Effect of reduced water intake on ovarian reserve, leptin immunoexpression and impact of leptin on the in vitro culture of sheep secondary follicles.

This study evaluated the effect of reduced water intake on survival, apoptosis and immunoexpression of leptin in sheep preantral follicles, activation of primordial follicles, serum levels of leptin, estradiol (E2) and progesterone (P4), and in vitro maturation (IVM) of oocytes antral follicles, as well evaluated the effects of leptin on in vitro culture of secondary follicles isolated these animals. Ewes (n = 32) were divided into four groups: water ad libitum (Control - 100%), 80%; 60% and 40% of ad libitum intake. Blood was collected to determine, leptin, E2 and P4, before and after experiment. After the slaughter, ovarian cortex was used to histological and immunohistochemistry analysis and oocytes IVM. Moreover, isolated secondary follicles were cultured in vitro for 12 days in control medium (α-MEM+) or α-MEM+ with 10 or 25 ng/mL leptin. The reduction of water intake caused a linear decreasing effect on the percentages of normal preantral follicles, especially of primordial (P < 0.05), increased the apoptosis (P < 0.05) and decreased leptin expression in preantral follicles. The treatment with 60% of water intake showed greater total growth rate of isolated secondary follicles cultured with 25 ng/L leptin (P < 0.05), compared to those cultured in α-MEM+ . In conclusion, reduced water intake impaired the number of normal sheep preantral follicles, especially of primordial follicles, increased apoptosis and decreased leptin expression in preantral follicles. Moreover, secondary follicles from of ewes that receive 60% water intake increased follicular growth after in vitro culture with 25 ng/mL leptin.

In vivo reflectance confocal microscopy can detect the invasive component of lentigo maligna melanoma: Prospective analysis and case-control study.

BACKGROUND: Lentigo maligna (LM), a form of melanoma in situ, has no risk of causing metastasis unless dermal invasive melanoma (LMM) supervenes. Furthermore, the detection of invasion impacts prognosis and management. OBJECTIVE: To assess the accuracy of RCM for the detection of invasion component on LM/LMM lesions. METHODS: In the initial case-control study, the performance of one expert in detecting LMM at the time of initial RCM assessment of LM/LMM lesions was recorded prospectively (n = 229). The cases were assessed on RCM-histopathology correlation sessions and a panel with nine RCM features was proposed to identify LMM, which was subsequently tested in a subset of initial cohort (n = 93) in the matched case-control study by two blinded observers. Univariable and multivariable logistic regression models were performed to evaluate RCM features predictive of LMM. Reproducibility of assessment of the nine RCM features was also evaluated. RESULTS: A total of 229 LM/LMM cases evaluated by histopathology were assessed blindly and prospectively by an expert confocalist. On histopathology, 210 were LM and 19 were LMM cases. Correct identification of an invasive component was achieved for 17 of 19 LMM cases (89%) and the absence of a dermal component was correctly diagnosed in 190 of 210 LM cases (90%). In the matched case-control (LMM n = 35, LM n = 58), epidermal and junctional disarray, large size of melanocytes and nests of melanocytes were independent predictors of LMM on multivariate analysis. The interobserver analysis demonstrated that these three features had a fair reproducibility between the two investigators (K = 0.4). The multivariable model including those three features showed a high predictive performance AUC = 74% (CI 95% 64-85%), with sensitivity of 63% (95% CI 52-78%) and specificity of 79% (CI 95% 74-88%), and likelihood ratio of 18 (p-value 0.0026). CONCLUSION: Three RCM features were predictive for identifying invasive melanoma in the background of LM.

Computer-Aided Diagnosis of Melanoma Subtypes Using Reflectance Confocal Images.

Lentigo maligna (LM) is an early form of pre-invasive melanoma that predominantly affects sun-exposed areas such as the face. LM is highly treatable when identified early but has an ill-defined clinical border and a high rate of recurrence. Atypical intraepidermal melanocytic proliferation (AIMP), also known as atypical melanocytic hyperplasia (AMH), is a histological description that indicates melanocytic proliferation with uncertain malignant potential. Clinically and histologically, AIMP can be difficult to distinguish from LM, and indeed AIMP may, in some cases, progress to LM. The early diagnosis and distinction of LM from AIMP are important since LM requires a definitive treatment. Reflectance confocal microscopy (RCM) is an imaging technique often used to investigate these lesions non-invasively, without biopsy. However, RCM equipment is often not readily available, nor is the associated expertise for RCM image interpretation easy to find. Here, we implemented a machine learning classifier using popular convolutional neural network (CNN) architectures and demonstrated that it could correctly classify lesions between LM and AIMP on biopsy-confirmed RCM image stacks. We identified local z-projection (LZP) as a recent fast approach for projecting a 3D image into 2D while preserving information and achieved high-accuracy machine classification with minimal computational requirements.

