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Ahola J, Kekäläinen T, Kinnunen ML, Tolvanen A, Pitkänen T, Pulkkinen L, Saajanaho M, Kokko K. Stability in health behavior patterns in middle adulthood: a 19-year follow-up study. Psychol Health 2024:1-21. [PMID: 38389311 DOI: 10.1080/08870446.2024.2316676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/06/2024] [Indexed: 02/24/2024]
Abstract
Objective: This study investigated subgroups of adults with particular health behavior patterns, their stability over 19 years, and the role of sociodemographic and personality characteristics in these. Methods and Measures: Data on smoking, alcohol consumption, and physical activity were collected at ages 42, 50, and 61 in the Jyväskylä Longitudinal Study of Personality and Social Development (n = 205-302). Latent class, latent transition, and logistic regression analyses were used. Results: Four similar classes of health behaviors were identified at each age. A class named low alcohol consumption (AC)-high physical activity (PA) included individuals with the lowest levels of alcohol consumption and the highest levels of physical activity, and a class named high AC-low PA vice versa. Classes between these extremes of alcohol consumption and physical activity levels were nonsmokers with the lowest proportion of smokers, and smokers vice versa. Although transitions emerged, class memberships were relatively stable. Women, those who were married, held a degree, had higher occupational status, and certain personality traits at age 42 were more likely to belong continuously to healthier classes compared to a stable membership in high AC-low PA. Conclusion: Health behaviors exist in patterns, are relatively stable across adulthood, and associated with sociodemographic and personality characteristics.
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Affiliation(s)
- Johanna Ahola
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tiia Kekäläinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Marja-Liisa Kinnunen
- The Wellbeing Services County of Central Finland, Jyväskylä, Finland
- School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Asko Tolvanen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | | | - Lea Pulkkinen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Milla Saajanaho
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Katja Kokko
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Birditt KS, Turkelson A, Polenick CA, Cranford JA, Smith JA, Ware EB, Blow FC. Alcohol Use and Mortality Among Older Couples in the United States: Evidence of Individual and Partner Effects. Gerontologist 2024; 64:gnad101. [PMID: 37487060 PMCID: PMC10825846 DOI: 10.1093/geront/gnad101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Spouses with concordant (i.e., similar) drinking behaviors often report better quality marriages and are married longer compared with those who report discordant drinking behaviors. Less is known regarding whether concordant or discordant patterns have implications for health, as couples grow older. The present study examined whether drinking patterns among older couples are associated with mortality over time. RESEARCH DESIGN AND METHODS The Health and Retirement Study (HRS) is a nationally representative sample of individuals and their partners (married/cohabiting) over age 50 in the United States, in which participants completed surveys every 2 years. Participants included 4,656 married/cohabiting different-sex couples (9,312 individuals) who completed at least 3 waves of the HRS from 1996 to 2016. Participants reported whether they drank alcohol at all in the last 3 months, and if so, the average amount they drank per week. Mortality data were from 2016. RESULTS Analyses revealed concordant drinking spouses (both indicated they drank in the last 3 months) survived longer than discordant drinking spouses (1 partner drinks and the other does not) and concordant nondrinking spouses. Analysis of average drinks per week showed a quadratic association with mortality such that light drinking predicted better survival rates among individuals and their partners compared with abstaining and heavy drinking. Further, similar levels of drinking in terms of the amount of drinking were associated with greater survival, particularly among wives. DISCUSSION AND IMPLICATIONS This study moves the field forward by showing that survival varies as a function of one's own and one's partner's drinking.
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Affiliation(s)
- Kira S Birditt
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Angela Turkelson
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | | | - James A Cranford
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Jennifer A Smith
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Erin B Ware
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Frederic C Blow
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
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Wieczorek M, Meier C, Kliegel M, Maurer J. Relationship Between Health Literacy and Unhealthy Lifestyle Behaviours in Older Adults Living in Switzerland: Does Social Connectedness Matter? Int J Public Health 2023; 68:1606210. [PMID: 37876738 PMCID: PMC10590881 DOI: 10.3389/ijph.2023.1606210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/25/2023] [Indexed: 10/26/2023] Open
Abstract
Objectives: To investigate the association between health literacy (HL) and unhealthy lifestyle behaviours and to explore the moderating role of social connectedness in this relationship in older adults in Switzerland. Methods: We used data from 1,455 respondents to Wave 8 of the Survey of Health, Ageing, and Retirement in Europe (SHARE). Associations between the number of unhealthy lifestyle behaviours (smoking, risky alcohol consumption, suboptimal daily consumption of fruits/vegetables, lack of vigorous physical activity) and HL were examined using multivariable Poisson regression models, which allowed for interactions between HL and social connectedness to test the moderation hypothesis. Results: Respondents with inadequate HL were significantly more likely to have a higher number of unhealthy lifestyle behaviours than respondents with sufficient HL. We found a stronger positive association between inadequate HL and the number of unhealthy lifestyle behaviours among socially isolated individuals. Conclusion: Greater social connectedness seems to buffer the negative impact of inadequate HL on unhealthy lifestyle behaviours in older adults, highlighting the importance of good HL for healthy lifestyles, especially in individuals with low social reserve.
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Affiliation(s)
- Maud Wieczorek
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
| | - Clément Meier
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland
- Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne, Lausanne, Switzerland
| | - Matthias Kliegel
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Jürgen Maurer
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
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4
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Feng Z, van den Broek T, Perra O, Cramm JM, Nieboer AP. Longitudinal health behaviour patterns among adults aged ≥50 years in China and their associations with trajectories of depressive symptoms. Aging Ment Health 2023; 27:1843-1852. [PMID: 36444931 DOI: 10.1080/13607863.2022.2149694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Against the background of the growing recognition of the need for a holistic perspective on health behaviour, we aim to identify longitudinal patterns of multiple health behaviours, and to assess associations of such patterns with depressive symptoms among older people in China. METHODS Using three waves of China Health and Retirement Longitudinal Study data (n = 8439), we performed latent class growth analyses (LCGAs) to identify longitudinal patterns of multiple health behaviours. Random-effects models were estimated to assess associations between health behaviour patterns and depressive symptoms. RESULTS The best fitting LCGA model had seven classes: (1) connected active non-smokers (average posterior probability: 21.8%), (2) isolated active non-smokers (24.7%), (3) isolated inactive non-smokers (17.0%), (4) isolated active smokers (14.5%), (5) connected active smokers (12.2%), (6) increasingly connected and active non-smokers (5.4%), and (7) moderately connected inactive smokers (4.4%). Depressive symptoms were highest in the four classes with lower probabilities of social participation across waves. No evidence was found of change over time in depressive symptomatology gaps between people with different health behaviour trajectories. CONCLUSION Health behaviour patterns characterized by consistently low social participation were associated with raised depressive symptomatology, suggesting that focusing on social participation may benefit later-life mental health promotion strategies.
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Affiliation(s)
- Zeyun Feng
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Thijs van den Broek
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Oliver Perra
- School of Nursing and Midwifery & Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, UK
| | - Jane Murray Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Anna Petra Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
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Choi SH, Stommel M, Broman C, Raheb-Rauckis C. Age of Smoking Initiation in Relation to Multiple Health Risk Factors among US Adult Smokers: National Health Interview Survey (NHIS) Data (2006-2018). Behav Med 2023; 49:312-319. [PMID: 35465849 DOI: 10.1080/08964289.2022.2060930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 02/23/2022] [Accepted: 03/23/2022] [Indexed: 11/02/2022]
Abstract
The adverse effects of multiple health risk factors have been well-documented; however, still understudied are the effects of early smoking in the context of multiple health risk factors. This study aimed to examine the role of early smoking initiation in relation to several health risk factors, including heavy drinking, physical inactivity, and obesity in later life among ever smokers in the USA. The National Health Interview Survey (NHIS) data from 2006 through 2018 were analyzed. The primary dependent variables were presence of three other risk factors: heavy drinking, physical inactivity, and obesity. The independent variable was the age of smoking initiation. Logit regression models were constructed to evaluate the association between smoking initiation and multiple health risk factors. All analyses were done in 2022. Among US adult smokers, 18.2% started smoking before age 15 (early initiators), 55.9% at ages 15-18 (middle initiators), and 25.9% at age 20 or later (late initiators). Compared to late smoking initiators, the odds of engaging in additional health risk factors increased by 37.3% among early initiators (OR = 1.373, 95% CI = 1.316, 1.432) and 7.7% among middle initiators (OR = 1.077, 95% CI= 1.041, 1.116). Additionally, current smoking was associated with higher odds (OR = 1.369, 95% CI = 1.322, 1.417) of having additional health risk factors compared to former smoking, with one exception: current smokers had lower odds of obesity (OR = 0.566, 95% CI = 0.537, 0.597). Tobacco control programs to prevent adolescents from initiating smoking may have the potential to prevent other health risk factors in adulthood.
