Search Results (76)

Background/Objectives: Hearing impairment in middle-aged adults is a significant, modifiable risk factor for cognitive decline and dementia, and therapy with hearing aids or cochlear implants has been suggested to reduce this risk. However, most research on auditory rehabilitation and cognition has focused on older adults, and evidence regarding cognitive outcomes in middle-aged adults remains scarce despite this group being identified as critical for dementia prevention. Thus, this study aimed to assess cognitive skills in middle-aged hearing-impaired individuals 1 year after receiving a cochlear implant (CI) as part of auditory rehabilitation. Methods: Thirty-two patients with a mean age of 52.4 were enrolled in a prospective pre-post study. Hearing was tested using the Freiburg Monosyllable Test (FS) and the Oldenburg Inventory (OI). Cognitive performance was assessed using the WAIS-IV, operationalized through the Working Memory Index (Digit Span, Arithmetic) and Processing Speed Index (Symbol Search, Coding). Quality of life was assessed with the NCIQ, tinnitus-related distress with the Tinnitus Questionnaire (TQ), and depressive symptoms with the ADS-L. Results: After one year, speech intelligibility (FS) improved from a median of 0 to 70.0 (Wilcoxon Z = −4.864, p < 0.001, r = −0.61), and subjective hearing from a median of 2.55 to 3.18 (Wilcoxon Z = −3.072, p = 0.002). The NCIQ score increased from 52.3 to 60.6 (Z = −3.899, p < 0.001), and tinnitus-related distress decreased from 25 to 21 (Wilcoxon Z = −2.209, p = 0.027). Depressive symptoms declined numerically, although this change did not reach statistical significance. Working memory improved from 82.0 to 89.0 (Wilcoxon Z = −4.090, p < 0.001), and processing speed from 89.5 to 95.5 (Wilcoxon Z = −2.533, p = 0.011). Before CI, WMI and PSI showed a strong correlation (ρ = 0.533, p = 0.002), and WMI correlated moderately with education level (ρ = 0.452, p = 0.012). One year after CI, correlations strengthened between PSI and NCIQ (ρ = 0.510, p = 0.006), PSI and OI (ρ = 0.400, p = 0.039), and WMI and TQ (ρ = –0.459, p = 0.021), indicating emerging associations between cognitive outcomes and auditory or psychosocial measures. Conclusions: One year of CI-based auditory rehabilitation improves auditory function, quality of life, tinnitus distress, and—critically—working memory and processing speed in middle-aged adults. These findings address a previously unfilled research gap and support the relevance of CIs for preserving cognitive health during midlife. Full article

Background/Objective: Perimenopause, the final years of a woman’s reproductive life, may be symptomatic, affecting health and wellbeing. Lifestyle factors, such as diet, may alleviate these symptoms and improve health. Understanding nutrient intake at this stage of life is critical for tailoring dietary recommendations. This study investigated the nutrient intake of perimenopausal women in relation to adult guidelines and explored the associations between nutrients and symptoms. Methods: Irish perimenopausal women were recruited (>40 years old). Participants reported symptom severity via the Menopause Rating Scale (MRS). They completed a 4-day food diary along with a physical activity (PA) and demographic questionnaire. Hierarchal multiple regression was used to test the relationship between MRS and nutrients. A one-sample t-test or Wilcoxon signed-rank test was used to compare nutrient intake to the guidelines. Results: Participants (n = 63) had a mean age of 47.8 ± 3.5 years, a body mass index (BMI) of 27.0 ± 3.9 kg/m² and an overall MRS score of 13.5 ± 6.9. Participants were not meeting dietary reference values (DRVs) for most nutrients, with intakes significantly below guidelines for fibre (p < 0.001), total vitamin D (p = 0.031), calcium (p < 0.001), and iron (p < 0.001), and exceeding guidelines for saturated fat (p < 0.001). Hierarchal multiple regression models (adjusted for BMI, age, marital status, and PA) showed that Vitamin E intake was a predictor of a higher urogenital sub-score (β = 0.405, p < 0.001). Conclusions: There was variable adherence amongst midlife women to dietary guidelines, which may impact on both current and future health status. Public health initiatives are required to address this. Full article

