Childhood Emotional Neglect and Cognitive Function Among Middle-Aged and Older Adults: Mediating Role of Social Engagement.

Studies have demonstrated that childhood maltreatment and adverse experiences lead to impaired cognitive function. However, relatively few studies have examined the independent effect of childhood emotional neglect on cognitive function in middle-aged and older adults, and the role of social engagement in this relationship. Using a sample from the China Health and Retirement Longitudinal Study, the current study examined the mediating role of social engagement in the association between childhood emotional neglect and cognitive function among middle-aged and older adults. Participants were 32,540 middle-aged and older adults (Mage = 63.45, SD = 8.83). Data were analyzed using a fixed effects model for panel data and bootstrap resampling method. Results showed that participants who experienced emotional neglect had poorer cognitive function (ß = -.068, p < .001). Social engagement mediated 7.55% of the association between emotional neglect and cognitive function (ß = -.004, 95% CI [-0.006, -0.002], p < .05). The results indicated that interventions are required to improve awareness of emotional neglect and facilitate healthy parenting practices. Further research on how to motivate adults who experienced emotional neglect to engage in social activities is necessary.

Trajectories of depressive symptoms in young and middle-aged men who have sex with men with new HIV-diagnosis: a 1-year prospective cohort study in Beijing, China.

Introduction: Due to the sexual orientation and HIV diagnosis, young and middle-aged men who have sex with men (MSM) with new HIV-diagnosis may experience more depressive syndromes and face greater psychological stress. The study explored trajectories of depressive symptoms of young and middle-aged MSM within 1 year after new HIV-diagnosis and analyze the related factors. Methods: From January 2021 to March 2021, 372 young and middle-aged MSM who were newly diagnosed as HIV-infection were recruited in two hospitals in Beijing. Self-rating Depression Scale was used to measure the participants' depressive symptom in 1st month, 3rd month, 6th month, 9th month and 12th month after HIV diagnosis. The latent class growth model was used to identify trajectories of the participants' depressive symptoms. Multinomial logistic regression was used to analyse factors related with the trajectories. Results: Three hundred and twenty-eight young and middle-aged MSM with new HIV-diagnosis completed the research. Depressive symptom in 328 young and middle-aged MSM was divided into three latent categories: non-depression group (56.4%), chronic-mild depression group (28.1%), and persistent moderate-severe depression group (15.5%). The participants assessed as non-depression (non-depression group) or mild depression (chronic-mild depression group) at the baseline were in a non-depression state or had a downward trend within one-year, and the participants assessed as moderate and severe depression (persistent moderate-severe depression group) at the time of diagnosis were in a depression state continuously within 1-year. Multinomial logistic regression analysis showed that, compared with the non-depression group, monthly income of 5,000 ~ 10,000 RMB (equal to 690 ~ 1,380 USD) was the risk factor for the chronic-mild depression group, and self-rating status being fair/good and self-disclosure of HIV infection were protective factors for the persistent moderate-severe depression group while HIV-related symptoms was the risk factor. Conclusion: Depressive symptoms in young and middle-aged MSM is divided into three latent categories. Extra care must be given to young and middle-aged MSM assessed as moderate or severe depression at the time of HIV-diagnosis, especially to those who had poor self-rating health status, did not tell others about their HIV-infection and experienced HIV-related symptoms.

Influencing Factor Analysis of First-Choice Medical Institutions for Aging People in China.

Purpose: This study aimed to analyze first-choice medical institutions for middle-aged and older adults in Fujian Province to promote the development of hierarchical diagnosis and treatment for them. Patients and Methods: Single factor analysis, disordered multi-classification logistic regression, and multiple correspondence classification were used to analyze the influencing factors of first-choice medical institutions for middle-aged and older adults. A total of 486 valid questionnaires were obtained. The questionnaire was based on Health Service Integration Theory and the behavioral model of Andersen. Results: Age, education level, living area, monthly income, nearest medical institution to home, and integrated health service system understanding significantly influenced respondents' preference of first medical institution. Middle-aged and older adults were more inclined to visit county and municipal hospitals first. The treatment center's proximity was also an important determinant of their first-choice selection of medical care. Conclusion: To realize high-quality hierarchical diagnosis and treatment and integrated health service system construction, it is important to improve the service capacity of primary medical institutions, increase the training of family doctors, implement the contract coverage of family doctors, optimize the allocation and geographical layout of primary medical institutions, ensure adequate income levels, and promote township hospital staff.