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Affiliation(s)
- Seung Hee Choi
- College of Nursing, Wayne State University, Detroit, MI, USA
| | - Manfred Stommel
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Clifford Broman
- Department of Sociology, Michigan State University, East Lansing, MI, USA
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6
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van Allen Z, Bacon SL, Bernard P, Brown H, Desroches S, Kastner M, Lavoie KL, Marques MM, McCleary N, Straus S, Taljaard M, Thavorn K, Tomasone JR, Presseau J. Clustering of Health Behaviors in Canadians: A Multiple Behavior Analysis of Data from the Canadian Longitudinal Study on Aging. Ann Behav Med 2023:7156981. [PMID: 37155331 PMCID: PMC10354845 DOI: 10.1093/abm/kaad008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Health behaviors such as physical inactivity, unhealthy eating, smoking tobacco, and alcohol use are each leading risk factors for non-communicable chronic disease. Better understanding which behaviors tend to co-occur (i.e., cluster together) and co-vary (i.e., are correlated) may provide novel opportunities to develop more comprehensive interventions to promote multiple health behavior change. However, whether co-occurrence or co-variation-based approaches are better suited for this task remains relatively unknown. PURPOSE To compare the utility of co-occurrence vs. co-variation-based approaches for understanding the interconnectedness between multiple health-impacting behaviors. METHODS Using baseline and follow-up data (N = 40,268) from the Canadian Longitudinal Study of Aging, we examined the co-occurrence and co-variation of health behaviors. We used cluster analysis to group individuals based on their behavioral tendencies across multiple behaviors and to examine how these clusters are associated with demographic characteristics and health indicators. We compared outputs from cluster analysis to behavioral correlations and compared regression analyses of clusters and individual behaviors predicting future health outcomes. RESULTS Seven clusters were identified, with clusters differentiated by six of the seven health behaviors included in the analysis. Sociodemographic characteristics varied across several clusters. Correlations between behaviors were generally small. In regression analyses individual behaviors accounted for more variance in health outcomes than clusters. CONCLUSIONS Co-occurrence-based approaches may be more suitable for identifying sub-groups for intervention targeting while co-variation approaches are more suitable for building an understanding of the relationships between health behaviors.
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Affiliation(s)
- Zack van Allen
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Simon L Bacon
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
- Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, QC, Canada
| | - Paquito Bernard
- Department of Physical Activity Sciences, University of Quebec at Montreal, Montreal, QC, Canada
- Research Center of the Montreal Mental Health University Institute, Montreal, QC, Canada
| | - Heather Brown
- Lancaster University, Division of Health Research, Lancaster UK
| | | | | | - Kim L Lavoie
- Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, QC, Canada
- Departement is Psychology, University of Quebec at Montreal, Montreal, QC, Canada
| | - Marta M Marques
- Comprehensive Health Research Centre (CHRC), NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM,) Universidade Nova de Lisboa, Lisboa, Portugal
| | - Nicola McCleary
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Sharon Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Kednapa Thavorn
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queens University, Kingston, ON, Canada
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
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7
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Regan C, Fehily C, Campbell E, Bowman J, Faulkner J, Oldmeadow C, Bartlem K. Clustering of chronic disease risks among people accessing community mental health services. Prev Med Rep 2022; 28:101870. [PMID: 35813396 PMCID: PMC9256721 DOI: 10.1016/j.pmedr.2022.101870] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/19/2022] [Accepted: 06/24/2022] [Indexed: 10/26/2022] Open
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Birditt KS, Turkelson A, Polenick CA, Cranford JA, Blow FC. Alcohol Use and Blood Pressure Among Older Couples: The Moderating Role of Negative Marital Quality. J Gerontol B Psychol Sci Soc Sci 2022; 77:1592-1602. [PMID: 35219278 PMCID: PMC9434470 DOI: 10.1093/geronb/gbac015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Spouses often have concordant drinking behaviors and important influences on one another's cardiovascular health. However, little is known about the implications of dyadic drinking patterns for blood pressure, and the marital factors that confer risk or resilience. This article examined links between alcohol use and blood pressure within individuals and opposite-sex couples over time, and whether those links vary by negative marital quality among older adults. METHODS Participants were from the nationally representative longitudinal Health and Retirement Study that included 4,619 respondents in 2,682 opposite-sex couples who participated in at least 2 of the waves from 2006 to 2016. Participants reported the number of drinks they typically consume per week, negative marital quality, and had their blood pressure measured via a cuff. RESULTS Analyses revealed that greater drinking was associated with increased systolic blood pressure among both husbands and wives. Furthermore, husbands who drank more had higher blood pressure when wives drank more alcohol, whereas there was no association between husbands' drinking and blood pressure when wives drank less alcohol. Interactions with negative marital quality showed that drinking concordance may be associated with increased blood pressure over time in more negative marriages. DISCUSSION Findings indicated that spousal drinking concordance, although often associated with positive marital quality, may have negative long-term health effects.
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Affiliation(s)
- Kira S Birditt
- Address correspondence to: Kira S. Birditt, PhD, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA. E-mail:
| | - Angela Turkelson
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | | | - James A Cranford
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Frederic C Blow
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
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Abstract
Four common health risk behaviors have the greatest impact on all-cause mortality risk, but studies are needed with larger samples and the appropriate age range for cigarette smokers. We examined the impact of smoking in the context of multiple health behaviors on all-cause mortality using a nationally representative sample of adults aged 30 and older in the United States. National Health Interview Survey data from 1997 to 2005 were linked to the National Death Index with a follow-up to December 2015. The primary dependent variable was all-cause mortality, and the primary predictors were smoking, heavy drinking, physical inactivity, and unhealthy weight (underweight or obesity). The sample contained 189,087 individuals (≥ age 30; population estimate = 140.7 million). Our primary statistical analysis tool involved fitting Cox proportional hazards models. Our findings demonstrated that smoking led to the highest mortality risk among the four risk behaviors examined, but more than half of smokers engaged in at least one additional health risk behavior. Smokers who engaged in multiple health behaviors experienced higher increased mortality risks: smoking combined with one other health risk behavior increased mortality risk by 32% and by 82% when combined with two behaviors. Engaging in all four risk behaviors more than doubled the mortality risk of smokers. Smoking cessation interventions that address multiple risk behaviors-physical inactivity, heavy drinking, and unhealthy weight-will likely prevent premature death better than interventions that address only smoking.
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Affiliation(s)
- Seung Hee Choi
- College of Nursing, Wayne State University, Detroit, Michigan, USA
| | - Manfred Stommel
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Jiying Ling
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Devon Noonan
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - Joonho Chung
- College of Medicine, Yonsei University, Seoul, Korea
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10
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van Allen Z, Bacon SL, Bernard P, Brown H, Desroches S, Kastner M, Lavoie K, Marques M, McCleary N, Straus S, Taljaard M, Thavorn K, Tomasone JR, Presseau J. Clustering of Unhealthy Behaviors: Protocol for a Multiple Behavior Analysis of Data From the Canadian Longitudinal Study on Aging. JMIR Res Protoc 2021; 10:e24887. [PMID: 34114962 PMCID: PMC8235290 DOI: 10.2196/24887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 03/08/2021] [Accepted: 04/19/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Health behaviors such as physical inactivity, unhealthy eating, smoking tobacco, and alcohol use are leading risk factors for noncommunicable chronic diseases and play a central role in limiting health and life satisfaction. To date, however, health behaviors tend to be considered separately from one another, resulting in guidelines and interventions for healthy aging siloed by specific behaviors and often focused only on a given health behavior without considering the co-occurrence of family, social, work, and other behaviors of everyday life. OBJECTIVE The aim of this study is to understand how behaviors cluster and how such clusters are associated with physical and mental health, life satisfaction, and health care utilization may provide opportunities to leverage this co-occurrence to develop and evaluate interventions to promote multiple health behavior changes. METHODS Using cross-sectional baseline data from the Canadian Longitudinal Study on Aging, we will perform a predefined set of exploratory and hypothesis-generating analyses to examine the co-occurrence of health and everyday life behaviors. We will use agglomerative hierarchical cluster analysis to cluster individuals based on their behavioral tendencies. Multinomial logistic regression will then be used to model the relationships between clusters and demographic indicators, health care utilization, and general health and life satisfaction, and assess whether sex and age moderate these relationships. In addition, we will conduct network community detection analysis using the clique percolation algorithm to detect overlapping communities of behaviors based on the strength of relationships between variables. RESULTS Baseline data for the Canadian Longitudinal Study on Aging were collected from 51,338 participants aged between 45 and 85 years. Data were collected between 2010 and 2015. Secondary data analysis for this project was approved by the Ottawa Health Science Network Research Ethics Board (protocol ID #20190506-01H). CONCLUSIONS This study will help to inform the development of interventions tailored to subpopulations of adults (eg, physically inactive smokers) defined by the multiple behaviors that describe their everyday life experiences. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/24887.
