dermatological Department between 1970 and 1980 have retrospectively been examined concerning the frequency and clinical types of drug-induced side effects on the oral mucosa. Among 4.766 inpatients with registered side effects (27.63% to the total) there were 187 (3.92%) exhibiting drug-induced oral lesions. These conditions included, with decreasing prevalence rates, various types of enanthemas, mucosal oedemas, and erythema multiforme exsudativum, whereas other side effects (denture sore mouth, allergic contact stomatitis, lichenoid lesions, etc.) have been observed less frequently. Among the drugs involved analgetics, antiphlogistics and anti-infective ones prevailed being followed by psychopharmaca and dental materials. In 91 our of 121 inpatients, the causative allergen(s) could be ascertained by allergologic examinations (mostly by epi- or intracutaneous testing, or controlled drug exposition). Middle-aged inpatients, in comparison to the total of inpatients, suffered overproportionally from drug-induced oral side effects.