Programa del Adulto Mayor y su impacto integral en el municipio Trinidad, periodo 2020-2022 / Elderly Adult Program and its integral impact in Trinidad municipality, period 2020-2022

Fundamento: Con el aumento de la esperanza de vida en Cuba se hace necesario insertar al adulto mayor en la actividad física comunitaria, que es uno de los procesos de funcionamiento del Instituto Nacional de Deportes, Educación Física y Recreación, mediante el Programa del Adulto Mayor para mejorar la calidad de vida de este grupo etario. Objetivo: Determinar los rasgos distintivos que caracterizan el impacto integral del Programa del Adulto Mayor en la calidad de vida de los practicantes del municipio Trinidad en la provincia Sancti Spíritus. Metodología: Se realizó estudio exploratorio que incluyó a 10 directivos y 65 profesores que atienden directamente el Programa del Adulto Mayor en el municipio Trinidad y 64 adultos mayores practicantes sistemáticos; a profesores y directivos se les realizaron entrevistas. Se utilizaron los métodos inductivo-deductivo, análisis de documento, medición y la entrevista. Los métodos estadísticos matemáticos se aplicaron para el procesamiento de los datos, específicamente dentro de la estadística descriptiva se utilizaron tablas de distribución empírica de frecuencias. Resultados: El Programa e Indicaciones metodológicas no ofrecen información relacionada con el impacto integral del mismo, el 100 % de los directivos considera necesario que se investigue en relación con el impacto integral de este Programa, la totalidad de los profesores entrevistados expresaron que solo se evalúa la condición física del adulto mayor. El 80 % de los adultos mayores se sienten satisfechos con su estado de salud y el 98 % consideraron que el Programa mejora su calidad de vida. Conclusiones: Se ofrecen los rasgos distintivos que caracterizan el impacto integral del Programa del Adulto Mayor; las deficiencias detectadas orientan la necesidad de evaluar de forma integral el impacto del mismo en la calidad de vida de los practicantes sistemáticos.

Background: Due to the increase in life expectation in Cuba, it becomes necessary to insert the elderly adults in community physical activity, which is one of National Institute of Sports, Physical Education and Recreation functioning processes, by means of the Elderly Adult Program to improve quality of life in this age group. Objective: To determine the distinguishing features that characterize the integral impact of the Elderly Adult Program on the quality of life of the participants of the Municipality of Trinidad in the Province of Sancti Spiritus. Methodology: An exploratory study was conducted that included 10 managers and 65 teachers who directly attend the Elderly Adult Program in the municipality of Trinidad and 64 systematically practicing elderly adults; interviews were conducted with teachers and managers. Inductive-deductive methods, document analysis, measurement and interview were used. Mathematical-statistical methods were applied to process the data, specifically, within the descriptive statistics, empirical frequency distribution tables were used. Results: The Program and Methodological Indications do not offer information relating to the integral program impact, 100% of the managers consider necessary to investigate the integral impact of the program, most of the teachers interviewed said that only the physical condition of elderly adults is evaluated. The 80% of them are satisfied with their health and 98% believe the program improves their quality of life. Conclusions: The features that characterize the integral impact of the Senior Program are offered; the deficiencies detected suggest the need for a comprehensive evaluation of its impact on the life quality of systematic practitioners.

Sugar intake and colorectal cancer risk: A prospective Japanese cohort study.

The influence of sugar consumption on the risk of colorectal cancer (CRC) remains controversial. Prospective cohort studies focusing on total and specific types of sugar intake among the Asian population who have different patterns of sugar intake sources than American and European populations are scarce. We intended to examine the association of sugar intake with CRC risk among middle-aged adults in a Japanese large-scale population-based cohort study. The participants (42,405 men and 48,600 women) who were 45-74 years old and answered the questionnaire in 1995-1999 in the Japan Public Health Center-based Prospective Study were followed up until December 2013. Total sugars, total fructose, and specific types of sugar intake were estimated using a validated 147-item food frequency questionnaire and divided into quintiles (Q1-Q5). We used Cox proportional hazard regression models adjusted for potential confounders to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During the follow-up, 2118 CRC cases (1226 men and 892 women) were identified. We did not observe any clear association between all types of sugar intake and an increased risk of CRC. Analyses by tumor sites yielded a positive association of total sugar consumption with rectal cancer in women (1.75 [1.07-2.87] for Q1 vs. Q5; p linear trend  = 0.03), but no statistically significant trend was detected among men. Sugar intake was not associated with CRC risk in middle-aged Japanese adults. However, for rectal cancer, the probability of an increased risk among women with a higher total sugar intake cannot be excluded.