Sex Differences in Falls: The Mediating Role of Gait Stability Ratio and Body Balance in Vulnerable Older Adults.

This study, conducted on a large sample of older adults at elevated fall risk (1), aimed to verify statistical differences in gait stability ratio (GSR) and body balance (BB) according to sex, (2) to examine and compare GSR and BB performance between older adult fallers and non-fallers, (3) to determine an association between GSR and BB according to the history of falls, and (4) to explore whether GSR and BB mediate the association between sex and falls. We included 619 individuals (69.8 ± 5.6 years) living in the Autonomous Region of Madeira, Portugal. The frequency of falls was obtained by self-report. BB was determined by the Fullerton Advanced Balance scale, while GSR was established by dividing cadence by gait speed and data collected during the 50-foot walk test. Males indicated a lower prevalence of falls in the last 12 months (23.6%), while females had a higher score (48.7%), as well as a lower balance performance (p < 0.001) and higher GSR scores (p < 0.001). Lower BB control (p < 0.001), as well as higher GSR, were more expressive for fallers (p < 0.001). We found a large, negative and significant correlation between GSR and BB for historical falls (r = −0.560; p < 0.001), and between male and female cohorts (r = −0.507; p < 0.001). The total effect of sex on falls mediated by GSR and BB was 16.4%. Consequently, GSR and BB mediated this association by approximately 74.0% and 22.5%, respectively.

Differential Patterns in Motivations for Practicing Sport and Their Effects on Physical Activity Engagement across the Lifespan.

This study aims to report what motivates individuals to be physically active, to determine whether motivating factors influence physical activity (PA) levels, and whether this differs across the lifespan. This is a cross-sectional study with 498 individuals: 117 adolescents, 306 adults, and 75 older adults. PA was assessed using Baecke's questionnaire, and motivating factors for practicing sports were investigated using a scale with twelve questions. The factor analysis identified three motivating factors for sports practice: psychosocial, bodily, and well-being. The scale's overall reliability and internal consistency indicated a Cronbach's alpha of 0.885. The analysis of covariance (ANCOVA) adjusted for sex indicated the three factors as having a significant effect on PA (p < 0.050); however, only the well-being factor showed a significant interaction with age groups (p = 0.023, ηp2 = 0.030). Subsequently, the effect of the well-being factor on PA scores in each age group was explored through regression analyses. Only older adults showed a significant association in the unadjusted [OR = 0.378, p = 0.001, R2 = 0.243] and the sex-adjusted analysis [OR = 0.377, p = 0.001, R2 = 0.288]. These results help us to better understand the underlying motivational reasons in different age groups for engaging in sports.

The Relation of Having Experienced a Fall in the Past to Lower Cognitive Functioning in Old Age Is Mediated via Less Physical Activity Engagement as Cognitive Reserve Contributor.

Physical activity and exercise contribute to the accumulation of cognitive reserve, which is instrumental for preserving cognitive health in old age. In a large sample of 701 older adults (mean age = 70.36 years), we investigated whether the relationship between having experienced a fall in the past and lower performance in cognitive functioning was mediated via less physical activity engagement as a cognitive reserve contributor. General cognition was assessed using the mini-mental state examination (MMSE), long-term memory using a word-pair delayed recall test and working memory using a backward digit-span test. In face-to-face interviews, individuals reported information on falls during the past 12 months and their habitual physical activity engagement. Our analyses demonstrated that the relationship between having experienced a fall in the past and lower performance in the cognitive functioning measures was partly mediated (by 16.3% for general cognition, 30.6% for long-term memory, and 33.1% for working memory, respectively) via less physical activity engagement. In conclusion, we suggest as a core bio-psychological mechanism that experiencing a fall at an older age is a critical life event that hinders sufficient physical activity engagement and thereby impedes cognitive reserve build-up, resulting in lower cognitive functioning outcomes.