Background: Individuals with untreated hearing loss often experience cognitive decline as a result of increased cognitive load and reduced sensory stimulation. Despite the well-established link between untreated hearing loss and cognitive decline in older adults, its impact on cognition in young and middle-aged adults has not been systematically examined. Given the Lancet Commission’s identification of midlife hearing loss as the leading modifiable risk factor for dementia, early identification of cognitive decline is essential. This review explored the cognitive impact of untreated hearing loss in adults. Method: A comprehensive search was conducted in PubMed, Scopus, Web of Science, and EMBASE to include studies comparing cognitive function between adults with normal hearing and those with untreated hearing loss aged 18–65 years. The methodological quality of the included studies was examined via the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Pooled mean differences and heterogeneity were analysed for each domain. Results: Seven studies included in the qualitative synthesis had “moderate” to “strong” methodological quality. The cognitive domains assessed in these studies were global cognitive function, memory, attention, and executive function. Of these, six were eligible for meta-analysis, which revealed a small but statistically significant decline in overall cognitive performance and memory and executive function among adults with untreated hearing loss. Conclusions: Cognitive vulnerabilities exist in young and middle-aged adults with untreated hearing loss. Hence, incorporating cognitive assessment into routine audiological evaluation may enable earlier intervention and delay the future burden of Alzheimer’s disease and related dementias in such a population. Full article

Background/Objectives: Cardiovascular disease (CVD) and cerebrovascular disease (CeVD) remain leading causes of death in the United States, with Mississippi consistently reporting some of the nation’s highest mortality rates. Despite earlier national declines, recent evidence suggests stagnation or increases, particularly in high-burden regions. This study examined short-term trends in CVD and CeVD mortality in Mississippi between 2018 and 2022, stratified by age, sex, and race. Methods: Mortality data for adults aged ≥45 years were obtained from the Mississippi Statistically Automated Health Resource System (MSTAHRS). Age-adjusted mortality rates were calculated per 100,000 population and standardized to the 2000 U.S. population. Joinpoint regression was used to estimate annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CIs). Analyses were stratified by sex, and within each racial group (White, Black, Other), mortality trends were further examined across age categories (45–54, 55–64, 65–74, 75–84, ≥85 years). Results: Cardiovascular mortality increased significantly among White women in midlife (ages 45–74), while “Other race” men in early midlife and “Other race” women in the oldest age group showed steep increases. Although Black adults did not experience significant changes over time, their mortality rates remained consistently higher than those of White adults. Conclusions: Progress in reducing cardiovascular and cerebrovascular mortality in Mississippi has reversed in several subgroups, particularly midlife White women and smaller racial populations. These findings mirror national stagnation and pandemic-related disruptions, highlighting the urgent need for equity-focused prevention, improved healthcare access, and targeted interventions addressing structural determinants of health. Full article

Cybersexual victimization is a growing public health concern with severe psychosocial consequences, particularly for younger populations. Despite growing awareness of its prevalence, understanding how cybersexual victimization evolves across different demographic and regional contexts remains limited. The aim was to analyze sex- and age-specific temporal trends and projections of cybersexual victimization in Spain (2011–2022), disaggregated by sex, age group, autonomous community, and offense type, to identify where disparities emerge and persist (particularly from adolescence (<18) into midlife) while also examining gender and regional inequalities to provide evidence for prevention strategies that are both gender-sensitive and tailored to different developmental stages and territorial contexts. Spanish national police-reported data on seven cybersexual offenses (sexual abuse, sexual harassment, corruption of minors, grooming, exhibitionism, child sexual abuse images, and sexual provocation) from 2011 to 2022 were analyzed. Data were disaggregated by sex, age group, and regions. Mean rates per 100,000 inhabitants were calculated, independent-sample t-tests assessed sex differences, and linear regression models projected trends to 2035 for each age-sex group. Between 2011 and 2022, cybersexual crimes in Spain increased across most offense types, with grooming, child sexual abuse images, and contact offenses showing the steepest upward trends (all p < 0.001). Women consistently presented higher mean victimization rates than men in most offense types and age groups. Among those under 18, mean grooming rates were 2.55 for females versus 0.95 per 100,000 for males (p < 0.001), with significant differences also in corruption of minors (p < 0.01). In young adulthood (18–25 years), women showed higher rates in sexual harassment (p < 0.001) and sexual abuse (p < 0.01), while, in midlife (26–40 and 41–50 years), female predominance persisted for sexual harassment, sexual abuse, and sexual provocation (all p < 0.05). Projections to 2035 indicate that sex gaps will remain or widen, particularly among females under 18 and in the 26–40 age group. The Balearic, Canary Islands, and Andalusia regions recorded the highest mean rates, whereas Galicia and Castilla-La Mancha reported the lowest. Cybersexual victimization in Spain disproportionately affects females from adolescence into midlife, with the most considerable disparities emerging before age 18 and persisting into adulthood. The combination of rapid offense growth, persistent sex-based disparities, and marked regional inequalities underscores the urgent need for gender-sensitive, developmentally targeted prevention strategies that address both early vulnerability and the reinforcement of risk in adult digital environments. Full article