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Affiliation(s)
- Zack van Allen
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Simon L Bacon
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, QC, Canada
- Montreal Behavioural Medicine Centre, Le Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Paquito Bernard
- Department of Physical Activity Sciences, University of Quebec in Montreal, Montreal, QC, Canada
- Research Center of the Montreal Mental Health University Institute, Montreal, QC, Canada
| | - Heather Brown
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Sophie Desroches
- Department of Food and Nutrition Sciences, Laval University, Quebec City, QC, Canada
| | - Monika Kastner
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- North York General Hospital, Toronto, ON, Canada
| | - Kim Lavoie
- Montreal Behavioural Medicine Centre, Le Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
- Department of Psychology, University of Quebec in Montreal, Montreal, QC, Canada
| | - Marta Marques
- ADAPT Science Foundation Ireland Research Centre, Trinity College Dublin, Dublin, Ireland
- Comprehensive Health Research Centre, NOVA Medical School, Lisbon, Portugal
| | - Nicola McCleary
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Sharon Straus
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Monica Taljaard
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Kednapa Thavorn
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | | | - Justin Presseau
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
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Abstract
Objectives: Drawing on UK Household Longitudinal Study data, this study assessed a pathway from early-life disadvantage to suboptimal later-life health via health behavior. Methods: Latent class analysis was used to identify distinct smoking, nutrition, alcohol, and physical activity health behavior profiles. Mediation analyses were performed to assess indirect effects of early-life disadvantage via health behavior on allostatic load, an objective measure of physiological wear and tear. Results: Four health behavior profiles were identified: (1) broadly healthy and high alcohol consumption, (2) low smoking and alcohol consumption, healthy nutrition, and physically inactive, (3) broadly unhealthy and low alcohol consumption, and (4) broadly moderately unhealthy and high alcohol consumption. Having grown up in a higher socioeconomic position family was associated with lower later-life allostatic load. This was partly attributable to health behavioral differences. Discussion: Growing up under disadvantageous socioeconomic circumstances may initiate a chain of risk by predisposing people to health behavior profiles associated with poorer later-life health.
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12
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Kurpas D. Commentary: Thinking rural health in Santal community in West Bengal: An interprofessional bottom-up approach to rural health. J Res Nurs 2020; 25:538-540. [PMID: 34394671 DOI: 10.1177/1744987120938338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Donata Kurpas
- Professor, Family Medicine Department, Wroclaw Medical University, Poland
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13
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Hunsberger M, Mehlig K, Björkelund C, Lissner L. Regular versus episodic drinking in Swedish women: Reporting of regular drinking may be less biased by social desirability. Alcohol 2020; 86:57-63. [PMID: 31926927 DOI: 10.1016/j.alcohol.2020.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 12/06/2019] [Accepted: 01/02/2020] [Indexed: 10/25/2022]
Abstract
AIM To describe the personality and social characteristics associated with regular and episodic alcohol consumption in a Swedish cohort of women. METHODS 406 women aged 38 and 50 who participated in the Population Study of Women in Gothenburg in 2004-2005 with complete data on the key variables are included. Regular alcohol use was based on frequencies of alcoholic beverage consumption, reported to examining physicians. Regular drinking was defined as those consuming wine, beer, or spirits at least twice weekly. Episodic drinking was defined as consumption of six drinks or more on a single occasion at least once during the last year. Personality traits were studied using the self-administered 57-item Eysenck Personality Inventory, which includes a 'lie scale' measuring the tendency toward social desirability, a 'neuroticism scale', and an 'extraversion scale'. Logistic regression was used to estimate odds ratios (OR) for regular and episodic drinking, respectively, in relation to standardized (SD) personality scores and selected social characteristics. RESULTS 49% of the women reported episodic drinking, while 58% reported regular drinking, and 34% reported both. Women with a higher tendency toward socially desirable responses were less likely to report episodic drinking (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.53-0.84) per standard deviation (SD), a trait that was not associated with regular drinking. CONCLUSIONS The strong inverse association between the propensity to lie scale with episodic but not regular drinking suggests that episodic drinking is subject to greater social desirability and under-reporting biases than regular drinking. Our findings indicate that this type of problem drinking may be missed in medical examinations, which limits the ability of health professionals to intervene.
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Kim B, Kim K, Burr JA, Han G. Health Behavior Profiles of Korean Baby Boomers. Int J Aging Hum Dev 2020; 90:363-384. [DOI: 10.1177/0091415018811095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study identified profiles of health behaviors among Korean baby boomers and examined a set of individual characteristics associated with these latent profiles. We analyzed a sample of 4,047 middle-aged adults (aged 53–61) from the Korean Baby Boomer Panel Study (2014). Latent profile analysis was used to uncover distinct health behavior profiles, and multinomial regression was performed to investigate the associations between health behavior profiles and predisposing, enabling, and need factors—following from the behavioral models of health behaviors and health services use. Five profiles of health behaviors were identified: (a) low-risk and high-preventive behaviors (50%), (b) low-risk and low-preventive behaviors (35%), (c) moderate-risk and moderate-preventive behaviors (7%), (d) moderate-risk and high-preventive behaviors (6%), and (e) high-risk and low-preventive behaviors (2%). Further, individuals with more enabling and need characteristics, indicated by higher socioeconomic status and greater health concerns, were more likely to engage in healthier profiles.
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Affiliation(s)
- Bon Kim
- Department of Gerontology, John W. McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, MA, USA
| | - Kyungmin Kim
- Department of Gerontology, John W. McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, MA, USA
| | - Jeffrey A. Burr
- Department of Gerontology, John W. McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, MA, USA
| | - Gyounghae Han
- Department of Child Development and Family Studies, Seoul National University, South Korea
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15
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Burgard SA, Lin KYP, Segal BD, Elliott MR, Seelye S. Stability and Change in Health Behavior Profiles of U.S. Adults. J Gerontol B Psychol Sci Soc Sci 2020; 75:674-683. [PMID: 32059056 DOI: 10.1093/geronb/gby088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES While understanding of complex within-person clustering of health behaviors into meaningful profiles of risk is growing, we still know little about whether and how U.S. adults transition from one profile to another as they age. This study assesses patterns of stability and change in profiles of tobacco and alcohol use and body mass index (BMI). METHOD A nationally representative cohort of U.S. adults 25 years and older was interviewed up to 5 times between 1986 and 2011. Latent transition analysis (LTA) models characterized the most common profiles, patterning of transitions across profiles over follow-up, and assessed whether some were associated with higher mortality risk. RESULTS We identified 5 profiles: "health promoting" with normal BMI and moderate alcohol consumption; "overweight"; "current smokers"; "obese"; and "nondrinkers". Profile membership was largely stable, with the most common transitions to death or weight gain. "Obese" was the most stable profile, while "smokers" were most likely to transition to another profile. Mortality was most frequent in the "obese" and "nondrinker" profiles. DISCUSSION Stability was more common than transition, suggesting that adults sort into health behavior profiles relatively early. Women and men were differently distributed across profiles at baseline, but showed broad similarity in transitions.
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Affiliation(s)
| | | | - Brian D Segal
- Department of Biostatistics, University of Michigan, Ann Arbor
| | | | - Sarah Seelye
- Population Studies Center, University of Michigan, Ann Arbor
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16
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Abstract
Baby boomers are aging, and their health is an important concern. Research has suggested that (1) aging boomers are more vulnerable to mental and physical health problems than their parents' generation; (2) adoption of healthy lifestyles is critically important for the health of the aging population; and (3) religious attendance, often found to be associated with health-related outcomes, is lower among aging boomers than their parents' generation. In this research, we use a large national dataset to examine (1) whether the baby boom generation lags behind their parents' generation in adoption of healthy lifestyles and perceived health; and (2) if it does, whether the lag might possibly be attributed to lower religious attendance. We analyzed data collected by University of Michigan's Health and Retirement Study from the silent generation in 1994 and from the baby boom generation in 2010 when both generation cohorts were at about the same age (age 49-64 years). The results indicated that (1) the baby boom generation lagged behind the silent generation in adoption of three healthy lifestyles (not smoking, not drinking excessively, and not being overweight or obese) and in perceived health; (2) the lag may be partially attributed to lower religious attendance in the baby boom generation. We also discuss implications for the health of the baby boom generation and for promoting healthy lifestyles and health to the baby boom generation.