Satisfação dos enfermeiros de reabilitação com o trabalho / Job satisfaction of rehabilitation nurses / Satisfacción laboral de los enfermeros de rehabilitación

Resumo Enquadramento: A satisfação dos enfermeiros de reabilitação com o trabalho contribui para o desempenho individual, a qualidade e segurança dos cuidados prestados aos clientes e para o sucesso organizacional, sendo crucial a sua avaliação. Objetivo: Analisar a satisfação dos enfermeiros de reabilitação com o trabalho, no Serviço de Saúde da Região Autónoma da Madeira, EPE. Metodologia: Estudo quantitativo, transversal, exploratório-descritivo e analítico. Utilizamos a Escala de Satisfação dos Enfermeiros para a colheita de dados. A análise estatística incluiu estatística descritiva simples. Obteve-se parecer favorável da comissão de ética para a saúde (Parecer n.º 25/2019). Resultados: Globalmente 97,35% dos enfermeiros estão moderadamente satisfeitos com o trabalho. Relativamente às dimensões 43, 36% dos participantes referem estar satisfeitos com a "valorização profissional" e 51,33% encontram-se insatisfeitos com a "valorização e remuneração salarial". Conclusão: A maioria dos participantes estão moderadamente satisfeitos. Deve-se atender à satisfação global e às suas dimensões, principalmente, à satisfação com as "chefias", "organizações e recursos", "valorização e remuneração" e "dotações", para potenciar a satisfação com o trabalho.

Abstract Background: The job satisfaction of rehabilitation nurses contributes to individual performance, patient care quality and safety, and organizational success. Thus, its assessment is vital. Objective: To analyze the job satisfaction of rehabilitation nurses in the Health Service of the Autonomous Region of Madeira (SESARAM - Serviço de Saúde da Região Autónoma da Madeira), Public Corporation (EPE - Entidade Pública Empresarial). Methodology: This is a quantitative, cross-sectional, exploratory-descriptive, and analytical study. The Nurse Job Satisfaction Scale was used to collect the data. The statistical analysis included simple descriptive statistics. This study was approved by the Health Ethics Committee (Opinion no. 25/2019). Results: Overall, 97.35% of nurses are moderately satisfied with their work. Concerning the dimensions, 43.36% of the participants express their "Satisfaction with Professional Recognition," while 51.33% are dissatisfied with "Recognition and Remuneration." Conclusion: Most participants are moderately satisfied. It is necessary to pay closer attention to global satisfaction and its dimensions, particularly "Satisfaction with leadership," "Satisfaction with organizations and resources," "Satisfaction with recognition and remuneration," and "Satisfaction with staffing," to improve Job Satisfaction.

Resumen Marco contextual: La satisfacción laboral de los enfermeros de rehabilitación contribuye al rendimiento individual, a la calidad y seguridad de los cuidados prestados a los pacientes y al éxito de la organización, por lo que evaluarla es crucial. Objetivo: Analizar la satisfacción laboral de los enfermeros de rehabilitación en el Servicio de Salud de la Región Autónoma de Madeira, EPE. Metodología: Estudio cuantitativo, transversal, exploratorio-descriptivo y analítico. Se utilizó la Escala de Satisfacción Laboral de los Enfermeros para la recogida de datos. El análisis estadístico incluyó estadísticas descriptivas simples. Se obtuvo el dictamen favorable del Comité de Ética de la Salud (Dictamen n.º 25/2019). Resultados: En general, el 97,35% de los enfermeros están moderadamente satisfechos con su trabajo. En cuanto a las dimensiones, el 43,36% de los participantes mencionan que están satisfechos con el "desarrollo profesional" y el 51,33% está insatisfecho con la "valoración y la remuneración salarial". Conclusión: La mayoría de los participantes están moderadamente satisfechos. Se debe considerar la satisfacción global y sus dimensiones, especialmente la satisfacción con los "gerentes", "organizaciones y recursos", "apreciación y remuneración" y "asignaciones", para mejorar la satisfacción con el trabajo.

Exploring Mediation Effects of Gait Speed, Body Balance, and Falls in the Relationship between Physical Activity and Health-Related Quality of Life in Vulnerable Older Adults.