Background/Objectives: Cardiometabolic risk clustering (CMRC), the coexistence of multiple risk factors, markedly increases the risk of cardiovascular disease and diabetes. While obesity is central, the independent roles of vitamin D status and systemic inflammation remain unclear. This study examined determinants of CMRC in middle-aged Korean adults, focusing on vitamin D and C-reactive protein (CRP). Methods: Cross-sectional data were analyzed from 2062 adults aged 40–64 years in the 2023 Korea National Health and Nutrition Examination Survey. CMRC was defined as ≥3 of abdominal obesity, hypertension, diabetes, hypertriglyceridemia, and low high-density lipoprotein cholesterol. Serum 25-hydroxyvitamin D [25(OH)D], CRP, lifestyle behaviors, and covariates were assessed. Complex-sample logistic regression identified factors associated with CMRC. Results: CMRC prevalence was 16.5%. Older age (OR = 1.04, 95% CI: 1.02–1.06), current smoking (OR = 1.76, 95% CI: 1.26–2.45), elevated CRP (1–3 mg/L: OR = 1.40, 95% CI: 1.04–1.87; ≥3 mg/L: OR = 1.63, 95% CI: 1.00–2.66), and obesity (OR = 8.29, 95% CI: 6.12–11.21) increased CMRC risk. Protective factors included male sex (OR = 0.60, 95% CI: 0.45–0.81), sufficient vitamin D (≥20 ng/mL: OR = 0.76, 95% CI: 0.58–0.99), and meeting World Health Organization physical activity guidelines (OR = 0.71, 95% CI: 0.55–0.92). Conclusions: These survey-weighted associations may help identify at-risk mid-life adults at the population level and motivate longitudinal evaluation of vitamin D deficiency and inflammation in risk assessment and targeted prevention. Full article

Background and Objectives: Midlife represents a critical window for the emergence of metabolic risk factors. This study aimed to investigate age- and sex-related changes in lipid profiles, body composition, oxidative stress, and fatty acid content. Materials and Methods: This cross-sectional study included adults grouped by age: <30, 30–39, and 40–49 years. The assessments covered body composition (fat mass, fat distribution, and lean mass), fasting lipids, inflammation markers measurements, and platelet fatty acids evaluation. Results: In total, 169 adults took part in this study (60 men and 109 women), aged 36.30 ± 6.25 years. Fat mass and its regional distribution were higher after age 40, especially in females. In women, fat mass was lower in the thirties and higher again in the forties, while, in men, fat accumulation was progressive. Participants aged 40–49 had a significantly worse metabolic profile than younger individuals. Statistically significant higher total cholesterol, LDL cholesterol, triglycerides, and glucose were shown in the 40–49-years group when compared to younger groups. Malondialdehyde was higher in the 40–49-years vs. 30–39-years group (105.83 vs. 99.72, p = 0.034). In women aged 40–49, a more adverse lipid and glycemic profile was observed compared to younger groups. Platelet fatty acids in the 40–49-years group showed higher polyunsaturated fatty acids and ω6 percentages (12.85% vs. 10.14%, p = 0.046 and 11.44% vs. 8.79%, p = 0.031), including higher linoleic (8.80 ± 5.18 vs. 6.97 ± 5.05, p = 0.045), arachidonic (2.64 ± 2.64 vs. 1.82 ± 1.73, p = 0.030), and docosahexaenoic (0.61 ± 0.86 vs. 0.31 ± 0.49, p = 0.008) acids, when compared to younger groups. Fat mass strongly correlated with insulin resistance, triglycerides, and CRP, and inversely with HDL-C. Conclusions: Significant age-related changes in body composition, metabolic biomarkers, and platelet fatty acid profiles occur after the age of 40, with distinct gender-specific patterns. The fifth decade of life is a transitional period characterized by central adiposity, deteriorating metabolic profiles, and altered fatty acid composition, especially in women. Full article