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Affiliation(s)
- Anyuan Shen
- School of Business, State University of New York at New Paltz, New Paltz, USA.
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17
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Lacombe J, Armstrong MEG, Wright FL, Foster C. The impact of physical activity and an additional behavioural risk factor on cardiovascular disease, cancer and all-cause mortality: a systematic review. BMC Public Health 2019; 19:900. [PMID: 31286911 PMCID: PMC6615183 DOI: 10.1186/s12889-019-7030-8] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 05/22/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Regular physical activity improves overall health, and has the capacity to reduce risk of chronic diseases and death. However, better understanding of the relationship between multiple lifestyle risk behaviours and disease outcomes is pertinent for prioritising public health messaging. The aim of this systematic review is to examine the association between physical inactivity in combination with additional lifestyle risk behaviours (smoking, alcohol, diet, or sedentary behaviour) for cardiovascular disease, cancer, and all-cause mortality. METHODS We searched Ovid Medline, EMBASE, and the Cochrane Register from 1 January 2010 to 12 December 2017, for longitudinal observational studies of adults (18+ years) in the general population with a publication date of 2010 onwards and no language restriction. Main exposure variables had to include a physical activity measure plus at least one other lifestyle risk factor. In total, 25,639 studies were identified. Titles, abstracts and full-text articles of potentially relevant papers were screened for eligibility. Data was extracted and quality assessment was completed using a modified Newcastle-Ottawa Scale (NOS). RESULTS Across the 25 eligible studies, those participants who reported being physically active combined with achieving other health behaviour goals compared to those who were categorised as physically inactive and did not achieve other positive lifestyle goals, were at least half as likely to experience an incident cardiovascular disease (CVD) event, die from CVD, or die from any cause. These findings were consistent across participant age, sex, and study length of follow-up, and even after excluding lower quality studies. We also observed a similar trend among the few studies which were restricted to cancer outcomes. Most studies did not consider epidemiological challenges that may bias findings, such as residual confounding, reverse causality by pre-existing disease, and measurement error from self-report data. CONCLUSIONS High levels of physical activity in combination with other positive lifestyle choices is associated with better health outcomes. Applying new approaches to studying the complex relationships between multiple behavioural risk factors, including physical activity, should be a priority.
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Affiliation(s)
- Jason Lacombe
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK.
| | - Miranda E G Armstrong
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, Bristol, UK
| | - F Lucy Wright
- Unit of Health Care Epidemiology, Big Data Institute, Nuffield Department of Population Health, NIHR Oxford Biomedical Research Centre, University of Oxford, Old Road, Oxford, OX3 7LF, UK
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, Bristol, UK
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18
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Keyes KM, Calvo E, Ornstein KA, Rutherford C, Fox MP, Staudinger UM, Fried LP. Alcohol Consumption in Later Life and Mortality in the United States: Results from 9 Waves of the Health and Retirement Study. Alcohol Clin Exp Res 2019; 43:1734-1746. [PMID: 31276233 DOI: 10.1111/acer.14125] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 06/04/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Alcohol consumption in later life has increased in the past decade, and the relationship between alcohol consumption and mortality is controversial. Recent studies suggest little, if any, health benefit to alcohol. Yet most rely on single-time point consumption assessments and minimal confounder adjustments. METHODS We report on 16 years of follow-up from the Health and Retirement Study (HRS) cohorts born 1931 to 1941 (N = 7,904, baseline mean age = 61, SD = 3.18). Respondents were queried about drinking frequency/quantity. Mortality was established via exit interviews and confirmed with the national death index. Time-varying confounders included but were not limited to household assets, smoking, body mass index, health/functioning, depression, chronic disease; time-invariant confounders included baseline age, education, sex, and race. RESULTS After adjustment, current abstainers had the highest risk of subsequent mortality, consistent with sick quitters, and moderate (men: HR = 0.74, 95% CI: 0.60 to 0.91; women: HR = 0.82, 95% CI: 0.63 to 1.07) drinking was associated with a lower mortality rate compared with occasional drinking, though smokers and men evidenced less of an inverse association. Quantitative bias analyses indicated that omitted confounders would need to be associated with ~4-fold increases in mortality rates for men and ~9-fold increases for women to change the results. CONCLUSIONS There are consistent associations between moderate/occasional drinking and lower mortality, though residual confounding remains a threat to validity. Continued efforts to conduct large-scale observational studies of alcohol consumption and mortality are needed to characterize the changing patterns of consumption in older age.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Columbia University, New York, New York.,Robert N. Butler Columbia Aging Center, Columbia University, New York, New York.,Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Esteban Calvo
- Department of Epidemiology, Columbia University, New York, New York.,Robert N. Butler Columbia Aging Center, Columbia University, New York, New York.,Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Katherine A Ornstein
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine, New York, New York
| | | | - Matthew P Fox
- Departments of Epidemiology and Global Health, Boston University, Boston, Massachusetts
| | - Ursula M Staudinger
- Robert N. Butler Columbia Aging Center, Columbia University, New York, New York.,Department of Sociomedical Sciences, Columbia University, New York, New York
| | - Linda P Fried
- Department of Epidemiology, Columbia University, New York, New York.,Robert N. Butler Columbia Aging Center, Columbia University, New York, New York
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19
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Keyes KM, Jager J, Mal-Sarkar T, Patrick ME, Rutherford C, Hasin D. Is There a Recent Epidemic of Women's Drinking? A Critical Review of National Studies. Alcohol Clin Exp Res 2019; 43:1344-1359. [PMID: 31074877 DOI: 10.1111/acer.14082] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/02/2019] [Indexed: 12/17/2022]
Abstract
Alcohol consumption is increasing in the United States, as is alcohol-attributable mortality. Historically, men have had higher rates of alcohol consumption than women, though evidence for birth cohort effects on gender differences in alcohol consumption and alcohol-related harm suggests that gender differences may be diminishing. We review studies using U.S. national data that examined time trends in alcohol consumption and alcohol-related harm since 2008. Utilizing a historical-developmental perspective, here we synthesize and integrate the literature on birth cohort effects from varying developmental periods (i.e., adolescence, young adulthood, middle adulthood, and late adulthood), with a focus on gender differences in alcohol consumption. Findings suggest that recent trends in gender differences in alcohol outcomes are heterogeneous by developmental stage. Among adolescents and young adults, both males and females are rapidly decreasing alcohol consumption, binge and high-intensity drinking, and alcohol-related outcomes, with gender rates converging because males are decreasing consumption faster than females. This pattern does not hold among adults, however. In middle adulthood, consumption, binge drinking, and alcohol-related harms are increasing, driven largely by increases among women in their 30s and 40s. The trend of increases in consumption that are faster for women than for men appears to continue into older adult years (60 and older) across several studies. We conclude by addressing remaining gaps in the literature and offering directions for future research.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Columbia University, New York, New York.,Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Justin Jager
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, Arizona
| | | | - Megan E Patrick
- Institute for Translational Research in Children's Mental Health, University of Minnesota, Minneapolis, Minnesota
| | | | - Deborah Hasin
- Department of Epidemiology, Columbia University, New York, New York
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20
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Kim J, Chen ST, Hwang SH. Effectiveness of Web-based physical activity interventions for older adults: A systematic review of randomized controlled trials. ACTA ACUST UNITED AC 2018. [DOI: 10.23949/ijhms.2018.08.12.2.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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21
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Hofer F, Kauczor HU, Stargardt T. Cost-utility analysis of a potential lung cancer screening program for a high-risk population in Germany: A modelling approach. Lung Cancer 2018; 124:189-198. [PMID: 30268459 DOI: 10.1016/j.lungcan.2018.07.036] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Lung cancer is the leading cause of cancer death in Germany. Although several randomized trials in Europe have evaluated the effectiveness of lung cancer screening programs, evidence on the cost-effectiveness of lung cancer screening is scarce. OBJECTIVE To evaluate the cost-effectiveness of a population-based lung cancer screening program from the perspective of a German payer. METHODS We conducted a cost-effectiveness analysis from the public payer perspective for a high-risk population defined as heavy former and current smokers (≥20 cigarettes per day) between 55 and 75 years of age. The underlying model consisted of two Markov models. We differentiated between a population-based annual screening program and standard clinical care. Depending on stage at diagnosis, simulated patients were assigned to one of five treatment paths according to the German clinical guideline for the diagnosis and treatment of lung cancer. Costs, life years saved, and quality adjusted life years (QALYs) were used as outcomes. Values for input parameters were taken from the literature. The model was run for 60 cycles with a cycle length of three months. Deterministic and probabilistic sensitivity analyses were conducted. RESULTS In the base case, annual lung cancer screening led to an increase in incremental costs (€ 1,153 per person) compared to standard clinical care. However, the screening approach was associated with an incremental gain in life years (0.06 per person) and QALYs (0.04 per person). Thus, the incremental cost-effectiveness ratio (ICER) was € 19,302 per life year saved and € 30,291 per QALY. A probabilistic sensitivity analysis with 10,000 draws resulted in average ICERs of € 22,118 per life year and € 34,841 per QALY. CONCLUSION We provide evidence that lung cancer screening for a high-risk population may be more effective, but also more costly, than standard clinical care from the perspective of a German payer.