The present study aimed to examine whether gait speed (GS), body balance (BB), and falls mediated the relationship between physical activity (PA) and health-related quality of life (HRQoL) in community-dwelling older adults. This is a cross-sectional study that included 305 men and 314 women (69.5 ± 5.6 years), residing in the Autonomous Region of Madeira, Portugal. HRQoL and PA were assessed using the SF-36 and Baecke Questionnaires, respectively. While BB was obtained by the Fullerton Advance Balance (FAB) scale, GS by the 50-foot (15 m) walk test, and the frequency of falls was obtained by self-report. According to the analyses, when GS and BB were placed concomitantly as mediators, the direct effect revealed by the model revealed a non-significant relationship between PA and falls. Thus, in the context of falls, GS and BB partially mediated the association between PA and HRQoL in approximately 29.7%, 56%, and 49.2%, respectively. The total HRQoL model explained a variance of 36.4%. The results can help to understand the role that GS, BB, and falls play in the relationship between PA and HRQoL of the vulnerable older adult population.

Associations of Gait Speed, Cadence, Gait Stability Ratio, and Body Balance with Falls in Older Adults.

To investigate the association between gait speed (GS), cadence (CAD), gait stability ratio (GSR), and body balance (BB) with falls in a large sample of older adults. The analysis included 619 individuals-305 men and 314 women (69.50 ± 5.62 years)-residing in the Autonomous Region of Madeira, Portugal. Mobility in GS, CAD, and GSR was assessed using the 50-foot walk test and BB by the Fullerton Advanced Balance scale. The frequency of falls was obtained by self-report. Linear regression analysis showed that higher performance in GS and BB was able to reduce the risk of falling by up to 0.34 and 0.44 times, respectively. An increase in the GSR value enhanced the risk of falling by up to 0.10 times. Multinomial analysis indicated that, in relation to the highest tertile (reference), older adults classified with GS and BB performance in the lowest tertile (lowest) had an increased chance (OR) of falling by up to 149.3% and 48.8%, respectively. Moreover, in relation to the highest tertile, the performance of the GSR classified in the lowest and medium tercile showed an increase in the chance of falling by up to 57.4% and 56.4%, respectively.

The Mediating Role of Physical Activity and Physical Function in the Association between Body Mass Index and Health-Related Quality of Life: A Population-Based Study with Older Adults.

This study aimed (1) to investigate the association between body mass index (BMI), physical activity (PA), and physical function (PF) with health-related quality of life (HRQoL), and (2) to examine in-depth whether PA and PF mediate the relationship between BMI and HRQoL in older adults. We investigated 802 individuals (mean age 69.8 ± 5.6 years), residents of the Autonomous Region of Madeira, Portugal. Harmol and PA were assessed using the SF-36 and Baecke questionnaires, respectively, and PF by the Senior Fitness Test. The prevalence of overweight was 71.3%, 26.5% for normal weight, and 2.1% for underweight. We verified a small correlation between age and sex with BMI, PA, PF, and medium borderline with HRQoL. After adjusting for covariates (i.e., sex, age, comorbidities), the multivariate regression analysis indicated a 93.1% chance of improvement in HRQoL for low BMI, while PA and PF revealed a chance of increasing HRQoL by 91.8% and 60.0%, respectively. According to the serial mediation pathway, PA and PF partially mediated the association between BMI and HRQoL by 32.3% and 81.5%, respectively. The total variance of the model was 90%. It was concluded that BMI can negatively affect HRQoL. On the other hand, PA and PF are able to increase HRQoL levels during the aging process.

The Role of Physical Function in the Association between Physical Activity and Gait Speed in Older Adults: A Mediation Analysis.

Adequate levels of physical function (PF) are essential for vulnerable older adults to perform their daily tasks safely and remain autonomous. Our objective was to explore the mediating role of PF in the relationship between physical activity (PA) and gait speed (GS) in a large sample of older adults from the north of Brazil. This is a cross-sectional study that analyzed 697 older adults (mean age 70.35 ± 6.86 years) who participated in the project "Health, Lifestyle, and Physical Fitness in Older Adults in Amazonas" (SEVAAI). PA was assessed using the Baecke Questionnaire, PF using the Senior Fitness Test, and GS using the 50-foot Walk Test. Mediation pathways were analyzed to test the possible mediating role of PF between specific PA domains (PA-total score, PA-housework, PA-sport, PA-leisure) and GS. Regarding PA-total, the analysis showed that high-performance GS was partially mediated in approximately 19% by better PF performance. Moreover, the PF could partially mediate the association between PA-sport and PA-leisure with GS, at levels of approximately 9% and 46%, respectively. An inverse relationship was observed between PA-housework (sedentary lifestyle) and GS. This association was partially mediated to an extent of approximately 9% by better PF performance. We conclude that PF plays a crucial role in mediating the association between PA and GS among vulnerable older adults.