Roland-Morris disability questionnaire is bidimensional and has 16 items when applied to community-dwelling older adults with low back pain.

PURPOSE: To explore the evidence of the internal structure validity of the Roland-Morris Disability Questionnaire in older adults with low back pain. METHODS: This was a cross-sectional study of psychometric testing involving 528 older adults with low back pain. Internal structure validity was explored by exploratory factor analysis and semi-confirmatory factor analysis. Reliability was verified using Kuder-Richardson Formula 20, Cronbach's alpha, and McDonald's omega. Replicability was observed by the generalized H index. RESULTS: Roland-Morris Disability Questionnaire displayed two factors that assess "functional capacity" and "mobility". Eight items were excluded for presenting cross-loading (2 and 10), inadequate loading factors and communalities (18, 24, 13, and 12), or did not relate to the latent construct (15 and 22). Semi-confirmatory factor analysis indicated that the questionnaire had a good fitness model [X2 = 153.698 (p = 0.00001); RMSEA = 0.037; RMSR = 0.06; WRMR = 0.04; NNFI = 0.987; GFI = 0.979; AGFI = 0.971]. Reliability was acceptable (KR-20 = 0.79; Cronbach's alpha = 0.86; McDonald's Omega = 0.85), but replicability was poor in both factors (G-H factor 1 = 0.816-0.655; G-H factor 2 = 0.889-0.775). CONCLUSIONS: The most appropriate version of the Roland-Morris Disability Questionnaire to apply to older adults with low back pain has 16 items and assesses functional capacity and mobility. IMPLICATIONS FOR REHABILITATIONThe RMDQ-16 is the most appropriate version of the RMDQ to use in older adults with LBP;The RMDQ-16 is bidimensional and assesses "functional capacity" and "mobility";The poor replicability of the RMDQ-16 indicates that it will probably not be stable across studies, but it can be useful in a clinical setting.

Disparate Cardiovascular Hospitalization Trends Among Young and Middle-Aged Adults Within and Across Race and Ethnicity Groups in Four States in the United States.

Background Inpatient hospitalizations for cardiovascular disease (CVD) decreased nationally in the past decade. However, data are lacking on whether national declines represent trends within and across race and ethnicity populations from different US regions. Methods and Results Using State Inpatient Databases, Census Bureau and Behavioral Risk Factor Surveillance System data for Florida, Kentucky, New Jersey, and North Carolina, we identified all CVD hospitalizations and population characteristics for adults aged 18 to 64 years between January 1, 2009 and December 31, 2018. We calculated yearly CVD hospitalization rates for each state for the overall population, by sex, race, and ethnicity. We modeled yearly trends in age-adjusted CVD hospitalization rate in each state using negative binomial regression. State base populations were similar by age (mean age: 40-42 years) and sex (50%-51% female) throughout the study period. There were 314 973 and 288 843 total CVD hospitalizations among the 4 states in 2009 and 2018, respectively. Crude hospitalization rates declined in all states (age 18-44 years NJ: -33.4%; KY: -17.0%; FL: -11.9%; NC: -11.2%; age 45-64 years NJ: -29.8%; KY: -20.3%; FL: -12.2%; NC: -11.6%) over the study period. In age-adjusted models, overall hospitalization rates declined significantly in NJ -2.5%/y (95% CI, -2.9 to -2.1) and in KY -1.6%/y (-1.9 to -1.2) with no significant declining trend in FL and NC. Similar findings were present by sex. Among non-Hispanic White populations, mean yearly decline in hospitalization rate was significant in all states except FL, with the greatest declines in NJ (-3.8%/y [-4.4 to -3.2], P values for state-year interaction <0.0001). By contrast, a significant declining trend was present for non-Hispanic Black and Hispanic populations only in NJ (P values for state-year interaction <0.001). We found similar differences in trend between states in sensitivity analyses incorporating additional demographic and comorbid characteristics. Conclusions Decreases in CVD hospitalization rates in the past decade among nonelderly adults varied considerably by state and appeared largely driven by declines among non-Hispanic White populations. Overall declines did not represent divergent trends between states within non-Hispanic Black and Hispanic populations. Recognition of differences not just between but also within race and ethnicity populations should inform national and local policy initiatives aimed at reducing disparities in CVD outcomes.

Food consumption and dyslipidemia in middle-aged adults in Indonesia: A cross-sectional national study.