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Affiliation(s)
- Florian Hofer
- Hamburg Center for Health Economics (HCHE), University of Hamburg, Esplanade 36, 20354 Hamburg, Germany.
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany
| | - Tom Stargardt
- Hamburg Center for Health Economics (HCHE), University of Hamburg, Esplanade 36, 20354 Hamburg, Germany
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22
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Tan SL, Storm V, Reinwand DA, Wienert J, de Vries H, Lippke S. Understanding the Positive Associations of Sleep, Physical Activity, Fruit and Vegetable Intake as Predictors of Quality of Life and Subjective Health Across Age Groups: A Theory Based, Cross-Sectional Web-Based Study. Front Psychol 2018; 9:977. [PMID: 29967588 PMCID: PMC6016042 DOI: 10.3389/fpsyg.2018.00977] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 05/28/2018] [Indexed: 12/31/2022] Open
Abstract
Background: Due to the increase in unhealthy lifestyles and associated health risks, the promotion of healthy lifestyles to improve the prevention of non-communicable diseases is imperative. Thus, research aiming to identify strategies to modify health behaviors has been encouraged. Little is known about addressing multiple health behaviors across age groups (i.e., young, middle-aged, and older adults) and the underlying mechanisms. The theoretical framework of this study is Compensatory Carry-Over Action Model which postulates that different health behaviors (i.e., physical activity and fruit and vegetable intake) are interrelated, and they are driven by underlying mechanisms (more details in the main text). Additionally, restful sleep as one of the main indicators of good sleep quality has been suggested as a mechanism that relates to other health behaviors and well-being, and should therefore also be investigated within this study. The present study aims to identify the interrelations of restful sleep, physical activity, fruit and vegetable intake, and their associations with sleep quality as well as overall quality of life and subjective health in different age groups. Methods: A web-based cross-sectional study was conducted in Germany and the Netherlands. 790 participants aged 20–85 years filled in the web-based baseline questionnaire about their restful sleep, physical activity, fruit and vegetable intake, sleep quality, quality of life, and subjective health. Descriptive analysis, multivariate analysis of covariance, path analysis, and multi-group analysis were conducted. Results: Restful sleep, physical activity, and fruit and vegetable intake were associated with increased sleep quality, which in turn was associated with increased overall quality of life and subjective health. The path analysis model fitted the data well, and there were age-group differences regarding multiple health behaviors and sleep quality, quality of life, and subjective health. Compared to young and older adults, middle-aged adults showed poorest sleep quality and overall quality of life and subjective health, which were associated with less engagement in multiple health behaviors. Conclusion: A better understanding of age-group differences in clustering of health behaviors may set the stage for designing effective customized age-specific interventions to improve health and well-being in general and clinical settings. Trial Registration: A clinical trial registration was conducted with ClinicalTrials.gov (NCT01909349) https://clinicaltrials.gov/ct2/show/NCT01909349.
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Affiliation(s)
- Shu Ling Tan
- Health Psychology and Behavioral Medicine, Department of Psychology and Methods, Jacobs University Bremen, Bremen, Germany.,Institute of Sport and Exercise Sciences, Department of Social Sciences of Sport, University of Münster, Münster, Germany
| | - Vera Storm
- Institute of Sport and Exercise Sciences, Department of Sport Psychology, University of Münster, Münster, Germany
| | - Dominique A Reinwand
- Rehabilitative Gerontology, Department of Special Education and Rehabilitation, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Julian Wienert
- Health Psychology and Behavioral Medicine, Department of Psychology and Methods, Jacobs University Bremen, Bremen, Germany.,Scientific Institute of TK for Benefit and Efficiency in Health Care (WINEG), Hamburg, Germany
| | - Hein de Vries
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Sonia Lippke
- Health Psychology and Behavioral Medicine, Department of Psychology and Methods, Jacobs University Bremen, Bremen, Germany.,Bremen International Graduate School of Social Sciences, Jacobs University Bremen, Bremen, Germany
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Winning A, McCormick MC, Glymour MM, Gilsanz P, Kubzansky LD. Childhood Psychological Distress and Healthy Cardiovascular Lifestyle 17–35 Years Later: The Potential Role of Mental Health in Primordial Prevention. Ann Behav Med 2018; 52:621-632. [DOI: 10.1093/abm/kax001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Winning
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - M C McCormick
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - M M Glymour
- Department of Epidemiology & Biostatistics, University of California San Francisco School of Medicine, San Francisco, CA
| | - P Gilsanz
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - L D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
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24
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Stewart D, Han L, Doran T, McCambridge J. Alcohol consumption and all-cause mortality: an analysis of general practice database records for patients with long-term conditions. J Epidemiol Community Health 2017; 71:729-735. [DOI: 10.1136/jech-2017-209241] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/15/2017] [Accepted: 05/20/2017] [Indexed: 11/03/2022]
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25
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Äijö M, Kauppinen M, Kujala UM, Parkatti T. Physical activity, fitness, and all-cause mortality: An 18-year follow-up among old people. J Sport Health Sci 2016; 5:437-442. [PMID: 30356537 PMCID: PMC6188871 DOI: 10.1016/j.jshs.2015.09.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 04/09/2015] [Accepted: 05/25/2015] [Indexed: 05/25/2023]
Abstract
BACKGROUND Little is known about change in physical activity (PA) and its relationship to all-cause mortality among old people. There is even less information about the association between PA, fitness, and all-cause mortality among people aged 80 years and above. The objective is to investigate persistence and change in PA over 5 years as a predictor of all-cause mortality, and fitness as a mediator of this association, among people aged 80 and 85 years at the beginning of an 18-year mortality follow-up period. METHODS Using Evergreen Project data (started in 1989), 4 study groups were formed according to self-reported changes in PA level, over a 5-year period (starting in 1989-1990 and ending in 1994-1995): remained active (RA, control group), changed to inactive (CI), remained inactive (RI), and changed to active (CA). Mortality was followed up over the 18-year period (1994-2012). Cox models with different covariates such as age, sex, use of alcohol, smoking, chronic diseases, and a 10 m walking test were used to analyze the association between change in PA level and mortality. RESULTS Compared to RA, those who decreased their PA level (CI) between baseline and follow-up had higher all-cause mortality (hazard ratio (HR = 2.09; 95%CI: 1.63-2.69) when adjusted for age, gender, and chronic diseases. RI showed the highest all-cause mortality (HR = 2.16; 95%CI: 1.59-2.93). In CA, when compared against RA, the risk of all-cause mortality was not statistically significant (HR = 1.51; 95%CI: 0.95-2.38). In comparison with RA, when walking speed over 10 m was added as a covariate, all-cause mortality risk was almost statistically significant only in CI (HR = 1.37; 95%CI: 1.00-1.87). CONCLUSION Persistence and change in PA level was associated with mortality. This association was largely explained by fitness status. Randomized controlled studies are needed to test whether maintaining or increasing PA level could lengthen the life of old people.