Background: The relationship between total cholesterol (TC) levels and mortality in older adults is complex and may differ from younger populations. While hypercholesterolemia is a known midlife risk factor, this association may weaken or reverse with age. Biological differences in cholesterol metabolism—particularly hormonal changes—may contribute to sex-specific mortality risks, but this remains underexplored. We examined the association between TC and all-cause mortality in older adults, assessing sex-specific differences. Methods: We used data from the InCHIANTI study, a longitudinal, population-based study conducted in Tuscany, Italy. From the original cohort (N = 1453), 999 participants ≥ 65 years with baseline TC and mortality data were included. TC levels were categorized as <200 mg/dL, 200–239 mg/dL, and ≥240 mg/dL. The primary outcome was all-cause mortality over 6-years. Kaplan–Meier curves and Cox proportional hazards models assessed mortality risk across TC categories in the overall population and by sex. Restricted cubic splines explored non-linear associations. Models were adjusted for age, sex (only in overall population), BMI, physical activity, diabetes, COPD, hypertension, eGFR, polypharmacy and frailty. Results: A threshold effect was observed: mortality risk rose sharply below ~200 mg/dL and remained stable above. Compared to the <200 mg/dL group, intermediate and high TC levels were associated with lower mortality risk (HR 0.72; 95% CI: 0.53–0.99 and HR 0.71; 95% CI: 0.49–1.02, respectively). In sex-stratified analyses, this pattern was pronounced in women but weaker and not statistically significant in men. Results held after excluding statin users and were confirmed by spline analysis. Conclusions: In older adults, particularly women, low TC may signal underlying vulnerability, including malnutrition or inflammation. Full article

Background/Objectives: Sarcopenia is a major public health concern, and early preventive strategies in midlife are increasingly emphasized. The goal of this study was to evaluate the effectiveness of a 12-week lifestyle intervention that included nutrition education, exercise education, and dietary supplementation in Korean baby boomers. Methods: This single-blind, randomized controlled trial included 42 Korean baby boomers born between 1955 and 1963. Participants were randomly assigned to one of three groups: (1) nutrition and exercise education plus dietary supplementation (DiExSp), (2) nutrition and exercise education only (DiEx), or (3) control. The intervention was delivered online, and the DiExSp group additionally received a daily supplement containing protein, vitamins, and minerals. Primary outcomes included dietary intake, body composition, physical function, and fasting blood biomarkers. Nonparametric tests and effect size calculations were performed using SAS version 9.4. Results: A total of 31 participants completed the study. The results showed significant increases in protein and micronutrient intake (p < 0.05), with large effect sizes in the DiExSp group. Handgrip strength showed improvement in both the DiExSp and DiEx groups (DiExSp: p = 0.027, r = 0.63; DiEx: p = 0.020, r = 0.73), while no changes were observed in other physical parameters. HbA1c levels showed a significant decrease in the DiExSp group compared to the control (p < 0.05, ε² = 0.01). No significant differences were observed for other biomarkers. Conclusions: A 12-week intervention combining dietary supplementation with education resulted in improved dietary intake, muscle strength, and glycemic control. However, most effects were confined to within-group changes. Between-group differences were minimal, and effect sizes were small. These findings provide preliminary evidence that lifestyle intervention strategies may contribute to sarcopenia prevention in midlife adults. Full article