Background: Most people with abnormal lipid profiles are found in middle-aged adults in Indonesia. Unhealthy food consumption was positively associated with dyslipidemia. In contrast, healthy food consumption, including fruits and vegetables, was inversely associated with dyslipidemia. Aim: The aim of the study was to explore the association between food consumption with dyslipidemia among middle-aged adults in Indonesia. Methods: This is a cross-sectional study using secondary data from the national representative survey of Indonesian Basic Health Research (IBHR) conducted by the National Institute of Health Research Development (NIHRD), Ministry of Health, Indonesia, in 2018. The study recruited 10,608 participants aged from 45 to 59 years old. An unadjusted or adjusted odds ratio (OR) and 95% confidence intervals (CIs), and a multivariate logistic regression model were performed to evaluate the associations of food consumption with dyslipidemia. Results: Frequent consumption of barbecue and soft drink was significantly correlated with dyslipidemia (OR = 1.149, CI: 1.055-1.251 and OR = 1.202, CI: 1.041-1.388). Frequent consumption of soft drink, and inadequate intakes of fruits and vegetables were significantly correlated with dyslipidemia (OR = 1.254, CI: 1.012-1.553, OR = 1.178, CI: 1.013-1.388, OR = 1.219, CI: 1.011-1.471, respectively) in men. While, frequent consumption of barbecue was significantly correlated with dyslipidemia (OR = 1.203, CI: 1.068-1.355) in women. Conclusion: Frequent consumption of barbecue and soft drink increased the risk of developing dyslipidemia among middle-aged adults in Indonesia.

Complementary and Alternative Medicines Used by Middle-Aged to Older Taiwanese Adults to Cope with Stress during the COVID-19 Pandemic: A Cross-Sectional Survey.

Background: This study aimed to investigate the factors influencing the use of complementary and alternative medicines (CAMs) to manage stress during the COVID-19 pandemic in Taiwan. Methods: A cross-sectional survey was administered to community-dwelling adults between the ages of 46 and 75 years, and a total of 351 participants completed the questionnaire. Log-binominal regression analyses were fitted to explore the factors associated with the use of CAMs. Results: The mean age of the participants was 57.0 years, and 67.0% reported that they had used CAMs within the past three months. Middle-aged adults were more likely to use CAMs than late middle-aged adults and older adults (p < 0.001). Overall, the major CAMs utilized to relieve psychological stress were music therapies (37.6%), massage (31.1%), spinal manipulation (25.1%), relaxing therapies (24.2%), and reading scriptures or The Bible (23.9%). Religion and vegetarian diets were the most important factors influencing participants to use CAMs, especially music therapies, massage, and reading scriptures/The Bible. Conclusions: CAM use was very prevalent among middle-aged adults in Taiwan; in particular, music therapies were the most favored activities for reducing stress. Population-specific mental health interventions using music can be developed to improve stress management outcomes during public health emergencies.

Higher platelet count, even within normal range, is associated with increased arterial stiffness in young and middle-aged adults.

BACKGROUND: Platelet counts and mean platelet volume (MPV) are related to cardiovascular disease, but a thorough investigation into the connection between increased arterial stiffness, MPV, and platelet counts is lacking. This study aimed to explore the association of platelet count and MPV with arterial stiffness in young and middle-aged adults. METHODS: A total of 2464 participants who underwent health checkups at National Cheng Kung University Hospital, Taiwan from November 2018 to December 2019 were included. We excluded participants aged <18 or >50 years; who are pregnant; on medication for dyslipidemia; with abnormal platelet count, incomplete data, and past history of hematologic disorders. We examined the association of platelet counts and MPV values with brachial-ankle pulse wave velocity (baPWV) levels and increased arterial stiffness. RESULTS: Platelet count was significantly higher in participants with increased arterial stiffness than in those without. The multiple linear regression model revealed that platelet counts were positively associated with baPWV levels (ß = 1.88, 95% confidence interval (CI): 0.96 to 2.80). In the binary logistic regression analysis, subjects in the higher platelet counts quartiles had a higher risk of developing increased arterial stiffness (Q2 vs. Q1: odds ratio (OR): 1.54, 95% CI: 1.05 to 2.27; Q3 vs. Q1: OR: 1.57, 95% CI: 1.06 to 2.33; and Q4 vs. Q1: OR: 2.23, 95% CI: 1.50 to 3.30). In contrast, MPV levels were not associated with arterial stiffness. CONCLUSIONS: Platelet count in midlife was positively associated with baPWV levels. Participants in higher platelet quartiles were at risk for increased arterial stiffness.