Utility of optical coherence tomography in basal cell naevus syndrome: A case report.

Optical Coherence Tomography (OCT) is a useful non-invasive diagnostic tool for diagnosing and monitoring treatment of basal cell carcinomas. We describe the use of OCT in a patient with Basal Cell Naevus Syndrome. Through measuring tumour depth on OCT, management of individual tumours was triaged accordingly using 0.4 mm tumour depth as a cut-off for surgical and non-surgical management. OCT has potential to reduce unnecessary excisions and associated morbidity in this population of patients.

Muscle Strength and Balance as Mediators in the Association between Physical Activity and Health-Related Quality of Life in Community-Dwelling Older Adults.

Lower extremity muscle strength (LEMS) and body balance (BB) are essential for older adults to maintain an upright posture and autonomously perform their basic activities of daily living. This study aimed to examine whether LEMS and BB mediate the relationship between physical activity (PA) and health-related quality of life (HRQoL) in a large sample of community-dwelling older adults. This is a cross-sectional study carried out with 802 individuals, 401 males and 401 females (69.8 ± 5.6 years), residents of the Autonomous Region of Madeira, Portugal. PA and HRQoL were assessed by the Baecke Questionnaire and e SF-36, respectively. LEMS was assessed by the Senior Fitness Test and BB by the Fullerton Advance Balance (FAB). The serial mediation pathway model pointed out that LEMS and BB partially mediated the association between PA and HRQoL in approximately 39.6% and 47%, respectively. The total variance in HRQoL explained by the entire model was 98%. Our findings may indicate the role that LEMS and BB play in the relationship between PA and HRQoL in the older population.

Amburana cearensis leaf extract protects against cisplatin-induced ovarian damage through regulation of p-PTEN and p-Akt proteins in mice.

Objectives: To evaluate the effects of Amburana cearensis leaf extract against cisplatin-induced ovarian toxicity in mice and involvement of p-PTEN and p-Akt proteins. Materials and Methods: A. cearensis ethanolic leaf extract was analyzed by high-performance liquid chromatography (HPLC). Mice were pretreated once daily for 3 days as follows: (1) the control group was pretreated with oral administration (o.p.) of saline solution, followed by intraperitoneal (IP) injection of saline solution. The other groups were pretreated (o.p.) with (2) saline solution (cisplatin group), (3) N-acetylcysteine (positive control), with (4) 50, or (5) 200 mg/kg body weight of A. cearensis extract, followed by injection of 5 mg/kg body weight (IP) of cisplatin. The ovaries were harvested and destined for histological (follicular morphology), immunohistochemistry (apoptosis and cell proliferation), and fluorescence (reactive oxygen species [ROS], glutathione concentrations [GSH], and active mitochondria) analyses. Furthermore, immunoexpression of p-PTEN and p-Akt was evaluated to elucidate a potential mechanism by which A. cearensis extract could prevent cisplatin-induced ovarian damage. Results: After HPLC analysis, protocatechuic acid was detected in the extract. The pretreatment with N-acetylcysteine or A. cearensis extract maintained the percentage of normal follicles and cell proliferation, reduced apoptosis and ROS concentrations, and increased GSH concentrations and mitochondrial activity compared with cisplatin treatment. Furthermore, pretreatment with A. cearensis extract regulated p-PTEN and p-Akt immunoexpression after cisplatin exposure. Conclusion: Pretreatment with A. cearensis extract prevented cisplatin-induced ovarian damage through its anti-oxidant actions and by modulating the expression of phosphorylated PTEN and Akt proteins.

The Role of Cognitive Performance and Physical Functions in the Association between Age and Gait Speed: A Mediation Study.

INTRODUCTION: With vulnerable aging, gait speed (GS) undergoes progressive changes, becoming slower. In this process, cognitive performance (CP) and physical function (PF) both play an important role. This study aims (1) to investigate the association between CP and PF with GS and (2) to examine whether CP and PF mediate the association between age and GS in a large sample of Brazilian older adults. METHODS: A cross-sectional study analyzed 697 individuals (mean age 70.35 ± 6.86 years) from the state of Amazonas. The CP was evaluated by the COGTEL test battery, PF by the Senior Fitness Test battery, and GS with the 50-foot Walk Test. RESULTS: Older adults with a lower CP and PF had a 70% and 86% chance of slow GS, respectively. When CP and PF were placed simultaneously as mediators, the direct effect estimated by the model revealed a non-significant relationship between age and GS. Specifically, CP and PF mediated the association between age and GS, at approximately 12% and 98%, respectively. CONCLUSIONS: CP and PF show the potential to estimate GS performance among older adults. Moreover, CP and PF indicated a negative and direct association between age and slow GS, especially PF.