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Affiliation(s)
- Marja Äijö
- Unit of Health Care, Savonia University of Applied Sciences, Kuopio 70111, Finland
| | - Markku Kauppinen
- Department of Health Sciences, University of Jyväskylä, Jyväskylä 40014, Finland
| | - Urho M. Kujala
- Department of Health Sciences, University of Jyväskylä, Jyväskylä 40014, Finland
| | - Terttu Parkatti
- Department of Health Sciences, University of Jyväskylä, Jyväskylä 40014, Finland
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26
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Grand S, Morehouse-Grand K, Carter S. Chiropractic intern attitudes, beliefs, and future practice intentions with regard to health promotion, wellness, and preventive services. J Chiropr Educ 2016; 30:152-157. [PMID: 27314433 PMCID: PMC5067124 DOI: 10.7899/jce-15-10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE This pilot study explored the attitudes, beliefs, and intentions of a group of chiropractic interns concerning health promotion, wellness, and preventive services before and after a series of brief educational interventions. METHODS Interns completed a survey before (n = 37) and after (n = 22) the interventions. The survey included 12 Likert scale questions about attitudes and intentions toward wellness and health promotion models. The interventions consisted of classroom lectures, clinical training, and online information pertaining to health promotion and wellness. RESULTS The interns initially favored wellness models, perceived a need for them, and felt partially prepared to administer them, with mean Likert scores 4 or greater on a 1 to 5 scale. Afterward, the average scores were higher and the interns reported some benefit from this short course of training. CONCLUSION The initial survey demonstrated that interns had some understanding of wellness, health promotion, and preventive services, and favored utilization of these services. The follow-up survey suggested that a short educational intervention could have a positive impact on these attitudes and future utilization of wellness procedures in their practices.
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27
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Trudel-Fitzgerald C, Tworoger SS, Poole EM, Williams DR, Kubzansky LD. Prospective Changes in Healthy Lifestyle Among Midlife Women: When Psychological Symptoms Get in the Way. Am J Prev Med 2016; 51:327-35. [PMID: 27291076 PMCID: PMC4992620 DOI: 10.1016/j.amepre.2016.04.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 04/15/2016] [Accepted: 04/15/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Anxiety and depression are linked to increased risk of cardiometabolic disease and mortality, and unhealthy behaviors may be the key mechanisms underlying these associations. Although higher levels of psychological symptoms are associated with individual unhealthy behaviors (e.g., physical activity, smoking), their roles in overall lifestyle remain understudied. METHODS Midlife women (n=55,395) from the cohort Nurses' Health Study reported anxiety and depression symptoms in 1988 and 1992, respectively. Health behaviors (i.e., physical inactivity, BMI, diet, and alcohol and tobacco consumption) were measured in self-administered questionnaires in 1988 or 1992, and every 4 years until the last assessment available (2010; follow-up, 18-22 years). Data were analyzed in 2014-2015. Women were categorized according to initial level of psychological symptoms (e.g., lower versus higher anxiety symptoms). RESULTS Despite slight improvements in healthy lifestyle over time among women with higher versus lower anxiety (βinteraction=0.002, 95% CI=0.001, 0.003), those experiencing more severe symptoms had a consistently less healthy lifestyle over time (p<0.0001). Each SD increase in anxiety symptoms was related to a decrease in healthy lifestyle score throughout follow-up (βpooled=-0.09, 95% CI=-0.09, -0.08). Women with higher versus lower anxiety symptoms also had decreased odds of having a healthy lifestyle in 2010 (AOR=0.78, 95% CI=0.75, 0.81), particularly among women with an initially unhealthy lifestyle (pinteraction≤0.0001). Comparable patterns were observed with depression symptoms. CONCLUSIONS Among midlife women, anxiety and depression symptoms were associated with unhealthier lifestyle throughout follow-up and reduced odds of having a healthy lifestyle 20 years later. Treating psychological symptoms may promote healthier lifestyles.
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Affiliation(s)
- Claudia Trudel-Fitzgerald
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Shelley S Tworoger
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts;; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Elizabeth M Poole
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Simpson TL, Rillamas-Sun E, Lehavot K, Timko C, Rubin A, Cucciare MA, Williams EC, Padula CB, Hunt JR, Hoggatt KJ. Alcohol Consumption Levels and All-Cause Mortality Among Women Veterans and Non-Veterans Enrolled in the Women's Health Initiative. Gerontologist 2016; 56 Suppl 1:S138-49. [PMID: 26768387 PMCID: PMC5881619 DOI: 10.1093/geront/gnv667] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 09/21/2015] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To address research gaps regarding women Veterans' alcohol consumption and mortality risk as compared to non-Veterans, the current study evaluated whether alcohol consumption amounts differed between women Veterans and non-Veterans, whether Veterans and non-Veterans within alcohol consumption groups differed on all-cause mortality, and whether Veteran status modified the association between alcohol consumption and all-cause mortality. DESIGN AND METHODS Six alcohol consumption groups were created using baseline data from the Women's Health Initiative Program (N = 145,521): lifelong abstainers, former drinkers, less than 1 drink/week (infrequent drinkers), 1-7 drinks/week (moderate drinkers), 8-14 drinks/week (moderately heavy drinkers), and 15 or more drinks/week (heavy drinkers). The proportions of Veteran and non-Veteran women within each alcohol consumption category were compared. Mortality rates within each alcohol consumption category were compared by Veteran status. Cox proportional hazard models, including a multiplicative interaction term for Veteran status, were fit to estimate adjusted mortality hazard (rate) ratios for each alcohol consumption category relative to a reference group of either lifelong abstainers or moderate drinkers. RESULTS Women Veterans were less likely to be lifelong abstainers than non-Veterans. Women Veterans who were former or moderate drinkers had higher age-adjusted mortality rates than did non-Veterans within these alcohol consumption categories. In the fully adjusted multivariate models, Veteran status did not modify the association between alcohol consumption category and mortality with either lifelong abstainers or moderate drinkers as referents. IMPLICATIONS The results suggest that healthcare providers may counsel Veteran and non-Veteran women in similar ways regarding safe and less safe levels of alcohol consumption.
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Affiliation(s)
- Tracy L Simpson
- Center of Excellence in Substance Abuse Treatment and Education, VA Puget Sound Health Care System, Seattle, Washington. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle.
| | - Eileen Rillamas-Sun
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington. VA Puget Sound Health Care System, Seattle, Washington
| | - Keren Lehavot
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle. Health Services Research & Development, VA Puget Sound Health Care System, Seattle, Washington
| | - Christine Timko
- Health Services Research and Development, Center for Innovation to Implementation, VA Palo Alto Health Care System, California. Stanford University, Menlo Park, California
| | - Amy Rubin
- Section of General Internal Medicine and the National Center for PTSD, VA Boston Health Care System, Massachusetts. Boston University, Massachusetts
| | - Michael A Cucciare
- Center for Mental Health Care and Outcomes Research (CeMHOR), Central Arkansas Veterans Health Care System, Little Rock. University of Arkansas for Medical Sciences, Little Rock
| | - Emily C Williams
- Health Services Research & Development, VA Puget Sound Health Care System, Seattle, Washington. Department of Health Services, University of Washington School of Public Health, Seattle
| | - Claudia B Padula
- Stanford University, Menlo Park, California. VA Palo Alto Health Care System, California
| | - Julie R Hunt
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Katherine J Hoggatt
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, California. University of California, Los Angeles
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Linardakis M, Papadaki A, Smpokos E, Micheli K, Vozikaki M, Philalithis A. Association of Behavioral Risk Factors for Chronic Diseases With Physical and Mental Health in European Adults Aged 50 Years or Older, 2004-2005. Prev Chronic Dis 2015; 12:E149. [PMID: 26378895 PMCID: PMC4576501 DOI: 10.5888/pcd12.150134] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Noncommunicable diseases are the leading cause of illness and death worldwide; behavioral risk factors (BRFs) contribute to these diseases. We assessed the presence of multiple BRFs among European adults according to their physical and mental health status. METHODS We used data from 26,026 adults aged 50 years or older from 11 countries that participated in the Survey of Health, Ageing and Retirement in Europe (2004-2005). BRFs (overweight or obesity, smoking, physical inactivity, and risky alcohol consumption) were assessed according to physical health (ie, presence of chronic diseases, disease symptoms, or limitations in activities of daily living) and mental health (depression) through multiple regression estimations. RESULTS Overweight or obesity in men and physical inactivity in women were the most prevalent BRFs. Compared with physically active adults, physically inactive adults had a higher mean number of chronic diseases (1.33 vs 1.26) and chronic disease symptoms (1.55 vs 1.47). Risky alcohol consumption (≥4 servings of an alcohol beverage ≥3 times a week) was associated with a higher mean depression score (2.84 vs 2.47). Compared with adults with 0 or 1 BRF, adults with 2 or more BRFs had significantly higher odds of having 1 or more chronic diseases (men: 1.52; women: 1.73) and functional limitations (men: 1.65; women: 1.79) and higher prevalence of high blood pressure (37.8% vs 28.2). Belgian adults with BRFs had the highest mean number of chronic diseases or functional limitations among those who were overweight or obese and the highest mean number of chronic diseases and disease symptoms among those who smoked and were physically inactive. CONCLUSION We found revealed significant positive associations between BRFs and poor health among middle-aged and older European adults. Primary health care intervention programs should focus on developing ways to reduce BRF prevalence in this population.