Association of Number of Teeth with ADL/IADL in Korean Middle-Aged and Older Adults: An Analysis of the 7th Korean Longitudinal Study of Aging.

We determined the association between the number of natural and implant teeth with activities of daily living (ADL) and instrumental ADL (IADL) levels in middle-aged and older adults aged ≥ 55 years. We included 6,925 participants, who underwent a computer-assisted personal interview in the 7th Korean Longitudinal Study of Aging. After controlling for general characteristics, the associations between the number of natural and implant teeth with ADL and IADL levels were examined using multiple regression analysis. The participants had 21.2 natural teeth and 1.08 implant teeth on average. The ADL and IADL levels were 0.61 and 1.56, 0.40 and 1.16, and 1.10 and 0.31 in participants with ≤ 9, 10-19, and ≥ 20 teeth, respectively. There was no significant association between ADL and the number of natural and implant teeth (p > 0.05). However, a one-unit increase in IADL score was associated with a reduced number of natural (ß = -0.031, p < 0.001) and implant (ß = -0.194, p = 0.006) teeth. Difficulties regarding IADL were associated with fewer natural and implant teeth, suggesting that maintaining and managing the number of teeth is critical to promoting the health of middle-aged and older adults.

Development of an Online-Coaching Blended Couple-Oriented Intervention for Preventing Depression in Middle Adulthood: An Intervention Mapping Study.

Background: Although middle-aged adults in Korea are vulnerable to depression, there are few preventive interventions for depression in middle adulthood. Studies consistently suggest that interventions that include both spouses are effective in decreasing depression and relationship distress. Considering the busy lives of middle-aged couples, it is essential to develop an online-coaching blended couple-oriented intervention. This study aimed to describe the development, implementation, and evaluation of an online-coaching blended couple-oriented intervention using an online program and coaching via videoconference to prevent middle-aged couples' depression; this was done using an intervention mapping (IM) protocol. Methods: Six steps of IM were used to systematically develop a tailored multi-level intervention specific to middle-aged couples' depression. These steps of the IM protocol involve needs assessment, formulation of change objectives, theory-based methods, and practical strategies for program design, program development, program implementation, and program evaluation. Results: The results of the six steps were as follows: (a) middle-aged couples' needs and mental health problems were identified through a scoping review study, mixed-method study, and expert interviews; (b) six performance objectives (POs) were formulated based on the results of Step 1, and intrapersonal, interpersonal, and temporal/transpersonal determinants were identified based on the self-transcendence theory. Change objectives were developed by combining POs with determinants; (c) self-regulated learning was chosen for theoretical teaching methods and practical strategies to change the determinants of each level; (d) four modules consisting of 16 sessions were developed based on the self-transcendence theory; (e) experts evaluated the program and coaches were trained; and (f) the evaluation plan for the program's feasibility, acceptability, usability, and preliminary effects was developed. Discussion: The systematic process using IM allowed us to develop an online-coaching blended couple-oriented intervention to prevent depression and promote couples' relationships. The primary effects of this newly developed program should be evaluated in future studies. This may lead to the increased adoption and implementation of evidence-based and tailored interventions for psychological wellbeing in middle adulthood.

Efectividad de una intervención educativa dirigida a adultos mayores con riesgo suicida / Effectiveness of an Educational Intervention in Aged Adults at Suicidal Risk

Introducción: El suicidio ha constituido desde siempre uno de los grandes enigmas de la humanidad, plantea cuestiones filosóficas, sociales, psicológicas, religiosas y morales. La conducta suicida constituye en Cuba un problema de salud en aumento. Objetivo: Valorar la efectividad de una intervención educativa sobre conducta suicida en el adulto mayor en riesgo. Métodos: Se realizó un estudio preexperimental, prospectivo, durante el período comprendido desde noviembre 2017 a marzo 2019 en el consultorio 1 del policlínico "Mario A. Pérezˮ de Sagua la Grande. La población de estudio estuvo constituida por todos los adultos mayores dispensarizados como riesgo suicida. La muestra quedó integrada por 42 pacientes seleccionados por criterios de inclusión, exclusión y salida. Resultados: Predominó en la muestra el grupo de edad de 60-64 (40,5 por ciento), y las mujeres (59,5 por ciento), el indicador de riesgo desesperanza (61 por ciento) y depresión menor (30,9 por ciento). Al diagnóstico, la información global del tema no era aceptable y posteriormente se constató 97,6 por ciento de información global adquirida. Se aplicó una intervención educativa, validada por los especialistas como factible y pertinente, la cual abarcó 8 encuentros. Conclusiones: La intervención educativa aplicada resultó efectiva al elevar el nivel de información de los adultos mayores con riesgo suicida. El equipo básico de salud es un pilar fundamental para evitar esta conducta, aplicando el enfoque de riesgo en la población(AU)