Exploring the Role of Physical Activity in Mediating the Association between Educational Level and Health-Related Quality of Life in an Adult Lifespan Sample from Madeira Island.

Background: People more socioeconomically vulnerable tend to have a poorer health-related quality of life (HRQoL). Studies are trying to analyse the factors that may condition this relationship, including physical activity (PA), which may influence the relationship between socioeconomic status (SES) and HRQoL. This study aimed to analyse the relationship between SES and HRQoL through specific domains of PA. Methods: A total of 381 adults (≥18 years) from the Autonomous Region of Madeira completed the measurements. Mediation analyses using bootstrapping methods adjusted for confounding variables were performed to relate SES and HRQoL; the latter was evaluated using the physical component score (PCS) of the SF-12, the mental component score (MCS) of the SF-12, and the total score in the SF-12 questionnaire (SF-12 score), through physical activity. Results: Educational level was positively related to PCS and SF-12 score. Leisure-time PA (not including sports PA) and PA at work, as single mediating variables, did not mediate the relationship between SES and HRQoL. The total PA suppressed the socioeconomic gradient of HRQoL by 8-10%, 39-46%, and 15-16%, respectively, for the PCS, MCS, and the SF-12 score; sports PA mediated the relationship by 13-16%, 50%, and 15-21%, respectively. Conclusions: The results suggest that sports PA contributes to reducing the socioeconomic gradient of HRQoL.

Modeling Adoption, Security, and Privacy of COVID-19 Apps: Findings and Recommendations From an Empirical Study Using the Unified Theory of Acceptance and Use of Technology.

BACKGROUND: The global health crisis caused by COVID-19 has drastically changed human society in a relatively short time. However, this crisis has offered insights into the different roles that such a worldwide virus plays in the lives of people and how those have been affected, as well as eventually proposing new solutions. From the beginning of the pandemic, technology solutions have featured prominently in virus control and in the frame of reference for international travel, especially contact tracing and passenger locator applications. OBJECTIVE: The objective of this paper is to study specific areas of technology acceptance and adoption following a unified theory of acceptance and use of technology (UTAUT) research model. METHODS: We presented a research model based on UTAUT constructs to study the determinants for adoption of COVID-19-related apps using a questionnaire. We tested the model via confirmatory factor analysis (CFA) and structural equation modeling (SEM) using travelers' data from an insular tourist region. RESULTS: Our model explained 90.3% of the intention to use (N=9555) and showed an increased understanding of the vital role of safety, security, privacy, and trust in the usage intention of safety apps. Results also showed how the impact of COVID-19 is not a strong predictor of adoption, while age, education level, and social capital are essential moderators of behavioral intention. CONCLUSIONS: In terms of scientific impact, the results described here provide important insights and contributions not only for researchers but also for policy and decision makers by explaining the reasons behind the adoption and usage of apps designed for COVID-19.

Cognitive Reserve Mediates the Relation between Neighborhood Socio-Economic Position and Cognitive Decline.

Introduction: We investigated the mediating role of leisure activity engagement as marker of cognitive reserve in the relation between neighborhood socio-economic position (SEP) and cognitive decline over 6 years. Methods: The study analyzed longitudinal data from 897 older adults who participated in the two waves (2011 and 2017) of the Vivre-Leben-Vivere (VLV) survey in Switzerland (M = 74.33 years in the first wave). Trail Making Test parts A and B were administered in both waves. Leisure activity engagement was assessed during interviews. Neighborhood SEP was derived from the Swiss Neighborhood Index of Socio-Economic Position (Swiss-SEP), provided by the Swiss National Cohort (SNC). Results: Latent change score modeling revealed that 42.5% of the relationship between higher neighborhood SEP and smaller cognitive decline was mediated via a higher frequency of leisure activities in the first wave. Conclusion: Neighborhood SEP constitutes an important contextual factor potentially influencing the pathways of cognitive reserve accumulation and, therefore, should be taken into account to better understand their effects on cognitive decline in old age.