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Affiliation(s)
- Manolis Linardakis
- Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, Heraklion 71003, Crete, Greece.
| | - Angeliki Papadaki
- Centre for Exercise, Nutrition, and Health Sciences, School for Policy Studies, University of Bristol, United Kingdom, and Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | - Emmanouil Smpokos
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | - Katerina Micheli
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | - Maria Vozikaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | - Anastas Philalithis
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
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Griffin B, Sherman KA, Jones M, Bayl-Smith P. The clustering of health behaviours in older Australians and its association with physical and psychological status, and sociodemographic indicators. Ann Behav Med 2015; 48:205-14. [PMID: 24500081 PMCID: PMC4212155 DOI: 10.1007/s12160-014-9589-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Increasing life expectancies, burgeoning healthcare costs and an emphasis on the management of multiple health-risk behaviours point to a need to delineate health lifestyles in older adults. Purpose The aims of this study were to delineate health lifestyles of a cohort of older adults and to examine the association of these lifestyles with biological and psychological states and socio-economic indices. Methods Cluster analysis was applied to data derived from the self-reported 45 and Up cohort study (N = 96,276) of Australians over 45 years, regarding exercise, smoking, alcohol consumption, diet and cancer screening behaviours. Results Six lifestyle clusters emerged delineated by smoking, screening and physical activity levels. Individuals within health-risk dominant clusters were more likely to be male, living alone, low-income earners, living in a deprived neighbourhood, psychologically distressed and experiencing low quality of life. Conclusions Health lifestyle cluster membership can be used to identify older adults at greatest risk for physical and psychological health morbidity.
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Affiliation(s)
- Barbara Griffin
- Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia
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Ford CL, Mulatu MS, Godette DC, Gaines TL. Trends in HIV Testing Among U.S. Older Adults Prior to and Since Release of CDC's Routine HIV Testing Recommendations: National Findings from the BRFSS. Public Health Rep 2015; 130:514-25. [PMID: 26327729 PMCID: PMC4529835 DOI: 10.1177/003335491513000514] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study examined temporal trends in HIV testing among U.S. older adults (50-64 years of age) before and after the release of CDC's routine HIV testing recommendations in 2006. METHODS The sample (n=872,797; 51.4% female) comprised 2003-2010 Behavioral Risk Factor Surveillance System respondents in the oldest categories to which the recommendations apply: 50-54 years (34.5%, n=301,519), 55-59 years (34.1%, n=297,865), and 60-64 years (31.3%, n=273,413). We calculated (1) four-year pooled prevalences of past-year HIV testing before and after 2006, when the recommendations were released; and (2) annual prevalences of HIV testing overall and by age category from 2003-2010. Using weighted, multivariable logistic regression analyses, we examined binary (pre- vs. post-recommendations) and annual changes in testing, controlling for covariates. We stratified the data by recent doctor visits, examined racial/ethnic differences, and tested for linear and quadratic temporal trends. RESULTS Overall and within age categories, the pooled prevalence of past-year HIV testing decreased following release of the recommendations (p<0.001). The annual prevalence decreased monotonically from 2003 (5.5%) to 2006 (3.6%) (b=-0.16, p<0.001) and then increased immediately after release of the recommendations, but decreased to 3.7% after 2009 (b=0.01, p<0.001). By race/ethnicity, testing increased over time among non-Hispanic black people only. Annual prevalence also increased among respondents with recent doctor visits. CONCLUSION CDC's HIV testing recommendations were associated with a reversal in the downward trend in past-year HIV testing among older adults; however, the gains were neither universal nor sustained over time.
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Affiliation(s)
- Chandra L. Ford
- University of California at Los Angeles, Fielding School of Public Health, Department of Community Health Sciences, Los Angeles, CA
| | - Mesfin S. Mulatu
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA
| | - Dionne C. Godette
- National Institutes of Health, National Institute of Alcohol Abuse and Alcoholism, Division of Epidemiology and Prevention Research, Rockville, MD
| | - Tommi L. Gaines
- University of California at San Diego, Division of Global Public Health, Department of Medicine, San Diego, CA
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Antunes HK, De Mello MT, Santos-Galduróz RF, Galduróz JCF, Lemos VA, Tufik S, Bueno OFA. Effects of a physical fitness program on memory and blood viscosity in sedentary elderly men. ACTA ACUST UNITED AC 2015. [PMID: 26222648 PMCID: PMC4568808 DOI: 10.1590/1414-431x20154529] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to investigate the effects of a 6-month exercise program on cognitive function and blood viscosity in sedentary elderly men. Forty-six healthy inactive men, aged 60-75 years were randomly distributed into a control group (n=23) and an experimental group (n=23). Participants underwent blood analysis and physical and memory evaluation, before and after the 6-month program of physical exercise. The control group was instructed not to alter its everyday activities; the experimental group took part in the fitness program. The program was conducted using a cycle ergometer, 3 times per week on alternate days, with intensity and volume individualized at ventilatory threshold 1. Sessions were continuous and maximum duration was 60 min each. There was significant improvement in memory (21%; P<0.05), decreased blood viscosity (-19%; P<0.05), and higher aerobic capacity (48%; P<0.05) among participants in the experimental group compared with the control group. These data suggest that taking part in an aerobic physical fitness program at an intensity corresponding to ventilatory threshold-1 may be considered a nonmedication alternative to improve physical and cognitive function.
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Affiliation(s)
- H K Antunes
- Departamento de Biociências, Universidade Federal de São Paulo, Santos, SP, BR
| | - M T De Mello
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP, BR
| | - R F Santos-Galduróz
- Centro de Matemática, Computação e Cognição, Universidade Federal do ABC, Santo André, SP, BR
| | - J C F Galduróz
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP, BR
| | - V Aquino Lemos
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP, BR
| | - S Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP, BR
| | - O F A Bueno
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP, BR
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Robman LD, Islam FMA, Chong EWT, Adams MKM, Simpson JA, Aung KZ, Makeyeva GA, Hopper JL, English DR, Giles GG, Baird PN, Guymer RH. Age-Related Macular Degeneration in Ethnically Diverse Australia: Melbourne Collaborative Cohort Study. Ophthalmic Epidemiol 2015; 22:75-84. [DOI: 10.3109/09286586.2015.1010688] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Vroege DP, Wijsman CA, Broekhuizen K, de Craen AJM, van Heemst D, van der Ouderaa FJG, van Mechelen W, Slagboom PE, Catt M, Westendorp RGJ, Verhagen EALM, Mooijaart SP. Dose-response effects of a Web-based physical activity program on body composition and metabolic health in inactive older adults: additional analyses of a randomized controlled trial. J Med Internet Res 2014; 16:e265. [PMID: 25486673 PMCID: PMC4275504 DOI: 10.2196/jmir.3643] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/18/2014] [Accepted: 09/22/2014] [Indexed: 11/20/2022] Open
Abstract
Background Low physical activity is a major risk factor for several age-related diseases. Recently, we showed in a randomized controlled trial that a 12-week Web-based intervention (Philips DirectLife) to increase physical activity was effective in increasing physical activity levels and metabolic health in an inactive population aged 60-70 years. Objective The goal of this paper was to assess how many participants successfully reached the physical activity level as targeted by the intervention and what the effects of the intervention on body composition and metabolic health in these successful individuals were to provide insight in the maximum attainable effect of the intervention. Methods Among the 235 participants in a randomized controlled trial of the Actief en Gezond Oud (AGO) study, we assessed the effects of the intervention on metabolic parameters in those who had successfully reached their personalized physical activity target compared with the entire intervention group. Furthermore, we studied the dose-response effect of increase in physical activity on metabolic outcome within the intervention group. Results Of the intervention group, 50 of 119 (42.0%) participants successfully reached the physical activity target (corresponding to a 10% increased daily physical activity on average). This group showed markedly higher effects of the intervention compared to the entire intervention group, with greater decreases in body weight (2.74 vs 1.49 kg), waist circumference (3.74 vs 2.33 cm), insulin resistance (HOMA index: 0.23 vs 0.20), and in cholesterol/HDL ratio (0.39 vs 0.20) and Framingham risk score (0.90% vs 0.54%). We found that men compared to women were more likely to be successful. The dose-response analysis showed that there was a significant association between increase in minutes spent in moderate-to-vigorous activity and body weight loss, BMI reduction, waist circumference reduction, HDL cholesterol increasing, and cholesterol/HDL ratio lowering. Conclusions Of the intervention group, 42.0% (50/119) reached their daily physical activity end goal, which was associated with a markedly better effect on body composition and metabolic health compared to the effect in the entire intervention group. In this population, men are more likely to be successful in increasing physical activity. Findings demonstrate that improving the effect of such physical activity interventions requires finding new ways to increase the proportion of the population reaching the targeted goal. Trial Registration Dutch Trial Registry: NTR 3045; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3045 (Archived by WebCite at http://www.webcitation.org/6KPw52dCc).