Introduction: Suicide has always been one of the great enigmas of humanity: it raises philosophical, social, psychological, religious and moral questions. Suicidal behavior is a growing health concern in Cuba. Objective: To assess the effectiveness of an educational intervention on suicidal behavior in the elderly at risk. Methods: A prospective and pre-experimental study was carried out, during the period from November 2017 to March 2019, in the family medical office # 1 of Mario A. Pérez Polyclinic of Sagua la Grande Municipality. The study population consisted of all the older adults classified as being at suicidal risk. The sample was made up of 42 patients selected by inclusion, exclusion and exit criteria. Results: The age group 60-64 (40.5 percent) predominated in the sample, together with women (59.5 percent), the indicator of hopelessness risk (61 percent) and minor depression (30.9 percent). At diagnosis, the global information on the subject was not acceptable and, subsequently, 97.6 percent of the global information acquired was obtained. An educational intervention was applied, validated by the specialists as feasible and pertinent, which included eight meetings. Conclusions: The educational intervention applied was effective in raising the level of information of older adults at suicide risk. The basic health team is a significant tool for avoiding this behavior, applying the risk approach to the population(AU)

Hábitos tóxicos y enfermedades crónicas no transmisibles en una población de la tercera edad / Toxic Habits and Chronic Noncommunicable Diseases in an Aged Population

Introducción: Los hábitos tóxicos son uno de los principales factores que convierten a las enfermedades crónicas no transmisibles en una importante causa de morbilidad y mortalidad. Objetivo: Describir la presencia de enfermedades crónicas no transmisibles y hábitos tóxicos como el consumo de café, alcohol y tabaco en una población de la tercera edad. Métodos: Se realizó un estudio descriptivo en el Consultorio médico 20 del municipio Arroyo Naranjo de La Habana entre octubre de 2018 y mayo de 2019. La población en estudio estuvo conformada por 365 pacientes geriátricos con diagnóstico de enfermedades crónicas no transmisibles. Las variables analizadas fueron edad, sexo, enfermedades crónicas no transmisibles asociadas y sustancias tóxicas consumidas. Los datos fueron obtenidos mediante revisión de historias clínicas y entrevistas realizadas a cada paciente. Los resultados se expresaron mediante tablas y gráficos estadísticos. Resultados: Predominó el sexo femenino y la hipertensión arterial como enfermedad de mayor prevalencia. La enfermedad pulmonar obstructiva crónica fue mayor en hombres y fueron estos los más fumadores. La presencia de úlceras y el consumo de café fueron mayores en las mujeres. En los pacientes entre 60-71 años fue donde se encontró el mayor número de hipertensos y los mayores consumidores de bebidas alcohólicas. Los del grupo 72-82 años fueron los mayores consumidores de tabaco y los más afectados por el asma bronquial. Conclusiones: Las enfermedades crónicas no transmisibles constituyen un problema de salud en la población estudiada. Los hábitos tóxicos detectados se asocian a la presencia de dichas enfermedades en los pacientes estudiados(AU)

Introduction: Toxic habits are one of the main factors that make chronic noncommunicable diseases an important cause of morbidity and mortality. Objective: To describe the presence of chronic noncommunicable diseases and toxic habits such as consumption of coffee, alcohol and tobacco in an elderly population. Methods: A descriptive study was carried out in the family medical office # 20 of the Arroyo Naranjo Municipality, Havana, between October 2018 and May 2019. The study population consisted of 365 geriatric patients diagnosed with chronic noncommunicable diseases. The variables analyzed were age, sex, associated chronic noncommunicable diseases and toxic substances consumed. The data were obtained by reviewing medical records and through interviews with each patient. The results were expressed using statistical tables and graphs. Results: In the research, the female sex predominated, together with arterial hypertension as the most prevalent disease. Chronic obstructive pulmonary disease was higher in men, who also accounted for the higher number of smokers. The presence of ulcers and coffee consumption were higher among women. It was in patients aged 60-71 years where the highest number of hypertensive patients and the highest consumers of alcoholic beverages were found. Those in the 72-82 age group were the greatest tobacco consumers and the most affected by bronchial asthma. Conclusions: Chronic noncommunicable diseases are a health concern in the studied population. The toxic habits detected are associated with the presence of these diseases in the patients studied(AU)