Multimorbidity, or the presence of two or more co-occurring chronic medical conditions, is extremely prevalent within the United States (US), with disproportionately high incidence rates in individuals with minoritized identities. Sleep disturbances are an empirically supported risk factor contributing to disease status and maintenance throughout the lifespan. Given this, this study examines the relationship between disturbed sleep and multiple chronic conditions (MCCs) in adults using cross-sectional data from (n = 1013) participants enrolled in the Survey of Midlife Development in the US Study (MIDUS-2). Participants within this study were predominantly female (54.9%), white (93.2%), middle-aged (M_AGE = 58 years old), and experienced multimorbidity (56.6%) by having two or more (M_CHRON = 2.25) chronic health conditions in the past year. A negative binomial regression indicated that sleep disturbances significantly predict the number of chronic health conditions, with sleep-disturbed individuals reporting a 41% increase in reported health conditions (IRR = 1.407, p < 0.001). Findings suggest that disturbed sleep is significantly related to disease presence in aging populations and should be addressed through early intervention to mitigate negative health consequences. Full article

Discrimination has been linked to greater stress and higher levels of depressive symptoms. However, there has been no research to date that has examined how life course inequality due to everyday discrimination is associated with mental health outcomes later in life. Using data from Waves I, IV, and V of the National Longitudinal Study of Adolescent to Adult Health (Add Health) from 1994 to 2018, we examined how everyday discrimination in young adulthood (Wave IV) was associated with depressive symptoms at early midlife (Wave V). We also examined how parent–child relationships in young adulthood (maternal and paternal closeness; satisfaction of communication with mothers and fathers) moderated this association. We analyzed two sub samples: a mother sample (n = 9390) and a father sample (n = 8229). Results from both showed that everyday discrimination in young adulthood was significantly associated with depressive symptoms at early midlife, and parent–child relationships served as significant protective factors against depression. Mental health policy and intervention efforts should address how discrimination experienced in young adulthood can have enduring adverse effects on mental health into early midlife and invest in strategies that promote supportive parent–child relationships as protective resources. Full article

Background/Objectives: A growing body of literature has demonstrated that living with food insecurity (FI) increases risk for mental health concerns in addition to nutritional deficits (e.g., suboptimal micronutrient consumption, excessive macronutrient consumption, malnutrition). Yet, research is needed to improve our understanding of subpopulations potentially at increased risk for mental health concerns when living in the context of FI. The current study examined psychosocial health across women of different developmental life stages all living with FI. Methods: Female clients of a large, urban food bank (N = 680) living with FI completed measures of mental health and health-related quality of life (HRQOL) in a cross-sectional design conducted on site at the food bank. Results: Consistent with past research, FI severity was correlated with poorer psychosocial health across all variables. A multivariate analysis of covariance compared women living with FI across 4 developmental life stages (young adult, early midlife, late midlife, and older adult; age range = 18–94 years), controlling for FI severity and race/ethnicity, on outcomes related to mental health and HRQOL. Women in early and late midlife reported higher anxiety, eating disorder symptoms, and eating-related psychosocial impairment than younger and older women. Conclusions: The mental health toll of living with FI is profound; midlife may comprise a developmental period of increased vulnerability to experience this mental health burden of living with FI for women. Thus, efforts are needed to develop innovative pathways for interventions to support the mental health of midlife women living with FI, likely involving multi-level and/or multicomponent approaches to resource access. Full article