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Affiliation(s)
- David P Vroege
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, Netherlands
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McGue M, Skytthe A, Christensen K. The nature of behavioural correlates of healthy ageing: a twin study of lifestyle in mid to late life. Int J Epidemiol 2014; 43:775-82. [PMID: 24711605 DOI: 10.1093/ije/dyt210] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND With the greying of the industrialized world has come increased interest in identifying the modifiable lifestyle factors that promote healthy and successful ageing. Whereas many of the behavioural correlates of late-life morbidity and mortality have been identified, relatively little is known about the origins of individual differences in these factors. METHODS A sample of 12,714 twins, including both members of 3806 pairs of known zygosity, ascertained through the Danish Twin Registry and aged 40 to 80 years, completed a self-report assessment of six lifestyle factors associated with ageing: smoking, drinking, diet and physical, social and intellectual activities. Standard biometric methods were used to analyse the twin data and determine the extent to which individual differences in each of the lifestyle factors are heritable. RESULTS For each of the six lifestyle factors, the estimate of heritability ranged from 32% (95% CI: 19-42%) for the diet scale to 69% (62-72%) for the smoking measure. Biometric estimates of the contribution of the twins' common rearing environment were uniformly small (≤6%). There was little evidence that standardized biometric estimates varied by gender or age. CONCLUSIONS Individuals likely construct lifestyles in part to complement and reinforce underlying genetically influenced dispositions and talents. The heritable nature of lifestyle factors implies that the behavioural and genetic contributors to ageing processes are not necessarily conceptually distinct but rather reflect the complexity of gene-environment interplay in ageing.
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Affiliation(s)
- Matt McGue
- Department of Psychology, University of Minnesota, Minneapolis, MN USA, Department of Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark, The Danish Twin Registry and Danish Ageing Research Centre, Institute of Public Health, University of Southern Denmark, Odense, Denmark Department of Clinical Genetics and Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark Department of Psychology, University of Minnesota, Minneapolis, MN USA, Department of Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark, The Danish Twin Registry and Danish Ageing Research Centre, Institute of Public Health, University of Southern Denmark, Odense, Denmark Department of Clinical Genetics and Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Axel Skytthe
- Department of Psychology, University of Minnesota, Minneapolis, MN USA, Department of Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark, The Danish Twin Registry and Danish Ageing Research Centre, Institute of Public Health, University of Southern Denmark, Odense, Denmark Department of Clinical Genetics and Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark Department of Psychology, University of Minnesota, Minneapolis, MN USA, Department of Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark, The Danish Twin Registry and Danish Ageing Research Centre, Institute of Public Health, University of Southern Denmark, Odense, Denmark Department of Clinical Genetics and Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Kaare Christensen
- Department of Psychology, University of Minnesota, Minneapolis, MN USA, Department of Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark, The Danish Twin Registry and Danish Ageing Research Centre, Institute of Public Health, University of Southern Denmark, Odense, Denmark Department of Clinical Genetics and Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark Department of Psychology, University of Minnesota, Minneapolis, MN USA, Department of Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark, The Danish Twin Registry and Danish Ageing Research Centre, Institute of Public Health, University of Southern Denmark, Odense, Denmark Department of Clinical Genetics and Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark Department of Psychology, University of Minnesota, Minneapolis, MN USA, Department of Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark, The Danish Twin Registry and Danish Ageing Research Centre, Institute of Public Health, University of Southern Denmark, Odense, Denmark Department of Clinical Genetics and Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
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Ruf E, Baumert J, Meisinger C, Döring A, Ladwig KH. Are psychosocial stressors associated with the relationship of alcohol consumption and all-cause mortality? BMC Public Health 2014; 14:312. [PMID: 24708657 PMCID: PMC3986452 DOI: 10.1186/1471-2458-14-312] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 03/19/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several studies have shown a protective association of moderate alcohol intake with mortality. However, it remains unclear whether this relationship could be due to misclassification confounding. As psychosocial stressors are among those factors that have not been sufficiently controlled for, we assessed whether they may confound the relationship between alcohol consumption and all-cause mortality. METHODS Three cross-sectional MONICA surveys (conducted 1984-1995) including 11,282 subjects aged 25-74 years were followed up within the framework of KORA (Cooperative Health Research in the Region of Augsburg), a population-based cohort, until 2002. The prevalences of diseases as well as of lifestyle, clinical and psychosocial variables were compared in different alcohol consumption categories. To assess all-cause mortality risks, hazard ratios (HRs) were estimated by Cox proportional hazards models which included lifestyle, clinical and psychosocial variables. RESULTS Diseases were more prevalent among non-drinkers than among drinkers: Moreover, non-drinkers showed a higher percentage of an unfavourable lifestyle and were more affected with psychosocial stressors at baseline. Multivariable-adjusted HRs for moderate alcohol consumption versus no consumption were 0.74 (95% confidence interval (CI): 0.58-0.94) in men and 0.87 (95% CI: 0.66-1.16) in women. In men, moderate drinkers had a significantly lower all-cause mortality risk than non-drinkers or heavy drinkers (p=0.002) even after multivariable adjustment. In women, moderate alcohol consumption was not associated with lowered risk of death from all causes. CONCLUSIONS The present study confirmed the impact of sick quitters on mortality risk, but failed to show that the association between alcohol consumption and mortality is confounded by psychosocial stressors.
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Affiliation(s)
| | | | | | | | - Karl-Heinz Ladwig
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr, 1, 85764 Neuherberg, Germany.
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Wijsman CA, Westendorp RG, Verhagen EA, Catt M, Slagboom PE, de Craen AJ, Broekhuizen K, van Mechelen W, van Heemst D, van der Ouderaa F, Mooijaart SP. Effects of a web-based intervention on physical activity and metabolism in older adults: randomized controlled trial. J Med Internet Res 2013; 15:e233. [PMID: 24195965 PMCID: PMC3841355 DOI: 10.2196/jmir.2843] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 09/12/2013] [Accepted: 09/18/2013] [Indexed: 11/15/2022] Open
Abstract
Background Lack of physical activity leads to detrimental changes in body composition and metabolism, functional decline, and increased risk of disease in old age. The potential of Web-assisted interventions for increasing physical activity and improving metabolism in older individuals holds great promise but to our knowledge it has not been studied. Objective The goal of our study was to assess whether a Web-based intervention increases physical activity and improves metabolic health in inactive older adults. Methods We conducted a 3-month randomized, waitlist-controlled trial in a volunteer sample of 235 inactive adults aged 60-70 years without diabetes. The intervention group received the Internet program Philips DirectLife, which was directed at increasing physical activity using monitoring and feedback by accelerometer and digital coaching. The primary outcome was relative increase in physical activity measured objectively using ankle- and wrist-worn accelerometers. Secondary outcomes of metabolic health included anthropometric measures and parameters of glucose metabolism. Results In total, 226 participants (97%) completed the study. At the ankle, activity counts increased by 46% (standard error [SE] 7%) in the intervention group, compared to 12% (SE 3%) in the control group (Pdifference<.001). Measured at the wrist, activity counts increased by 11% (SE 3%) in the intervention group and 5% (SE 2%) in the control group (Pdifference=.11). After processing of the data, this corresponded to a daily increase of 11 minutes in moderate-to-vigorous activity in the intervention group versus 0 minutes in the control group (Pdifference=.001). Weight decreased significantly more in the intervention group compared to controls (−1.5 kg vs −0.8 kg respectively, P=.046), as did waist circumference (−2.3 cm vs −1.3 cm respectively, P=.036) and fat mass (−0.6% vs 0.07% respectively, P=.025). Furthermore, insulin and HbA1c levels were significantly more reduced in the intervention group compared to controls (both P<.05). Conclusions This was the first study to show that in inactive older adults, a 3-month Web-based physical activity intervention was effective in increasing objectively measured daily physical activity and improving metabolic health. Such Web-based interventions provide novel opportunities for large scale prevention of metabolic deregulation in our rapidly aging population. Trial Registration Dutch Trial Registry: NTR 3045; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3045 (Archived by WebCite at http://www.webcitation.org/6KPw52dCc).
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Affiliation(s)
- Carolien A Wijsman
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, Netherlands.
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