Concordancia entre pruebas de estabilidad unipodal estática para riesgo de caída en adultos mayores chilenos / Concordance between Static Unipodal Stability Tests concerning Risk of Falling in Chilean Aged Adults

Introducción: El equilibrio postural conforma parte de la evaluación funcional para riesgo de caída en adultos mayores. El Ministerio de Salud Chileno aplica el Test Estación Unipodal para valora la estabilidad unipodal estática como herramienta de prevención en salud. Objetivo: Determinar la concordancia o equivalencia diagnóstica entre el Test Estación Unipodal y el Test unipodal para estabilidad corporal estática, en modalidad ojos abiertos. Métodos: Estudio de concordancia diagnóstica, de tipo transversal; aplicado en 60 adultos mayores autovalentes pertenecientes a talleres deportivos del Gimnasio Olímpico de San Miguel, Región Metropolitana, Chile, quienes voluntariamente ejecutaron dos pruebas de estabilidad unipodal estática y respondieron un instrumento de consulta al final de la evaluación referida al Test unipodal para estabilidad corporal estática. Resultados: Entre las dos pruebas de estabilidad unipodal, en modalidad ojos abiertos, se presentó una concordancia significativa al evaluar buena o deficiente estabilidad (p = 0,0005). Los adultos mayores evaluados percibieron el Test unipodal para estabilidad corporal estática como prueba de fácil aplicación, bajo nivel de riesgo físico y cansancio, declarando intención de volver a realizarla si se requiere valorar nuevamente su estabilidad. Conclusión: Ambos métodos, Test Estación Unipodal y Test unipodal para estabilidad corporal estática, en modalidad ojos abiertos, fueron capaces de clasificar correctamente buena estabilidad o estabilidad deficiente en los adultos mayores evaluados. Por lo tanto, resultan equivalentes y concordantes para el diagnóstico de la estabilidad estática con apoyo unipodal(AU)

Introduction: Postural balance is part of the functional assessment for risk of falling in aged adults. The Chilean Ministry of Health applies the Unipodal Station Test to assess static unipodal stability as a health prevention tool. Objective: To determine concordance or diagnostic equivalence between the Unipodal Station Test and the Unipodal Test for static body stability, in the open eyes modality. Methods: Cross-sectional study of diagnostic concordance applied in sixty self-supporting aged adults belonging to sports workshops of the Olympic Gymnasium of San Miguel, in the Metropolitan Region of Chile, who voluntarily completed two static unipodal stability tests and answered a consultation instrument at the end of the assessment concerning the Unipodal Test for static body stability. Results: Between the two unipodal stability tests, in the open eyes modality, a significant concordance was present upon assessing good or poor stability (p = 0.0005). The aged adults who underwent assessment perceived the Unipodal Test for static body stability as a test of easy application and low level of physical risk and fatigue, as well as declared their intention to complete it again if their stability needed to be reassessed. Conclusion: Both the Unipodal Station Test and the Unipodal Test for static body stability, in the open eyes modality, were effective methods to classify good stability or poor stability correctly in the aged adults who underwent assessment. Therefore, they are equivalent and concordant for the diagnosis of static stability with unipodal support(AU)

Abdominoscrotal Hydrocele With Intra-abdominal Undescended Testis in an Elderly: A Case Report.

Abdominoscrotal hydrocele (ASH) is an uncommon congenital anomaly in which a scrotal hydrocele extends to the abdomen through the inguinal canal in an hourglass fashion. Coexisting undescended testes (UDT) have mainly been reported in pediatric populations and are mostly located along the inguinal canal. We present a 66-year-old male with a history of neglected left cryptorchidism, who presented with a progressive ipsilateral inguino-scrotal swelling suggesting indirect inguinal hernia. On physical examination, inguino-scrotal hydrocele was suspected. Abdomen and pelvis computed tomography scan and magnetic resonance imaging revealed an abdominoscrotal cyst with a pathognomonic dumbbell appearance of an ASH, as well as an intra-abdominal testicle that proved to be intracystic, atrophic, and hypovascular. The patient underwent successful radical en-bloc excision of the ASH and testis via an extended inguinal approach. To our knowledge, this is the first case with this constellation of urogenital abnormalities to be reported in an aged man. What makes this case further unique and interesting is the unusual ASH's relationship with the patient's cryptorchid testicle and peritoneal sac.