Retinoic acid (RA) exerts biological effects through RA receptors (RARs) to regulate transcription. RA also elicits rapid, RAR-independent (noncanonical) activities mediated by Cellular RA Binding Protein 1 (CRABP1) to modulate cytosolic signaling. CRABP1 functions by forming protein complexes, named CRABP1 signalosomes, to modulate signal propagation in a cell type-specific manner. This review summarizes multiple CRABP1 signalosomes and their physiological functions. CRABP1 knockout (CKO) mice develop multiple phenotypes progressively throughout the lifespan. These include altered brain function, obesity, and insulin resistance starting at young adult stages, increased vulnerability to heart failure and altered serum exosome profiles in midlife, and motor deterioration and thyroid dysfunction (hypothyroidism) in later life. The mouse Crabp1 gene is tightly regulated by multiple epigenetic mechanisms, whereas human CRABP1 gene dysregulation is associated with multiple human diseases in which age is an important factor. Further, CRABP1 expression in human and mouse thyroid glands gradually increases with aging. This underscores the clinical relevance of CRABP1 signalosomes in maintaining health and the functions of certain cells/organ systems, especially in the thyroid and during the aging process. The CRABP1 sequence is highly conserved, likely due to its functional constraint in forming various signalosomes; its tight regulation ensures proper expression of CRABP1 required for the forming of various signalosomes critical to the health and functions of multiple cell types/organ systems. Finally, CRABP1-specific (without activating RARs) signaling pathway-selective compounds have been designed. It may be an attractive therapeutic strategy to exploit these CRABP1-specific compounds to modulate selective signaling pathways in certain disease conditions, such as thyroid dysfunction, to maximize efficacy while minimizing retinoid toxicity. Full article

Background: Individual nutrients are associated with cognitive performance, but there is less evidence on the relationship between overall dietary patterns and cognitive performance in midlife. Objective: To examine the relation between dietary patterns and cognitive performance in midlife adults within the Bogalusa Heart Study (BHS). Methods: Cross-sectional data from the 2013–2016 cycle of the Bogalusa Heart Study, a life-course prospective cohort study, were used to generate diet quality scores, including the Alternate Healthy Eating Index 2010 (AHEI), the Healthy Eating Index 2015 (HEI), and the Alternate Mediterranean Dietary Pattern (aMed), based on food frequency questionnaires. Cognitive scores assessing attention and processing, episodic memory, and executive function were generated through validated cognitive tests. Generalized linear and logistic regression models were fit with adjustment for potential confounders. Results: Of 1053 participants included in the analysis, the mean age was 48.18 (SD = 5.22) years; 38.94% were male; and 31.14% identified as Black. Higher diet quality scores were associated with a higher global cognitive score (P-trend = 0.01 for AHEI, 0.02 for HEI, and 0.04 for aMed) after adjusting for age, sex, race, employment, education, smoking status, total energy intake, physical activity, BMI, diabetes, and hypertension. In dichotomous outcome analyses, higher AHEI and aMed scores remained inversely associated with low cognition when adjusting for similar covariates (P-trend = 0.03 for AHEI, 0.03 for aMed), but the association was attenuated to non-significance for HEI. In joint effect analysis between employment and dietary patterns (P-interaction = 0.28 for AHEI, 0.01 for HEI, and 0.11 for aMed), unemployment with a lower quality diet was associated with lower cognitive performance (P-trend = 0.02 for AHEI, 0.02 for HEI, and 0.01 for aMed). Conclusions: A high-quality diet is associated with optimal cognitive performance among midlife adults, and unemployment status may influence this association. These findings suggest that dietary interventions during midlife may represent a public health strategy to preserve cognitive function and reduce future neurodegenerative disease burden, especially in disadvantaged populations. Full article

Aging is associated with gradual mobility decline, often undetected until it affects daily life. This study investigates the potential of smartphone-based accelerometry to detect early age-related changes in gait and stair performance in middle-aged adults. Eighty-eight healthy participants were divided into four age groups: young (20–35 years), early middle-aged (45–54 years), late middle-aged (55–65 years), and older adults (65–80 years). They completed single-task, cognitive, and physical dual-task gait assessments and stair negotiation tests. While single-task walking did not reveal early changes, cognitive dual-task cost (DTC) of stride time variability deteriorated in late middle age. A strong indicator of early mobility changes was movement similarity, measured using dynamic time warping (DTW), which declined from early middle age for both cognitive DTC and stair negotiation. These findings highlight the potential of smartphone-based assessments, particularly movement similarity, to detect subtle mobility changes in midlife, allowing for targeted interventions to promote healthy aging. Full article