Special Considerations for Healthy Lifestyle Promotion Across the Life Span in Clinical Settings: A Science Advisory From the American Heart Association.

At a population level, engagement in healthy lifestyle behaviors is suboptimal in the United States. Moreover, marked disparities exist in healthy lifestyle behaviors and cardiovascular risk factors as a result of social determinants of health. In addition, there are specific challenges to engaging in healthy lifestyle behaviors related to age, developmental stage, or major life circumstances. Key components of a healthy lifestyle are consuming a healthy dietary pattern, engaging in regular physical activity, avoiding use of tobacco products, habitually attaining adequate sleep, and managing stress. For these health behaviors, there are guidelines and recommendations; however, promotion in clinical settings can be challenging, particularly in certain population groups. These challenges must be overcome to facilitate greater promotion of healthy lifestyle practices in clinical settings. The 5A Model (assess, advise, agree, assist, and arrange) was developed to provide a framework for clinical counseling with consideration for the demands of clinical settings. In this science advisory, we summarize specific considerations for lifestyle-related behavior change counseling using the 5A Model for patients across the life span. In all life stages, social determinants of health and unmet social-related health needs, as well as overweight and obesity, are associated with increased risk of cardiovascular disease, and there is the potential to modify this risk with lifestyle-related behavior changes. In addition, specific considerations for lifestyle-related behavior change counseling in life stages in which lifestyle behaviors significantly affect cardiovascular disease risk are outlined. Greater attention to healthy lifestyle behaviors during every clinician visit will contribute to improved cardiovascular health.

Sustained Effects of Acute Resistance Exercise on Executive Function in Healthy Middle-Aged Adults.

The present study examined the sustained effects of acute resistance exercise on inhibitory function in healthy middle-aged adults. Seventy healthy middle-aged adults (mean age = 46.98 ± 5.70 years) were randomly assigned to exercise or control groups, and the Stroop test was administered before, immediately after, and 40 min after exercise. The resistance exercise protocol involved two sets of seven exercises performed for a maximum of 10 repetitions, with 60 s between sets and exercises. Acute resistance exercise resulted in higher Stroop test performance under the incongruent (inhibition) and interference conditions immediately post-exercise and 40 min post-exercise. Furthermore, the difference in scores after 40 min was significant. The findings indicate that a moderately intensive acute resistance exercise could facilitate Stroop performance and has a more beneficial effect on sustaining of cognition that involves executive control at least 40 min.

Age-Specific Differences in the Severity of COVID-19 Between Children and Adults: Reality and Reasons.

In severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, children experience mild symptoms compared to adults. However, the precise explanations for this disparity are not clear. Thus, we attempted to identify rational explanations about age-related differences as reported in different studies. Given the incomplete data on SARS-CoV-2, some information has been gathered from other studies of earlier coronavirus or influenza outbreaks. Age-related differences in disease severity are important with regard to diagnosis, prognosis, and treatment of SARS-CoV-2 infections. In addition, these differences impact social distancing needs, since pediatric patients with mild or asymptomatic are likely to play a significant role in disease transmission.

Abdominal Obesity is Associated with Physical Activity Index in Indonesian Middle-Aged Adult Rural Population: A Cross-Sectional Study.

BACKGROUND: Obesity is one of the significant health problems. Physical activity includes a potential modifier in the development of abdominal obesity. OBJECTIVE: The objective of the study is to analyze the association between physical activity and abdominal obesity in middle-aged adults in the Indonesian rural population. METHODS: A community-based study was conducted in a rural area of Malang, Indonesia. Data were collected using interviews to obtain sociodemographic and physical activity index (PAI). Waist circumference was measured using a tape measure. Data were analyzed using one-way ANOVA and logistic regression. RESULTS: A total of 75 adults (62.7% were female) was included in this study. Mean waist circumference was 88.18 ± 9.21 cm. Total prevalence of abdominal obesity was 69.3%. Among the total of participants, 29.3% were inactive. A significant association was found between physical activity and abdominal obesity. Participants with inactive PAI have a higher risk of suffering from abdominal obesity than those with active PAI with odds ratio = 7.04; 95% confidence interval: 1.55-31.99. CONCLUSION: In middle-aged adults living in a rural area of Indonesia, physical activity was associated with a lower risk of abdominal obesity. Strategies for preventing and reducing abdominal obesity in rural areas should consider improving physical activity.